瓜蒌薤白半夏汤加减联合胺碘酮对急性心肌梗死合并室性心律失常疗效、QT离散度及炎症因子的影响  

Efficacy of Modified Gualou Xiebai Banxia Decoction Combined with Amiodarone on Acute Myocardial Infarction Complicated with Ventricular Arrhythmia and Its Effect on QT Dispersion and Inflammatory Factors

作　　者：崔胜利[1] 常燕 康宏瑛 李娟 牛燕运[1] 赵自冰 Cui Shengli;Chang Yan;Kang Hongying;Li Juan;Niu Yanyun;Zhao Zibing(Handan Hospital of Traditional Chinese Medicine,Hebei,Handan 056001,China)

机构地区：[1]河北省邯郸市中医院,河北邯郸056001 [2]河北工程大学附属医院,河北邯郸056002

出　　处：《中国中医急症》2021年第7期1251-1254,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020575)。

摘　　要：目的探讨瓜蒌薤白半夏汤加减联合胺碘酮对急性心肌梗死(AMI)合并室性心律失常疗效、QT离散度及炎症因子的影响。方法选择78例AMI合并室性心律失常患者为研究对象,随机分为对照组与观察组各39例,对照组予常规西药+胺碘酮治疗,观察组在对照组基础上予以瓜蒌薤白半夏汤加减口服。观察两组中医证候积分、临床疗效、QT离散度及炎症因子。结果1)治疗后观察组中医证候积分显著优于对照组(P<0.05);2)观察组总有效率显著高于对照组(P<0.05);3)治疗后观察组心率变异性各项指标显著优于对照组(P<0.05);4)治疗后观察组QT离散度指标显著好于对照组(P<0.05);5)治疗后观察组各项炎症因子水平均显著好于对照组(P<0.05)。结论瓜蒌薤白半夏汤联合胺碘酮能有效改善AMI合并室性心律失常症状,改善心率变异性,降低QT离散度,继而减少或控制室性心律失常的发作,其机制可能与本方可调节AMI合并室性心律失常炎性因子水平、抑制炎症反应有关。Objective:To investigate the efficacy of modified Gualou Xiebai Banxia Decoction on acute myocardial infarction complicated with ventricular arrhythmia and its effect on QT dispersion and inflammatory factors.Methods:A total of 78 patients with acute myocardial infarction complicated with ventricular arrhythmia were selected as the research objects and were randomly divided into the control group and the observation group,39 cases in each group.The control group was treated with conventional western medicine and amiodarone,while the observation group was treated with modified Gualou Xiebai Banxia Decoction on the basis of the control group.The TCM symptom scores,efficacy,QT dispersion and inflammatory factors of the two groups were observed.Results:1)After treatment,the TCM symptom score of the observation group was significantly better than that of the control group(P<0.05).2)The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).3)After treatment,the indexes of heart rate variability of the observation group were significantly better than those of the control group(P<0.05).4)After treatment,the QT dispersion index of the observation group was significantly better than that of the control group(P<0.05).5)After treatment,the levels of inflammatory factors of the observation group were significantly better than those of the control group(P<0.05).Conclusion:Gualou Xiebai Banxia Decoction combined with amiodarone can effectively improve the symptoms of acute myocardial infarction complicated with ventricular arrhythmia,improve heart rate variability,reduce QT dispersion,and then reduce or control the attack of ventricular arrhythmia.Its mechanism may be related to the regulation of inflammatory factor levels and inhibition of inflammatory reactions.

关 键 词：急性心肌梗死 室性心律失常 瓜蒌薤白半夏汤 胺碘酮 QT离散度 炎症因子 

分 类 号：R542.22[医药卫生—心血管疾病]