芪灵方联合西医常规疗法对气阴两虚型阵发性房颤患者心率变异的影响

Combination of “Qiling Formula” and western medicine for the treatment of heart rate variability in patients with paroxysmal atrial fibrillation of deficiency of both qi and yin type

目的观察芪灵方联合西医常规疗法治疗气阴两虚型阵发性房颤的临床疗效,及其对患者心率变异的影响。方法将60例气阴两虚型阵发性房颤患者随机分为治疗组和对照组,每组30例。对照组予西医常规疗法,治疗组予西医常规疗法联合中药芪灵方。两组疗程均为2个月,观察房颤疗效、中医证候疗效及心率变异指标的变化情况。结果治疗组房颤、中医证候总有效率均为100.0%,对照组分别为90.0%、76.7%;治疗组房颤疗效和中医证候疗效均优于对照组(P<0.05)。治疗后两组SDNN均显著增加(P<0.05);治疗组SDANN显著增加,而对照组显著减少,组间治疗后差异有统计学意义(P<0.05);治疗组rMMSD、PNN50有上升趋势,而对照组呈下降趋势。治疗后治疗组LF/HF较治疗前显著增加(P<0.05),对照组无明显变化(P>0.05);组间治疗后比较,LF/HF差异有统计学意义(P<0.05)。结论芪灵方联合西医常规疗法用于治疗气阴两虚型阵发性房颤,可明显减少房颤发作,改善气阴两虚症状,同时可升高心率变异指标SDNN、SDANN、LF/HF水平,使房颤患者交感-迷走神经系统平衡性明显增强。

Objective To observe effect of ＂Qiling Formula＂ and western medicine in treating heart rate variability in patients with paroxysmal atrial fibrillation of deficiency of both qi and yin type. Methods Sixty patients were randomly divided into two groups, with 30 patients in each group. Control group was treated with routine western medicine, and treatment group was treated by western medicine and ＂Qiling Formula＂, with the course of 2 months. The changes of the frequency of atrial fibrillation attacking, clinical manifestations and heart rate variability before and after treatment were observed. Results The SDNN was increased after treatment in both groups （P 〈 O. 05 ）; SDANN in the treatment group was increased significantly, but was decreased in the control group, with significant difference between the two groups （ P 〈 0. 05 ） ; rMMSD and PNN50 showed a tendency to increase in the treatment group, while showed a tendency to decrease in the control group. LF/HF was increased after treatment in the treatment group （ P 〈 0.05 ） , but no significant difference was found in the control group （P 〉 0.05 ）. Conclusion Combined ＂ Qiling Formula＂ and western medicine can treat heart rate variability in patients with paroxysmal atrial fibrillation by reducing the frequency of atrial fibrillation attack, improving the clinical manifestations, increasing the levels of SDNN, SDANN and LF/HF and regulating sympathetic-vagus nervous system.