加味真武汤联合温针治疗心肾阳虚型心动过缓的疗效及其对患者心脏自主神经功能、心功能的影响  

Efficacy of Modified Zhenwu Decoction Combined with Warm Acupuncture in the Treatment of Bradycardia with Heart Kidney Yang Deficiency Type and Its Impact on Cardiac Autonomic Nervous Function and Cardiac Function of Patients

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 Chinese Medicine,Harbin 150040,China;Department of Cardiology,Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China;Department of Cardiology,Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China)

机构地区：[1]黑龙江中医药大学,黑龙江省哈尔滨市150040 [2]黑龙江中医药大学附属第二医院心内二科,黑龙江省哈尔滨市150001 [3]黑龙江中医药大学附属第四医院心内一科,黑龙江省哈尔滨市150001

出　　处：《实用心脑肺血管病杂志》2025年第1期81-85,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

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温针治疗心肾阳虚型心动过缓的疗效及其对患者心脏自主神经功能、心功能的影响。方法选取2022年3月—2024年3月黑龙江中医药大学附属第二医院收治的80例心肾阳虚型心动过缓患者作为研究对象,采用随机数字表法将患者分为对照组与观察组,各40例。对照组采用加味真武汤治疗,观察组在对照组基础上联合温针治疗,两组均持续治疗4周。比较两组临床疗效,治疗前、治疗4周后中医证候积分、心率变异性指标[正常R-R间期的标准差(SDNN)、24 h内连续5 min节段平均正常R-R间期的标准差(SDANN)、连续正常R-R间期差值的均方根(rMSSD)、低频功率(LF)、高频功率(HF)、LF/HF]、神经内分泌激素[血清肾素、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平]、心室率、心功能指标[心排血量(CO)、每搏输出量(SV)、左心室射血分数(LVEF)]及不良事件发生率。结果观察组临床疗效优于对照组(u=3.344,P<0.001)。治疗4周后,观察组心悸、胸闷、气促乏力、头晕耳鸣、畏寒肢冷、面色苍白积分低于对照组(P<0.05)。治疗4周后,观察组SDNN、LF、LF/HF大于对照组,SDANN、rMSSD小于对照组(P<0.05)。治疗4周后,观察组血清肾素、AngⅡ、ALD水平低于对照组(P<0.05)。治疗4周后,观察组心室率、CO快于对照组,SV、LVEF大于对照组(P<0.05)。两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论加味真武汤联合温针治疗心肾阳虚型心动过缓的疗效确切,其可有效减轻患者疾病症状,改善患者心脏自主神经功能及心脏节律性,增强心功能,且具有一定安全性。Objective To investigate the efficacy of modified Zhenwu decoction combined with warm acupuncture in the treatment of bradycardia with heart kidney Yang deficiency type and its impact on cardiac autonomic nervous function and cardiac function of patients.Methods A total of 80 patients with bradycardia of heart kidney Yang deficiency type admitted to Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from March 2022 to March 2024,and they were divided into the control group and the observation group by random number table method,with 40 patients in each group.The control group was treated with modified Zhenwu decoction,and the observation group was treated with modified Zhenwu decoction combined with warm acupuncture,and both group were treated for 4 weeks.Clinical efficacy,TCM syndrome score,heart rate variability indexes[standard deviation of normal R-R intervals(SDNN),standard deviation of five-minute average of normal R-R intervals(SDANN),root mean of square of the difference of successive R-R intervals(rMSSD),low frequency(LF),high frequency(HF),LF/HF],neuroendocrine hormone[serum renin,angiotensinⅡ(AngⅡ),aldosterone(ALD)levels],ventricular rate and cardiac function indices[cardiac output(CO),stroke volume(SV),left ventricular ejection fraction(LVEF)]before treatment and after 4-week treatment,and incidence of adverse events were compared between the two groups.Results The clinical efficacy of the observation group was better than that of the control group(u=3.344,P<0.001).After 4-week treatment,scores of palpitation,chest tightness,shortness of breath and fatigue,dizziness and tinnitus,coldness and cold limbs,and pallor in the observation group were lower than those in the control group(P<0.05).After 4-week treatment,SDNN,LF,and LF/HF of the observation group were bigger than those in the control group,SDANN and rMSSD of the observation group were smaller than those of the control group(P<0.05).After 4-week treatment,serum renin,AngⅡand ALD levels in the observation group were lo

关 键 词：心动过缓 心肾阳虚 加味真武汤 温针 心脏自主神经功能 心功能 治疗结果 

分 类 号：R541.72[医药卫生—心血管疾病]