益心舒胶囊治疗心脏神经官能症疗效评估

Efficacy of Yixinshu Capsule for Cardiac Neurosis

目的:探讨益心舒胶囊在治疗心脏神经官能症患者中的疗效。方法:选择286例心脏神经官能症患者,分为对照组(n=125)和治疗组(n=161),检查心电图、动态心电图、冠状动脉CT、冠状动脉造影排除器质性心脏疾病。治疗组病例口服益心舒胶囊;对照组病例科口服盐酸美托洛尔加谷维素。2组均行心理治疗。4周后评价临床症状,观察心电图、动态心电图改变。结果:所有286例对象中,常规心电图正常者为108例(37.8%),动态心电图正常者为77例(26.9%)。被研究的286例患者都伴有程度不同的胸闷、心悸、气短、胸痛、失眠的临床表现。治疗4周后,治疗组161例中,上述症状明显改善(显效)者为62例,有所改善(进步)者为20例,总有效率为87.0%(140/161);对照组125例中,上述症状明显改善(显效)者为37例,有所改善(进步)者为47例,总有效率为67.2%(84/125),2组症状改善总有效率比较,差异有统计学意义(P<0.05)。治疗组患者24 h动态心电图结果:治疗前房性早搏20例、室性早搏19例、非特异ST-T改变40例、心动过缓13例、心动过速12例,治疗后分别为13、14、28、9、7例;对照组患者24 h动态心电图结果:治疗前房性早搏22例、室性早搏15例、非特异ST-T改变42例、心动过缓12例、心动过速14例,治疗后分别为18、12、35、10、8例。结论:益心舒胶囊有益气复脉、活血化瘀、养阴生津、安神、增强心肌收缩力等作用,不仅对心脏神经官能症有良好的作用,也对多种心律失常症状有治疗作用。

OBJECTIVE：To evaluate the efficacy of Yixinshu Capsule for cardiac neurosis. METHODS： 286 patients with cardiac neurosis were assigned to either control group or trial group. All patients underwent ECG, dynamic ECG and coronary arteriongraphy to exclude organic heart disease. 161 cases in the treatment group received Yixinshu Capsule plus psychotherapy and 125 cases in the control group received Hydrochloric Metoprolol and Oryzanol plus psychotherapy. After 4-week treatment, the clinical symptoms, the ECG and the dynamic ECG changes were followed. RESULTS： Of the total 286 cases, 108 （37.8%） were normal in routine ECG versus 77 （26.9%） normal in dynamic ECG. All the 286 cases presented chest tightness, palpitation, shortness of breath, chest pain, insomnia in different degree. Of the total 161 cases in treatment group, 62 cases showed significant improvement in the above clinical symptoms and 20 cases showed improvement after 4-week treatment, with total response rate of 87.0% （ 140/161 ） ; of the total 125 cases in the control group, 37 cases showed significant improvement and 47 cases showed improvement in the above clinical symptoms after 4-week treatment, with total response rate of 67.2% （84/125）, and the differences between the two groups were statistically significant （ P 〈 0.05 ）. With regard to 24-h dynamic ECG, in the treatment group, atrial premature beat was noted in 20, premature ventricualr contraction in 19 cases, nonspecific ST-T changes in 40 cases, bradycardia in 13 cases, tachycardia in 12 cases before treatment, as compared with 13, 14, 28, 9 and 7 cases after treatment; in the control group, atrial premature beat was noted in 22, premature ventricualr contraction in 15 cases, nonspecific ST-T changes in 42 cases, bradycardia in 12 cases, tachycardia in 14 cases before treatment, as compared with 18, 12, 35, 10 and 8 cases after treatment. CONCLUSION： Yixinshu Capsule has the function of tonifying qi and recovering blood circulation, activating blood and removing stasis, nourishing Yin and regenerating fluid, calming the nerves and strengthening myocardial contractility in patients with cardiac neurosis and it is also effective arrhythmia symptoms.