Holter指导下中西医结合疗法在心率变异超常患者中的应用效果

Application effect of integrated Chinese and Western medicine therapy guided by Holter in patients with abnormal heart rate variation

目的探讨动态心电图(Holter)指导下中西医结合疗法在心率变异超常患者中的应用效果。方法选取2019年5月至2021年12月南昌医学院第一附属医院收治的120例心率变异超常患者作为研究对象,采用随机数字表法分为观察组和对照组,每组各60例。对照组患者采用单药心宝丸治疗,观察组患者采用Holter指导下中西医结合疗法治疗。治疗2周后比较两组患者的最高心率、最低心率、平均心率、异位心律数、心率变异性指标[窦性心搏RR间期的标准差(SDNN)、RR间期的平均值标准差(SDANN)、相邻RR间期差的均方根(rMMSD)、相邻RR间期差>50 ms的个数占总心跳次数的百分比(PNN50)],并比较中医症候积分,评价中医证候疗效。结果观察组患者治疗后的异位心律总数、各心率变异性指标、总心搏数、最快心率、平均心率低于对照组,差异有统计学意义(P<0.05),两组的最慢心率比较,差异无统计学意义(P>0.05)。观察组患者治疗后的中医证候总积分和主要症状心悸、气短、头晕单症状积分均低于对照组,差异有统计学意义(P<0.05),两组的胸闷单症状积分比较,差异无统计学意义(P>0.05)。结论在Holter指导下,个体化心宝丸与美托洛尔联合治疗较单药心宝丸能有效改善心率变异超常患者临床症状。

Objective To explore the application effect of integrated Chinese and Western medicine therapy under dynamic electrocardiogram(Holter)in patients with abnormal heart rate variation.Methods A total of 120 patients with abnormal heart rate variability admitted to the First Affiliated Hospital of Nanchang Medical College from May 2019 to December 2021 were selected as research objects,and were divided into observation group and control group by random number table method,with 60 cases in each group.The control group was treated with single drug Xinbao Pill,and the observation group was treated with integrated traditional Chinese and Western medicine under the guidance of Holter.After 2 weeks,the highest heart rate,the lowest heart rate,the average heart rate,the ectopic heart rhythm number and the heart rate variability indexes(standard diviation of NN intervals[SDNN],standard deviation NN intervals all 5-minute segments entire recording[SDANN],root-mean-square successive difference[rMMSD],percentage successive RR intervals more than 50 ms[PNN50])were compared between the two groups,and the points of TCM syndrome were compared to evaluate the efficacy of TCM syndrome.Results After treatment,the total ectopic heart rate,each heart rate variability index,total cardiac volume,fastest heart rate and average heart rate in observation group were lower than those in control group,with statistical significances(P<0.05),while there was no statistical significance in the slowest heart rate between the two groups(P>0.05).After treatment,the total TCM syndrome scores and main symptoms single symptom scores of palpitation,shortness of breath and dizziness in the observation group were lower than those in the control group,with statistical significances(P<0.05),while there were no statistical significances in chest tightness single symptom scores between the two groups(P>0.05).Conclusion Under the guidance of Holter,the combination of individualized Xinbao Pill and Metoprolol can effectively improve the clinical symptoms of patients with abnormal heart rate variability.