复方罗布麻片结合通冠复脉汤治疗冠心病室性心律失常疗效观察

Clinical observation on treatment of coronary heart disease ventricular arrhythmia with compound Apocynum tablets and Tongguan Fumai decoction

目的观察复方罗布麻片结合通冠复脉汤治疗冠心病室性心律失常的临床疗效。方法将130例冠心病室性心律失常患者随机分为2组,对照组65例给予胺碘酮治疗,观察组55例在对照组治疗的基础上加用复方罗布麻片结合通冠复脉汤治疗,观察2组治疗前后主要证候积分、室性早搏数量、短阵室性心动过速数量、一氧化氮(NO)、内皮素-1(ET-1)、血栓素B2(TXB2)及6-酮-前列腺素F-1a(6-Keto-PGF-1a)水平变化情况,统计2组近期疗效和不良反应发生情况。结果治疗后2组心悸、胸痛、神疲乏力、气短及唇色紫或暗积分,室性早搏数量,短阵室速数量,ET-1和TXB2水平均显著降低(P均<0.05),NO和6-keto-PGF-1a水平均显著提高(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05)。观察组治疗总有效率显著高于对照组(P<0.05);2组不良反应均轻微。结论复方罗布麻片结合通冠复脉汤治疗冠心病室性心律失常可有效缓解症状体征,降低心律失常发生频率,调节NO、ET-1、TXB2及6-keto-PGF-1a水平,且较安全。

Objective It is to observe the clinical effect of compound Apocynum tablet combined with Tongguan Fumai decoction on coronary heart disease ventricular arrhythmia. Methods 130 cases of patients with coronary heart disease with ventricular arrhythmia were randomly divided into 2 groups. 65 cases in the control group were treated with amiodarone. 55 cases in the observation group were treated with compound Apocynum tablet combined with Tongguan Fumai decoction. The changes of the main syndrome scores,number of early ventricular premature beats,number of short ventricular tachycardia,the levels of nitric oxide（ NO）,endothelin-1（ ET-1）,thromboxane B2（ TXB2） and 6-keto-prostaglandin F-1 a（ 6-KetoPGF-1 a） before and after treatment were observed in both group. The short-term efficacy and occurrences of adverse reactions were calculated in both groups. Results After treatment,the scores of palpitations,chest pain,fatigue,shortness of breath and lip violet or dark integral,early ventricular count,number of short ventricular tachycardia,and ET-1 and TXB2 levels were significantly decreased while the level of 6-keto-PGF-1 a was increased significantly in both groups（ P〈0. 05）,and the improvements of the above indicators in the observation group were significantly better than that in the control group（ P〈0. 05）. The total effective rate in the observation group was significantly higher than that in the control group（ P〈0. 05）,the adverse reactions were mild in both groups. Conclusion Compound Apocynum tablet combined with Tongguan Fumai decoction can effectively relieve symptoms and signs,reduce the frequency of arrhythmia,regulate NO,ET-1,TXB2 and 6-keto-PGF-1 a levels,and is Safe in the treatment of coronary heart disease ventricular arrhythmia.