参松养心胶囊对持续性心房颤动经射频消融术后患者左心功能及生活质量的影响

Effect of Shensongyangxin capsule on left ventricular function and quality of life in patients with persistent atrial fibrillation after radiofrequency ablation

目的 观察参松养心胶囊对持续性心房颤动经射频消融术后患者窦性心律维持、左心功能及生活质量的影响。方法 选取2019年5月—2021年6月在山东中医药大学第二附属医院心血管病科行射频消融术转窦性心律的持续性心房颤动患者60例,随机数字表法分成常规组和联合组,各30例。常规组患者术后给予基础方案治疗,联合组在常规组的基础上服用参松养心胶囊,3个月为1个疗程,治疗2个疗程。每个疗程结束后,监测患者动态心电图、心脏彩色超声指标并统计心房颤动特异生活质量量表(AFEQT)评分,比较2组患者窦性心率维持、左心房内径(LAD)、左心室射血分数(LVEF),以及不良反应发生情况。结果 术后6个月,联合组总有效率高于常规组(90.0%vs.83.3%,χ^(2)=6.825,P=0.033)。术后3个月,2组AFEQT量表总分及4个维度得分(症状维度、日常活动维度、治疗焦虑维度、治疗满意维度)均高于治疗前(P<0.05),且联合组在治疗焦虑维度方面得分高于常规组(P<0.05);术后6个月,2组AFEQT量表总分及4个维度得分均高于术前(P<0.05),且联合组均高于常规组(t/P=10.311/<0.001,6.139/<0.001,5.763/<0.001,3.076/0.005,4.899/<0.001)。2组术后3个月、6个月窦性心律维持率比较差异无统计学意义(P>0.05)。术后3个月,联合组左心房内径小于术前,且明显小于常规组(t/P=4.187/<0.001),2组LVEF均高于术前(P<0.05),而组间比较差异无统计学意义(P>0.05);术后6个月,2组左心房内径均小于术前,LEVF均高于术前(P<0.05),联合组LVEF明显高于常规组(t/P=2.142/0.036),而2组左心房内径比较差异无统计学意义(P>0.05)。结论 持续性心房颤动患者射频消融术后经参松养心胶囊治疗可减少左心房内径、提高LVEF及改善患者生活质量。

Objective To observe the effect of Shensongyangxin capsule on sinus rhythm maintenance, left ventricular function and quality of life in patients with persistent atrial fibrillation after radiofrequency ablation. Methods From May 2019 to June 2021, 60 patients with persistent atrial fibrillation who underwent radiofrequency ablation and converted to sinus rhythm in the Cardiovascular Department of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected. They were randomly divided into the conventional group and the combined group, with 30 patients in each group. The patients in the conventional group were treated with basic scheme after operation, and the patients in the combined group were treated with Shensongyangxin capsule on the basis of the conventional group. Three months was one course of treatment, and two courses of treatment. At the end of each course of treatment, the patients’ dynamic electrocardiogram and cardiac color ultrasound indexes were monitored and the scores of atrial fibrillation specific quality of life scale(AFEQT) were counted. Sinus heart rate maintenance, left atrial diameter, left ventricular ejection fraction(LVEF) and adverse reactions were compared between the two groups. Results Six months after operation, the total effective rate of the combined group was higher than that of the conventional group(90.0% vs.83.3%, χ^(2)=6.825,P=0.033).Three months after operation, the total score of the AFEQT scale and the scores of four dimensions(symptom dimension, daily activity dimension, treatment anxiety dimension, treatment satisfaction dimension) of the two groups were higher than those before treatment(P<0.05), and the scores of the combined group in the treatment anxiety dimension were higher than those of the conventional group(P<0.05). Six months after operation, the total score and four-dimension scores of the AFEQT scale in both groups were higher than those before operation(P<0.05), and those in the combined group were higher than those in the conventional group(t/P=10.311/<0.001, 6.139/<0.001, 5.763/<0.001, 3.076/0.005, 4.899/<0.001). There was no significant difference in the maintenance rate of sinus rhythm between the two groups at 3 and 6 months after operation(P>0.05). Three months after operation, the left atrial diameter in the combined group was smaller than that before operation, and significantly smaller than that in the conventional group(t/P=4.187/<0.001). LVEF in both groups was higher than that before operation(P<0.05), but there was no significant difference between the two groups(P>0.05). Six months after operation, the left atrial diameter in both groups was smaller than that before operation, and LEVF was higher than that before operation(P<0.05). LVEF in the combined group was significantly higher than that in the conventional group(t/P=2.142/0.036), but there was no significant difference in the left atrial diameter between the two groups(P>0.05).Conclusion Shensongyangxin capsule can reduce the left atrial diameter, improve LVEF and improve the quality of life of patients with persistent atrial fibrillation after radiofrequency ablation.