加味真武汤联合胺碘酮治疗缓慢性心律失常患者的临床效果观察  

Clinical Observation of Jiawei Zhenwu Decoction Combined with Amiodarone in the Treatment of Patients with Bradyarrhythmia

作　　者：万冬梅[1,2] 赵御凯 郝学东 翟文姬[1,2] 高晶 徐倩[1,2] WAN Dongmei;ZHAO Yukai;HAO Xuedong;ZHAI Wenji;GAO Jing;XU Qian(Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;the Second Department of Cardiology,the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150001,China;the First Department of Cardiology,the Fourth Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150001,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第二医院心病二科,哈尔滨150001 [3]黑龙江中医药大学附属第四医院心内一科,哈尔滨150001

出　　处：《转化医学杂志》2023年第5期225-230,共6页Translational Medicine Journal

基　　金：黑龙江省中医药科研项目(ZHY2022-168)。

摘　　要：目的探讨加味真武汤联合胺碘酮治疗对缓慢性心律失常(BA)患者炎症指标及环磷酸腺苷(cAMP)/蛋白激酶A(PKA)信号通路相关蛋白表达的影响。方法选取2021年12月—2022年12月收治的BA 80例,中医诊断为心悸心肾阳虚证,按随机数字表法分为研究组和对照组,每组40例。对照组给予胺碘酮治疗,在此基础上研究组给予加味真武汤治疗。观察2组临床疗效及不良反应发生率,比较2组治疗前后心率情况、中医证候积分、炎性指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]及cAMP/PKA信号通路相关蛋白表达情况。结果研究组治疗总有效率为97.50%(39/40)明显高于对照组77.50%(31/40)(P<0.01)。治疗后,2组平均心率、最慢心率、24 h心率及cAMP蛋白、PKA蛋白表达均较治疗前升高,且研究组高于对照组(P<0.05)。治疗后,2组心悸、乏力、胸闷气短各证候积分以及血清TNF-α、IL-6、hs-CRP水平均较治疗前降低,且研究组低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论加味真武汤联合胺碘酮能提高BA的治疗效果,改善心率过缓及临床症状,降低炎性指标水平,调节cAMP/PKA信号通路相关蛋白表达,且安全性良好。Objective To investigate the effects of Jiawei Zhenwu Decoction combined with Amiodarone on inflammatory indexes and expression of cyclic adenosine monophosphate(cAMP)/protein kinase A(PKA)signaling pathway-related proteins in patients with bradyarrhythmia(BA).Methods A total of 80 patients with BA treated from December 2021 to December 2022,diagnosed as palpitations of Yang deficiency of heart and kidney by traditional Chinese medicine,were selected and divided into research group(n=40)and control group(n=40)according to random number table method.The control group was treated with Amiodarone,and the research group was treated with Jiawei Zhenwu decoction.The clinical efficacy and incidence of adverse reactions of the two groups were observed,and the heart rate,TCM syndrome score,inflammatory indicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C reactive protein(hs-CRP)]and cAMP/PKA signaling pathway-related proteins were compared between the two groups before and after treatment.Results The total effective rate of the research group was 97.50%(39/40),which was significantly higher than that of the control group[77.50%(31/40)](P<0.01).After treatment,the mean heart rate,the minimum heart rate,24 h heart rate and cAMP protein and PKA protein expressions in the two groups were higher than those before treatment,and higher in the research group than in the control group(P<0.05).After treatment,the scores of each syndrome of palpitation,fatigue,chest tightness and shortness of breath and the levels of serum TNF-α,IL-6 and hs-CRP in the two groups were lower than those before treatment,and lower in the research group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jiawei Zhenwu decoction combined with Amiodarone can improve the therapeutic effect of BA,improve bradycardia and clinical symptoms,reduce the level of inflammatory indicators,and regulate the expression of cAMP/PKA signaling pat

关 键 词：缓慢性心律失常 加味真武汤 胺碘酮 心率 白细胞介素-6 证候 环磷酸腺苷 蛋白激酶A 

分 类 号：R541.72[医药卫生—心血管疾病]