护心胶囊联合胺碘酮治疗心房颤动及逆转心房电重构的临床研究

The effect of Huxin Capsule and amiodarone on the reversion of atrial electrical remodeling in the patients with non-valvular atrial fibrillation

目的探讨护心胶囊联合胺碘酮治疗非瓣膜病心房颤动的疗效与安全性以及逆转心房电重构的作用。方法将68例非瓣膜性房颤住院患者随机分为治疗组(n=36)和对照组(n= 32)。两组患者2周内均给胺碘酮负荷量7g,第3周开始予以维持量200mg；治疗组在此基础上应用护心胶囊5粒日3次。随访6个月。治疗前后行心电图、心脏超声、胸部X线、肝肾及甲状腺功能检查。结果治疗后第3周及第6个月,治疗组显效率分别为88．8%、77．8%,优于对照组(75%、56%),总有效率亦显著高于对照组(P＜0．05)。两组显效及有效患者治疗后1、3、6个月心脏超声检查左房直径均渐缩小,左心室舒张早期经二尖瓣血流的最大值(E峰)、左心房收缩时经二尖瓣血流的最大值(A峰)及E/A均增大,两组同期比较在第1个月差异显著(P＜0．05),第3、6个月无明显差异(P＞0．05),表明治疗组较对照组左房血流动力学及左房功能较快得到改善和恢复,从而逆转心房电重构。结论护心胶囊具有转复房颤及维持窦律的作用；与胺碘酮联用能更好地抑制心房电重构,并对心房组织重构有一定疗效。

Objective To observe the effect of Huxin Capsule and amiodarone on the reversion of atrial electrical remodeling in the patients with non-valvular atrial fibrillation （NRN-AF）. Methods 68 patients with NRN-AF were randomly divided into treated group （n=36） and control group （n= 32） . The two groups were treated with 7 g of amiodarone in two weeks and from the third week they all underwent the maintaining dosage of amiodareone （200 mg）, but to the treated group, Huxin Capsule was given additionally （2.0 g tid×6 months）. Electrocardiagram（ECG） and echocardiography, X-ray of chest, liver, kidney and thyroid function tests were measured before treatment and once in a month after treatment. Results At the third week and six month after treatment, the remarkable effective rates were 88.8%, 77.8% respectively in the treatment group and were 75%, 56% in control group, showing significant difference （P〈0.05） . At 1, 3, 6 month after treatment in both treatment and control group, echocardiography showed left atrial diameter decreased, peak value of blood flow via mitral valve at early left ventricular diastolic period （E value） and via mitral value at left atrial systolic period （A value）, and E/A ratio increased. But there was an earlier and faster effect in improving left atrial blood flow dynamics and recovering left atrial function in the treated group than that in the control group. Conclusion Huxin Capsule is effective in the treatment of atrial fibrillation and maintenance of normal sinus rhythm. It is more effective on reversion of areal electrical remodeling and myocardial remodeling, when combined with amiodarone.