温阳复脉益心加减方联合铜砭刮痧治疗老年冠心病并发心律失常疗效研究

Curative effect study on Wenyang Fumai Yixin Jiajian prescription combined with Tongbian Guasha on coronary heart disease accompanied by arrhythmia

目的:探究温阳复脉益心加减方联合铜砭刮痧治疗老年冠心病并发心律失常的临床价值。方法:选取冠心病并发心律失常患者94例,依据简单随机数字表法分为中西医组、西医组,各47例。西医组口服胺碘酮、美托洛尔,中西医组在西医组基础上采取温阳复脉益心加减方联合铜砭刮痧,两组均治疗1个月。统计两组治疗前后中医证候积分、临床疗效、心率、短阵室性心动过速数量、室性早搏数量、校正QT间期(QTc)、QT离散度(QTd)、不良反应发生情况。结果:治疗后两组胸闷气短、心悸不安、眩晕、自汗懒言、神疲乏力、形寒肢冷、面色白评分较治疗前下降,且中西医组低于西医组,差异有统计学意义(均P<0.05)。中西医组治疗总有效率93.62%高于西医组78.72%,差异有统计学意义(均P<0.05)。治疗后两组静息心率、24 h最快心率、24 h最慢心率、24 h平均心率、24 h总心率较治疗前增高,且中西医组高于西医组,差异有统计学意义(均P<0.05)。治疗后两组短阵室性心动过速数量、室性早搏数量少于治疗前,且中西医组少于西医组,差异有统计学意义(均P<0.05)。治疗后两组QTc、QTd较治疗前降低,且中西医组低于西医组,差异有统计学意义(均P<0.05)。中西医组不良反应发生率6.38%与西医组10.64%比较,差异无统计学意义(P>0.05)。结论:温阳复脉益心加减方联合铜砭刮痧治疗老年冠心病并发心律失常可改善心率,缓解临床症状,提升治疗效果,且较安全。

Objective:To explore clinical value of Wenyang Fumai Yixin Jiajian prescription combined with Tongbian Guasha in elderly patients with coronary heart disease accompanied by arrhythmia.Methods:94 patients with coronary heart disease accompanied by arrhythmia were selected and divided into traditional Chinese and Western medicine group and Western medicine group,each group 47 cases,according to simple random numbertable method.The western medicine group took amiodarone and metoprolol,and the traditional Chinese and Western medicine group took Wenyang Fumai Yixin Jiajian prescription and Tongbian Guasha on the basis of the Western medicine group.Both groups were treated foR1 month.TCM syndrome score,clinical efficacy,heart rate,numberof short ventriculaRtachycardia and premature ventriculaRbeats,corrected QT interval(QTc)and QT dispersion(QTd),occurrence of adverse reactions in the two groups before and aftertreatment were analyzed.Results:AfteRtreatment,the scores of chest depression,shortness of breath,palpitation,vertigo,spontaneous sweating,mental fatigue,cold shape and limbs,and facial concentration decreased in the two groups,and the scores of traditional Chinese and western medicine group were lowerthan those in the western medicine group,difference statistically significant(all P<0.05).The total effective rate of the Chinese and western medicine group 93.62%was higheRthan that in the Western medicine group 78.72%,difference statistically significant(P<0.05).AfteRtreatment,the resting heart rate,24 h fastest heart rate,24 h slowest heart rate,24 h average heart rate and 24 h total heart rate of the two groups were higheRthan before treatment,and the western medicine group were higheRthan those in the western medicine group,difference statistically significant(all P<0.05).AfteRtreatment,the numberof short ventriculaRtachycardia and premature ventriculaRbeats in the two groups were lowerthan before treatment,and the numberof Chinese and western medicine group were lowerthan that in the Western medicine group,difference statistically significant(all P<0.05).AfteRtreatment,QTc and QTd in the two groups were lower than before treatment,and the western medicine group were lowerthan those in the western medicine group,difference statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the Chinese and western medicine group 6.38%and the Western medicine group 10.64%(P>0.05).Conclusion:The combination of Wenyang Fumai Yixin Jiajian prescription and Tongbian Guasha in the treatment of elderly coronary heart disease with arrhythmia can improve heart rate,relieve clinical symptoms,improve therapeutic effect of disease,and better safety.