1.北京中医药大学,北京市朝阳区北三环东路11号,100029
2.北京中医药大学东直门医院
3.中日友好医院
4.北京市丰台中西医结合医院
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收稿:2024-05-14,
修回:2024-09-30,
纸质出版:2025-01-02
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马梁,王保福,丁宇坤等.参龙定悸方对阵发性房颤气阴两虚、痰瘀阻络型患者生活质量的影响[J].中医杂志,2025,66(01):42-49.
MA Liang,WANG Baofu,DING Yukun,et al.Effect of Shenlong Dingji Formula (参龙定悸方) on the Quality of Life in Patients with Paroxysmal Atrial Fibrillation of Qi-Yin Deficiency and Phlegm-Stasis Obstructing Collaterals Syndrome[J].Journal of Traditional Chinese Medicine,2025,66(01):42-49.
马梁,王保福,丁宇坤等.参龙定悸方对阵发性房颤气阴两虚、痰瘀阻络型患者生活质量的影响[J].中医杂志,2025,66(01):42-49. DOI: 10.13288/j.11-2166/r.2025.01.008.
MA Liang,WANG Baofu,DING Yukun,et al.Effect of Shenlong Dingji Formula (参龙定悸方) on the Quality of Life in Patients with Paroxysmal Atrial Fibrillation of Qi-Yin Deficiency and Phlegm-Stasis Obstructing Collaterals Syndrome[J].Journal of Traditional Chinese Medicine,2025,66(01):42-49. DOI: 10.13288/j.11-2166/r.2025.01.008.
目的
2
观察参龙定悸方对阵发性房颤(PAF)气阴两虚、痰瘀阻络型患者生活质量的影响与安全性。
方法
2
收集PAF气阴两虚、痰瘀阻络型患者60例,随机分为治疗组与对照组各30例。对照组予以西医基础治疗,治疗组在对照组基础上口服参龙定悸方,每日1剂。两组均治疗4周。主要结局指标为房颤特异性生活质量(AFEQT)量表积分,包括房颤相关症状、治疗担心、日常生活及治疗满意度4个维度积分;次要结局指标包括有症状性房颤发作频率及持续时间、中医证候积分(包括心悸、胸闷、疲乏、气短、懒言、自汗、刺痛、失眠评分)。以上指标分别于治疗前、治疗2周后、治疗4周后、给药结束后4周(随访时)各评价1次,并记录治疗前后安全性指标及试验过程中不良事件的发生情况以评价安全性。
结果
2
共有56例患者完成试验,两组各28例。主要结局指标:1)治疗组治疗2周后、治疗4周后及随访时AFEQT量表积分较前一时间点均明显升高,且治疗2周后、治疗4周后及随访时均高于治疗前(
P
<0.05)。对照组仅治疗4周后与治疗前比较明显升高(
P
<0.05)。治疗组治疗2周后、治疗4周后、随访时AFEQT量表积分均高于对照组同时间(
P
<0.01)。2)治疗组随访时AFEQT量表治疗满意度维度积分较治疗4周后差异无统计学意义(
P
>0.05),其余各维度积分每个时间点均高于前一时间点(
P
<0.05)。对照组治疗2周后、治疗4周后房颤相关症状维度积分均高于前一时间点(
P
<0.05),治疗满意度维度中仅在治疗2周后、治疗4周后较治疗前有明显升高(
P
<0.05)。次要结局指标:1)治疗组除持续时间在随访时较治疗4周后无明显降低(
P
>0.05),其余各时间点治疗组有症状性房颤发作频率和持续时间均较前一时间点明显降低(
P
<0.05)。对照组发作频率在各时间点均较治疗前有明显降低(
P
<0.05),持续时间则在随访时较治疗2周后明显降低(
P
<0.05)。2)治疗组中医证候积分治疗2周后、治疗4周后及随访时与前一时间点比较均明显降低(
P
<0.05),对照组治疗2周后较治疗前明显降低(
P
<0.05)。治疗组中医证候积分在治疗2周后、治疗4周后及随访时均低于同时间点对照组(
P
<0.01)。两组患者试验期间均未发生不良事件,治疗前后安全性指标未见明显变化。
结论
2
参龙定悸方治疗PAF气阴两虚、痰瘀阻络型可显著提高患者生活质量、改善中医证候、降低有症状性房颤的发生率及缩短持续时间,且安全性较好。
Objective
2
To explore the effectiveness and safety of
Shenlong Dingji Formula
(参龙定悸方) on the quality of life in patients with paroxysmal atrial fibrillation (PAF) of
qi
-
yin
deficiency and phlegm-stasis obstructing collaterals syndrome.
Methods
2
A total of 60 patients with PAF of
qi
-
yin
deficiency and phlegm-stasis obstructing collaterals syndrome were recruited and randomly divided into a treatment group and a control group, with 30 patients in each group. The control group received standard western medicine treatment, while the treatment group was additionally given
Shenlong Dingji Formula
orally, one dose per day. Both groups were treated for 4 weeks. The primary outcome measure is the Atrial Fibrillation Effect on Quality of Life (AFEQT) score including scores of four dimensions,i.e. atrial fibrillation-related symptoms, treatment concerns, daily activities, and treatment satisfaction. The secondary outcome measures included the frequency and duration of symptomatic atrial fibrillation episodes and traditional Chinese medicine (TCM) syndrome scores covering symptoms such as palpitations, chest tightness, fatigue, shortness of breath, reluctance to speak, spontaneous sweating, stabbing pain, and insomnia. These indicators were assessed at baseline (before treatment), after 2-week of treatment, after 4-week of treatment, and 4 weeks after the end of treatment (follow-up). Ad
ditionally, safety indicators before and after treatment and adverse events occurring during the trial were recorded to evaluate safety.
Results
2
A total of 56 patients completed the study, with 28 in each group. Primary outcome indicators: 1) the treatment group showed significant improvement in the total score of the AFEQT scale, with significantly higher total scores after 2-week treatment, 4-week treatment, and follow-up compared to the previous time point (
P
<0.05). In the control group, the AFEQT score significantly increased only after 4-week treatment compared to baseline (
P
<0.05). In the treatment group, the AFEQT scores after 2-week, 4-week treatment, and during follow-up were all higher than those of the control group at the corresponding time points (
P
<0.01). 2) In the treatment group, there was no statistically significant difference in the AFEQT treatment satisfaction dimension score during follow-up compared to that after 4-week treatment (
P
>0.05). However, the scores for all other dimensions at each time point were higher than those at the previous time point (
P
<0.05). In the control group, the scores for the atrial fibrillation-related symptom dimension were higher after 2-week and 4-week treatment than those of the previous time points (
P
<0.05). For the treatment satisfaction dimension, significant increases were observed only after 2-week and 4-week treatment compared to baseline (
P
<0.05). Secondary outcome indicators: 1) In the treatment group, the frequency and duration of symptomatic atrial fibrillation episodes decreased significantly at each time point compared to the previous time point (
P
<0.05), except for the duration of trial fibrillation at follow-up. In the control group, the frequency of episodes decreased significantly at all time points compared to baseline (
P
<0.05), while the duration of trial fibrill
ation showed a significant reduction at follow-up compared to those after 2-week treatment (
P
<0.05). 2) In the treatment group, TCM syndrome scores significantly reduced after 2-week treatment, 4-week treatment, and during follow-up compared to the previous time point and baseline (
P
<0.05). In the control group, significant reductions were observed only after 4-week after treatment and during follow-up (
P
<0.05). The TCM syndrome scores in the treatment group were lower than those in the control group at the same time points (
P
<0.01). No adverse events occurred during the trial in either group, and safety indicators showed no significant changes after treatment.
Conclusion
2
Shenlong Dingji Formula
effectively improves the quality of life, alleviates TCM syndromes, and reduces the frequency and duration of symptomatic atrial fibrillation in patients with PAF of
qi
-
yin
deficiency and phlegm-stasis obstructing collaterals syndrome, and demonstrates good safety.
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