宁心贴穴位贴敷联合西药治疗心脾两虚型室性早搏的临床观察
Clinical observation on acupoint application of Ningxin Paste combined with western medicine in treatment of ventricular extrasystole with syndrome of deficiency of heart and spleen
- 上海中医药杂志 2022年56卷第7期 页码：63-67
- 作者机构：
1.上海中医药大学附属龙华医院心病科（上海 200032）
2.上海市徐汇区斜土街道社区卫生服务中心中医科（上海 200032）
3.上海交通大学医学院附属瑞金医院中医科（上海 200020）
- 作者简介：
王雲，女，硕士，住院医师，主要从事心血管疾病的中西医结合诊疗工作
马子霖，主治医师；E-mail：178478808@qq.com
- 基金信息：上海市科委科研计划项目(18401971500);上海市卫计委中医优势病种培育项目(zybz-2017003);2019年上海市教委上海中医健康协同创新中心第三批开放项目（老年人群健康管理类）(ZYJKFW201811003)
DOI：10.16305/j.1007-1334.2022.2202040
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王雲,马子霖,沈琳,等.宁心贴穴位贴敷联合西药治疗心脾两虚型室性早搏的临床观察[J].上海中医药杂志,2022,56(7):63-67.
WANG Yun,MA Zilin,SHEN Lin,et al.Clinical observation on acupoint application of Ningxin Paste combined with western medicine in treatment of ventricular extrasystole with syndrome of deficiency of heart and spleen[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(7):63-67.
王雲,马子霖,沈琳,等.宁心贴穴位贴敷联合西药治疗心脾两虚型室性早搏的临床观察[J].上海中医药杂志,2022,56(7):63-67. DOI： 10.16305/j.1007-1334.2022.2202040.
WANG Yun,MA Zilin,SHEN Lin,et al.Clinical observation on acupoint application of Ningxin Paste combined with western medicine in treatment of ventricular extrasystole with syndrome of deficiency of heart and spleen[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(7):63-67. DOI： 10.16305/j.1007-1334.2022.2202040.
摘要
目的,2,观察宁心贴穴位贴敷联合西药治疗心脾两虚型室性早搏的临床疗效。,方法,2,将70例心脾两虚型室性早搏患者随机分为治疗组和对照组，每组35例，对照组予盐酸普罗帕酮治疗，治疗组在对照组治疗措施的基础上加用宁心贴外敷双侧内关穴，两组疗程均为4周。观察临床疗效，比较中医证候积分、24 h动态心电图指标、心律失常危险分层的变化情况。,结果,2,①治疗组、对照组中医证候总有效率分别为88.57%和60.00%，室性早搏总有效率分别为91.43%和80.00%；两组中医证候疗效、室性早搏疗效比较，治疗组优于对照组（,P,<,0.05，,P,<,0.01）。②治疗前后组内比较，两组中医证候积分、室性早搏次数均减少（,P,<,0.05）；组间治疗后比较，治疗组中医证候积分、室性早搏次数少于对照组（,P,<,0.05，,P,<,0.01）。③心率变异性指标［总体标准差（SDNN），平均标准差（SDANN），差值均方根（RMSSD），超过50 ms百分比（pNN50）］变化情况：治疗前后组内比较，两组SDNN、SDANN、RMSSD、pNN50值升高（,P,<,0.05）；组间治疗后比较，治疗组SDNN、SDANN、RMSSD、pNN50值高于对照组（,P,<,0.05，,P,<,0.01）。④治疗后，两组心律失常危险分层均得到改善（,P,<,0.05），且治疗组的改善情况优于对照组（,P,<,0.05）。⑤治疗期间，两组均未见明显的不良反应。,结论,2,宁心贴穴位贴敷联合西药治疗心脾两虚型室性早搏疗效满意，与单纯使用西药相比，加用宁心贴穴位贴敷能更好地改善患者的临床症状和预后，且安全性良好。
Abstract
Objective,2,To observe the clinical efficacy of acupoint application of Ningxin Paste combined with western medicine in the treatment of ventricular extrasystole with syndrome of deficiency of heart and spleen.,Methods,2,Seventy patients of ventricular extrasystole with syndrome of deficiency of heart and spleen were randomly divided into the control group and treatment group， 35 patients in each group. The control group was treated with propafenone hydrochloride， and the treatment group was treated with Ningxin Paste by acupoint application at bilateral Neiguan acupoints. The course of treatment in both groups was 4 weeks. The clinical efficacy was observed， and the changes of Chinese medical syndrome score， 24 h dynamic electrocardiogram （ECG） indexes and arrhythmia risk stratification were compared.,Results,2,①The total effective rates of Chinese medical syndrome in the treatment group and the control group were 88.57% and 60.00% respectively， and the total effective rates of ventricular extrasystole were 91.43% and 80.00% respectively. The efficacy of the treatment group was better than that of the control group （,P,<,0.05， ,P,<,0.01）. ②Compared with those before treatment， the score of Chinese medical syndrome and the number of ventricular extrasystole were decreased in both groups after treatment （,P,<,0.05）. After treatment， the score of Chinese medical syndrome and the number of ventricular extrasystole in the treatment group were less than those in the control group （,P,<,0.05， ,P,<,0.01）. ③Changes of heart rate variability indexes ［overall standard deviation （SDNN）， average standard deviation （SDANN）， root mean square difference （RMSSD）， percentage of exceeding 50 ms （pNN50）］： Compared with those before treatment， the values of SDNN， SDANN， RMSSD and pNN50 were increased in both groups （,P,<,0.05）. After treatment， the values of SDNN， SDANN， RMSSD and pNN50 in the treatment group were higher than those in the control group （,P,<,0.05， ,P,<,0.01）. ④After the treatment， the risk stratification of arrhythmia was improved in both groups （,P,<,0.05）， and the improvement in the treatment group was better than that in the control group （,P,<,0.05）. ⑤During the treatment， there were no obvious adverse reactions in both groups.,Conclusions,2,Acupoint application of Ningxin Paste combined with western medicine shows good efficacy in the treatment of ventricular extrasystole with syndrome of deficiency of heart and spleen. Compared with western medicine alone， acupoint application of Ningxin Paste combined with western medicine can better improve the clinical symptoms and prognosis of patients， with good safety.
关键词
室性期前收缩心律失常心脾两虚证穴位贴敷归脾汤内关心率变异性临床试验
Keywords
ventricular extrasystolearrhythmiasyndrome of deficiency of heart and spleenacupoint applicationGuipi DcoctionNeiguan acupointheart rate variabilityclinical trial
references
FENG X F， HAI J J， MA Y， et al. Sudden cardiac death in mainland China： A systematic analysis［J］. Circ Arrhythm Electrophysiol， 2018， 11（11）： e006684.
GOLDBERGER J J， BUXTON A E， CAIN M， et al. Risk stratification for arrhythmic sudden cardiac death： identifying the roadblocks［J］. Circulation， 2011， 123（21）： 2423-2430.
林宝，晏飞，恵仪. 葛根虎杖汤治疗室性早搏疗效观察［J］. 上海中医药杂志，2015， 49（1）： 49-50.
李威，苏泓. 参麦冰宁心片治疗室性早搏临床观察［J］. 上海中医药杂志，2012， 46（10）： 40-42.
陈灏珠，林果为，王吉耀. 实用内科学［M］. 14版. 北京：人民卫生出版社，2013： 1368.
卢喜烈. 现代动态心电图诊断学［M］. 北京：人民军医出版社，1995： 232-235.
中华中医药学会. 中医内科常见病诊疗指南：中医病证部分［M］. 北京：中国中医药出版社，2008： 46.
国家药品监督管理局. 中药新药临床研究指导原则（试行）［M］. 北京：中国医药科技出版社，2002： 72．
郭继鸿，张萍. 动态心电图学［M］. 北京：人民卫生出版社，2003： 77-85.
中华医学会心电生理和起搏分会，中国医师协会心律学专业委员会. 2020室性心律失常中国专家共识（2016共识升级版）［J］. 中国心脏起搏与心电生理杂志，2020， 34（3）： 189-253.
黄骏腾，杜雪梅，吴伟，等. 吴伟教授运用桃仁红花膏治疗室性早搏经验［J］. 中西医结合心脑血管病杂志，2020， 18（5）： 853-854.
刘新野，周亚滨. 周亚滨教授运用辨病辨证辨体思想治疗室性早搏经验［J］. 成都中医药大学学报，2018， 41（2）： 73-75.
MA X， ZHANG K， LI H， et al. Extracts from Astragalus membranaceus limit myocardial cell death and improve cardiac function in a rat model of myocardial ischemia［J］. J Ethnopharmacol， 2013， 149（3）： 720-728.
谢琦，程雪梅，胡芳弟，等. 党参化学成分、药理作用及质量控制研究进展［J］. 上海中医药杂志，2020， 54（8）： 94-104.
呼明哲，李湘玲，杨涛，等. 丹参饮预处理对心肌缺血/再灌注大鼠心肌损伤和心功能影响的研究［J］. 上海中医药杂志，2021， 55（6）： 61-66.
CRAIGHEAD D H， ALEXANDER L M. Topical menthol increases cutaneous blood flow［J］. Microvasc Res， 2016， 107： 39-45.
YI Q F， YAN J， TANG S Y， et al. Effect of borneol on the transdermal permeation of drugs with differing lipophilicity and molecular organization of stratum corneum lipids［J］. Drug Dev Ind Pharm， 2016， 42（7）： 1086-1093.
李作珍. 心率变异性与冠心病严重心律失常的关系［J］. 慢性病学杂志，2020， 21（4）： 131-133.
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