<?xml version="1.1" encoding="utf-8"?>
<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">MRP</journal-id><journal-title-group><journal-title>Medical Research and Practice</journal-title></journal-title-group><issn>2993-9690</issn><eissn>2993-9704</eissn><publisher><publisher-name>Art and Design</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.61369/MRP.2025050015</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>频发早搏目前研究现状及治疗展望综述</title><url>https://artdesignp.com/journal/MRP/3/5/10.61369/MRP.2025050015</url><author>张之瑄,覃佐岸</author><pub-date pub-type="publication-year"><year>2025</year></pub-date><volume>3</volume><issue>5</issue><history><date date-type="pub"><published-time>2025-05-20</published-time></date></history><abstract>早搏是一种常见的心律失常，临床上长期以来，早搏都被认为是良性改变，但目前研究提示早搏并不完全是良性改变，其可以引起心肌重塑、心肌病、其他更加严重的心律失常、心力衰竭等不良预后，但目前临床对于早搏的治疗尤其是房性早搏的手段有限，炙甘草汤作为中医经典《伤寒杂病论》中的经典方剂，现有研究提示对于早搏和心律失常治疗效果不劣于目前一线药物治疗手段，为早搏的治疗方案上提供优化选择。本综述聚焦于目前早搏以及炙甘草汤现有的研究进展，为治疗早搏以及炙甘草汤在临床应用提供理论基础和科学依据。</abstract><keywords>早搏,抗心律失常药,炙甘草汤,中西医结合</keywords></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>[1]FARINHA J M, GUPTA D, LIP G Y H. Frequent premature atrial contractions as a signalling marker of atrial cardiomyopathy, incident atrial fibrillation, and stroke [J].&amp;nbsp;Cardiovasc Res, 2023, 119(2): 429-39.&amp;nbsp;[2]AHMED S, HISAMATSU T, KADOTA A, et al. Premature Atrial Contractions and Their Determinants in a General Population of Japanese Men [J]. Circ J, 2022, 86(8): 1298-306.&amp;nbsp;[3]KRISHNAPPA D, WANG W, ROONEY M R, et al. Life&amp;rsquo;s Simple 7 cardiovascular health score and premature atrial contractions: The atherosclerosis risk in communities&amp;nbsp;(ARIC) study [J]. Int J Cardiol, 2021, 332: 70-7.&amp;nbsp;[4]AL-KHATIB S M, STEVENSON W G, ACKERMAN M J, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the&amp;nbsp;Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice&amp;nbsp;Guidelines and the Heart Rhythm Society [J]. Circulation, 2018, 138(13): e210-e71.&amp;nbsp;[5]LUKAS LAWS J, LANCASTER M C, BEN SHOEMAKER M, et al. Arrhythmias as Presentation of Genetic Cardiomyopathy [J]. Circ Res, 2022, 130(11): 1698-722.&amp;nbsp;[6]MARCUS G M. Evaluation and Management of Premature Ventricular Complexes [J]. Circulation, 2020, 141(17): 1404-18.&amp;nbsp;[7]AL-KHATIB S M, STEVENSON W G, ACKERMAN M J, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention&amp;nbsp;of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm&amp;nbsp;Society [J]. Heart Rhythm, 2018, 15(10): e73-e189.&amp;nbsp;[8]PHAM T, BENNETT R, KANAWATI J, et al. Impact of sex on clinical, procedural characteristics and outcomes of catheter ablation for ventricular arrhythmias according&amp;nbsp;to underlying heart disease [J]. J Interv Card Electrophysiol, 2023, 66(1): 203-13.&amp;nbsp;[9]BAMAN T S, LANGE D C, ILG K J, et al. Relationship between burden of premature ventricular complexes and left ventricular function [J]. Heart Rhythm, 2010, 7(7): 865-9.&amp;nbsp;[10]HUIZAR J F, ELLENBOGEN K A, TAN A Y, et al. Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review [J]. J Am Coll Cardiol, 2019, 73(18): 2328-44.&amp;nbsp;[11]HAMON D, RAJENDRAN P S, CHUI R W, et al. Premature Ventricular Contraction Coupling Interval Variability Destabilizes Cardiac Neuronal and Electrophysiological&amp;nbsp;Control: Insights From Simultaneous Cardioneural Mapping [J]. Circ Arrhythm Electrophysiol, 2017, 10(4).&amp;nbsp;[12]TORRADO J, KOWLGI G N, RAMIREZ R J, et al. Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction-induced&amp;nbsp;cardiomyopathy [J]. Heart Rhythm O2, 2021, 2(1): 80-8.&amp;nbsp;Copyright &amp;copy; This Work is Licensed under A Commons Attribution-Non Commercial 4.0 International License. | 033临床研究 | CLINICAL RESEARCH&amp;nbsp;[13]BALDERAS-VILLALOBOS J, MEDINA-CONTRERAS J M L, LYNCH C, et al. Mechanisms of adaptive hypertrophic cardiac remodeling in a large animal model of&amp;nbsp;premature ventricular contraction-induced cardiomyopathy [J]. IUBMB Life, 2023, 75(11): 926-40.&amp;nbsp;[14]TSIACHRIS D, BOTIS M, DOUNDOULAKIS I, et al. Electrocardiographic Characteristics, Identification, and Management of Frequent Premature Ventricular&amp;nbsp;Contractions [J]. Diagnostics (Basel), 2023, 13(19).&amp;nbsp;[15]KANTHARIA B K, SHAH A N. Are antiarrhythmic agents indicated in premature ventricular complex-induced cardiomyopathy and when? [J]. J Cardiovasc Electrophysiol,&amp;nbsp;2024, 35(3): 574-82.&amp;nbsp;[16]TAN A Y, ELHARRIF K, CARDONA-GUARACHE R, et al. Persistent Proarrhythmic Neural Remodeling Despite Recovery From Premature Ventricular ContractionInduced Cardiomyopathy [J]. J Am Coll Cardiol, 2020, 75(1): 1-13.&amp;nbsp;[17]HIGUCHI S, VOSKOBOINIK A, IM S I, et al. Frequent Premature Atrial Contractions Lead to Adverse Atrial Remodeling and Atrial Fibrillation in a Swine Model [J].&amp;nbsp;Circulation, 2024, 149(6): 463-74.&amp;nbsp;[18]HOWELL S J, DUKES J W, VITTINGHOFF E, et al. Premature Atrial Contraction Location and Atrial Fibrillation Inducibility [J]. Circ Arrhythm Electrophysiol, 2023, 16(2): e011623.&amp;nbsp;[19]HIGUCHI S, VENKATESWARAN R, IM S, et al. Shorter Premature Atrial Complex Coupling Interval Leads to Mechanical Dysfunction, Fibrosis, and AF in Swine [J].&amp;nbsp;JACC Clin Electrophysiol, 2025, 11(1): 30-42.&amp;nbsp;[20]PY A, SCHAAF M, DUHAMEL S, et al. Atrial premature activity detected after an ischaemic stroke unveils atrial myopathy [J]. Arch Cardiovasc Dis, 2020, 113(4): 227-36.&amp;nbsp;[21]HA&amp;iuml;SSAGUERRE M, JA&amp;iuml;S P, SHAH D C, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins [J]. N Engl J Med, 1998,&amp;nbsp;339(10): 659-66.&amp;nbsp;[22]NORTAMO S, KENTT&amp;auml; T V, UKKOLA O, et al. Supraventricular premature beats and risk of new-onset atrial fibrillation in coronary artery disease [J]. J Cardiovasc&amp;nbsp;Electrophysiol, 2017, 28(11): 1269-74.&amp;nbsp;[23]HANSON M, FUTYMA P, BODE W, et al. Catheter ablation of intramural outflow tract premature ventricular complexes: a multicentre study [J]. Europace, 2023, 25(5).&amp;nbsp;[24]HA&amp;iuml;SSAGUERRE M, SHAH D C, JA&amp;iuml;S P, et al. Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation [J]. Lancet, 2002, 359(9307): 677-8.&amp;nbsp;[25]JOGLAR J A, CHUNG M K, ARMBRUSTER A L, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the&amp;nbsp;American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [J]. Circulation, 2024, 149(1): e1-e156.&amp;nbsp;[26]HUANG B T, HUANG F Y, PENG Y, et al. Relation of premature atrial complexes with stroke and death: Systematic review and meta-analysis [J]. Clin Cardiol, 2017, 40(11): 962-9.&amp;nbsp;[27]CHONG B H, PONG V, LAM K F, et al. Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events [J]. Europace, 2012, 14(7): 942-7.&amp;nbsp;[28]LITTMANN L. Unusual pacemaker indication: Premature atrial complexes [J]. J Electrocardiol, 2022, 72: 16-7.&amp;nbsp;[29]LIN C Y, LIN Y J, CHEN Y Y, et al. Prognostic Significance of Premature Atrial Complexes Burden in Prediction of Long-Term Outcome [J]. J Am Heart Assoc, 2015, 4(9): e002192.&amp;nbsp;[30]BINICI Z, INTZILAKIS T, NIELSEN O W, et al. Excessive supraventricular ectopic activity and increased risk of atrial fibrillation and stroke [J]. Circulation, 2010, 121(17): 1904-11.&amp;nbsp;[31]HUANG T C, LEE P T, HUANG M S, et al. Higher premature atrial complex burden from the Holter examination predicts poor cardiovascular outcome [J]. Sci Rep, 2021, 11(1): 12198.&amp;nbsp;[32]HIMMELREICH J C L, LUCASSEN W A M, HEUGEN M, et al. Frequent premature atrial contractions are associated with atrial fibrillation, brain ischaemia, and&amp;nbsp;mortality: a systematic review and meta-analysis [J]. Europace, 2019, 21(5): 698-707.&amp;nbsp;[33]ARNAR D O, MAIRESSE G H, BORIANI G, et al. Management of asymptomatic arrhythmias: a European Heart Rhythm Association (EHRA) consensus document,&amp;nbsp;endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa&amp;nbsp;(CASSA), and Latin America Heart Rhythm Society (LAHRS) [J]. Europace, 2019, 21(6): 844&amp;ndash;5.&amp;nbsp;[34]中华医学会心血管病学分会, 中国生物医学工程学会心律分会.抗心律失常药物临床应用中国专家共识 [J]. 中华心血管病杂志, 2023, 51(03): 256-69.&amp;nbsp;[35]RIESINGER L, SIEBERMAIR J, WAKILI R. Mapping strategies and ablation of premature atrial complexes [J]. Herzschrittmacherther Elektrophysiol, 2021, 32(1): 9-13.&amp;nbsp;[36]MAZZELLA A J, KOURI A, O&amp;rsquo;QUINN M P, et al. Improvement in left ventricular ejection fraction after radiofrequency catheter ablation of premature atrial contractions&amp;nbsp;in a 23-year-old man [J]. HeartRhythm Case Rep, 2019, 5(10): 524-7.&amp;nbsp;[37]于海睿, 万来平, 邓绮梅, et al. 炙甘草汤&amp;ldquo;异病同治&amp;rdquo;冠心病心律失常和肺纤维化的网络药理学机制研究 [J]. 广州中医药大学学报, 2024, 41(06): 1588-97.&amp;nbsp;[38]WEI P, LONG D, TAN Y, et al. Integrated Pharmacogenetics Analysis of the Three Fangjis Decoctions for Treating Arrhythmias Based on Molecular Network Patterns [J].&amp;nbsp;Front Cardiovasc Med, 2021, 8: 726694.&amp;nbsp;[39]高强, 张万义, 史磊, et al. 李晓教授运用炙甘草汤治疗心血管疾病的方证相关分析 [J]. 中国民族民间医药, 2023, 32(01): 98-101+18.&amp;nbsp;[40]邱凤, 苏伟. 炙甘草汤治疗室性期前收缩的研究进展 [J]. 中国民间疗法, 2022, 30(04): 122-5.&amp;nbsp;[41]李海田, 李金懋, 赵芸, et al. 7种经方及中成药治疗室性早搏的网状Meta分析 [J]. 世界中医药, 2022, 17(21): 3045-54+60.&amp;nbsp;[42]郭晟, 周承志, 杨波, et al. 炙甘草汤对大鼠心房肌细胞L型钙电流及其动力学特征的影响 [J]. 世界中医药, 2022, 17(10): 1385-9.&amp;nbsp;[43]郭晟. 炙甘草汤对大鼠心房肌细胞离子通道的影响及机制研究 [D], 2021.&amp;nbsp;[44]CUI Z Q, ZHANG H R, LIN X Z. [Prophylactic and therapeutic effect of jiawei zhigancao tang injection on experimental arrhythmia in rats] [J]. Zhongguo Zhong Xi Yi Jie&amp;nbsp;He Za Zhi, 1993, 13(7): 423-5, 389-90.&amp;nbsp;[45]SUN J, WUGETI N, MAHEMUTI A. Reversal effect of Zhigancao decoction on myocardial fibrosis in a rapid pacing-induced atrial fibrillation model in New Zealand&amp;nbsp;rabbits [J]. J Int Med Res, 2019, 47(2): 884-92.&amp;nbsp;[46]LIU W, XIONG X, FENG B, et al. Classic herbal formula Zhigancao Decoction for the treatment of premature ventricular contractions (PVCs): a systematic review of&amp;nbsp;randomized controlled trials [J]. Complement Ther Med, 2015, 23(1): 100-15.&amp;nbsp;[47]彭华莉. 炙甘草汤联合美西律治疗室性心律失常气阴两虚型临床观察 [J]. 实用中医药杂志, 2022, 38(11): 1918-20.&amp;nbsp;[48]宋鹏玺. 加味炙甘草汤治疗阵发性心房颤动临床疗效观察 [J]. 基层医学论坛, 2024, 28(10): 139-41.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
