中西药结合治疗病毒性心肌炎合并室性心律失常的临床观察

Clinical Observation of Integrated Traditional Chinese and Western Medicine in the Treatment of Viral Myocarditis Accompanied with Ventricular Arrhythmia

目的观察中西药结合治疗病毒性心肌炎合并室性心律失常的临床疗效。方法对20例辨证为心阳亏虚证患者以桂枝甘草龙骨牡蛎汤加减联合慢心律治疗(1组),对20例辨证为阴虚火旺证患者以天王补心丹加减联合慢心律治疗(2组),对20例病毒性心肌炎合并室性心律失常患者仅用慢心律治疗(西药组),对3组患者分别用药14d,用药前后观察中医症候和24h动态心电图(Holter)。结果心阳亏虚组改善中医证候总有效率为80%,Holter疗效总有效率为85%;阴虚火旺组改善中医证候总有效率为90%,Holter疗效总有效率为90%;西药组改善中医证候总有效率为50%,Holter疗效总有效率为85%。其中对于改善中医症候,两中西药结合组无显著性(P>0·05),两中西药结合组明显优于西药组(P<0·05);而3组间Holter疗效无显著性(P>0·05)。结论中西药结合治疗病毒性心肌炎合并室性心律失常较单用西药更为优越,值得临床推广。

[Objective]Observe clinical therapeutic effect of integrated traditional Chinese and western medicine in the treatment of viral myocarditis accompanied with ventricular arrhythmia. [Method]Treat 20 patients （group 1）, who were diagnosed as deficiency of heart -yang by differentiation of signs, with Guizhi Gancao Longgu Muli Tang and Mexiletinc, and another 20 patients （group 2）, diagnosed as deficiency of yin and hyperactivity of fire, with Tianwang Buxin Dan and Mexiletinc. Treat other 20 cases（western medicine group） with Mexiletinc. Each group lasted 14 days, observe the therapeutic effects on symptoms and dynamic electrocardiogram of 24 hours（Hoher） before and after the treatment. [Result] The effective rate of relieving symptoms： group 1 was 80%, group 2 was 90 %, western medicine group was 50%, while the effective rates of hoher were 85 %, 90% and 85% respectively. As for relieving symptoms there was no significant difference between group 1 and group 2（P〉0. 05）, and both of the integrated traditional Chinese and western medicine groups were better than that of western medicine group（P〈0.05） ,but there was no significant difference among the 3 groups about hoher effect. [Conclusion] Treating viral myocarditis accompanied with ventricular arrhythmia with integrated traditional Chinese and western medicine is better than that only with western medicine, and the former is valuable to be put into practice.