Yan Dong, Xu Xiang-Ru, Qian Yu-Liang, Peng Hai-Yan, Qian Hui, Yue Bo-Wen, Zhao Li-Li, Zhang Zi-Han, Fang Zhu-Yuan
Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine.
Affiliated Hospital of Nanjing University of Chinese Medicine.
Medicine (Baltimore). 2019 May;98(19):e15536. doi: 10.1097/MD.0000000000015536.
Sinus bradycardia refers to a sinus heart rate <60 bpm. Cardiac sinus arrests refer to the omission of atrial activation caused by transient cessation of impulse generation at the sinoatrial node. Normally, drugs such as atropine, isoproterenol, dopamine, dobutamine, or epinephrine can be used for the acute treatment of bradycardia. Temporary pacing is used for treating severe symptomatic bradycardia due to a reversible cause. Permanent cardiac pacing is used for chronic therapy of bradycardia. However, for traditional Chinese medicine (TCM), benefiting qi and nourishing yin and activating blood circulation is the general principle in treatment and show remarkable curative effects.
A 32-year-old man was found to have 1-degree atrioventricular block and sinus bradycardia during a physical examination. He reported suffering from palpitation and shortness of breath occasionally. An ambulatory electrocardiogram showed sinus arrhythmia, sinus bradycardia, and significant sinus arrhythmia. The minimum heart rate was 33 bpm (beats per minute). The number of sinus arrest was 42 and the maximum RR interval was 2216 ms.
The patient was diagnosed with bradyarrhythmia in Western medicine and "palpitation" in TCM.
The patient was treated with methods of benefiting qi and nourishing yin and activating blood circulation along with warming yan for nearly 5 months. CPM (Chinese patent medicine) such as Yixinshu capsule, Bingdouling oral liquid, Zhenyuan capsule, Zhibaidihuang pills were used for treatment. At the same time, he was suggested to change his lifestyles including falling asleep before 10:00 PM and abandoning spicy diets.
The symptoms of palpitation and shortness of breath disappeared. The minimum heart rate increased from 33 to 42 bpm and sinus arrests did not occur. The maximum RR interval decreased from 2216 to 1650 ms and the remarkable sinus arrhythmia had improved obviously.
This case report shows that TCM can be an effective alternative therapy for sinus bradycardia and cardiac sinus arrests. CPM may have been a successful intervention in arrhythmias.
窦性心动过缓是指窦性心率<60次/分钟。心脏窦性停搏是指由于窦房结冲动产生暂时停止而导致心房激动缺失。通常，阿托品、异丙肾上腺素、多巴胺、多巴酚丁胺或肾上腺素等药物可用于心动过缓的急性治疗。临时起搏用于治疗由可逆原因引起的严重症状性心动过缓。永久性心脏起搏用于心动过缓的慢性治疗。然而，对于中医来说，益气养阴、活血化瘀是治疗的一般原则，并显示出显著疗效。
一名32岁男性在体检时被发现有一度房室传导阻滞和窦性心动过缓。他报告偶尔有心悸和呼吸急促症状。动态心电图显示窦性心律不齐、窦性心动过缓以及显著的窦性心律不齐。最低心率为33次/分钟。窦性停搏次数为42次，最大RR间期为2216毫秒。
该患者西医诊断为缓慢性心律失常，中医诊断为“心悸”。
采用益气养阴、活血化瘀并温阳的方法对患者进行了近5个月的治疗。使用了益心舒胶囊、病窦灵口服液、振源胶囊、知柏地黄丸等中成药进行治疗。同时，建议他改变生活方式，包括晚上10点前入睡并摒弃辛辣饮食。
心悸和呼吸急促症状消失。最低心率从33次/分钟增加到42次/分钟，未再发生窦性停搏。最大RR间期从2216毫秒降至1650毫秒，显著的窦性心律不齐明显改善。
本病例报告表明，中医可以作为窦性心动过缓和心脏窦性停搏有效的替代疗法。中成药可能是心律失常的一种成功干预措施。
