Systemic evaluation and Meta-analysis of Wenxin Keli in treatment of idiopathic premature beats in randomized controlled trails

Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled trials of Wenxin Keli for premature beats without cardiac diseases.The included literatures were systematically evaluated with Cochrane Handbook 5.1 evaluation criteria and tools,and Meta analysis was performed with software RevMan5.3.Results:A total of 13 randomized controlled trials with 1278 subjects were included.The exprimental group used Wenxin Keli alone while the control group used antiarrhythmic medicine.The Meta analysis results showed that the total effective rate(RR=1.06,95%CI[0.97,1.16],P=0.23)and clinical symptom effective rate(RR=1.16,95%CI[0.94,1.44],P=0.18)of Wenxin Keli on idiopathic premature beats was not significantly different from western medicine group.The subgroup analysis of total effective rate showed that Wenxin Keli had no significant difference with metoprolol(RR=1.04,95%CI[0.95,1.15],P=0.41),bisoprolol(RR=1.32,95%CI[0.85,2.05],P=0.22)and propanone(RR=1.07,95%CI[0.90,1.26],P=0.44).ECG changes showed that the PR intervals(MD=-12.57,95%CI[-16.15,-8.99],P<0.00001)and QTc intervals(MD=-8.09,95%CI[-15.52,-0.65],P=0.03)in the western medicine group were prolonged significantly more than those of Wenxin Keli.In terms of safety,the incidence of adverse reactions of Wenxin Keli was significantly less than that of western medicine group(RR=0.32,95%CI[0.19,0.54],P<0.0001).Conclusion:The efficacy of Wenxin Keli in the treatment of premature beats with structurally normal heart is accurate,and there are no serious adverse reactions.However,because of the low quality of the included papers,which affected the reliability of the conclusions,high-quality clinical research is needed to further demonstrate.

Clinical Efficacy of Ningxin Tongluo Decoction(宁心通络汤)Combined with Dapagliflozin on Patients of Type 2 Diabetes Mellitus Complicated with Ventricular Premature Beats

Objective:To explore the clinical efficacy of Ningxin Tongluo Decoction(宁心通络汤)combined with Dapagliflozin in the treatment of type 2 diabetes mellitus complicated with ventricular premature beats.Methods:Ninety-two patients with type 2 diabetes mellitus complicated with ventricular premature beats in our hospital were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with routine Western medicine,and the observation group was treated with Ningxin Tongluo Decoction on the basis of the control group.The clinical efficacy of the two groups before and after treatment,TCM syndrome score,blood glucose levels[fasting blood glucose(GLU),glycosylated hemoglobin(Hb A1c)],glucose metabolism levels[fasting insulin(FINS),insulin resistance index(HOMA-IR)],the number of ventricular premature beats detected by 24-hour ambulatory electrocardiogram,heart rate turbulence(HRT)[initial oscillation(TO),oscillation slope(TS)],and heart rate variability(HRV)standard deviation of two normal R-R intervals(SDNN),standard deviation of average normal R-R intervals every 5 minutes(SDANN)and root mean square of adjacent normal R-R intervals(RMSSD)were observed.Results:After treatment,the total effective rate of the observation group was 89.13%,significantly higher than that of the control group(73.91%),and the difference was statistically significant(P<0.05).Both groups could reduce TCM syndrome score,blood glucose level,glucose metabolism level,reduce the number of ventricular premature beats,improve HRT and HRV levels,and the observation group was superior to the control group,and the difference was statistically significant(P<0.05).Conclusion:Ningxin Tongluo Decoction combined with Dapagliflozin is effective in treating type 2 diabetes mellitus patients with ventricular premature beats.It can reduce blood glucose level,improve HRV and HRT,improve autonomic nerve function and exert antiarrhythmic effect.

Isolated Tricuspid Valve Repair and Right Atrial Plication Performed Using a Beating-Heart Technique for Atrial Functional Tricuspid Valve Regurgitation

Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.

Clinical Study on Huangku Qingxin Mixture Combined with Metoprolol Tartrate Tablets for Treatment of Ventricular Premature Beat

[Objectives] To observe the clinical effect and safety of Huangku Qingxin Mixture combined with Metoprolol Tartrate Tablets for patients with ventricular premature beat.[Methods] 126 patients were divided randomly into the control group (62 cases) and the treatment group (64 cases). The control group was treated with routine western medicine, and the treatment group was treated with routine western medicine combined with Huangku Qingxin Mixture, both for one month. Then, observed the changes of Myerburg score, SAS score, symptom score and dynamic electrocardiogram in the two groups before and after treatment.[Results] The total effective rate of clinical symptoms was 82.81% in the treatment group and 64.52% in the control group. Through comparison of two groups, the difference was statistically significant ( P <0.05). The total effective rate of dynamic electrocardiogram was 84.38% in the treatment group and 58.06% in the control group. Through comparison of two groups, the difference was statistically significant ( P <0.05). Before treatment, there was no significant difference being found in the comparison of the scores of Myerburg and SAS in the two groups ( P >0.05). After treatment, Myerburg score and SAS score in the two groups were lower than those before treatment ( P <0.05);Myerburg score and SAS score in the treatment group were both better than those in the control group ( P <0.05). Before treatment, there was no significant difference in the comparison of the QT interval dispersion (QTd) and the corrected QT interval dispersion (QTcd) by Bazette formula ( P >0.05). After treatment, the results of QTd and QTcd in the two groups were lower than those before treatment ( P <0.05);the results of QTd and QTcd in the treatment group were better than those in the control group ( P <0.05).[Conclusions] The application of Huangku Qingxin Mixture combined with Metoprolol Tartrate Tablets can effectively reduce Myerburg scores and SAS scores in patients with ventricular premature beat, shorten QTd and QTcd, and improve the life quality of patients. It has no adverse clinical reaction.

An introduction of the experience in treating Ventricular premature beat with stasis heat

Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.

升陷汤加味联合酒石酸美托洛尔治疗气虚下陷型室性早搏患者的疗效及其对心电图指标及心率震荡的影响

目的探讨升陷汤加味联合酒石酸美托洛尔治疗气虚下陷型室性早搏患者的疗效及其对心电图指标和心率震荡的影响。方法选择2019年8月至2023年1月中国中医科学院广安门医院接收的160例气虚下陷型室性早搏患者为研究对象进行前瞻性研究,根据随机数字表法将其分为中西组和对照组,每组各80例。对照组采用酒石酸美托洛尔治疗,中西组采用酒石酸美托洛尔+升陷汤加味治疗,均连续用药8周。比较两组总有效率,治疗前、治疗8周后的中医证候积分、室性早搏发作次数、心电图指标、心率震荡参数及不良反应情况。结果治疗8周后,中西组总有效率为93.75%,明显高于对照组(80.00%),差异有统计学意义(P<0.05)。治疗8周后,两组证候积分、室性早搏发作次数均较治疗前显著下降,且中西组的证候积分、室性早搏发作次数分别为(6.61±0.83)分、(112.61±13.83)次/h,显著低于对照组[(10.05±1.32)分、(151.05±17.32)次/h],差异均有统计学意义(P<0.05)。治疗8周后,两组PR间期均较治疗前显著缩短,QRS波时限、QTc间期均较治疗前显著延长,且中西组的PR间期为(0.132±0.014)ms,显著短于对照组[(0.141±0.016)ms],QRS波时限、QTc间期分别为(0.093±0.013)、(0.496±0.052)s,均显著长于对照组[(0.082±0.011)、(0.433±0.047)s],差异均有统计学意义(P<0.05)。治疗8周后,两组T0水平均较治疗前显著下降,TS水平均较治疗前显著上升,且中西组的T0水平为(0.09±0.02)%,显著低于对照组[(0.21±0.05)%],TS水平为(5.72±0.83)ms/RR,显著高于对照组[(4.45±0.66)ms/RR],差异均有统计学意义(P<0.05)。中西组与对照组的总不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用升陷汤加味联合酒石酸美托洛尔治疗气虚下陷型室性早搏患者可有效减少患者早搏次数,调节心功能,效果较为理想,临床应用价值较高。

益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效

目的:观察益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效。方法:选取2021年8月—2022年8月在北京中医药大学东方医院住院治疗的室性期前收缩病人60例,按照随机数字表法分为对照组和治疗组。在常规治疗基础上,治疗组采用益气复脉方(颗粒剂)治疗,对照组采用颗粒安慰剂治疗。评估并比较两组治疗前后室性期前收缩数量变化,中医证候积分及中医单项症状心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆积分变化。结果:治疗后,治疗组室性期前收缩数量较治疗前减少,且治疗组少于对照组,差异有统计学意义(P<0.05)。治疗后,两组中医证候总积分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.001)。治疗后,两组心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆的症状积分均较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组总有效率高于对照组,差异有统计学意义(77.8%与24.0%,P<0.05)。结论:益气复脉方可减少气虚血瘀、痰瘀互阻型室性期前收缩病人室性期前收缩次数,改善中医证候。

清热安神胶囊联合胺碘酮治疗痰火扰心型频发室早临床研究

目的观察清热安神胶囊联合胺碘酮治疗痰火扰心型频发室性早搏(premature ventricualr contraction,PVC)的临床疗效。方法将80例符合纳入排除标准的患者随机分成两组,对照组给予单用胺碘酮治疗,治疗组采用胺碘酮联合清热安神胶囊治疗,治疗1月后比较两组患者的检测指标和临床效果,房室大小、EF值、早搏类型、数量、形态、总心搏数、室性早搏数量等变化。结果治疗后治疗组患者心悸症状比例(16.25%vs 47.50%,P<0.05)、中医证候积分和室早负荷中位数(13.9%vs 16.4%,P<0.05)的改善程度明显优于对照组。结论联合使用胺碘酮和清热安神胶囊用于治疗PVC的临床效果明显优于单用胺碘酮治疗。

益气平悸颗粒联合酒石酸美托洛尔对气阴两虚证室性早搏患者心功能、血管内皮功能的影响

目的探讨益气平悸颗粒联合酒石酸美托洛尔对气阴两虚证室性早搏患者心功能、血管内皮功能的影响。方法选取2019年1月至2020年12月100例气阴两虚证室性早搏患者,采用随机数字表法均分为2组。对照组予酒石酸美托洛尔治疗,观察组在此基础上予益气平悸颗粒治疗。2组均以1个月为1个疗程,连续治疗2个疗程后比较疗效。比较2组治疗前、治疗1个疗程后、治疗2个疗程后中医证候积分、24 h动态心电图指标、左心功能指标、血管内皮相关因子,并分析2组临床疗效及治疗安全性。结果观察组临床总有效率为92.00%高于对照组的76.00%(P<0.05);治疗1个疗程及2个疗程后,观察组中医证候积分较对照组降低(P<001);治疗1个疗程及2个疗程后,观察组室性早搏次数少于对照组,NN间期标准差、RR间期平均值标准差高于对照组(P<001);治疗2个疗程后,观察组左心室收缩末期内径、左心室舒张末期内径较对照组降低,左心室射血分数较对照组升高(P<001);治疗1个疗程及2个疗程后,观察组血栓素B2、内皮素-1水平均较对照组降低,一氧化氮较对照组升高(P<001);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论益气平悸颗粒联合酒石酸美托洛尔能改善气阴两虚证室性早搏患者临床症状体征,促进心功能恢复,调控血栓素B2、内皮素-1、一氧化氮等血管内皮相关因子表达,且具有较高的疗效和治疗安全性。

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

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。

对心房颤动以外的快速性房性心律失常的认识

过去临床普遍认为,房性早搏(简称房早)、房性心动过速(简称房速)等心房颤动(简称房颤)以外的快速性房性心律失常并无重要临床意义。但近年来,随着检测手段的不断发展,越来越多的临床研究发现,房早、房速等除房颤以外的心房异位活动与脑卒中的风险相关,并可能进一步导致死亡率升高。同时,此类房性心律失常的发生次数与房颤、缺血性脑卒中等不良事件发生率之间存在正相关,其机制可能与亚临床心房心肌病的介导作用有关。对该类心律失常的临床临界值和室上异位活动,目前仍无明确定义。因此,通过动态心电图等手段、遵循规范化流程,对房颤以外的快速性房性心律失常进行规律检测和处理至关重要。本文介绍此类房性心律失常与心源性脑卒中的关系,以及对此类心律失常的检测在心源性脑卒中评估中的作用。

频发室性早搏与心脏瓣膜手术同期迷宫手术后心房颤动复发关系研究

目的:探讨频发室性早搏(VPB)与心脏瓣膜手术同期射频消融迷宫手术(CMA)后心房颤动(AF)复发的关系。方法:收集因瓣膜疾病合并AF行心脏瓣膜手术同期射频消融迷宫手术的患者115例进行单中心、回顾性、病例对照研究,按照AF是否复发进行分组,复发AF患者23例,未复发患者92例。收集患者一般临床资料和相关实验室检查并评估术前室性早搏负荷(室性早搏数量>10000个/24 h为频发室性早搏)。采用单因素和多因素Cox比例风险回归模型对合并瓣膜疾病的AF患者在接受心脏瓣膜手术及同期射频消融迷宫手术后AF复发的危险因素进行分析。结果:与未复发组比较,复发组室性早搏负荷较高(P<0.05)。多因素Cox回归分析结果显示,频发室性早搏和糖尿病是进行心脏瓣膜手术并同期接受射频消融迷宫手术的患者AF复发的独立危险因素(均P<0.05)。结论:频发室性早搏是心脏瓣膜手术同期射频消融迷宫手术后心房颤动复发的危险因素。

期前收缩病人中医证候特征的文献分析

目的:通过文献分析期前收缩病人的中医证候特征及构成证素分布规律。方法:检索建库至2022年12月中国知网、维普、万方和PubMed数据库公开发表的期前收缩文献,经筛选后提取符合纳入标准文献的证候及证素等信息,并进行统计分析。结果:共纳入文献63篇,其中室性期前收缩文献58篇,房性期前收缩文献5篇,共涉及病人6791例。期前收缩病人的常见证候包括气阴两虚证(15.42%)、气血两虚证(9.38%)、心血瘀阻证(7.18%)等;常见病位证素包括心(64.02%)、肾(12.84%)、脾(9.91%)等;常见病性证素包括气虚(23.14%)、阴虚(16.88%)、血瘀(15.99%)、痰(9.35%)等。亚组分析结果显示,房性期前收缩病人的常见证候为气血两虚(30.29%)、心阳不振(16.57%)、痰火扰心(14.86%)等;常见证素为气虚(19.51%)、血虚(19.21%)、血瘀(16.46%)等。室性期前收缩病人的常见证候为气阴两虚(15.87%)、气血两虚(8.76%)、心血瘀阻(7.40%)等;常见证素为气虚(23.23%)、阴虚(17.03%)、血瘀(15.98%)等。结论:期前收缩病人总体证候特征虚实夹杂、以虚为主,气阴两虚并重、痰热血瘀互结。

稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常有效性及安全性的Meta分析

目的:系统评价稳心颗粒结合胺碘酮治疗心力衰竭并发室性心律失常的疗效与安全性。方法:计算机检索中国知网(CNKI)、维普网(VIP)、万方、中国生物医学文献数据库(CBM)、PubMed、Web of Science和the Cochrane Library等数据库,检索有关稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常的随机对照试验(RCT)。由2名研究者分别对文献进行筛选、提取数据和评价纳入研究的偏倚风险后,采取RevMan 5.3及R语言统计软件进行Meta分析。结果:共纳入18项研究,涉及1 527例病人。Meta分析结果显示,稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常,在提高临床总有效率[RR=1.19,95%CI(1.14,1.25),P<0.000 1]、减少室性期前收缩次数[SMD=-2.42,95%CI(-4.66,-0.18),P=0.03]、稳定心率[SMD=-1.66,95%CI(-1.94,-1.37),P<0.000 1]、增加左室射血分数[SMD=1.57,95%CI(0.54,2.61),P=0.003]均优于单独使用胺碘酮,且不良反应发生率低于单独使用胺碘酮[RR=0.59,95%CI(0.43,0.80),P=0.000 8]。结论:现有证据表明,稳心颗粒联合胺碘酮在治疗心力衰竭并发室性心律失常,能够明显提高临床疗效、LVEF,且不良反应更少,安全性较好。

基于光电储备池计算的室性早搏识别

基于延迟反馈结构的光电储备池计算系统是一种软硬件设计简单的模拟光信号处理系统,将其成功应用到实时识别室性早搏中,对有效预防和早期治疗心电疾病具有重要的意义。利用马赫-曾德尔调制器附加光电反馈环,建立光电储备池计算模型,并对室性早搏心电图进行了识别。对模型中的关键参数进行了分析和优化,如分析了反馈强度β、输入增益γ、虚拟节点个数N等参数对心电图识别效果的影响,其最佳识别归一化均方误差值NMSE为0.080 9,最佳识别率达到94%,敏感度达到了94.9%。表明该光电储备池计算系统在室性早搏心电图识别方面表现出了良好的性能,简化了现今心电图识别算法的复杂性。

宁心汤治疗心律失常频发房性早搏临床观察

目的 研究自拟宁心汤联合西药酒石酸美托洛尔片(倍他乐克)对心律失常频发房性早搏的临床疗效。方法 随机选取2019年1月—2021年12月到吉林工商学院校医院进行治疗的心律失常频发房性早搏患者60例,分为治疗组和对照组,各30例。其中对照组给予常规西药治疗,治疗组在常规西药治疗基础上加用自拟宁心汤。8周为1个疗程,观察两组患者治疗前后症状的变化和心电图、血常规等实验室指标的变化,对不良反应等进行观察。结果 经过1个疗程之后,治疗组临床症状总有效率为93.3%(28/30),优于对照组的76.7%(23/30)。治疗组心电图总有效率为83.3%(25/30),明显优于对照组的66.7%(20/30)(P<0.05);治疗组动态心电图早搏总有效率为76.7%(23/30),高于对照组的53.3%(16/30)。治疗组中医证候疗效总有效率为73.3%(22/30),高于对照组的40.0%(12/30)(P<0.05)。治疗组在改善患者出现的情绪抑郁、胸胁或少腹胀痛、善太息等肝郁气滞的症状积分方面,积分高于对照组(P<0.05)。两组患者的血常规、肝肾功能、血糖、血脂、离子指标和用药前比较,差异无统计学意义,且无不良反应发生。结论 自拟宁心汤联合西药酒石酸美托洛尔片治疗心律失常频发房性早搏效果显著,具有较高的安全性和临床应用价值。

老年疑似房性期前收缩病人动态心电图诊断窦性心律不齐Lorenz-RR散点图特征及临床意义

目的:分析老年疑似房性期前收缩(房早)病人动态心电图诊断窦性心律不齐Lorenz-RR散点图特征。方法:对137例60岁以上老年疑似房早病人的动态心电图检查结果进行Holter记录,采用Holter软件描绘散点图,获得窦性心律不齐的Lorenz-RR散点图,并加以汇总归纳。结果:137例疑似房早病人经动态心电图诊断为窦性心律不齐,病人Holter Lorenz-RR散点图特征分类如下:137例病人中58例(42.3%)呈斜“Y”状;33例(24.1%)呈“棒状扩张型”;29例(21.2%)散点图呈“棒状”;13例(9.5%)为“不规则状”;2例(1.5%)呈现“纵向分离”;2例(1.5%)呈现“横向分离合并纵向分离”。结论:动态心电散点图对老年疑似房早病人窦性心律不齐的鉴别诊断更敏捷、更准确,具有较高的临床应用价值。

动态心电图对老年冠状动脉性心脏病患者心肌缺血及心律失常的诊断效果

目的探究存在心律失常、心肌缺血问题的老年冠状动脉性心脏病经过动态心电图检查后的诊断效果。方法选取我院收治的86例老年冠状动脉性心脏病患者,时间段为2022年1月至2024年2月,随机分成两组,对照组、观察组各43例,分别接受常规心电图、动态心电图诊断。结果观察组的心房颤动、房性早搏、室性早搏、房室传导阻滞以及心肌缺血检出率更高(P<0.05);观察组的临床诊断满意度高于对照组(P<0.05)。结论在临床治疗过程中,运用动态心电图方法可以在短时间内准确检测出所存在的心律失常、心肌缺血问题,进而提高临床诊断满意度。

胺碘酮联合美托洛尔治疗慢性心力衰竭合并室性早搏患者的效果

目的:观察胺碘酮联合美托洛尔治疗慢性心力衰竭(CHF)合并室性早搏患者的效果。方法:回顾性分析2022年4月至2023年4月该院收治的92例CHF合并室性早搏患者的临床资料,根据治疗方法不同将其分为对照组和研究组各46例。对照组采用美托洛尔治疗,研究组在对照组基础上联合胺碘酮治疗。比较两组治疗效果、治疗前后心率变异性指标[全部窦性心搏RR间期标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)、正常RR间期的标准差(SDANN)]水平、早搏发作频率、心功能指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)]水平、血管内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)、肱动脉内皮依赖性血管舒张功能(FMD)]水平,以及不良反应发生率。结果:研究组治疗总有效率为93.48%(43/46),高于对照组的65.22%(30/46),差异有统计学意义(P<0.05);治疗后,两组SDNN、RMSSD、SDANN水平均高于治疗前,且研究组高于对照组,两组早搏发作频率均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组LVEDD、LVESD水平均低于治疗前,且研究组低于对照组,两组LVEF水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组FMD、NO、CGRP水平均高于治疗前,且研究组高于对照组,两组ET-1水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:胺碘酮联合美托洛尔治疗CHF合并室性早搏患者可提高治疗总有效率和心率变异性指标水平,改善心功能指标、血管内皮功能指标水平,降低早搏发作频率,其效果优于单纯美托洛尔治疗。

舒心解郁汤治疗室性早搏伴焦虑的临床效果

目的 观察舒心解郁汤治疗室性早搏伴焦虑的临床效果。方法 选取2021年1月—2022年1月济南市中西医结合医院收治的室性早搏伴焦虑患者100例,采用随机数字表法分为研究组和对照组,每组50例。对照组实施西医治疗,研究组在对照组基础上加用舒心解郁汤治疗,2组均治疗4周。比较2组临床疗效、治疗前后汉密尔顿焦虑量表(HAMA)评分、中医证候评分及不良反应。结果 研究组临床总有效率为92.00%,高于对照组的76.00%(χ^(2)=4.762,P=0.029);治疗4周后,2组HAMA评分及中医证候评分均低于治疗前,且研究组低于对照组(P<0.01);研究组不良反应总发生率为4.00%,低于对照组的18.00%(χ^(2)=5.005,P=0.025)。结论 舒心解郁汤治疗室性早搏伴焦虑患者临床效果较好,可有效改善患者焦虑等不良心理状态,且不良反应较少,安全性高。