益气温阳通络法治疗心脏射频消融术后三度房室传导阻滞1例

A Case of Third-degree Atrioventricular Block after Cardiac Radiofrequency Ablation Treated with the Method of Boosting Qi,Warming Yang and Unblocking Collaterals

三度房室传导阻滞是一种严重的缓慢性心律失常,目前药物治疗效果欠佳,指南推荐行心脏永久起搏器植入治疗,但并非多数患者的选择。报告运用益气温阳通络法治疗心脏射频消融术后三度房室传导阻滞1例,中医辨证为阳气亏虚、痰瘀阻络,治以益气温阳升陷、化痰活血通络为法,方予保元汤合麻黄附子细辛汤加减。治疗近7个月后,患者心悸、气短、乏力等临床症状基本痊愈,心电图恢复正常。

Third-degree atrioventricular block is a severe bradyarrhythmia,for which there is no proven effective drugs currently.Permanent pacemaker implantation recommended by the guideline,however,is not suitable for most patients.This paper reported on a case of third-degree atrioventricular block after cardiac radiofrequency ablation who has been treated with the method of boosting qi,warming yang and unblocking collaterals.The TCM syndrome of this case was diagnosed as yang qi depletion and phlegm-stasis blocking the collaterals,for which Baoyuan Decoction and Mahuang Fuzi Xixin Decoction(保元汤合麻黄附子细辛汤)in modification has been used to boost qi,warm yang and raise the sunken,dissolve phlegm,invigorate blood and unblock collaterals.After nearly 7-month treatment,the symptoms such as palpitations,shortness of breath and fatigue were basically cured,and the electrocardiogram returned to the normal.