炙甘草汤联合西药治疗气阴两虚型冠心病合并室性心律失常患者的效果

Effect of Zhigancao Decoction Combined with Western Medicine in the Treatment of Patients with Qi Yin Deficiency Type Coronary Heart Disease Complicated with Ventricular Arrhythmia

目的探讨炙甘草汤联合西药治疗气阴两虚型冠心病合并室性心律失常(VA)的临床效果。方法选取济南市第三人民医院2022年1月—2023年10月收治的56例冠心病合并VA患者为研究对象,按随机数字表法将其分为对照组和观察组,每组28例。对照组采用西药治疗,观察组在此基础上采用炙甘草汤治疗,均持续6周。比较两组患者的临床疗效、心电图指标、中医证候积分及不良反应发生情况。结果观察组的治疗总有效率为92.86%,高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗6周后,观察组的室性期前收缩数、短阵室速数分别为(2824.63±225.31)次/24 h、(1.82±0.23)次/24 h,均少于对照组的(3025.59±234.16)次/24 h、(2.89±0.35)次/24 h,QT间期为(458.63±45.32)ms,长于对照组的(419.63±44.25)ms,QT离散度为(37.12±3.25)ms,短于对照组的(42.65±4.18)ms,组间差异有统计学意义(P<0.05);观察组的心悸胸闷、气短乏力、头晕眼花、失眠健忘积分分别为(0.76±0.13)分、(0.65±0.11)分、(0.59±0.11)分、(0.62±0.13)分,均低于对照组的(0.89±0.15)分、(0.84±0.13)分、(0.78±0.13)分、(0.81±0.14)分,组间差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论炙甘草汤联合西药可提高冠心病合并VA患者的治疗效果,改善其心电图指标,降低中医证候积分,且安全性良好。

Objective To investigate the clinical effect of Zhigaocao Decoction combined with western medicine in the treatment of Qi Yin deficiency type coronary heart disease with ventricular arrhythmia(VA).Methods Fifty-Six patients with coronary heart disease combined with VA admitted to Jinan Third People's Hospital from January 2022 to October 2023 were selected as the research objects and were divided into a control group and an observation group according to random number table method,with 28 cases in each group.The control group was treated with western medicine,and the observation group was treated with Zhigancao Decoction on this basis.Both groups were treated for 6 weeks.The clinical efficacy,electrocardiogram indexes,TCM syndrome scores and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 92.86%,which was higher than 71.43%of the control group,the difference was statistically significant(P<0.05).After 6 months of treatment,the number of pre-ventricular contractions and short ventricular tachycardia in the observation group were(2824.63±225.31)times/24 h and(1.82±0.23)times/24 h,which were less than(3025.59±234.16)times/24 h and(2.89±0.35)times/24 h in the control group,the QT interval was(458.63±45.32)ms,which was longer than(419.63±44.25)ms in the control group,and the QT dispersion was(37.12±3.25)ms,which was shorter than (42.65±4.18)ms in the control group, the differences between the groups were statistically significant (P<0.05);the scores of palpitation, chest tightness, shortness of breath, dizziness, insomnia and forgetfulness in the observation group were (0.76±0.13) points, (0.65±0.11) points, (0.59±0.11) points, and (0.62±0.13) points, respectively, which were lower than (0.89±0.15) points, (0.84±0.13) points, (0.78±0.13) points, (0.81±0.14) points in the control group, and the differences between the groups were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Zhigancao Decoction combined with western medicine can improve the therapeutic effect of coronary heart disease patients with VA, improve the electrocardiogram indexes, reduce the TCM syndrome scores, and have good safety.