中医药治疗心房扑动伴失眠的临床体会

Clinical experience on treating atrial flutter with insomnia in TCM

目的:探索心房扑动伴失眠的中医药论治的典型经验和体会。方法:采用对文献资料的分析、归纳、和典型病例论治的分析、研究等,表明中医药论治心房扑动伴失眠的可能性和有效性。结果:现代治疗射频消融术、富马酸伊布利特等药物治疗是当前心房扑动的主要治疗方法,但也有不理想之处,术后房颤发生率随访时间延长而增高;药物可致窦性心动过缓、窦性停搏及多形性室速,窦性心动过缓,尤其是老年人。中医药临床论治心律失常伴失眠,主要从心、肝、脾、肾诸脏的气血、阴阳亏虚、瘀血、痰饮的留滞阻脉入手,辨证论治,疗效确切。房扑中医治疗以养心补肾,活血通脉、安神化痰为总原则,持续用药,使心神得安,窦性心搏复原,异位搏律消失,心肾阴阳得以协调。结论:中医药治疗房扑扶正祛邪、标本兼顾、安神补心,疗效肯定,见效周期长。

Objective：To explore the experience and function of western medicine and TCM in relieving atrial fibrillation symptoms combined insomnia.Methods：By analyzing,inducing and summarizing the documents and cases to indicate the potentiality and effectively of TCM toward atrial fibrillation symptoms combined insomnia.Results：Radiofrequency and drugs,such as ibutilide,are the mainly treating measures to AF;The conversion rate is matched 75%～90%.Besides,these WM treatments also cause fibrillation reoccurring after surgery,the sinus bradycardia,sinus arrest and supraventricular tachycardia after taking drugs.TCM believed that the pathogenesis of AF symptoms combined insomnia and more dominated by the virtual,behalf of the pulse,heart throbbing.The AF combined insomnia undoubtedly caused by the heart of both yin and yang qi deficiency,heart failure has raised,due to weak agitation.And the treatment should follow supporting Xin and Shen,promoting blood flow,eliminate sputum and calm the nerves by sustained medication.Conclusion：TCM curing AF could strengthen healthy qi and eliminate pathogens both apparently and substantial,calm the nerves and reinforce Xin,which effectively and longly.