五参顺脉胶囊联合胺碘酮对阵发性心房颤动复律后维持窦性心律及左心室功能的影响

Effect of Wushen Shunmai Capsule Combined with Amiodarone on Maintenance of Sinus Rhythm and P Wave Dispersion in Patients with Paroxysmal Atrial Fibrillation after the Restoration of Sinus Rhythm

目的:观察五参顺脉胶囊联合低剂量胺碘酮对阵发性心房颤动(PAF)复律后维持窦性心律,P波离散度(Pd),左房内径(LAD)及左室射血分数(LVEF)的影响。方法:选择经iv胺碘酮转复后的PAF患者100例,随机分为两组,对照组50例单独口服低剂量胺碘酮;治疗组50例在对照组治疗的基础上加用五参顺脉胶囊口服。两组疗程均为12个月。结果:两组患者维护窦律治疗后15 d,1个月窦性心律维持率无显著差异;维护窦律治疗后6,12个月治疗组窦性心律维持率(85.1%,80.9%)均显著高于对照组(71.1%,57.8%)(均P<0.05);维护窦律治疗12个月后,治疗组的最大P波时限(Pmax)为(105.5±8.6)ms,低于对照组的(109.6±9.3)ms,Pd为(39.5±8.6)ms,低于对照组(43.4±9.2)ms,LAD为(32.6±2.9)mm,低于对照组的(34.0±3.4)mm(均P<0.05);治疗组LVEF为(48.3±7.1)%,显著高于对照组的(45.0±7.5)%(P<0.05)。五参顺脉胶囊未发生不良反应。结论:五参顺脉胶囊联合低剂量胺碘酮用于阵发性心房颤动复律后维持窦性心律效果良好,优于单用胺碘酮,显著缩短最大P波时限和P波离散度,缩小左房内径,提高左室射血分数,且安全性好。

Objective： To observe Wushen Shunmai capsule combined with low dose amiodarone on maintenance of sinus rhythm, P wave dispersion （Pd）, left atrial diameter （LAD） and left ventricular shootejection fraction （LVEF） in patients with paroxysmal atrial fibrillation （PAF） after the restoration of sinus rhythm. Method： PAF patients （100 patients）, who received intravenous amiodarone converted to sinus rhythm, were randomly divided into two groups, the control group （50 patients） was received oral low dose amiodarone alone, the treatment group was received Wushen Shunmai capsule on the basis of the control group. Two groups were treated continuously for 6 months. Result： There were no significant difference on rate of sinus rhythm maintenance in 15 d, 1 month after maintenance of sinus rhythm therapy between the two groups, the sinus rhythm maintenance rates of the treatment group （85.1%, 80.9% ） were significantly higher than the control group （71.1%, 57.8% ） at 6, 12 months after maintenance of sinus rhythm therapy, （all P 〈 0.05）. At 12 months after maintenance of sinus rhythm therapy the P Pd, LAD of the treatment group was significantly shorter than before treatment （P 〈0.01） and the control group （all P 〈 0.05）. The LVEF of the treatment group was significantly higher than that before treatment （P 〈0. 01 ） and the control group （P 〈0.05） ; Wushen Shunmai capsule had no adverse reaction. Conclusion： It was the good effect with safety that Wushen Shunmai capsule combination with low dose amiodarone for paroxysmal atrial fibrillation to maintain sinus rhythm, better than amiodarone alone, significantly reducing the maximum P wave duration and P wave dispersion, reduce the left atrial diameter, and improve left ventricular ejection fraction.