参松养心胶囊联合美托洛尔治疗心率相关性室性早搏的临床研究

Clinical study on the treatment of heart rate-related premature ventricular contraction with Shensong Yangxin capsule combined with metoprolol

目的探讨参松养心胶囊联合美托洛尔对心率相关性室性早搏的临床疗效。方法选取有症状的室性早搏患者共300例,随机纳入联合用药组和对照组。联合用药组患者同时口服参松养心胶囊和美托洛尔缓释片,对照组只口服美托洛尔缓释片。分析每组患者治疗前后的动态心电图参数及患者症状缓解率,比较参松养心胶囊联合美托洛尔对快心率相关性室性早搏(fast heart rate-dependent premature ventricular complex,F-HR-PVC)、非心率相关性室性早搏(heart rate-independent premature ventricular complex,I-HR-PVC)、慢心率相关性室性早搏(slow heart rate-dependent premature ventricular complex,S-HR-PVC)的治疗效果。结果与对照组比较,联合用药组24 h室性早搏数[(5536.22±3826.35)次vs.(4348.59±3267)次,P=0.037]和室性早搏负荷[(5.82±4.29)%vs.(3.77±3.37)%,P=0.018]均明显下降。各类型室性早搏分析结果显示,与对照组相比,联合用药组I-HR-PVC型和S-HR-PVC型患者的临床症状缓解率明显提高,室性早搏数减少>50%的患者数明显增加(P均<0.05),而两组中F-HR-PVC型患者治疗的有效率无明显差异。结论参松养心胶囊联合美托洛尔治疗室性早搏的有效率明显高于单用美托洛尔的患者,联合用药的有效率主要来自I-HR-PVC和S-HR-PVC患者。

Objective To investigate the clinical efficacy of Shensong Yangxin(SSYX)capsule combined with metoprolol on heart rate-related premature ventricular complex(PVC).Methods Three hundred PVC patients with symptoms were selected,and randomized into combined medication group and control group—in the former group a combined metoprolol and SSYX capsules were simultaneously prescribed while in the latter group metoprolol was took alone.The Holter monitoring indexes and symptom alleviation rate were analyzed before and after the treatment.The efficacy of the combined medication was compared among fast heart rate-dependent PVC(F-HR-PVC),heart rate-independent PVC(I-HR-PVC)and slow heart rate-dependent PVC(S-HR-PVC).Results Compared with the control group,the frequency of PVCs during 24 hours in the combined medication group is significantly declined[(5536.22±3826.35)times vs.(4348.59±3267.00)times,P=0.037],and so is the PVC load[(5.82±4.29)%vs.(3.77±3.37)%,P=0.018].Subgroup analysis shows that the clinical symptom relief rate and the number of patients with a reduced PVC frequency by 50%both significantly increase among patients with I-and S-HR-PVC from the combined medication group,if compared with the control group(P<0.05);the effectiveness rate on patients with F-HR-PVC does not vary significantly between the two groups.Conclusion Compared with metoprolol used alone,the effectiveness rate of SSYX capsule combined with metoprolol proves to be significantly higher,especially on those with I-and S-HR-PVC.