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目的观察五参复脉汤对病毒性心肌炎后室性早搏的疗效及QT间期离散度(QTd)的影响。方法将100例病毒性心肌炎慢性期并频发室性早搏患者随机分为观察组和对照组各50例。对照组给予常规治疗+普罗帕酮片每次150mg,每日3次,有效后减为每次100mg;观察组给予常规治疗+五参复脉汤每日1剂,分早晚2次空腹温服。30天后评价临床疗效并检查治疗前后心电图、24小时动态心电图,观察室性早搏次数及QTd、校正后的QT离散度(QTcd)变化。结果观察组总有效率84.0%,对照组总有效率90.0%,两组患者总有效率比较差异无统计学意义(P>0.05)。治疗后对照组患者的QTd、QTcd与治疗前比较差异无统计学意义(P>0.05),观察组患者QTd、QTcd均显著小于治疗前和对照组(P<0.05);两组患者的室性早搏频率均显著低于治疗前(P<0.01),对照组患者室性早搏改善程度优于观察组(P<0.01)。观察组不良反应发生率显著低于对照组(P<0.05)。结论五参复脉汤治疗病毒性心肌炎后频发室性早搏有效,其能缩短QTd、QTcd,无明显的不良反应。
Objective To observe the curative effect of Wushen Fumailang on ventricular premature beats after viral myocarditis and the influence of QTd (QTd). Methods 100 cases of chronic viral myocarditis and frequent premature ventricular contractions were randomly divided into observation group and control group of 50 cases. The control group was given routine treatment + propafenone tablets 150mg each time, 3 times a day, effectively reduced to 100mg each; the observation group given conventional treatment + Wuxin Fumai Tang 1 day a day, morning and evening fasting 2 times . Thirty days later, the clinical effects were evaluated and the ECG before and after treatment, 24-hour ambulatory electrocardiogram, the number of premature ventricular contractions and QTd, the corrected QT dispersion (QTcd) were observed. Results The total effective rate was 84.0% in the observation group and 90.0% in the control group. There was no significant difference in the total effective rate between the two groups (P> 0.05). QTd and QTcd in the control group after treatment were not significantly different from those before treatment (P> 0.05). The QTd and QTcd in the observation group were significantly lower than those before treatment and the control group (P <0.05). The ventricular The frequency of premature beat was significantly lower than that before treatment (P <0.01), and the improvement rate of premature ventricular contractions in control group was better than that of observation group (P <0.01). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P <0.05). Conclusion Wushenfumai Tang treatment of viral myocarditis frequent premature ventricular contractions effective, it can shorten the QTd, QTcd, no significant adverse reactions.