胺碘酮联合参松养心胶囊治疗老年心力衰竭合并阵发性房颤疗效观察

Clinical Effect of Amiodarone Combined with Shensong Yangxin Capsule in Treatment of Elderly Patients with Heart Failure Complicated by Paroxysmal Atrial Fibrillation

目的观察胺碘酮联合参松养心胶囊对老年心力衰竭合并阵发性房颤的治疗效果。方法将30例符合纳入标准的老年心力衰竭合并阵发性房颤患者随机分为对照组和实验组,每组15例,对两组患者基础疾病行不含抗心律失常的常规治疗4周。在此基础上,对照组患者给予胺碘酮治疗,实验组在胺碘酮疗法的基础上加用参松养心胶囊,所有患者均接受8周药物治疗。观察两组临床疗效、左心室射血分数(left ventricular ejectfraction,LVEF)、血清中N-氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NTproBNP)水平、6min步行距离(6minute walk test,6MWT)、左心室舒张末期内径(left ventricular end-diastolic dimension,LVDD)、QT离散度(QT dispersion,QTd)和肝肾功能,记录各组患者出现的不良反应发生情况。结果两组患者临床疗效比较,差异无统计学意义(P>0.05)。与对照组比较,实验组LVEF、6MWT、QTd、LVDD和NT-proBNP差值差异均有统计学意义(P<0.05)。两组患者治疗后血清肌酐和丙氨酸氨基转移酶差值比较,差异具有统计学意义(P<0.05)。结论胺碘酮联合参松养心胶囊对老年心力衰竭合并阵发性房颤的治疗效果较好,且能提高运动耐量,改善心功能,同时不影响患者的肝肾功能,具有较高的临床使用价值。

Objective To investigate the clinical effect of amiodarone combined with Shensong Yangxin Capsule in the treatment of elderly patients with heart failure complicated by paroxysmal atrial fibrillation(PAF).Methods A total of 30 elderly patients with heart failure complicated by PAF who met the inclusion criteria were randomly divided into control group and experimental group,with 15 patients in each group.The patients in both groups were given routine treatment for underlying diseases which did not include antiarrhythmic therapy for 4 weeks.In addition,the patients in the control group were given amiodarone alone,while those in the experimental group were given amiodarone combined with Shensong Yangxin Capsule;the course of treatment was 8 weeks for both groups.The two groups were observed in terms of clinical outcome,left ventricular ejection fraction(LVEF),serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level,distance in six-minute walk test(6 MWT),left ventricular end-diastolic dimension(LVDD),QT dispersion(QTd),and liver and renal function.The adverse events were also recorded.Results There was no significant difference in the distribution of clinical outcomes between the two groups(P>0.05).There were significant differences in LVEF,6 MWT distance,QTd,LVDD,and NTproBNP between the experimental group and the control group(P<0.05).There were also significant differences in serum creatinine and alanine aminotransferase after treatment between the two groups(P<0.05).Conclusion Amiodarone combined with Shensong Yangxin Capsule has a good clinical effect in the treatment of elderly patients with heart failure complicated by PAF and can improve exercise tolerance and cardiac function,without any influence on liver and renal function.Therefore,it holds promise for clinical application.