Clinical Efficacy Of Integrated Traditional Chinese And Western Medicine Under The Guidance Of Holter In The Treatment Of Patients With Abnormally High Heart Rate Variability

ObjectiveTo explore the clinical efficacy of integrated traditional Chinese and western medicine guided by Holter in the treatment of patients with abnormal heart rate variability.MethodsFrom May 2019 to December 2020,60 outpatients and inpatients with Significant heart rate variability who visited our hospital and Yuren County People’s Hospital were selected.60 patients with Significant heart rate variability were selected: daytime heart rate(heart rate greater than 100 beats/min occupying more than 50% of the time),nighttime bradycardia(Average heart rate < 50 beats per minute,RR interval appeared between 2.1 and 2.9 s).According to the results of Holter,individualized treatment of integrated traditional Chinese and Western medicine was carried out,the heart rate is slow at night,Xinbao pills are used for treatment,the heart rate is fast during the day,and metoprolol tartrate can be used to control the ventricular rate.According to the heart rate at different times shown by dynamic electrocardiogram,the dose of metoprolol and Xinbao pills was adjusted according to the heart rate(The average heart rate at night is not less than 50 bpm,and the average heart rate during the day is not more than 80 bpm).The course of treatment was 4 weeks.After the course of treatment,24 h dynamic electrocardiogram was reexamined.The highest heart rate,lowest heart rate,mean heart rate,number of ectopic heart rhythm,heart rate variability indicators(SDNN,SDANN,r MMSD,PNN50)shown by dynamic electrocardiogram before and after treatment,total score of TCM symptoms and single symptom score were compared to evaluate the efficacy of TCM statistics.25.0 software was used for data analysis.Results1.After treatment,the highest heart rate,total number of ectopic rhythm and 24 h total heart beat number were significantly lower than those before treatment,and the differences had statistical significance(p<0.01).The slowest heart rate after treatment was higher than that before treatment(p<0.01);there was no significant difference in the mean heart rate before and after treatment(p>0.05).2.After treatment,the heart rate variability indexes(SDNN,SDANN,r MSSD,PNN50)of the patients were decreased compared with those before treatment,and the differences were statistically significant(p<0.05).3.TCM:(1)TCM efficacy: According to the TCM efficacy determination criteria,32 cases(53.3%)were significantly effective,20 cases(33.4%)were effective,8 cases(13.3%)were ineffective,and the overall response rate was 86.7%.(2)The total score of TCM after treatment(14.33 ± 3.36)was lower than that before treatment(20.80 ± 2.98),and the difference had statistical significance(p<0.05);(3)The comparison of single symptom score of main symptoms before and after treatment: the TCM scores of palpitation(3.47 ± 1.32),shortness of breath(3.25 ±1.38)and dizziness(2.78 ± 1.72)after treatment were significantly lower than those before treatment(4.23 ± 1.43),shortness of breath(4.17±1.57)and dizziness(4.60±1.66),p<0.01,and the difference had statistical significance.There was no significant difference before and after chest distress score,p>0.05.ConclusionUnder the guidance of dynamic electrocardiogram,individualized guidance of traditional Chinese medicine Xinbao pills and western medicine metoprolol treatment can effectively improve the clinical symptoms of patients with abnormal heart rate variability,reduce tachyarrhythmia attacks and bradyarrhythmia attacks,heart rate variability decreased.