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目的:观察益心补脾汤联合西药治疗心脾两虚型老年慢性心律失常患者对睡眠质量及心率变异性(HRV)的影响。方法:选取112例心脾两虚型老年慢性心律失常患者为研究对象,按随机数字表法分为2组各56例,对照组给予盐酸利多卡因注射液常规抗心律失常治疗,观察组以盐酸利多卡因注射液联合益心补脾汤治疗,比较2组的临床疗效,并观察2组治疗后睡眠质量[匹兹堡睡眠质量指数量表(PSQI)评分]改善情况,同时观察2组治疗后HRV指标[全部窦性心搏RR间期的标准差(SDNN),RR间期平均值的标准差(SDANN),相邻间期RR间期差值的均方根(RMSSD),相邻正常RR间期之差大于50 ms的个数占总窦性心搏个数的百分比(PNN50)]的变化情况。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,2组PSQI评分均较治疗前下降(P<0.05),观察组治疗1周、2周、4周的PSQI评分均低于对照组,差异均有统计学意义(P<0.05)。2组SDNN、SDANN、RMSSD、PNN50均较治疗前升高(P<0.05),观察组各指标值均高于对照组(P<0.05)。结论:益心补脾汤联合西药治疗心脾两虚型老年慢性心律失常患者临床疗效显著,可有效改善患者的睡眠质量,升高HRV各项指标。
Objective: To observe the effects of Yixin Bupi Decoction combined with western medicine on sleep quality and heart rate variability (HRV) in patients with chronic heart failure of heart and spleen type. Methods: A total of 112 patients with chronic heart failure of heart-spleen deficiency type were selected as study subjects. They were divided into two groups (n = 56) according to random number table. The control group was given routine antiarrhythmic treatment with lidocaine hydrochloride injection. Lidocaine Hydrochloride Injection and Yixin Bupi Decoction were compared to compare the clinical curative effect of the two groups and to observe the improvement of sleep quality [Pittsburgh Sleep Quality Index Scale (PSQI)] after treatment, and to observe the improvement of the two groups after treatment The HRV criteria (SDNN for all sinus beats, SDANN for mean RR intervals, root mean square (RMS) for RR interval differences between adjacent intervals, adjacent normal RR The difference between the number of periods of more than 50 ms in the total number of sinus beats percentage (PNN50)] changes. Results: The total effective rate in the observation group was higher than that in the control group (P <0.05). After treatment, the PSQI scores in both groups were significantly lower than those before treatment (P <0.05). PSQI scores in the observation group at 1 week, 2 weeks and 4 weeks after treatment were lower than those in the control group (P <0.05). SDNN, SDANN, RMSSD and PNN50 in 2 groups were significantly higher than those before treatment (P <0.05). The indexes in observation group were higher than those in control group (P <0.05). Conclusion: Yixin Bupi Decoction combined with Western medicine in the treatment of heart-spleen deficiency type of elderly patients with chronic cardiac arrhythmia significant clinical effect, which can effectively improve the quality of sleep in patients with elevated HRV various indicators.