灵宝护心丹联合参松养心胶囊治疗窦性心动过缓的临床观察

Clinical observation of Lingbao Huxin Dan combined with Shensong Yangxin Capsules in treatment of sinus bradycardia

目的 探讨灵宝护心丹联合参松养心胶囊治疗窦性心动过缓的临床疗效。方法 选取2019年3月—2020年12月抚州市中医医院内科诊断为窦性心动过缓患者100例,随机分为对照组(50例)和治疗组(50例)。对照组给予参松养心胶囊(每天3次,每次4粒),治疗组在对照组的基础上给予灵宝护心丹(每天3次,每次4粒),治疗24周。治疗后比较两组的临床疗效、24 h动态心电图指标、心率变异性时域指标及不良反应。结果 治疗组中医证候有效率84.0%,对照组为60.0%,两组比较差异有统计学意义(P<0.05)。治疗组动态心电图总有效率86.0%,对照组64.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组平均心率、总心率、最快心率、最慢心率、24 h全部正常心室搏动间距(R wave-R wave,R-R)间期标准差(standard diviation of NN intervals,SDNN)、24 h连续5 min节段正常R-R间期的标准差(standard deviation of sequential five-minute R-R interval means,SDANN)、24 h内连续5 min节段平均正常R-R间期标准差平均数(mean value of the SD of all normal R-R intervals in every 5-min interval within 24 h,SDNN index)、24 h连续正常R-R间期差值均方的平方根(root mean of square of successive differences between adjacent normal NN intervals,RMSSD)、2个相邻R-R间期差>50 ms心率数所占分析信息期内HR数的百分比(percentage of heart rate between two adjacentR-R intervals> 50 ms in analysis information period,PNN50)均显著升高(P<0.05),且治疗组平均心率、总心率、最快心率、最慢心率、SDNN、SDANN、SDNN index明显高于对照组。治疗期间两组安全性较好,两组之间无显著性差异(P>0.05)。结论 灵宝护心丹联合参松养心胶囊治疗窦性心动过缓疗效好,值得临床推广。

Objective To investigate the clinical effect of Lingbao Huxin Dan(灵宝护心丹)combined with Shensong Yangxin Capsules(参松养心胶囊)in the treatment of sinus bradycardia.Methods A total of 100 patients diagnosed as sinus bradycardia in the internal medicine department of Fuzhou Hospital of Traditional Chinese Medicine from March 2019 to December 2020 were selected and randomly divided into control group(50 cases)and treatment group(50 cases).The control group was given Shensong Yangxin Capsules(3 times/d,four capsules each time),and the treatment group was given Lingbao Huxin Dan(3 times/d,four capsules each time)on the basis of the control group.After 24 weeks of treatment,the efficacy,24 h dynamic electrocardiogram index,time domain index of heart rate variability and adverse reactions of the two groups were compared.Results The effective rate of TCM syndromes in the treatment group was 84.0%,and that in the control group was 60.0%,the difference between the two groups was statistically significant(P<0.05).The total effective rate of dynamic electrocardiogram was 86.0%in the treatment group and 64.0% in the control group, the difference between the two groups was statistically significant (P < 0.05). After treatment, average heart rate, total heart rate, the fastest heart rate, the slowest heart rate, standard diviation of NN intervals (SDNN), standard deviation of sequential five-minute R-R interval means (SDANN), mean value of the SD of all normal R-R intervals in every 5-min interval within 24 h (SDNN index), root mean of square of successive differences between adjacent normal NN intervals (RMSSD), and percentage of heart rate between two adjacent R-R intervals > 50 ms in analysis information period (PNN50) of two groups were significantly increased (P < 0.05), and the mean heart rate, total heart rate, fastest heart rate, slowest heart rate, SDNN, SDANN and SDNN index of the treatment group were significantly higher than those of the control group (P < 0.05). During treatment, the safety of the two groups was good, and there was no significant difference between the two groups (P > 0.05). Conclusion Lingbao Huxin Dan combined with Shensong Yangxin Capsules in the treatment of sinus bradycardia is effective and worthy of clinical promotion.