基于经络皮部理论探析针药并举防治快速性心律失常疗效研究  

Efficacy of Acupuncture Combined with Traditional Chinese Medicine in the Prevention and Treatment of Tachyarrhythmia Based on the Meridian Cutaneous Region Theory

作　　者：姜会来 焦蕊[1] JIANG Huilai;JIAO Rui(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2020年第6期156-159,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省“兴辽英才计划”高水平创新团队(XLYC1808011)。

摘　　要：目的基于经络皮部理论探讨针药并举防治快速性心律失常的临床疗效,以期为临床防治提供理论依据。方法将120例快速性心律失常阴虚火旺证患者采取随机数字表法随机分为观察组和对照组,每组各60例,对照组应用酒石酸美托洛尔治疗,观察组加用皮部针刺疗法联合当归地黄汤治疗。观察两组患者治疗前后的临床疗效、中医证候积分与单一症状积分、QT离散度(QTcd)及心脏变异性指标。结果治疗4周后,观察组临床总有效率(91.67%)显著高于对照组(70.00%),观察组心悸、心烦、脉律异常、五心烦热、颧红口干、耳鸣腰酸症状评分及中医证候总积分方面显著低于对照组,观察组QT间期(QTc)、QTcd显著低于对照组,观察组全部窦性心搏RR间期标准差(SDNN)、每5 min窦性心搏RR间期平均值标准差(SDANN)、全程相邻窦性心搏RR间期差值均方根(rMSSD)、全部相邻窦性心搏RR间期差值超过50 ms百分比(pNN50)水平显著高于对照组。结论针药并举治疗快速性心律失常阴虚火旺证临床疗效显著,可改善患者心悸、心烦、脉律异常、五心烦热、颧红口干、耳鸣腰酸症状,降低QT离散度,提高心率变异性指标,达到减少室性心律失常发生及改善自主神经功能的作用,安全性较高,值得临床推广。Objective To investigate efficacy of acupuncture combined with traditional Chinese medicine on tachyarrhythmia based on the meridian cutaneous region theory,in order to provide theoretical basis for clinical prevention and treatment. Methods From October 2018 to October 2019,one hundredtwenty tachyarrhythmia with syndrome of hyperactivity of fire due to deficiency of Yin cases were randomly divided into the control group and the observation group referring to the random number table. The control group was given with metoprolol tartrate. The observation group was treated with cutaneous acupuncture combined with Danggui Dihuang Decoction. The course was for 4 weeks for two groups. Compared the efficacy,TCM syndrome and symptom score,QT interval dispersion index,heart rate variability index. Results After 4 weeks’ treatment,the total efficacy rate of the observation group(91.67%)was obviously higher than the control group(70.00%);the scores of palpitation,vexation,abnormal pulse law,dysphoria in chestpalms-soles,dryness of mouth,tinnitus and mild lumbago,TCM syndromes in the observation group were significantly lower than those in the control group;the levels of QTc and QTcd in the observation group were significantly lower than those in the control group;the levels of SDNN,SDANN,rMSSD,pNN50 in the observation group were significantly higher than those in the control group. Conclusion Acupuncture combined with traditional Chinese medicine can improve symptoms of palpitation,vexation,abnormal pulse law,dysphoria in chestpalms-soles,dryness of mouth,tinnitus and mild lumbago,reduce QT interval dispersion,improve heart rate variability index,in order to reduce the occurrence of ventricular arrhythmia and improve the autonomic nerve function,which is of high safety and worthy of clinical promotion.

关 键 词：皮部理论 快速性心律失常 阴虚火旺证 QT离散度 心率变异性 

分 类 号：R541.7[医药卫生—心血管疾病]