舒郁定悸汤治疗持续性心房颤动伴抑郁状态患者的临床研究

Clinical study on Shuyu Dingji Decoction in treating persistent atrial fibrillation with depressive state

目的观察舒郁定悸汤治疗持续性心房颤动伴抑郁状态患者的疗效。方法纳入2018年4月至2020年10月浙江省舟山市中医院门诊及住院的持续性心房颤动伴抑郁状态患者,共计100例,采用随机数字表法随机分为观察组(n=50)与对照组(n=50),分别予舒郁定悸汤治疗与酒石酸美托洛尔片治疗。比较两组患者用药前后中医证候积分、治疗总有效率、抑郁状态(HAMD)评定、房颤生活质量(改良EHRA)的评分,以及不良反应发生率。结果治疗后两组患者心悸、胸闷、胸胁胀痛、肢体麻木、心情抑郁、常喜叹息、腹胀食少等中医证候积分经过治疗均降低,差异有统计学意义(P<0.05);观察组与对照组患者中医证候总有效率分别为84.0%、68.0%,差异有统计学意义(P<0.05);两组HAMD评分及改良EHRA评分治疗后与治疗前比较均明显改善(P<0.05),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论舒郁定悸汤治疗持续性心房颤动伴抑郁状态的患者,能明显缓解患者胸闷、心悸、情绪抑郁等症状,患者的生活质量得到提高,药物不良反应与对照组比较未见增加,疗效可靠。

Objective To observe the efficacy of Shuyu Dingji Decoction in the treatment of patients with persistent atrial fibrillation and depression.Methods The included case data of patients with persistent atrial fibrillation and depression were from outpatient and inpatient of Zhoushan Hospital of Traditional Chinese Medicine in zhejiang Province from April 2018 to October 2020,with a total of 100 cases.The patients were randomly divided into the observation group(n=50)and the control group(n=50).The observation group was treated with Shuyu Dingji Decoction.The control group was treated with Metoprolol tartrate tablets.The scores of TCM syndromes,total effective rate of treatment,depressive status(HAMD)assessment,atrial fibrillation quality of life(modified EHRA)scores,and incidence of adverse reactions were compared between the two groups before and after treatment.Results After treatment,the scores of TCM syndromes such as palpitations,chest tightness,chest and hypochondriac pain,limb numbness,depression,sighing,abdominal distension and lack of appetite were reduced after treatment,and the difference was statistically significant(P<0.05).The total effective rates of treatment in the TCM syndromes of the observation group and the control group were 84.0%and 68.0%,respectively,and the difference was statistically significant(P<0.05).The HAMD scores and modified EHRA scores of the two groups were significantly improved after treatment compared with those before treatment(P<0.05).There was no difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Shuyu Dingji Decoction in the treatment of patients with persistent atrial fibrillation and depression can significantly improve the symptoms of palpitations,chest tightness,and depression,and improve patients′quality of life.The adverse drug reactions of Shuyu Dingji Decoction are not increased compared with the control group,and its effect is reliable.