稳心颗粒联合普萘洛尔对甲亢合并房颤患者相关激素水平及心脏功能的影响

Influence of Wenxin granule combined propranolol on related hormone levels and cardiac function in patients with hyperthyroidism and atrial fibrillation

目的:观察稳心颗粒联合普萘洛尔对甲状腺功能亢进合并房颤患者相关激素水平及心脏功能的影响。方法:选择我院确诊的甲状腺功能亢进合并房颤患者136例,随机分为普萘洛尔组和联合治疗组(普萘洛尔联合稳心颗粒治疗),各68例,两组均接受常规治疗,治疗8周,观察治疗前后两组患者血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)等激素水平变化及SBP、DBP、HR、LVEF等血压、心功能指标变化。结果:与治疗前比较,治疗后两组患者血清FT3、FT4水平及SBP、DBP、HR均显著降低,血清TSH水平及LVEF值均显著升高(P<0.05或<0.01);且与普萘洛尔组比较,联合治疗组FT3 [(6.68±1.94)pmol/L比(4.39±1.34)pmol/L]、FT4 [(28.67±5.17)pmol/L比(22.67±4.86)pmol/L]水平及SBP [(127.79±10.86)mmHg比(121.76±9.43)mmHg]、DBP [(81.65±8.41)mmHg比(75.12±8.16)mmHg]、HR [(85.67±7.64)次/min比(80.79±6.47)次/min]降低更显著,血清TSH [(1.28±0.26)mU/L比(1.81±0.34)mU/L]水平及LVEF [(56.28±5.12)%比(59.76±4.25)%]值升高更显著(P<0.05或<0.01);联合治疗组总有效率明显高于普萘洛尔组(95.59%比82.35%,P=0.014);两组不良反应无显著差异(P=1.000)。结论:稳心颗粒配合普萘洛尔,能显著改善甲状腺功能亢进患者甲状腺相关激素水平和心脏功能,值得临床推广。

Objective：To observe influence of Wenxin granule combined propranolol on related hormone levels and cardiac function in patients with hyperthyroidism and atrial fibrillation（AF）.Methods：A total of 136 AF patients with hyperthyroidism diagnosed in our hospital were randomly and equally divided into propranolol group and combined treatment group（received propranolol combined Wenxin granule）.Both groups received routine treatment for eight weeks also.Serum levels of free triiodothyronine（FT3）,free thyroxine（FT4）and thyrotropic-stimulating hormone（TSH）,blood pressure：SBP、DBP,HR and LVEF before and after treatment were compared between two groups.Results：Compared with before treatment,there were significant reductions in serum levels of FT3 and FT4,SBP,DBP and HR,and significant rise in serum TSH level and LVEF after treatment,in two groups,P〈0.05 or0.01.Compared with propranolol group after treatment,there were significant reductions in serum levels of FT3 [（6.68±1.94）pmol/L vs.（4.39±1.34）pmol/L]and FT4 [（28.67±5.17）pmol/L vs.（22.67±4.86）pmol/L],SBP [（127.79±10.86）mmHg vs.（121.76±9.43）mmHg],DBP [（81.65±8.41）mmHg vs.（75.12±8.16）mmHg]and HR [（85.67±7.64）beats/min vs.（80.79±6.47）beats/min],and significant rise in serum TSH level[（1.28±0.26）mU/L vs.（1.81±0.34）mU/L]and LVEF [（56.28±5.12）% vs.（59.76±4.25）%]in combined treatment group,P〈0.05 or0.01.Total effective rate of combined treatment group was significantly higher than that of propranolol group（95.59% vs.82.35%,P=0.014）.There was no significant difference in incidence of adverse reactions between two groups,P=1.000.Conclusion：Wenxin granule combined propranolol can significantly improve thyroid hormone levels and cardiac function in patients with hyperthyroidism,which is worth extending.