摘要
目的观察温阳通痹汤联合酒石酸美托洛尔片治疗冠心病(CHD)合并室性期前收缩(VPC)疗效及对患者射血功能、心率震荡的影响。方法将76例CHD合并VPC患者按照随机数字表法分为2组。对照组36例予酒石酸美托洛尔片治疗,治疗组40例在对照组治疗基础上加用温阳通痹汤加减治疗。2组均治疗4周后统计临床疗效,并比较2组治疗前后24 h动态心电图(DCG)指标[ST-T动态改变(ΣST)、QT离散度(QTd)]、心率震荡指标[震荡初始(TO)、震荡斜率(TS)]、射血功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)]、VPC次数及中医证候积分。结果治疗组总有效率77. 50%(31/40),对照组总有效率61. 11%(22/36),治疗组疗效优于对照组(P <0. 05)。治疗后2组中医证候心悸不安、神疲乏力、少气懒言、头晕健忘、胸闷气短评分及总分均低于本组治疗前(P <0. 05),且治疗组均低于对照组(P <0. 05)。治疗后2组ΣST、QTd及VPC次数均低于本组治疗前(P <0. 05),且治疗组均低于对照组(P <0. 05)。治疗后2组TO、TS均较本组治疗前改善(P <0. 05),且治疗组改善优于对照组(P <0. 05)。治疗后2组LVEF、LVESD、LVEDD均较本组治疗前改善(P <0. 05),且治疗组改善优于对照组(P <0. 05)。结论温阳通痹汤联合酒石酸美托洛尔片治疗CHD合并VPC疗效显著,可有效改善心脏自主神经功能和心肌供血,降低QTd,预防恶性心律失常事件发生。
Objective To observe the effect of Wenyang Tongbi decoction combined with metoprolol in the treatment of coronary heart disease( CHD) with ventricular premature contraction( VPC) and its influence on ejection function and heart rate turbulence. Methods 76 patients with CHD and VPC were randomly divided into two groups according to the random number table method. 36 cases in control group were treated by metoprolol. 40 cases in treatment group were treated by Wenyang Tongbi decoction on the basis of the control group. After 4 weeks of treatment,the clinical efficacy of the two groups was statistically analyzed. The 24-hour dynamic electrocardiogram( DCG) index[ST-T dynamic change( ∑ST),QT dispersion( QTd) ],heart rate turbulence index [turbulence onset( TO),turbulence slope( TS) ],ejection function index [left ventricular ejection fraction( LVEF),left ventricular end systolic diameter( LVESD) and left ventricular end diastolic diameter( LVEDD) ],VPC times and TCM syndromes were compared between the two groups before and after treatment. Results The total effective rate of the treatment group was 77. 50%( 31/40) and that of the control group was 61. 11%( 22/36). The curative effect of the treatment group was better than that of the control group( P < 0. 05). After treatment,the number of VPC and TCM syndrome scores in the two groups were lower than those in the group before treatment( P < 0. 05),and those in the treatment group were lower than those in the control group( P < 0. 05). After treatment,the ∑ ST and QTd of the two groups were lower than those in the group before treatment( P < 0. 05),and those in the treatment group were lower than those in the control group( P < 0. 05). After treatment,TO and TS were improved in both groups( P < 0. 05),and the improvement in the treatment group was better than that in the control group( P < 0. 05). After treatment,LVEF,LVESD and LVEDD were improved in both groups( P < 0. 05),and the improvement in the treatment group was better than that in the control group( P <0. 05). Conclusion Wenyang Tongbi decoction combined with metoprolol is effective in treating CHD complicated with VPC,which can effectively improve cardiac autonomic nerve function and myocardial blood supply,reduce QT dispersion and prevent malignant arrhythmia events.
作者
丁力
周淑妮
DING Li;ZHOU Shuni(Department of Cardiovascular Diseases,National Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi,Hubei 445000)
出处
《河北中医》
2020年第4期561-566,共6页
Hebei Journal of Traditional Chinese Medicine
基金
湖北省卫生计生科研项目(编号:ZC201900496)。
关键词
冠心病
室性早搏复合征
合并症
中医药疗法
Coronary heart disease
Ventricular premature beat syndrome
Complications
Chinese medicine therapy
