摘要
目的探讨益气养阴复脉颗粒联合酒石酸美托洛尔片治疗室性早搏的临床疗效及安全性。方法选取取2019年6月~2021年6月我院收治的98例室性早搏患者,采取随机数字表法分成观察组与对照组各49例。对照组口服酒石酸美托洛尔片治疗,在此基础上,观察组联合益气养阴复脉颗粒内服治疗。连续治疗4周后观察两组疗效。比较治疗前后两组中医症候积分、24 h动态心电图参数[室性早搏次数、24 h内全部窦性心律R-R间期标准差(SDNN)、24 h内每5 min窦性心律R-R间期平均值的标准差(SDANN)]、世界卫生组织生活质量测定量表简表(WHOQOL-BREF)评分及血清内皮素-1(ET-1)、一氧化氮(NO)和同型半胱氨酸(Hcy)水平,并统计两组不良反应情况。结果观察组总有效率较对照组显著升高(χ^(2)=4.021,P=0.045)。与治疗前对比,两组治疗后各项中医症状(包括心悸怔忡、五心烦热、气短乏力、头晕、神疲等)积分均显著降低(P<0.05);且均以观察组的下降更显著(P<0.05)。与治疗前对比,两组治疗后24 h内室性早搏次数均显著减少(P<0.05),SDNN和SDANN均显著升高(P<0.05);但均以观察组的改善更显著(P<0.05)。两组治疗后WHOQOL-BREF中各领域(心理、生理、社会关系、环境)评分及其总分均显著高于治疗前(P<0.05);且均以观察组的升高更显著(P<0.05)。与治疗前相比,两组治疗后血清ET-1和Hcy水平均显著下降(P<0.05),血清NO浓度均显著上升(P<0.05);且治疗后,观察组对血清ET-1、Hcy水平的降低作用及对血清NO水平的升高作用较对照组更显著(P<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.445,P=0.504)。结论益气养阴复脉颗粒联合酒石酸美托洛尔片治疗室性早搏的整体疗效确切,是减轻患者症状、稳定病情及提高生活质量的安全有效方案,其作用可能与其显著下调血清ET-1、Hcy表达水平及升高血清NO水平有关。
Objective To investigate the clinical efficacy and safety of Yiqi Yangyin Fumai Keli combined with Metoprolol Tartrate tablets in the treatment of ventricular premature beats.Methods A total of 98 patients with ventricular premature beats admitted to our hospital from June 2019 to June 2021 were selected and divided into observation group and control group using random number table method,49 cases in each group.The control group was treated with Metoprolol Tartrate tablets orally.On the basis of control group,the observation group was combined with Yiqi Yangyin Fumai Keli orally.The efficacy of the two groups was observed after 4 weeks of continuous treatment.TCM syndrome scores and 24 h dynamic electrocardiogram parameters[number of premature ventricular beats,standard deviation of all sinus rhythm RR intervals(SDNN)within 24 h,mean value of sinus rhythm RR intervals every 5 min within 24 h Standard deviation(SDANN)],WHOQOL-BREF score and serum endothelin-1(ET-1),nitric oxide(NO)and homocysteine(Hcy)level were compared.And adverse reactions in the two groups were recorded.Results The total effective rate of the observation group was significantly higher than that of the control group(χ^(2)=4.021,P=0.045).Compared with before treatment,the scores of all TCM symptoms(including heavy-palpitation,five-center heat,shortness of breath,fatigue,dizziness,mental fatigue,etc.)in the two groups after treatment were significantly reduced(P<0.05);and the decline in the observation group was more significant(P<0.05).Compared with before treatment,the number of ventricular premature beats within 24 h after treatment in the two groups was significantly reduced(P<0.05),and SDNN and SDANN were significantly increased(P<0.05);however,the improvement in the observation group was more significant(P<0.05).After treatment,the WHOQOL-BREF scores in various fields(psychology,physiology,social relations,environment)and their total scores were significantly higher than those before treatment(P<0.05);and the increase in the observation group was more significant(P<0.05).Compared with before treatment,serum ET-1 and Hcy levels decreased significantly after treatment in the two groups(P<0.05),and serum NO concentration increased significantly(P<0.05);and after treatment,the observation group had more significant effects on reducing serum ET-1 and Hcy levels and increasing serum NO levels than the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.445,P=0.504).Conclusion Yiqi Yangyin Fumai Keli combined with metoprolol tartrate tablets has a definite overall curative effect in the treatment of ventricular premature beats.It is a safe and effective solution for alleviating patients'symptoms,stabilizing the condition and improving the quality of life.Its effect may be related to the significant down-regulation of serum ET-1 and Hcy expression levels and the increase of serum NO levels.
作者
马玉娟
姚学旺
卢吉锋
Ma Yujuan;Yao Xuewang;Lu Jifeng(Affiliated Hospital of Henan Academy of Traditional Chinese Medicine,Zhengzhou 450003,China;Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450003,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2023年第5期1821-1827,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
河南省中医管理局科课题(2016ZY2073):益气养阴复脉颗粒治疗室性早搏多中心随机对照临床研究,负责人:马玉娟
关键词
室性早博
益气养阴复脉颗粒
酒石酸美托洛尔片
血管内皮功能
同型半胱氨酸
Ventricular premature bleeding
Yiqi Yangyin Fumai granules
Metoprolol tartrate tablets
Vascular endothelial function
Homocysteine
作者简介
通讯作者:马玉娟,硕士,副主任中医师,主要研究方向:从事心血管疾病研究。
