| The First Part:Cohort study of patients with the application ofnourishing yin sedative herbs coronary heart arrhythmia duringhospitalizationObjectiveselect hospitalized patients with coronary heart arrhythmia, investigate the application of prescription with nourishing yin and sedative, observing its effect 24 h Holter, obtain the law of a clinical Herbal Prescription,provides for clinical use basis.MethodsApply a cohort study design. Production of " questionnaire about cohort study of patients with coronary heart arrhythmia during hospitalized ", Through medical record information management system, the transfer of medical records 386 cases of arrhythmia coronary heart disease were treated from January 1, 2008 to December 31, 2013 in Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Record the general clinical features, types of arrhythmia types, TCM syndrome, Chinese medicine injections and decoction, the application time, and dynamic Holter changes. Established database software of the hospitalized patients with arrhythmia coronary heart with Epi Data information, data entry. Statistics TCM injections, decoction of application frequency, strong, weak, non-exposed group Holter changes.Result1. Chinese medicine treatment 386 cases of hospitalized patients with coronary heart arrhythmia, is a "wang, distraught" card 316 cases, 280 cases of application of traditional Chinese medicine injections(88.61%), involving 22 species, a higher frequency of SMI was 117 cases(19.09%), injection ligustrazine 80 cases(13.05%), injection breviscapine 78 cases(12.72%), 66 cases of Shengmai injection(10.77%), 44 cases of puerarin injection(7.17%); Nourishing yin sedative herbs 240 cases, accounting for 68.97%. Election party higher frequency is Shengmaisan 96 cases(26.37%), 61 cases Xinjining square(16.76%), licorice soup 27 cases(7.42%); Involving a total of 117 traditional Chinese medicine taste, overall drug use frequency 3408, The application of more than 40 times the frequency of 29 herbs cluster analysis derived four clusters parties and 10 pairs of commonly used drugs right.2. Holter Evaluation Strong, weak, non-exposed group Holter total efficiency of 86.95%, respectively, 78.31%, 56.45%, Analysis by χ2 test P = 0.003 <0.05, show differences in efficacy between the groups was statistically significant; Spearman rank correlation analysis P = 0.000 <0.05, Holter showed efficacy over Chinese intervention to improve and gain strength.Conclusion1.hospitalized patients with coronary heart arrhythmia treatment with Chinese medicine herbs nourishing yin and soothe the nerves mainly traditional Chinese medicine injections for injection, decoction for Shengmaisan, Xinjining party, licorice soup.2.Holter efficacy of prolonged treatment with Chinese medicine and gain.The Second Part: Cohort study of patients with the applicationof nourishing yin sedative herbs discharged with coronary heartarrhythmias during follow-up ObjectiveObjectiveObserving in patients with coronary heart arrhythmia with Nourishing yin and sedative herbs application situation and the endpoint events during follow-up, and analyze medical treatment and the end of the event correlation, Provide evidence based medicine for the treatment of coronary heart disease nourishing yin sedative herbs arrhythmias.MethodsWith telephone follow-up, combined with outpatient follow-up of patients with coronary heart arrhythmia discharged, to May 31, 2014 after a self-discharge follow-up time.Record patient was discharged after oral application of Chinese medicine and Chinese medicine decoction and cardiac death, worsening heart failure incidence of readmission, fill in the "cohort study of patients with coronary heart arrhythmia questionnaire" follow-up section. Establish follow-up cohort study of patients with coronary heart arrhythmia information database, data entry using Epi Data software. Statistics for each exposure group using medicine, decoction, the univariate logistic regression χ2 test correlation analysis combined medical treatment and the end of the event.Result1.Chinese medicine treatment Follow up of 313 cases, the rate of failure was 18.9%.313 cases of coronary heart disease in patients with oral medicine arrhythmia total frequency of 295 cases, the total frequency decoction 137 cases, in which the exposed group(application medicine or decoction ≥ 28 days after discharge) 194 cases(61.98%), application higher frequency of oral medicine were Shensongyangxin capsule 102 cases(34.57%), Wenxinkeli 24 patients(8.13%), etc., decoction Shengmaisan were 43 cases(31.39%), licorice soup 26 cases(18.98%), 21 cases Xinjining square(15.33%) and so on.2.The end of the event and nourishing Yin prescription sedative treatment-related Endpoints exposed 26 cases(13.47%) group occurs, the non-exposed group, 34 cases(28.57%), the incidence was significantly(P <0.05). Univariate analysis Χ2 test results "taking medicine" and "dyslipidemia" two factor P <0.05, nourishing yin show taking sedative medicine, no dyslipidemia can reduce the incidence of endpoint events. Multivariate Logistic regression analysis P values only "application of traditional Chinese medicine" and "intensity of exposure" factor of <0.05, illustrate the application of nourishing yin sedative herbs can not only reduce the incidence of endpoint events, and increases the strength of the intervention, the end event risk is further reduced.Conclusion1.During follow-up of patients with coronary heart arrhythmia commonly used oral medicine for Shensongyangxin capsule, Wenxinkeli; decoction for Shengmaisan, licorice soup, Xinjining party and so on.2.Nourishing yin sedative herbs can reduce the incidence of coronary heart disease in patients with end-arrhythmic events, to further reduce the intensity of treatment increases, the risk of cardiovascular events occur. Howevre, less extensive clinical application, needs to be improved utilization. |
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