经方炙甘草汤合潜阳封髓丹对室性早搏患者自主神经失衡的影响

Effects of Zhigancao Decoction and Qianyang Fengsui Pills on autonomic nerve imbalance in patients with ventricular premature beats

目的:观察经方炙甘草汤合潜阳封髓丹对室性早搏(阴阳两虚、虚阳上浮证)患者临床疗效及对自主神经失衡的影响。方法:将诊断明确的室性早搏患者80例,随机数字表法分为试验组和对照组各40例,两组均停用各种抗心律失常药物,并给予基础治疗。试验组给予炙甘草汤合潜阳封髓丹加减,对照组给予通脉养心丸治疗,疗程均为8周。比较两组治疗前后室性早搏总疗效及24h总数、Lown分级疗效、中医症状总积分、心率变异性(HRV)指标的变化。结果:治疗8周后,试验组室性早搏总有效率为87.5%,对照组总有效率为60.0%,试验组总疗效优于对照组(P<0.05);两组治疗后室性早搏总数均较治疗前显著降低(P<0.01),治疗后两组间比较,试验组显著优于对照组(P<0.01);在Lown分级疗效方面,试验组总有效率显著优于对照组(P<0.01);同治疗前比较,两组治疗后均能改善中医症状积分,试验组总积分改善程度显著优于对照组(P<0.01);治疗后两组HRV指标均升高(P<0.05,P<0.01),试验组HRV(SDNN、RMSSD、HF、LF)指标改善程度优于对照组(P<0.05,P<0.01)。结论:经方炙甘草汤合潜阳封髓丹治疗阴阳两虚、虚阳上浮证型室性早搏,疗效确切,可以减少室性早搏发作频次,降低Lown等级,改善临床症状,调节交感-迷走神经平衡,是中医药治疗室性早搏的新治法。

Objective： To observe the effects of Zhigancao Decoction and Qianyang Fengsui Pills on the clinical efficacy and autonomic nerve imbalance in patients with ventricular premature beats with yin-yang deficiency and deficient yang with upper manifestation. Methods： Eighty patients with definite Ventricular premature beats were randomly divided into experimental group（n=40） and control group（n=40）. All the two groups were discontinued with various antiarrhythmic drugs and were given basic treatment. The experimental group was given Zhigancao Decoction combined with Qianyang Fengsui Pills, and the control group was given Tongmai Yangxin Pills. The course of treatment was 8 weeks. Before and after treatment, the total curative effect of Ventricular premature beats and the total number of 24 h, Lown grading effect, TCM syndrome total score and heart rate variability（HRV） were compared. Results： After 8 weeks of treatment, the total efficacy of ventricular premature beats in the experimental group was 87.5% and that of control group was 60.0%, the total efficacy of the experimental group was better than that of the control group（P〈0.05）. The total number of ventricular premature beats in both groups was significantly lower than that before treatment（P〈0.01）. After treatment, the experimental group was significantly better than the control group（P〈0.01）. In Lown grading efficacy, the total effective rate of the experimental group was significantly better than that of the control group（P〈0.01）. Compared with before treatment, both groups could improve TCM symptom scores after treatment, and the improvement of total score in the experimental group was significantly better than that in the control group（P〈0.01）.After treatment, the two groups of HRV indicators were increased（P〈0.05, P〈0.01）, the improvement of HRV（SDNN, RMSSD, HF, LF） in the experimental group was better than that in the control group（P〈0.05, P〈0.01）. Conclusion： The effect of Zhigancao Decoction and Qianyang Fengsui Pills treatment of ventricular premature beats with yin-yang deficiency and deficient yang with upper manifestation is exact, it can reduce the frequency of premature ventricular seizures and Lown grade, improve clinical symptoms, regulate the balance between sympathetic and vagal. This may be a new treatment in the ventricular premature beats of traditional Chinese medicine.