Yue Qing-Qing, Hao Yi-Fang, Li Ting, Miao Han-Ying, Chen Bing-Chang, Li Sheng-Yao
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Shanxi University of Chinese Medicine, Taiyuan, China.
Medicine (Baltimore). 2025 Jan 31;104(5):e41206. doi: 10.1097/MD.0000000000041206.
Premature ventricular contraction (PVC) is a common type of arrhythmia, and obstructive sleep apnea (OSA) is a common trigger for this condition. Some patients still have PVC, even if ventilation is improved by wearing a respirator. Traditional Chinese medicine (TCM) has a long history of arrhythmia treatment, and this is the first report of a patient with PVC caused by OSA treated with TCM. Twenty-four-hour Holter showed that the number of PVCs decreased from 8968 to 0 before and after TCM treatment, and discomfort symptoms disappeared completely.
A 37-year-old middle-aged man, with no history of hypertension, diabetes, hyperlipidemia, or other underlying diseases, had been suffering from OSA for over 1 year and currently uses a respirator to sleep. He was diagnosed with PVC at Beijing Anzhen Hospital 1 year ago and had been taking propafenone hydrochloride tablets following the physician's advice, but palpitation had not been relieved. The patient did not consider surgery and hoped to take TCM to treat the palpitations.
The patient was diagnosed with PVC. After excluding other factors that could cause PVC, it was ultimately considered that the patient's PVC was related to OSA.
The patient visited Xiyuan Hospital on December 5, 2023, on the basis of existing Western medicine and TCM, using the modified Huanglian Wendan Decoction.
After taking TCM for 21 days, the Holter tests were conducted again. The results showed that the number of PVCs decreased from 8968 to 0 within 24 hours. Meanwhile, his palpitations were relieved, and the dosage of propafenone hydrochloride tablets was halved. After 7 days, he did not experience any discomfort; therefore, propafenone hydrochloride tablets were discontinued and TCM was exclusively administered. He received 7 additional courses in TCM. During the final consultation on April 23, 2024, the patient reported no discomfort, and snoring improved.
After treatment with TCM, the patient's palpitations disappeared completely and snoring improved, which proved that TCM can treat PVC caused by OSA. To verify this conclusion, more high-quality research is necessary to establish the efficacy and underlying mechanisms of TCM in treating PVC caused by OSA.
室性早搏（PVC）是一种常见的心律失常类型，阻塞性睡眠呼吸暂停（OSA）是引发这种病症的常见诱因。即便通过佩戴呼吸机改善了通气状况，一些患者仍会出现室性早搏。中医在治疗心律失常方面有着悠久的历史，这是首例关于采用中医治疗由阻塞性睡眠呼吸暂停引发的室性早搏患者的报告。24小时动态心电图显示，中医治疗前后室性早搏次数从8968次降至0次，不适症状完全消失。
一名37岁的中年男性，无高血压、糖尿病、高脂血症或其他基础疾病病史，患阻塞性睡眠呼吸暂停已逾1年，目前使用呼吸机辅助睡眠。他于1年前在北京安贞医院被诊断为室性早搏，一直遵照医嘱服用盐酸普罗帕酮片，但心悸症状未得到缓解。患者不考虑手术，希望采用中医治疗心悸。
患者被诊断为室性早搏。在排除其他可能导致室性早搏的因素后，最终认为患者的室性早搏与阻塞性睡眠呼吸暂停有关。
患者于2023年12月5日前往西苑医院就诊，在现有西医和中医治疗基础上，采用改良黄连温胆汤。
服用中药21天后，再次进行动态心电图检查。结果显示，24小时内室性早搏次数从8968次降至0次。与此同时，他的心悸症状得到缓解，盐酸普罗帕酮片的剂量减半。7天后，他未感到任何不适；因此，停用盐酸普罗帕酮片，仅服用中药。他又接受了7个疗程的中医治疗。在2024年4月23日的最后一次会诊中，患者报告无不适症状，打鼾情况有所改善。
经中医治疗后，患者心悸症状完全消失，打鼾情况改善，这证明中医能够治疗由阻塞性睡眠呼吸暂停引起的室性早搏。为验证这一结论，有必要开展更多高质量研究，以确立中医治疗由阻塞性睡眠呼吸暂停引起的室性早搏的疗效及潜在机制。
