Acupuncture combined with modified Zhi Gan Cao decoction in the treatment of frequent premature ventricular contractions

This study investigates the clinical efficacy of acupuncture combined with modified Zhi Gan Cao decoction in the treatment of frequent premature ventricular contractions (PVC) and its effect on cardiac function and analyzes the correlation between the improvement of TCM syndromes and the reduction of PVC, as well as the efficacy differences under different PVC burden levels. A retrospective cohort study was conducted to collect data of patients diagnosed with frequent PVC in our hospital from April 2023 to April 2025. After propensity score matching, 200 patients were included and divided into a treatment group (acupuncture combined with modified Zhi Gan Cao decoction) and a control group (conventional western medicine treatment), with 100 cases in each group. The treatment cycle lasted 4 weeks. Changes in 24-hour PVC frequency, PVC burden, left ventricular ejection fraction, left ventricular end-diastolic diameter, N-terminal pro-B-type natriuretic peptide, and TCM syndrome scores were evaluated before and after treatment. Efficacy differences were analyzed, and the correlation between TCM syndrome improvement and PVC reduction as well as the impact of PVC burden level on efficacy were explored. The treatment group showed superior results in reducing 24-hour PVC frequency (decrease of 62.3% vs 37.8%), PVC burden (decrease of 63.2% vs 36.5%), TCM syndrome scores (decrease of 57.0% vs 32.6%), and improving left ventricular ejection fraction (+2.6% vs +0.8%) compared with the control group (all P < .05). The total effective rate was 93.0%, with a marked effective rate of 54.0%. TCM syndrome improvement was positively correlated with PVC reduction (r = 0.812, P < .0001). Subgroup analysis showed that patients with high PVC burden (≥10%) benefited more significantly in terms of cardiac function and symptom improvement. Acupuncture combined with modified Zhi Gan Cao decoction demonstrates good efficacy in treating frequent PVC, effectively reducing arrhythmic burden, alleviating symptoms, and potentially improving left heart function. TCM syndrome improvement is closely related to PVC reduction, with high-burden patients benefiting more, suggesting a promising clinical application of this integrated approach worthy of further promotion and in-depth study.