探讨中西医结合治疗老年血管迷走神经性晕厥的疗效。

选取杭州市西溪医院2016年1月至2017年9月收治的81例老年血管迷走神经性晕厥门诊及住院患者，其中西医（美托洛尔缓释片+倾斜训练）治疗38例（西医组），中西医结合（柴胡疏肝散加味方+美托洛尔缓释片+倾斜训练）治疗43例（中西医组）。观察两组患者治疗前后的心率、收缩压（SBP）、舒张压（DBP）、抑郁焦虑评分，以及治疗后的倾斜试验情况、临床疗效。治疗后电话随访半年，记录复发情况。

西医组及中西医组患者治疗后的心率、SBP、DBP和抑郁焦虑评分均较治疗前显著降低，差异均有统计学意义（t=3.551、18.679、13.568、10.424，7.742、19.830、10.077、16.663；P<0.05或0.01）。治疗后，中西医组患者心率、SBP、DBP和抑郁焦虑评分均明显低于西医组，差异均有统计学意义（t=4.173、1.770、2.886、6.793，均P<0.05）。西医组患者治疗有效19例（76.32%；痊愈10例，有效19例），中西医组治疗有效36例（93.02%；痊愈17例，有效19例），差异有统计学意义（χ²=4.462，P<0.05）。西医组患者治疗后倾斜试验阳性29例、半年内复发6例，中西医组患者治疗后倾斜试验阳性22例、半年内复发1例，差异均有统计学意义（χ²=2.147、3.083，均P<0.05）。

美托洛尔缓释片+倾斜训练是治疗老年血管迷走神经性晕厥的有效西医方案，联合柴胡疏肝散加味方进行治疗效果更好，可改善患者心率、血压及抑郁焦虑症状，降低患者近期晕厥复发率。

To explore the curative effect of combination of traditional Chinese and western medicine in the treatment of senile vasovagal syncope.

Eighty one elderly patients with vasovagal syncope outpatients and inpatients who were admitted from January 2016 to September 2017 in Xixi Hospital of Hangzhou were included. Among them, 38 were Western medicine group (metoprolol sustained-release tablets + tilt training), and 43 were combination of traditional Chinese and Western medicine group (radix bupleuri liver scattered flavored party + Metoprolol sustained-release tablets + tilt training). Heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), depression and anxiety scores were observed before and after treatment in both groups, as well as tilt test after treatment and clinical efficacy. The patients were followed up by telephone for half a year after treatment and the recurrence was recorded.

Heart rate, SBP, DBP and depression anxiety score were significantly reduced in both Western medicine group and combination of traditional Chinese and western medicine group after treatment, and the differences were statistically significant (t=3.55, 18.68, 13.57, 18.68, 7.74, 19.83, 10.08, 19.83; P<0.05 or P<0.01). Heart rate, SBP, DBP and depression anxiety scores of patients after treatment in the combination of traditional Chinese and western medicine group were significantly lower than those in the western medicine group, with statistically significant differences (t=4.17, 1.77, 2.89, 6.79; all P<0.05).There were 19 effective cases in the western medicine group (76.32%, 10 cases cured, 19 cases effective), and 36 effective cases in the combination of traditional Chinese and western medicine group (93.02%, 17 cases cured, 19 cases effective). The difference was statistically significant (χ²=4.462, P<0.05). Twenty-nine patients with positive tilt test and 6 patients with relapse within 6 months after treatment were in Western medicine group. Twenty-two cases with positive tilt test and 1 case with recurrence within six months after treatment were in combination of traditional Chinese medicine and Western medicine group. The differences were statistically significant (χ²=2.147, 3.083; P<0.05).

Metoprolol sustained-release tablets + tilt training are effective in the treatment of senile vasovagal syncope. Western medicine combined radix bupleuri liver flavored party is better, with improved the patient's heart rate, blood pressure levels and depression anxiety symptoms, reducing the patients with recent recurrent syncope.