通脉复律汤治疗冠心病缓慢性心律失常患者110例的临床效果.docxVIP

通脉复律汤治疗冠心病缓慢性心律失常患者110例的临床效果 [Abstract] Objective To observe the clinical efficacy of Tongmaifulv Decoction on bradyarrhythmia patients with phlegm and blood stasis syndrome in coronary heart disease. Methods 110 cases of bradyarrhythmia patients with phlegm and blood stasis syndrome in coronary heart disease in the Gulou Hospital of Traditional Chinese Medicine of Beijing from June 2013 to December 2015 were randomly divided into treatment group and control group. Besides using standardized western medicine treatment in both groups， 55 cases in the treatment group were given Tongmaifulv Decoction while Linaoxin pills were applied in the control group. After 16 weeks of treatment， the changes of ventricular rate， electrocardiogram， and major symptoms such as chest distress and palpitation were compared between the two groups. Results The improvement of clinical symptoms and ventricular rate in the treatment group was better than that of the control group， with statistic difference （P 0.05）. The ischemic changes in electrocardiogram were improved in both groups， without statistical difference （P 0.05）. Conclusion Tongmaifulv Decoction showes good effect in the treatment of bradyarrhythmia in coronary heart disease and has advantages over some Chinese patent medicine. [Key words] Tongmaifulv Decoction； Bradyarrhythmia； Clinical observation 缓慢性心律失常是心血管系统疾病常见病症，是指有效心搏低于60次/min的心律失常，其病因复杂，可见于各种器质性疾病。笔者在临床中发现冠心病是老年发生缓慢性心律失常的主要原因，中医辨证以痰瘀互阻型多见。而在冠心病缓慢性心律失常中主要见于窦性心律失常中的窦性心动过缓、病态窦房结综合征及心脏传导失常中的房室传导阻滞等。 在临床治疗中，西医对于缓慢性心律失常治疗用药一般应用增强心肌自律性和/或加速传导的药物，如迷走神经抑制剂、拟交感神经药或碱化剂。非药物治疗应用心脏起搏器。而无论是药物还是器械辅助治疗都存在一定的局限性和不良反应，如抗心律失常药物大多有负性变力性作用，或对全身其他脏器有明显甚至严重的毒性作用，而安置人工心脏起搏器为有创治疗，多数患者难于接受。笔者临床治疗冠心病缓慢心律失常痰瘀互阻证，应用通脉复律汤，在提高心律、改善临床症状方面具有较好疗效，并且副作用小，远期疗效较好，现总结如下： 1 资料与方法 1.1 一般资料 经北京市鼓楼中医医院伦理委员会审核通过，所有病例来自2021年6月～2021年12月在鼓楼中医院门诊，符合纳入标准的患者110例。所有病例随机分组，通过随机数字表法将患者分为西医规范治疗同时合用通脉复律汤（治疗组），与西医规范治疗合用中成药利脑心片（对照组），每组各55例。治疗组中男24例，女31例；年龄45～75岁；病程1.5～3年。合并高血压21例，高脂血症17例，糖尿病11例，