大剂量比索洛尔联合黄连阿胶汤加减和电针治疗阴虚火旺型心血管神经症的效果

Effect of Large Dose of Bisoprold Combined with Huanglian Ejiao Decoction Modified and Electroacupuncture in the Treatment of Yin Deficiency Huo Excess Type Cardiovascular Neurosis

目的:观察大剂量比索洛尔联合黄连阿胶汤加减和电针治疗阴虚火旺型心血管神经症的效果。方法:选择2022年1月—2023年1月连江县中医院收治的80例阴虚火旺型心血管神经症患者作为研究对象。按随机数表法分为对照组和观察组,各40例。两组均进行常规治疗,对照组给予大剂量比索洛尔,观察组在对照组的基础上给予黄连阿胶汤加减和电针治疗。治疗前后比较两组中医症候积分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、血清同型半胱氨酸、脂联素、炎症因子(肿瘤坏死因子-α、超敏C反应蛋白)水平,治疗结束后评价两组临床疗效,记录不良反应发生情况,随访治疗后6个月疾病复发情况。结果:治疗4周后,两组各项中医症候积分低于治疗前,且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组HAMD评分和HAMA评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组同型半胱氨酸、肿瘤坏死因子-α、超敏C反应蛋白均低于治疗前,脂联素高于治疗前,且观察组同型半胱氨酸、肿瘤坏死因子-α、超敏C反应蛋白低于对照组,脂联素高于对照组,差异有统计学意义(P<0.05)。两组治疗过程未见明显不良反应。观察组临床总有效率为92.50%,明显高于对照组的72.50%,差异有统计学意义(P<0.05)。观察组复发率为5.41%(2/37),明显低于对照组24.14%(7/29),差异有统计学意义(χ^(2)=4.844,P<0.05)。结论:大剂量比索洛尔联合黄连阿胶汤加减和电针是治疗阴虚火旺型心血管神经症效果突出、安全可靠的治疗方案,能够更好地改善临床不适症状及焦虑、抑郁,降低炎症因子、同型半胱氨酸,升高脂联素水平,有效提高临床效果,减少疾病复发。

Objective:To observe the effect of large dose of Bisoprolol combined with Huanglian Ejiao Decoction modified and electroacupuncture in the treatment of Yin deficiency Huo excess type cardiovascular neurosis.Method:A total of 80 patients with Yin deficiency Huo excess type cardiovascular neurosis treated in Lianjiang County Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects.They were divided into control group and observation group,with 40 cases in each group.Both groups received conventional treatment,the control group was given large dose of Bisoprolol,and the observation group was given Huanglian Ejiao Decoction modified and electroacupuncture on the basis of the control group.Traditional Chinese medicine syndrome scores,Hamilton depression scale(HAMD)scores,Hamilton anxiety scale(HAMA)scores,serum homocysteine,adiponectin,inflammatory factors(tumor necrosis factor-α,hypersensitive C-reactive protein)levels of the two groups were compared before and after treatment.Clinical efficacy of the two groups was evaluated after treatment,and the occurrence of adverse reactions was recorded.The recurrence of disease was followed up 6 months after treatment.Result:After 4 weeks of treatment,the scores of traditional Chinese medicine symptoms in both groups were lower than those before treatment,and the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After 4 weeks of treatment,HAMD scores and HAMA scores in both groups were lower than those before treatment,and the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After 4 weeks of treatment,homocysteine,tumor necrosis factor-αand hypersensitive C-reactive protein in the two groups were lower than those before treatment,and adiponectin was higher than that before treatment,and homocysteine,tumor necrosis factor-αand hypersensitive C-reactive protein in observation group were lower than those in the control group,and adiponectin was higher than that in the control group,the differences were statistically significant(P<0.05).There were no obvious adverse reactions in the two groups.The total clinical effective rate of the observation group was 92.50%,which was significantly higher than 72.50%of the control group,and the difference was statistically significant(P<0.05).The recurrence rate of the observation group was 5.41%(2/37),which was significantly lower than 24.14%(7/29)of the control group,and the difference was statistically significant(X^(2)=4.844,P<0.05).Conclusion:Large dose of Bisoprolol combined with Huanglian Ejiao Decoction modified and electroacupuncture is an effective,safe and reliable treatment plan for Yin deficiency Huo excess type cardiovascular neurosis,which can better improve clinical discomfort symptoms,anxiety and depression,reduce inflammatory factors and homocysteine,increase adiponectin level,effectively improve clinical results and reduce disease recurrence.