| 张成成,王娜,王庆凯.黄芪桂枝五物汤联合沙丁胺醇治疗缓慢性心律失常 64例临床疗效及对动态心电图和心脏功能的影响[J].安徽医药,2024,28(4):830-834. |
| 黄芪桂枝五物汤联合沙丁胺醇治疗缓慢性心律失常 64例临床疗效及对动态心电图和心脏功能的影响 |
| Effect of Huangqi Guizhi Wuwu decoction combined with salbutamol in the treatment of 64 cases of bradyarrhythmia and its influences on dynamic electrocardiogram and cardiac function |
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| DOI：10.3969/j.issn.1009-6469.2024.04.042 |
| 中文关键词: 心动过缓 黄芪桂枝五物汤 动态心电图 心脏功能 临床疗效 心排血量 |
| 英文关键词: Bradycardia Huangqi Guizhi Wuwu decoction Dynamic electrocardiogram Heart function Clinical curative ef? fect Cardiac output |
| 基金项目:河北省中医药管理局科研计划( 2020514) |
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| 中文摘要: |
| 目的探讨黄芪桂枝五物汤联合西药治疗缓慢性心律失常疗效及对病人动态心电图和心脏功能的影响。方法选取 2019年 6月至 2022年 6月河北省沧州中西医结合医院收治的 128例缓慢性心律失常病人，按随机数字表法分为对照组(64例)和观察组( 64例)，对照组给予口服沙丁胺醇片治疗，观察组在对照组的基础上给予黄芪桂枝五物汤治疗。比较两组病人治疗前后中医证候积分、动态心电图(最快心率、最慢心率、平均心率、 QT间期、 QRS间期、心率变异性相关指标)、心功能指标［心排血量(cardiac output，CO)、心脏指数(cardiac index，CI)、左室射血分数( left ventricular ejection fraction，LVEF)］，比较两组病人治疗前、治疗 1个月、治疗 3个月的血压变化情况以及治疗后的临床疗效。结果与治疗前比较，对照组和观察组治疗后的中医证候积分［( 13.52±2.51)分比( 19.54±3.47)分，(10.85±2.04)分比( 19.23±3.26)分］、 QT间期［( 0.412±0.003)s比( 0.445±0.003)s，(0.408±0.004)s比( 0.446±0.004)s］、 QRS间期［( 0.09±0.05)s比( 0.11±0.02)s，(0.07±0.03)s比( 0.10±0.04)s］、正常窦性心律 R-R间期标准差( SDNN)、全程相邻正常窦性心律 R-R间期之差的均方根值( RMSSD)、正常窦性心律 R-R间期平均值的标准差(SDANN)、在一定时间内相邻两正常心动周期差值 >50 ms的个数所占的百分比( PNN50)均降低( P<0.05)且观察组更低( P<0.05)；治疗后对照组和观察组最快心率［(74.56±3.98)次 /分比( 66.47±2.87)次 /分，(83.23±4.68)次 /分比( 66±2.65)次 /分］、最慢心率［(45.32±2.68)次 /分比( 40.23±1.74)次 /分，(47.89±3.54)次 /分比( 40.46±1.89)次 /分］、平均心率、 CO、CI、LVEF均升高( P<0.23，0.05)且观察组更高( P<0.05)；经重复测量方差分析，收缩压( SBP)、舒张压( DBP)在组间、时间及交互方面差异无统计学意义(P>0.05)；观察组临床疗效( 90.63%)高于对照组( 76.56%)(P<0.05)。结论采用黄芪桂枝五物汤联合西药应用于缓慢性心律，失常病人，有利于其临床症状和心功能的改善，还可有效提高心率，具有较好的临床疗效。 |
| 英文摘要: |
| Objective To investigate the curative effect of Huangqi Guizhi Wuwu decoction combined with medicine in the treatmentof bradyarrhythmia and its influences on dynamic electrocardiogram and cardiac function.Methods A total of 128 patients with brady?arrhythmia admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province from June 2019to June 2022 were assigned into control group (n=64) and observation group (n=64) by random number table. The control group wastreated with salbutamol tablets, while the observation group was treated with Huangqi Guizhi Wuwu decoction in addition to salbutamoltablets. A comparison was made between the two groups of the traditional Chinese medicine (TCM) syndrome score, dynamic electrocar?diogram (fastest heart rate, slowest heart rate, average heart rate, QT interval, QRS interval, heart rate variability related indicators), car?diac function indexes [cardiac output (CO), cardiac index (CI), left ventricular ejection fraction (LVEF)] before and after treatment. Andthe changes of blood pressure before treatment, 1 month and 3 months after treatment as well as the clinical efficacy after treatmentwere compared between the two groups. Results Compared with pretreatment, the TCM syndrome score [(13.52±2.51) vs. (19.54± 3.47), (10.85±2.04) vs. (19.23±3.26)], QT interval [(0.412±0.003) s vs. (0.445±0.003) s, (0.408±0.004) s vs. (0.446±0.004) s], QRS inter? val [(0.09±0.05) s vs. (0.11±0.02) s, (0.07±0.03) s vs. (0.10±0.04) s], the standard deviation of normal sinus rhythm R-R intervals (SDNN), the root mean square value of the successive differences between adjacent normal sinus rhythm R-R intervals (RMSSD), the standard deviation of the average value of normal sinus rhythm R-R intervals (SDANN) and the percentage of the number of adjacent normal cardiac cycles with a difference of > 50 ms in a certain period of time (PNN50) in the control group and the observation group af?ter treatment were decreased (P < 0.05), and those in the observation group were lower (P < 0.05). After treatment, the fastest heart rate [(74.56±3.98) times/min vs. (66.47±2.87) times/min, (83.23±4.68) times/min vs. (66.23±2.65) times/min], slowest heart rate [(45.32± 2.68) times/min vs. (40.23±1.74) times/min, (47.89±3.54) times/min vs. (40.46±1.89) times/min], average heart rate, CO, CI and LVEF in the control group and the observation group increased (P < 0.05), and those in the observation group were higher (P < 0.05). After re?peated measurement ANOVA, there were no significant differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP)among the groups, time and interactions (P> 0.05). The total clinical effective rate of the observation group was higher than that of the control group (90.63% vs 76.56%, P < 0.05).Conclusion The application of Huangqi Guizhi Wuwu decoction combined with medi?cine in patients with bradyarrhythmia is beneficial to the improvement of clinical symptoms and cardiac function and can effectively im?prove heart rate, which achieves good clinical efficacy. |
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