乌梅丸加减治疗冠心病室性早搏40例

Treatment of Modified Wumei Pills on 40 Cases with Ventricular Premature Systole of Coronary Heart Disease

摘要:

目的: 观察乌梅丸加减治疗冠心病室性早搏的疗效及对患者心率变异性(HRV)的影响.方法: 80例冠心病室性早搏患者采用随机按数字表法分为对照组和观察组各40例.对照组采用盐酸胺碘酮片治疗,观察组在对照组治疗的基础上加服乌梅丸加减治疗,两组疗程均为4周.采用24 h动态心电图记录室性早搏的变化情况及心率变异性(HRV),记录心悸、胸闷、胸痛、气短等症状评分,治疗前后各评价1次.结果: 经Ridit分析,观察组室性早搏疗效优于对照组(P<0.05),观察组冠心病心电图疗效优于对照组(P<0.05);治疗后观察组心悸、胸闷、胸痛、气短等症状评分及总分均低于对照组(P<0.01);治疗后两组HRV各参数指标:正常R-R间期标准差(SDNN),24 h 每5 min平均正常的R-R间期的标准差(SDANN)、相邻正常R-R间期差值的均方根(RMSSD),相邻正常R-R间期差值≥50 ms的心搏数占总R-R间期数的百分数(PNN50)均较治疗前有所上升(P<0.01),观察组HRV各参数提高程度均优于对照组(P<0.01);治疗后观察组室性早搏数少于对照组(P<0.01).结论: 乌梅丸加减治疗冠心病室性早搏能减少室性早搏数,减轻临床症状,改善HRV各参数,对室性早搏和冠心病均有一定疗效.

Abstract:

Objective:To observe curative efficacy and influence on heart rate variability (HRV) of modified Wumei pills in treating patients with ventricular premature systole of coronary heart disease (VPSCHD). Method: Eighty patients with VPSCHD were randomly divided into control group (40 cases) and observation group (40 cases) by random number table. Patients in control group received amiodarone hydrochloride tablets. Based on the treatment in control group, patients in observation group added modified Wumei pills. The patients received 1 4-week periods of treatment. Before and after treatment, changes of ventricular premature beat and HRV were recorded by 24-hourdynamic electrocardiogram, and scores of palpitation, choking sensation in chest, chest pain and breathe hard were graded once before and after treatment. Result: The ventricular premature beat effect of observation group was superior to that of control group (P<0.05), and the electrocardiogram effect of coronary heart disease was better than that of control group (P<0.05) through ridit analysis. Symptom scores of heart palpitations, chest tightness, chest pain, shortness of breath and the total score in observation group were lower than those in control group after treatment (P<0.01). HRV parameters in both groups including standard deviation of normal number of intervals, each sequential 5-min R-R interval standard deviation during 24 h period, the root mean square difference of adjacent normal R-R interval and the percentage of phase difference between adjacent normal R-R was ≥50 ms heart beat being occupied the total R-R were higher after the treatment (P<0.01). The improvement of HRV parameters in observation group was superior to that in control group (P<0.01), and the number of ventricular premature beat in observation group was less than that in control group (P<0.01). Conclusion: Modified Wumei pills could reduce number of ventricular premature beat, relieve clinical symptoms, and improve HRV parameters in patients with VPSCHD. It has certain curative effect on both ventricular premature beat and coronary heart disease.