桂枝加龙骨牡蛎汤加减对围绝经期快速性心律失常疗效及对HRV、E_(2)、FSH的影响

Curative Effect of Guizhi Jia Longgu Muli Decoction(桂枝加龙骨牡蛎汤)on Perimenopausal Tachyarrhythmia and Its Effect on HRV,E_(2)and FSH

目的观察桂枝龙骨牡蛎汤加减对围绝经期快速性心律失常的疗效及对心率变异性(HRV)、血清雌二醇(E_(2))、卵泡刺激素(FSH)的影响。方法将纳入的104例患者随机分为对照组、治疗组各52例。对照组予西医控制心率治疗,治疗组在对照组基础上予桂枝龙骨牡蛎汤加减治疗,疗程为4周,观察比较两组心率变异性指标[全部窦性心搏RR间期(SDNN)、5 min节段平均正常心动周期标准差(SDNNidx)、相邻正常心动周期差值均方根(rMSSD)、RR间期平均值标准差(SDANN)]、中医证候积分以及血清E_(2)、FSH水平并观察其疗效。结果治疗后治疗组早搏患者总有效率88.89%大于对照组总有效率75.00%,室上速患者总有效率95.24%大于对照组85.00%,室速患者总有效率93.75%大于对照组77.78%,房颤患者总有效率83.33%大于对照组66.67%(均P<0.05),治疗后两组心率变异性指标:SDNN、SDNNidx、rMSSD、SDANN水平提高(P<0.05),且治疗组效果更优,组间比较差异具有统计学意义(均P<0.05)。两组治疗1、2、4周后与治疗前相比中医证候积分降低(P<0.05),且治疗组低于对照组(P<0.05)。两组治疗后血清E_(2)水平相比治疗前升高,FSH水平相比治疗前降低(均P<0.05)。各组治疗期间无不良反应,治疗后各项实验室指标均正常,无并发症产生。结论桂枝加龙骨牡蛎汤加减对女性围绝经期快速性心律失常疗效显著,可明显改善患者的临床症状及中医证候,改善心率变异性指标及雌激素水平,显著提高患者生活质量。

Objective To observe the curative effect of Guizhi Jia Longgu Muli Decoction(桂枝加龙骨牡蛎汤)on perimenopausal tachyarrhythmia and its effects on heart rate variability(HRV),serum estradiol(E_(2))and follicle stimulating hormone(FSH).Methods A total of 104 patients were randomly divided into the control group and the treatment group,52 cases in each group.The control group was treated with Western medicine to control the heart rate,and the treatment group was treated with Guizhi Longgu Muli Decoction on the basis of the control group.The course of treatment was 4 weeks.The indexes of heart rate variability[RR interval of all sinus beats(SDNN),the standard deviation of 5 min segment average normal cardiac cycle(SDNNidx),the root mean square difference of adjacent normal cardiac cycle(rMSSD),the standard deviation of average RR interval(SDANN)],the score of TCM syndrome and the level of serum E_(2)and FSH were observed and compared between the two groups.Results After treatment,the total effective rate of premature beat patients in the treatment group was 88.89%greater than that of the control group 75.00%,the total effective rate of patients with supraventricular tachycardia was 95.24%greater than that of the control group 85.00%,and the total effective rate of patients with ventricular tachycardia was 93.75%greater than that of the control group 77.78%,the total effective rate of patients with atrial fibrillation was 83.33%higher than that of the control group 66.67%(all P<0.05).After treatment,the levels of SDNN,SDNNidx,rMSSD and SDANN in the two groups were increased(P<0.05),and the treatment group had better effect.The differences were statistically significant(all P<0.05).After 1,2 and 4 weeks of treatment in the two groups,the TCM symptom scores were lower than those before treatment(P<0.05),and the effect of the treatment group was better than that of the control group(P<0.05).After treatment,the serum E_(2)level in the two groups was increased compared with that before treatment,and the FSH level was decreased compared with that before treatment(all P<0.05).There was no adverse reactions during the treatment in each group,all laboratory indexes were normal after treatment,and no complications occurred.Conclusion Modified Guizhi Jia Longgu Muli Decoction has significant curative effect on perimenopausal women with tachyarrhythmia,can significantly improve the clinical symptoms and TCM syndromes,improve heart rate variability,increase serum E_(2),reduce FSH levels,and significantly improve patients quality of Life.