国医大师雷忠义“从风论治”心律失常的疗效观察

Therapeutic Effect Observation of Arrhythmia Based on Chinese Medicine Master Lei Zhongyi′s Theory of "Treatiing Arrhythmia from the Wind"

目的观察国医大师雷忠义"从风论治"心律失常的临床疗效。方法选取2015年7月-2018年12月陕西省中医医院收治的心律失常病人60例,采用随机数字表法分为对照组和观察组,各30例。两组均予以抗凝、降压、改善循环、中药安神定悸等常规治疗;在此基础上,对照组选用养心活血汤、温胆汤等治疗,观察组在对照组基础上加入钩藤、僵蚕、荜茇、荜澄茄、珍珠粉、琥珀粉等熄风定悸之药。分析比较两组中医证候疗效、心电图疗效、动态心电图心律失常发生率及不良反应发生率,并比较治疗前后中医证候积分、心律失常改善情况(包括房性期前收缩、室性期前收缩单发、室性期前收缩二联律/三联律、阵发性室性心动过速、阵发性室上性心动过速、房室传导阻滞)及治疗前、治疗后3个月生活质量评分。结果观察组治疗后中医证候积分较对照组降低(P<0.05)。观察组中医证候有效率为90.0%,高于对照组的70.0%(P<0.05)。观察组心电图有效率为80.0%,高于对照组的63.3%(P<0.05)。观察组治疗后房性期前收缩、室性期前收缩发生率均较治疗前明显下降(P<0.05)。治疗后3个月,观察组生活质量各维度评分高于对照组(P<0.05)。结论国医大师雷忠义"从风论治"心律失常理论成立,常规辨证论治加入熄风定悸药可显著降低心律失常发生率及不良反应发生率,可进一步提高中医证候及心电图疗效,明显改善病人生活质量。

Objective To observe the clinical effect of the treatment of arrhythmia based on theory of"treating arrhythmia from the wind"by the traditional Chinese medicine(TCM)master Lei Zhongyi.Methods Sixty patients with arrhythmia in Shaanxi Hospital of Traditional Chinese Medicine from July 2015 to December 2018 were selected,all of whom received traditional Chinese medicine treatment.According to the random number table method,30 patients in the the observation group and 30 patients in the control group group received conventional TCM treatment.The patients in two groups were treated with conventional anticoagulation,antihypertensive,circulatory improvement,traditional Chinese medicine Anshen Dingji decoction.The patients in the control group choose Yangxin Huoxue decoction,Wendan decoction and the patients in the observation group joined uncaria,batryticated silkworm,piper Ba,cubeb,pearl powder extinguish wind.The efficacy of TCM syndromes,electrocardiogram(ECG)efficacy,dynamic electrocardiogram arrhythmia rate and incidence of adverse reactions were observed.The TCM syndrome scores and arrhythmia improvement before and after treatment and quality of life score before treatment and 3 months after treatment were observed.Results After treatment,the scores of TCM syndromes in the observation group were lower than those in the control group(P<0.05).The total effective rate of TCM syndromes in the observation group was 90.0%higher than that in the control group(70.0%,P<0.05).The total effective rate of ECG in the observation group was 80.0%higher than that in the control group(63.3%,P<0.05).The incidence of atrial premature contraction and ventricular premature contraction after treatment in the observation group were significantly lower than those before treatment(P<0.05).The scores of life quality in the observation group were higher than those in the control group 3 months after treatment(P<0.05).Conclusion Chinese medicine master Lei Zhongyi′s theory of"treating arrhythmia from the wind"is established.The addition of Xifeng Dingji decoction into conventional syndrome differentiation treatment can significantly reduce the frequency of arrhythmia and the incidence of adverse reactions,improve the efficacy of TCM syndromes and ECG,and significantly improve the quality of life in patients with arrhythmia.