针刺配合葛根桂枝甘草汤治疗心律失常疗效观察

Efficacy Observation of Acupuncture Combined with Gegen Guizhi Gancao Decoction for Arrhythmias

目的观察针刺配合口服葛根桂枝甘草汤治疗心律失常的临床疗效及其对心率变异性和氧化应激水平的影响。方法将123例心律失常患者随机分为A组、B组和C组,每组41例。A组采用口服葛根桂枝甘草汤治疗,B组采用针刺治疗,C组采用针刺配合口服葛根桂枝甘草汤治疗。观察各组治疗前后各项心率变异性指标[全部正常窦性心搏间期标准差(SDNN)、全程相邻窦性心搏间期差的均方根(RMSSD)、每5 min窦性心搏间期平均值的标准差(SDANN)、全程相邻窦性心搏间期差>50 ms的心搏占总心搏间期数的百分比(PNN50)、高频功率(HF)、低频功率(LF)]、炎症因子[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]的变化情况,并比较各组临床疗效及不良反应发生率。结果A组西医诊断及中医症状总有效率分别为75.6%和73.2%,B组分别为70.7%和65.9%,C组分别为92.7%和90.2%。C组西医诊断及中医症状总有效率与A组和B组比较差异均具有统计学意义(P<0.05)。3组治疗后各项心率变异性指标、炎症因子及氧化应激指标与同组治疗前比较差异均具有统计学意义(P<0.05)。C组治疗后各项心率变异性指标、炎症因子及氧化应激指标与A组和B组比较差异均具有统计学意义(P<0.05)。A组不良反应发生率为9.8%,B组为7.3%,C组为14.6%,各组不良反应发生率比较差异均无统计学意义(P>0.05)。结论针刺配合口服葛根桂枝甘草汤是一种治疗心律失常的有效方法,能提高患者心率变异性指标水平,降低炎症因子水平,抑制机体氧化应激反应。

Objective To observe the clinical efficacy of acupuncture plus oral administration of Gegen Guizhi Gancao decoction in treating arrhythmias and its effect on heart rate variability and oxidative stress(OS)level.Method A total of 123 patients with arrhythmias were randomized into group A,group B and group C,with 41 cases in each group.Group A was treated with oral administration of Gegen Guizhi Gancao decoction,group B was treated with acupuncture,and group C was treated with acupuncture plus oral administration of Gegen Guizhi Gancao decoction.Before and after intervention,the heart rate variability indicators[standard deviation of all normal to normal interval(SDNN),root mean square of successive differences(RMSSD),Standard deviation of the 5-min averaged NN intervals(SDANN),percent of differences between adjacent NN intervals greater than 50 ms(PNN50),high frequency(HF)and low frequency(LF)],inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF)-αand interleukin(IL)-6]and OS parameters[superoxide dismutase(SOD)and malondialdehyde(MDA)]were observed in each group.The clinical efficacy and adverse reaction rate were also compared.Result The total effective rate was 75.6%based on the Western medicine diagnosis and 73.2%based on the traditional Chinese medicine(TCM)symptoms in group A,versus 70.7%and 65.9%in group B and 92.7%and 90.2%in group C.The total effective rates based on Western medicine diagnosis and TCM symptoms in group C were significantly different from those in groups A and B(P<0.05).The heart rate variability indicators,inflammatory factors and OS parameters changed significantly after intervention in the three groups(P<0.05).After treatment,the heart rate variability indicators,inflammatory factors and OS parameters in group C were significantly different from those in groups A and B(P<0.05).The adverse reaction rate was 9.8%in group A,7.3%in group B and 14.6%in group C,and there were no significant differences in the adverse rate amongst the three groups(P>0.05).Conclusion Acupuncture plus oral administration of Gegen Guizhi Gancao decoction is an effective measure to treat arrhythmias;it can up-regulate the levels of heart rate variability indicators,down-regulate the levels of inflammatory factors,and inhibit the OS in the body.