基于数据挖掘的国医大师治疗心悸用药规律探讨

目的:基于中医传承软件系统探讨国医大师治疗心悸的用药规律。方法:收集整理《国医大师验案良方·心脑卷》中治疗心悸的病案并录入中医传承辅助平台,采用规则分析、改进互信息法、复杂系统熵聚类等数据挖掘方法,统计分析其中的用药规律。结果:分析纳入的83个病案得出149味中药,所用中药性味多为甘温,主要归心、肺、脾三经,包括丹参、黄芪、炙甘草、麦冬等高频次中药。提取置信度为1的丹参,五味子→麦冬组合,可窥见生脉饮的雏形并衍生出10个新方,新方可分为五类,分别为行气化痰类、滋阴养血类、温通心阳类、益气活血类和化痰祛瘀类。结论:国医大师治疗心悸有规律可循,主要以“益气通阳”“养阴补血”“化痰祛瘀”为组方规律,标本并治。     

248例心悸患者24h动态心电图分析

目的探讨心悸患者的病因,研究心悸与心律失常及其与心血管疾病之间的关系。方法将248例心悸患者分为器质性与非器质性两组,均进行24h动态心电图(DCG)监测分析。结果 248例心悸患者DCG检查共发现各种心律失常227例,检出率为91．53％。室性心律失常所致的心悸显著高于房性心律失常。频发室性期前收缩与短阵房性心动过速、心房纤颤多发生于器质性心脏病,心悸发作时器质性组与非器质性组出现心律失常的几率接近。结论心律失常和心悸的发作有直接关系。     

Cardiac monitoring for patients with palpitations

Palpitations are one of the most common reasons for medical consultation. They tend to worry patients and can affect their quality of life. They are often a symptom associated with cardiac rhythm disorders, although there are other etiologies. For diagnosis, it is essential to be able to reliably correlate the symptoms with an electrocardiographic record allowing the identification or ruling out of a possible rhythm disorder. However, reaching a diagnosis is not always simple, given that they tend to be transitory symptoms and the patient is frequently asymptomatic at the time of assessment. In recent years, electrocardiographic monitoring systems have incorporated many technical improvements that solve several of the 24-h Holter monitor limitations. The objective of this review is to provide an update on the different monitoring methods currently available, remarking their indications and limitations, to help healthcare professionals to appropriately select and use them in the work-up of patients with palpitations.     

从藏象学说探讨心悸与五脏的相关性

从藏象学说探讨心悸与五脏的关系,认识到心悸的病位主要在心,但与肾、脾、肝、肺四脏也密切相关,五脏之气血阴阳亏损,或心血瘀阻、水饮凌心、痰火扰心等均可致心动失常而发心悸。     

心悸验案三则

介绍心悸验案三则,气阴两虚炙甘草汤(复脉汤)主之,心脾两虚夹淤归脾汤化裁,阴虚火旺方选天王补心丹。     

Low impact of cardiovascular adverse events on anagrelide treatment discontinuation in a cohort of 232 patients with essential thrombocythemia

This retrospective study of the thrombocythemia Italian registry (RIT) documented that 71 (30.6%) out of 232 ET patients experienced 88 cardiovascular adverse events (CV-AEs) during anagrelide treatment (522 pt-y). The rate of CV-AEs was: 24.1% for palpitations, 4.3% for angina, 3.5% for arterial hypertension, 3.0% for congestive heart failure, 1.8% for arrhythmia, 0.9% for AMI, 0.4% for pericardial effusion. CV-AEs led to treatment discontinuation in nine (3.9%) patients, while in the remaining cases they were managed by pharmacological intervention and/or patient life style improvement. CV-AEs had no relationship with patient characteristics (including older age). A significant relationship was found only with a higher anagrelide induction dose.In the absence of any agreed protocol, a cardiovascular instrumental evaluation (CV-IE) was performed in 102 (44%) patients before commencement of anagrelide (with higher rate after the anagrelide/Xagrid EMA approval of 2004), and in 84 (36%) patients during treatment. Patients with and without CV-IEs, who resulted completely balanced for all their characteristics, did not significantly differ in the occurrence of CV-AEs.In conclusion, this study on ET patients treated with anagrelide shows that CV-AEs, equally distributed in younger and older subjects, were mostly mild and easily manageable, allowing safe treatment continuation in the majority of cases. Moreover, routinely performing a CV-IE did not appear to anticipate the occurrence of CV-AEs.     

古代心悸医案信息284例数理分析

目的:对古代心悸医案信息用数理分析方法挖掘其证治规律。方法:以古代心悸医案为研究对象,建立数据库,进行频数分析和关联分析。结果:284个心悸医案证型分布以心血虚证和痰湿内停证多见;共涉及药物411种,主要为安神类、健脾类、理气类、养血类等;挖掘出治疗心悸的基础方:半夏、陈皮、人参、茯苓、白术、甘草、当归、白芍、远志、茯神、酸枣仁、龙骨。结论:用数理分析医案,挖掘出常用药物组合,基本符合现行的中医理论,也从数理分析的角度证实了中医理论,为临床提供依据。     

心可舒片合用心得安片治疗甲亢心悸症的临床分析

目的观察心可舒片剂与心得安片剂联合应用治疗甲亢之心悸症疗效.方法选择甲亢伴有心悸症状的患者60例,随机分为两组各30例.两组均按甲亢常规治疗,其中观察组加服心可舒3片,tid,两组观察时间均为3个月.观察两组心悸症状、体征变化,以及甲状腺功能、转氨酶、粒细胞检测指标.结果甲亢心悸症3月内缓解率明显高于对照组(P＜0.05),缓解时间较快,而无明显副作用.结论心可舒片与心得安片联合应用,对甲亢之心季症疗效优于单用心得安片,且安全、副作用少,值得推厂应用.     

慢性充血性心力衰竭心气虚证与心阴不足证患者sEDF含量变化的临床意义

目的：观察慢性充血性心力衰竭中心气（血）虚证和心阴不足证患者血清内源性洋地黄因子含量的变化,探讨其临床意义。方法：以放免法测定正常人与慢性充血性心动力衰竭患者中心气（血）虚组与心阴不足组内源性洋地黄因子的含量。结果：心气（血）虚患者内源性洋地黄因子含量比心阴不足型显著下降（P＜0．01）。结论：内源性洋地黄因子分泌减少可能是导致中医心气（血）不足的主要原因之一,而心阴不足证患者内源性洋地黄因子含量比心气（血）虚证患者降低程度小,提示在中西医结合治疗中对前类患者使用洋地黄药物效果可能更好,而对后类患者应谨慎使用洋地黄类药物。