养心定悸胶囊联合盐酸胺碘酮片在阵发性心房颤动患者射频消融术后治疗中的应用效果

Application effect of Yangxin Dingji capsules combined with amiodarone hydrochloride tablets for patients with paroxysmal atrial fibrillation after radiofrequency ablation

目的观察养心定悸胶囊联合盐酸胺碘酮片在阵发性心房颤动(以下简称为房颤)患者射频消融术后治疗中的应用效果。方法选取2021年6月—2022年6月于九江市第一人民医院行射频消融术治疗的阵发性房颤患者88例,采用随机数字表法分为胺碘酮单药组和联合用药组,各44例。患者均行射频消融术治疗,术后胺碘酮单药组患者予以盐酸胺碘酮片治疗,联合用药组患者在胺碘酮单药组基础上联合养心定悸胶囊,2组患者均连续治疗3个月。比较2组临床疗效,治疗前、治疗3个月后心功能指标[左心房内径(LAD)、左心房射血分数(LAEF)、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(E/A值)、左心房舒张末期容积(LAEDV)、左心房收缩末期容积(LAESV)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、症状严重程度评分、健康调查量表36(SF-36)评分及随访6个月疾病复发率、不良反应。结果联合用药组总有效率高于胺碘酮单药组(95.45%vs.70.45%,χ^(2)=9.724,P=0.002)。治疗3个月后,2组LAD、LAEDV、LAESV小于治疗前,LAEF、E/A值高于治疗前,且联合用药组缩小/升高幅度大于胺碘酮单药组(P<0.01);2组血清hs-CRP、IL-6、TNF-α水平低于治疗前,且联合用药组低于胺碘酮单药组(P<0.01);2组症状严重程度评分低于治疗前,SF-36评分高于治疗前,且联合用药组降低/升高幅度大于胺碘酮单药组(P<0.01)。联合用药组随访6个月疾病复发率为4.55%,低于胺碘酮单药组的18.18%(χ^(2)=4.062,P=0.044)。胺碘酮单药组与联合用药组不良反应总发生率比较,差异无统计学意义(9.09%vs.4.55%,χ^(2)=0.179,P=0.672)。结论阵发性房颤患者射频消融术后采用养心定悸胶囊联合盐酸胺碘酮片治疗可增强疗效,可有效减轻机体炎性反应,改善患者临床症状及心功能,提高患者的生存质量,降低疾病复发率,且安全性较高。

Objective To analyze the application effect of Yangxin Dingji capsules combined with amiodarone hydrochloride tablets for patients with paroxysmal atrial fibrillation after radiofrequency ablation.Methods A total of 88 patients with paroxysmal atrial fibrillation after radiofrequency ablation were selected in Jiu Jiang NO.1 People′s Hospital from June 2021 to June 2022,and they were divided into the amiodarone group and the combination group according to random number table method,44 cases in each group.All patients were underwent radiofrequency ablation,after operation,patients in the amiodarone group were given amiodarone hydrochloride tablets,and patients in the combination group were given Yangxin Dingji capsules based on the amiodarone group,both groups were treated for 3 months.Clinical effect,cardiac function indexes(LAD,LAEF,E/A ratio,LAEDV,LAESV),serum inflammatory factors(hs-CRP,IL-6,TNF-α),symptom severity score,SF-36 score before and after 3 months of treatment,and recurrence rate of disease followed-up for 6 months,incidence of adverse reactions were compared between the two groups.Results Total effective rate of the combination group was higher than that of the amiodarone group(95.45%vs.70.45%,χ^(2)=9.724,P=0.002).After 3 months of treatment,LAD,LAEDV,LAESV of the two groups were less than those before treatment,LAEF,E/A ratio were higher than those before treatment,and decreased/increased range of above indexes in the combination group were larger than those of the amiodarone group(P<0.01);Serum levels of hs-CRP,IL-6,TNF-αof the two groups were lower than those before treatment,and the indexes of the combination group were lower than those of the amiodarone group(P<0.01);Symptom severity score of the two groups was lower than that before treatment,SF-36 score was higher than that before treatment,and decreased/increased range of above indexes in the combination group were larger than those of the amiodarone group(P<0.01).Recurrence rate of disease followed-up for 6 months of the combination group was 4.55%,which was lower than 18.18%of the amiodarone group(χ^(2)=4.062,P=0.044).There was no significant difference of the incidence of adverse reactions between the amiodarone group and the combination group(9.09%vs.4.55%,χ^(2)=0.179,P=0.672).Conclusion Yangxin Dingji capsules combined with amiodarone hydrochloride tablets can enhance the curative effect for paroxysmal atrial fibrillation patients after radiofrequency ablation,it can effectively reduce the inflammatory response,improve symptoms and cardiac function,and improve the quality of life of patients,prevent the recurrence rate,and with higher safety.