柴胡桂枝龙骨牡蛎汤联合美托洛尔治疗冠心病合并室性心律失常的临床观察

Clinical observation of Chaihu Guizhi Longgu Muli Decoction combined with metoprolol in the treatment of coronary heart disease complicated with ventricular arrhythmia

目的:探究柴胡桂枝龙骨牡蛎汤联合美托洛尔治疗冠心病合并室性心律失常的临床效果。方法:前瞻性选取2020年3月—2022年3月收治的冠心病合并室性心律失常患者84例为研究对象,随机分为观察组和对照组,每组42例。观察组给予柴胡桂枝龙骨牡蛎汤联合美托洛尔治疗,对照组仅给予美托洛尔治疗。比较两组患者临床治疗有效率,比较两组治疗前后心功能指标变化情况,即左心室射血分数(LVEF)与左心室舒张末期内径(LVEDD),比较两组中医证候积分变化情况,即胸闷与胸痛症状积分,比较两组不良反应发生率。结果:观察组患者治疗2个月后临床治疗总有效率为97.62%(41/42),明显高于对照组患者的80.95%(34/42),差异有统计学意义(χ^(2)=4.480,P=0.034)。两组患者治疗后LVEF与本组治疗前比较均升高(P<0.05),LVEDD与本组治疗前比较均降低(P<0.05),差异比较存在统计学意义,且治疗后观察组LVEF升高幅度与LVEDD降低幅度均大于对照组(t=5.314、4.305,P均<0.05),差异比较有统计学意义。两组患者治疗后胸闷、胸痛积分与本组治疗前比较均降低(P<0.05),差异有统计学意义,且观察组患者胸闷、胸痛积分降低幅度均大于对照组患者(t=8.973、8.327,P均<0.05),差异有统计学意义。观察组患者治疗期间不良反应发生率为4.76%(2/42),高于对照组的2.38%(1/42),但两组比较差异无统计学意义(χ^(2)=0.346,P=0.557)。结论:柴胡桂枝龙骨牡蛎汤联合美托洛尔能有效提升冠心病合并室性心律失常患者临床治疗效果,缓解临床症状,改善心功能,且具有一定安全性。

Objective:To explore the clinical effect of Chaihu Guizhi Longgu Muli Decoction combined with metoprolol on coronary heart disease complicated with ventricular arrhythmia.Methods:84 patients with coronary heart disease complicated with ventricular arrhythmia admitted to our hospital from March 2020 to March 2022 were prospectively selected as the study objects,and randomly divided into observation group and control group,with 42 patients in each group.The observation group was treated with Chaihu Guizhi Longgu Muli Decoction combined with metoprolol,and the control group was treated with metoprolol only.The clinical effective rate of the two groups was compared.The changes of cardiac function indexes before and after treatment,namely Left Ventricular Ejection Fraction(LVEF)and Left Ventricular End Diastolic Dimension(LVEDD),were compared between the two groups.The changes of TCM syndrome scores,namely chest distress and chest pain symptom scores,were compared between the two groups.The incidence of adverse reactions were compared between the two groups.Results:After 2 months of treatment,the total effective rate of clinical treatment in the observation group was 97.62%(41/42),which was significantly higher than 80.95%(34/42)in the control group,the difference was statistically significant(χ^(2)=4.480,P=0.034).After treatment,the LVEF of the two groups was higher than that before treatment(P<0.05),while the LVEDD of the two groups was lower than that before treatment(P<0.05),and the difference was statistically significant.After treatment,the increase of LVEF and decrease of LVEDD in the observation group were greater than those in the control group(t=5.314,4.305,all P<0.05),and the differences were statistically significant.The scores of chest distress and chest pain in the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).The reduction of chest distress and chest pain scores in the observation group was greater than that in the control group,and the differences were statistically significant(t=8.973,8.327,all P<0.05).The incidence of adverse reactions in the observation group was 4.76%(2/42),which was higher than 2.38%(1/42)in the control group,but there was no statistically significant difference between the two groups(χ^(2)=0.346,P=0.557).Conclusion:Chaihu Guizhi Longgu Muli Decoction combined with metoprolol can effectively improve the clinical treatment effect of patients with coronary heart disease complicated with ventricular arrhythmia,relieve clinical symptoms,improve cardiac function,and has certain safety.