养心定悸胶囊联合美托洛尔治疗冠心病合并心律失常的临床疗效

Clinical effect of Yangxin Dingji capsules combined with metoprolol in the treatment of coronary heart disease complicated with arrhythmia

目的探讨养心定悸胶囊联合美托洛尔治疗冠心病合并心律失常的临床疗效。方法选取2020年1月至2021年6月辽阳市中心医院收治的80例冠心病合并心律失常患者作为研究对象,采用随机数字表法分为对照组与观察组,每组40例。对照组予以美托洛尔治疗,观察组在对照组基础上给予养心定悸胶囊治疗,比较两组临床疗效与治疗前、治疗1个月中医证候评分和24h动态心电图指标(短阵室速次数、室性早搏次数、QT间期、PR间期)、心率变异性(HRV)指标[间距差值的均方根(RMSSD)、低频与高频比值(LF/HF)、平均窦性心律R-R间距的标准差(SDANN)、窦性心律R-R间距的标准差(SDNN)]及血流变学检查指标[全血低切黏度(NBL)、纤维蛋白原(Fg)、全血高切黏度(NBH)、血浆比黏度(PV)]及不良反应发生情况。结果观察组治疗总有效率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。治疗后,观察组胸闷胸痛、脉率失常、心悸怔忡、气短、乏力、盗汗积分均低于对照组,短阵室速次数、室性早搏次数均少于对照组,QT间期及PR间期均长于对照组,SDNN、SDANN及LF/HF均低于对照组,RMSSD高于对照组,Fg、NBL、NBH、PV水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为5.00%,低于对照组的22.50%,差异有统计学意义(P<0.05)。结论养心定悸胶囊联合美托洛尔治疗冠心病合并心律失常效果显著,可改善患者临床症状,纠正心律失常,且安全性较高。

Objective To investigate the clinical effect of Yangxin Dingji capsules combined with metoprolol in the treatment of coronary heart disease complicated with arrhythmia.Methods A total of 80 patients with coronary heart disease complicated with arrhythmia who were admitted to Liaoyang City Central Hospital from January 2020 to June 2021 were selected as the study subjects,they were divided into the control group and the observation group according to the random number table,with 40 cases in each group.The control group was treated with metoprolol,while the ob-servation group was treated with Yangxin Dingji capsules on the basis of the control group.The clinical efficacy,Traditional Chinese Medicine syn-drome scores,24 h dynamic electrocardiogram indicators(nonsustained ventricular tachycardia,ventricular premature beat,QT interval,and PR inter-val),heart rate variability(HRV)indicators(root mean square of successive differences[RMSSD],low frequency to high frequency ratio[LF/HF],standard deviation of average R-R intervals[SDANN],and standard deviation of R-R intervals[SDNN]),hemorheological indicators(whole blood low shear viscosity[NBL],fibrinogen[Fg],whole blood high shear viscosity[NBH],and plasma specific viscosity[PV])before treatment and after 1 month of treatment,and the incidence of adverse reactions were compared between the two group.Results The total effective rate in the observation group was 95.00%,which was higher than 77.50%in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of chest tightness,chest pain,abnormal pulse rate,palpitation,shortness of breath,fatigue and night sweat in the observation group were lower than those in the control group,the frequencies of nonsustained ventricular tachycardia and ventricular premature beats were less than those in the control group,QT interval and PR interval were longer than those in the control group,SDNN,SDANN,and LF/HF were lower than those in the con-trol group,and RMSSD was higher than that in the control group,the levels of Fg,NBL,NBH,and PV were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 5.00%,which was lower than 22.50%in the control group,and the differences were statistically significan(P<0.05).Conclusion Yangxin Dingji capsules combined with metoprolol is effective in the treatment of coronary heart disease complicated with arrhythmia,which can improve clinical symptoms and correct ar-rhythmia,and has high safety.