通脉养心丸治疗心房颤动临床观察

Clinical observation on the treatment of atrial fibrillation with Tongmai Yangxin pill

目的观察通脉养心丸治疗心房颤动的临床疗效。方法入选2018年1月~2019年12月于济南市中医医院心内科门诊及病房治疗的房颤患者64例,随机分为试验组和对照组两组,每组各32例。对照组患者采用琥珀酸美托洛尔缓释片、阿司匹林肠溶片,试验组在对照组治疗基础上加通脉养心丸治疗。观察两组患者用药前后中医证候积分、中医证候疗效、24 h动态心电图平均心室率、左心室射血分数、左房内径。结果试验组中医证候总疗效总有效率高于对照组(90.63%vs.65.63%,P=0.028)。试验组治疗后中医证候积分显著降低(21.59±6.153 vs.10.38±3.424,P<0.01),对照组治疗后中医证候积分显著降低(21.38±6.524 vs.12.84±4.629,P<0.01),两组间治疗后中医证候积分比较,试验组低于对照组(10.38±3.424 vs.12.84±4.629,P<0.05)。试验组治疗后24 h平均心室率较治疗前显著降低(101.81±10.654 vs.81.44±8.835,P<0.01)、心室射血分数较治疗前显著提高(51.28±7.185 vs.59.09±6.925,P<0.01),治疗后试验组24 h平均心室率低于对照组(81.44±8.835 vs.87.28±10.049,P<0.05),心室射血分数显著高于对照组(59.09±6.925 vs.53.41±6.628,P<0.01)。结论通脉养心丸治疗心房颤动(气阴两虚证)有良好的临床疗效。

Objective To observe the clinical effect of Tongmai Yangxin pill in the treatment of atrial fibrillation.Methods 64 patients with atrial fibrillation(deficiency of Qi and Yin)were randomly divided into experimental group and control group,32 cases in each group.The control group was treated with metoprolol succinate sustained-release tablets and aspirin enteric coated tablets,and the test group was treated with Tongmai Yangxin pills on the basis of the control group.Before and after treatment,TCM syndrome score,TCM syndrome efficacy,24-hour ambulatory ECG mean ventricular rate,left ventricular ejection fraction,left atrial diameter were observed.Results The total effective rate of TCM syndromes in the experimental group was higher than that in the control group(90.63%vs.65.63%,P=0.028).The scores of TCM syndromes in the experimental group were significantly reduced after treatment(21.59±6.153 vs.10.38±3.424,P<0.01),and the scores of TCM syndromes in the control group were significantly reduced after treatment(21.38±6.524 vs.12.84±4.629,P<0.01).Comparing the scores of TCM syndromes between the two groups after treatment,the test group was lower than the control group(10.38±3.424 vs.12.84±4.629,P<0.05).The average ventricular rate in the test group 24 hours after treatment was significantly lower than before treatment(101.81±10.654 vs.81.44±8.835,P<0.01),and the ventricular ejection fraction was significantly higher than before treatment(51.28±7.185 vs.59.09±6.925,P<0.01).After treatment,the 24-hour average ventricular rate of the test group was lower than that of the control group(81.44±8.835 vs.87.28±10.049,P<0.05),and the ventricular ejection fraction was significantly higher than that of the control group(59.09±6.925 vs.53.41±6.628,P<0.01).Conclusion:Tongmai Yangxin pill has a good clinical effect in the treatment of atrial fibrillation.