苓桂术甘汤合生脉散辅助治疗老年频发室性早搏55例临床分析  

Clinical Analysis of Linggui Zhugan Tang Combined with Shengmai San in Treatment of 55 Cases with Senility Frequent Ventricular Premature Beat

作　　者：陈萍[1] 刘婷[2] 

机构地区：[1]济南市中医医院,济南250004 [2]济南市槐荫人民医院,济南250012

出　　处：《中国实验方剂学杂志》2015年第19期150-153,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：济南市卫生局科技计划项目(2013-42)

摘　　要：目的:观察苓桂术甘汤合生脉散加减辅助治疗老年频发室性早搏的疗效及对心率变异性(HRV)和心率震荡(HRT)的影响。方法:105例频发室性早搏患者采用随机按住院先后顺序列表分为对照组53例和观察组55例。对照组采用盐酸艾司洛尔注射液,0.5 mg·kg-1·min-1,约1 min静脉注射,并以静脉点滴维持量,0.05 mg·kg-1·min-1。观察组在对照组治疗的基础上加用苓桂术甘汤合生脉散加减治疗。两组疗程均为4周。采用24 h动态心电图记录治疗前后室性早搏的次数、心率变异性(HRV)和心率震荡(HRT),HRV包括24 h正常R-R间期标准差(SDNN),24 h每5 min平均正常的R-R间期的标准差(SDANN),相邻正常R-R间期差值的均方根(RMSSD)和相邻正常R-R间期差值≥50 ms的心搏数占总R-R间期数的百分数(PNN50)4个指标,HRT包括震荡初始(TO)和震荡斜率(TS)2个指标;进行治疗前后主要症状评分。结果:观察组室性早搏总有效率92.73%,对照组总有效率为77.36%,组间比较观察组优于对照组(P<0.05);治疗后观察组SDNN,SDANN,RMSSD和PNN50多于对照组(P<0.05,P<0.01);治疗后两组TS比治疗前有所增加,观察组增加更为显著(P<0.01);治疗后观察组室性早搏数少于对照组(P<0.05),观察组室性早搏数减少次数多于对照组(P<0.05);治疗后观察组主要症状评分低于对照组(P<0.01),观察组主要症状评分下降幅度多于对照组(P<0.01)。结论:苓桂术甘汤合生脉散加减辅助治疗老年频发室性早搏能改善HRV,HRT,减少室性早搏的发生,改善临床症状,临床疗效优于单纯的西医治疗。Objective： To observe the effects of Linggui Zhugan Tang combined with Shengmai San in treating senility frequent ventricular premature beat （FVPB） as well as its influences to heart rate variability （HRV） and heart rate turbulence （HRT）. Method： One hundred and eight patients with frequent ventricular premature beat were randomly divided into control group （53 cases） and observation group （55 cases） according to their order of hospitalization. Patients in control group received about 1 minute of esmolol hydrochloride intravenous injection, 0.5 mg .kg-1.min-1, with a maintenance dose of 0.05 mg .kg-1.min-1 for intravenous drip. Based on the treatment of control group, patients in observation group also received Linggui Zhugan Tang combined with Shengmai San. Courses of treatment in two groups were both 4 weeks. Before and after treatment, times of ventricular premature beat, HRV and HRT were recorded by ：24 hours＇ ambulatory electrocardiogram. HRV included 4 indicators ： 24 hours＇ standard deviation of normal to normal RR intervals （ SDNN）, standard deviation of 5 min average normal RR intervals in 24 h （SDANN） , root mean square successive differences （RMSSD） in normal R-R intervals, and percentage of differences between adjacent normal RR intervals exceeding 50 milliseconds, PNN50. HRT included 2 indicators： turbulence onset （TO） and turbulence slope （TS）. And scoresof main symptoms were also graded. Result： Total effective rate for premature beat was 92.73% in observation group, and 77.36% in control group. Thus, the efficacy in observation group was better than that of control group for comparison （P 〈 0.05）. After treatment, the SDNN, SDANN, RMSSD and PNN50 in observation group were superior to these in control group （ P 〈 0.05, P 〈 0.01 ）. TS in two groups went up slightly compared with the data before therapy, while the increase in observation group was more obvious （P 〈 0.01 ）. The number of cases with ventricular premature beat i

关 键 词：频发室性早搏 苓桂术甘汤 生脉散 心率变异性 心率震荡 

分 类 号：R287[医药卫生—中药学]