张丽梅++++++胡元会++++++陈锦

[摘要] 目的 觀察养阴熄风复脉汤治疗心阴不足风动心络证室早的临床效果。 方法 将2011年11月～2016年8月于中国中医科学院广安门医院及中国中医科学院广安门医院南区就诊的室性早搏之心阴不足、风动心络证患者，采用随机数字表法分为治疗组和对照组，每组70例。治疗组给予养阴熄风复脉汤加减治疗，对照组给予美托洛尔治疗，疗程均为（28±2）d。比较两组患者临床疗效、24 h动态心电图疗效及心率变异性（HRV）的变化差异。 结果 治疗结束时，治疗组脱落1例，对照组脱落2例。中医证候总有效率方面，治疗组为89.9%，对照组为72.1%，治疗组优于对照组（P < 0.05）；24 h动态心电图总有效率方面，治疗组为73.9%，对照组为67.6%，组间比较差异无统计学意义（P > 0.05）；HRV方面，治疗后，两组SDNN、SDANN、PNN50、RMSSD均高于治疗前（P < 0.05），组间比较，SDNN、SDANN、RMSSD值的改变，治疗组优于对照组（P < 0.05）。 结论 养阴熄风复脉汤能有效改善心阴不足、风动心络证室早患者的症状、室早次数，提高HRV，且安全性良好。

[关键词] 养阴熄风复脉汤；美托洛尔；室性早搏；心阴不足风动心络证；心率变异性

[中图分类号] R541.7 [文献标识码] A [文章编号] 1673-7210（2017）06（a）-0090-04

Clinical study of Yangyin Xifeng Fumai Decoction in the treatment of premature ventricular contraction with syndrome of insufficiency of heart Yin and wind-driven heart collaterals

ZHANG Limei1 HU Yuanhui1 CHEN Jin2

1.Department of Cardiology， Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Beijing 100053， China； 2.Clinical Medical College， Beijing University of Chinese Medicine， Beijing 100029， China

[Abstract] Objective To observe the curative effect of Yangyin Xifeng Fumai Decoction on premature ventricular contraction with the syndrome of insufficiency of heart Yin and wind-driven heart collaterals. Methods The patients with premature ventricular contraction who were diagnosed as insufficiency of heart Yin and wind-driven heart collaterals syndrome admitted to Guang'anmen Hospital， China Academy of Chinese Medical Sciences and its south area from November 2011 to August 2016 were randomly divided into treatment group and control group by random number table method， with 70 cases in each group. The treatment group was given Yangyin Xifeng Fumai Decoction， while the control group received the treatment of Metoprolol. The course of both groups were （28±2） days. The differences of clinical curative effect， the curative effect of 24 hours dynamic electrocardiogram and the heart rate variability （HRV） between two groups were compared. Results At the end of treatment， 1 case of treatment group and 2 cases of control group were lost. The total effective rate of Chinese medicine syndrome was 89.9% in the treatment group， 72.1% in the control group， the treatment group was superior to the control group （P < 0.05）； the total effective rate of 24 hours dynamic electrocardiogram was 73.9% in the treatment group， 67.6% in the control group， the difference between the two groups was not statistically significant （P > 0.05）. After treatment， both groups were significantly higher than before treatment in SDNN， SDANN， PNN50， RMSSD indexes （P < 0.05）， and the treatment group was significantly better than the control group in SDNN， SDANN and RMSSD indexes （P < 0.05）. Conclusion Yangyin Xifeng Fumai Decoction can effectively improve the symptom， the number of premature ventricular contraction and the HRV in patients with premature ventricular contraction diagnosed as insufficiency of heart Yin and wind-driven heart collaterals syndrome， the security is good.

[Key words] Yangyin Xifeng Fumai Decoction； Metoprolol； Premature ventricular contraction； Syndrome of insufficiency of heart Yin and wind-driven heart collaterals； Heart rate variability

室性早搏又称室性期前收缩，是希氏束分叉以下部位的心肌提前激动，使心室提前除极引起的过早搏动，是临床上最常见的心律失常之一[1]。正常健康人群以及各种不同心脏病患者均可发生[2]。在临床治疗中，西医的抗心律失常药物、起搏器、射频消融等治疗手段对室性早搏的疗效肯定，但长期使用会出现较多的副作用，有一定的局限性。中医药用于治疗室性早搏，在调整患者整体功能、改善患者的生活质量及用药远期疗效方面也明显优于传统抗心律失常药物，且长期应用无明显不良反应。本研究旨在观察王永炎教授经验方养阴熄风复脉汤加减治疗心阴不足风动心络证室性早搏的临床效果。……