COPD合并房性心律失常的中西医结合治疗策略  

Integrative Traditional Chinese Medicine and Western Medicine Treatment Strategies for Chronic Obstructive Pulmonary Disease Complicated with Atrial Arrhythmia

作　　者：郭楠楠 罗建江[2] Guo Nannan;Luo Jianjiang(Xinjiang Medical University,Xinjiang,Urumqi 830054,China)

机构地区：[1]新疆医科大学,新疆乌鲁木齐830054 [2]新疆医科大学第四附属医院,新疆乌鲁木齐830000

出　　处：《中国中医急症》2022年第6期1022-1024,1028,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：新疆维吾尔自治区自然科学基金(2017D01C169)。

摘　　要：心血管疾病(CVD)和慢性阻塞性肺疾病(COPD)作为世界第二、三大死因,若二者共存时将进一步增加残疾率和死亡率。在药物治疗方面,β受体激动剂与β受体阻滞剂分别是治疗COPD与心律失常的一线药物,当共患病且心功能为Ⅲ、Ⅳ级时,指南推荐β1受体阻滞剂,但对于重度COPD患者,β1受体阻滞剂会随着使用剂量的增加而出现β2受体阻断的现象,从而引起支气管痉挛,导致肺功能恶化,与β受体激动剂作用相矛盾。炙甘草汤是《伤寒论》治疗“脉结代,心动悸”“肺痿”的经典名方,具有益气滋阴、通阳复脉之功,既可治疗房性心律失常,又可治疗COPD肺肾气阴两虚证。该文就低剂量β1受体阻滞剂联合炙甘草汤在重度COPD稳定期合并房性心律失常且伴有慢性心力衰竭患者应用中疗效的安全性及有效性作一论述。Cardiovascular disease(CVD)and chronic obstructive pulmonary disease(COPD)are the second and third leading causes of death in the world.If they coexist,they will further increase the disability rate and mortality rate.In terms of drug treatment,β receptor agonists and β receptor blockers are the first-line drugs for the treatment of COPD and arrhythmia.In case of comorbidity,the guidelines recommend the selection of antiarrhythmic drugs β1 receptor blocker,but for patients with severe COPD in stable stage complicated with atrial arrhythmia,β1 receptor blockers will appear with the increase of dosage β2 receptor blockade,which causes bronchospasm and worsens lung function,and is contradictory to the effect of β receptor agonists.Zhigancao Decoction is a classic prescription in Treatise on Febrile Diseases for the treatment of "pulse knot generation,palpitation" and "pulmonary impotence".It has the function of supplementing qi,nourishing yin,dredging yang and restoring pulse.It can not only treat atrial arrhythmia,but also treat COPD,lung,kidney,qi and yin deficiency syndrome.This paper discusses the safety and effectiveness of low dose β receptor blocker combined with Zhigancao Decoction in patients with severe COPD in stable stage complicated with atrial arrhythmia.

关 键 词：慢性阻塞性肺疾病 房性心律失常 中西医治疗 炙甘草汤 Β1受体阻滞剂 

分 类 号：R563.9[医药卫生—呼吸系统]