生脉散联合倾斜训练对心内科老年血管迷走神经性晕厥患者疗效及预后的影响

目的 探究生脉散联合倾斜训练对心内科老年血管迷走神经性晕厥(VS)患者疗效及预后的影响。 方法 选取2015-2017年间在西溪医院进行VS治疗的患者80例作为研究对象,采用随机数字法分为2组。对照组(40例)给予常规对症治疗,观察组(40例)在此基础上给予生脉散联合倾斜训练治疗,治疗3个月,对比2组患者治疗前后舌下硝酸甘油倾斜试验结果,血流动力学变化以及血浆儿茶酚胺水平,随访6个月观察药物副作用并比较2组患者晕厥症状复发率。 结果 观察组在倾斜前的基础收缩压、舒张压和心率在治疗前后的差异无统计学意义(P>0.05);治疗后,晕厥或终止试验时的收缩压、舒张压和心率均较治疗前明显升高(均P<0.05);治疗前,观察组在晕厥发作时伴有血浆肾上腺素和去甲肾上腺素水平显著升高,与平卧时差异有统计学意义(P<0.05);治疗后,晕厥或终止试验时患者血浆肾上腺素和去甲肾上腺素水平与平卧时相比差异无统计学意义(P>0.05);治疗3个月后,观察组患者HUTT试验转阴率显著高于对照组,差异有统计学(P<0.05);随访6个月,2组晕厥复发率差异有统计学意义(P<0.05),观察组与对照组平均晕厥发作次数差异有统计学意义(P<0.05); 结论 生脉散联合倾斜训练用于老年血管迷走神经性晕厥的治疗,能够改善患者血流动力学,降低血浆儿茶酚胺水平,有效减少晕厥发作次数,预防晕厥复发,值得临床推广。 

Effect of Shengmai powder combined with tilt training on the curative effect and prognosis of the elderly patients with vasovagal syncope in cardiology department

Objective To explore the effect of Shengmai powder combined with tilt training on the curative effect and prognosis of the elderly patients with vasovagal syncope (VS) in Cardiology Department. Methods Total 80 patients with VS in Xixi hospital between 2015 and 2017 were enrolled into this study and randomly divided into two groups with 40 cases in each group. The control group was given routine symptomatic treatment, while the observation group was additionally given Shengmai powder combined with tilt training treatment, the course was 3 months in both group. The results of sublingual nitroglycerin tilt table test, the levels of plasma catecholamine and the changes in hemodynamics were compared before and after the treatment. All patients were followed up to observe the side effects of drugs and recurrent rate of VS. Results In the observation group, the systolic pressure, diastolic pressure and heart rate before the tilt table test did not changed obviously after the Shengmai powder combined with tilt training treatment (P>0.05), however, the systolic pressure, diastolic pressure and heart rate when syncope or at end of the tilt table test elevated obviously after the treatment (P<0.05). Before the treatment, there was an obvious increment in the levels of plasma epinephrine and norepinephrine when syncope as compared with those at supine (P<0.05); however, after the treatment, there was no significant difference (P>0.05). After 3 months of treatment, HUTT test negative rate in the observation group was significantly higher than that in the control group, there was significant difference (P<0.05); Six months follow-up showed that the recurrence rate and the average time of syncope were significant differences between the two groups (P<0.05). Conclusion Shengmai powder combined with tilt training for senile vasovagal syncope can improve hemodynamics, reduce plasma catecholamine levels, reduce syncope episodes, prevent the recurrent of syncope. It is worthy of promotion.