摘要
目的探讨黄连温胆汤联合美托洛尔对2型糖尿病(T2DM)合并心律失常病人血清脂联素(APN)、肿瘤坏死因子-α(TNF-α)水平及心率变异性(HRV)影响。方法将2017年1月—2018年2月收治的88例T2DM合并心律失常病人随机分为对照组与试验组,每组44例。对照组予琥珀酸美托洛尔缓释片每次47.5 mg口服,1次/日;试验组加用中药黄连温胆汤口服,1剂/日。两组均维持治疗1个月。检测两组血清APN、TNF-α、超敏C反应蛋白(hs-CRP)、HRV以及心功能变化,比较临床疗效。结果与治疗前比较,治疗后两组APN水平升高(P<0.01),TNF-α、hs-CRP水平降低(P<0.01),全部窦性心搏RR间期标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻RR间期差值均方根(RMSSD)、相邻NN之差超过50 ms百分比(PNN50)水平升高(P<0.01),左室射血分数(LVEF)、每搏量(SV)、心脏指数(CI)、舒张早期最大血液流速与舒张晚期最大血液流速比值(E/A)水平升高(P<0.01);与对照组治疗后比较,试验组APN水平较高(P<0.01),TNF-α、hs-CRP水平较低(P<0.01),SDNN、SDANN、RMSSD、PNN50水平较高(P<0.01),LVEF、SV、CI、E/A水平较高(P<0.01),治疗总有效率较高(P<0.05)。结论黄连温胆汤联合美托洛尔治疗T2DM合并心律失常疗效确切,可能与调节APN、TNF-α以及HRV有关。
Objective To investigate the effect of huanglian wendan decoction combined with Metoprolol on adiponectin,tumor necrosis factor-α,and heart rate variability in patients with type 2 diabetes mellitus(T2DM)complicated with arrhythmia.Methods Eighty-eight patients with T2DM complicated with arrhythmia were randomly divided into the control group and the study group,44 cases in each group.The control group was treated with metoprolol succinate sustained-release tablets,and the study group was treated by Metoprolol combined with Huanglian Wendan decoction.The levels of adiponectin(APN),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),heart rate variability(HRV),cardiac function,and the clinical efficacy were compared between two groups.Results After treatment,the levels of APN in the two groups were increased(P<0.01),TNF-αand hs-CRP were decreased(P<0.01),and those in the study group were better than those in the control group(P<0.01).RR stage between the standard deviation,the RR mean standard deviation,the phase difference between adjacent RR root mean square,the difference between the adjacent NN over 50 ms percentage in the two groups were increased(P<0.01),left ventricular ejection fraction,stroke volume,cardiac index,early diastolic blood flow velocity ratio of the maximum and the late diastolic blood flow velocity in the two groups were increased(P<0.01),and those in the study group were better than those in the control group(P<0.01).The clinical efficacy in the study group was significantly higher than that in the control group(P<0.05).Conclusion Huanglian Wendan decoction combined with metoprolol was effective in the treatment of T2DM complicated with arrhythmia,which may be related to the regulation of APN,TNF-αand HRV.
作者
陈伟
CHEN Wei(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,Hebei,China)
出处
《中西医结合心脑血管病杂志》
2019年第15期2312-2315,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
河北省中医药管理局科研计划(No.2018319)
关键词
心律失常
黄连温胆汤
美托洛尔
脂联素
肿瘤坏死因子-Α
心率变异性
arrhythmia
Huanglian Wendan decoction
Metoprolol
adiponectin
tumor necrosis factor-α
heart rate variability
