心室颤动电除颤后辨证论治213例临床观察

Observation of treatment based in pathogenesis obtained through differentiation of symptoms and signs on ventricular fibrillation post electric defibrillation

目的探讨心室颤动电除颤后在常规复苏后高级生命支持治疗基础上采用中医辨证论治的临床疗效。方法将324例心室颤动电除颤后患者随机分为2组。治疗组213例在常规复苏后高级生命支持治疗基础上采用中医辨证论治,对照组111例予单纯常规复苏后高级生命支持治疗。2组均以1个月为1个疗程。观察患者治疗前后症状、体征的变化,并按照"快速急诊内科评分(REMS)"方法进行评分,1年后随访。结果治疗组总有效率73.71%,对照组总有效率54.05%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后REMS评分与本组治疗前比较差异均有统计学意义(P<0.05),2组治疗后REMS评分组间比较差异有统计学意义(P<0.05),治疗组优于对照组。1年后随访,治疗组1年存活率46.01%,对照组1年存活率35.14%,2组比较差异有统计学意义(P<0.05),治疗组高于对照组。结论心室颤动电除颤后在常规复苏后高级生命支持治疗基础上采用中医辨证论治可提高疗效,增加患者的存活率。

Objective To observe the effect of treatment based in pathogenesis obtained through differentiation of symptoms and signs on the basis of advanced life support on ventricular fibrillation post electric defibrillation. Methods 324 patients with ventricular fibrillation post electric defibrillation were randomly divided into two groups. Patients in control group （ n = 111 ） were treated by routine advanced life support. 213 cases in treatment group were treated by treatment based in pathogenesis obtained through differentiation of symptoms and signs on the basis of ad- vanced life support. The course was a month in two groups. The changes of symptoms and signs were observed before and after treatment. The effect was evaluated by REMS. Results The total effective rate in treatment group （73.71%） was higher than that in control group （54.05%, P 〈 0.05 ）. The effect from REMS in treatment group was superior to that in control group after treatment （ P 〈 0.05 ）. The annual survival rate in treatment group （46.01%） was higher than that in control group （35.14%, P 〈 0.05 ）. Conclusion Treatment based in pathogenesis obtained through differentiation of symptoms and signs on ventricular fibrillation post electric defibrillation on the basis of advanced life support can enhance effect on ventricular fibrillation post electric defibrillation, and in- crease annual survival rate.