活血化瘀汤辅助常规疗法治疗心肌梗死伴心房颤动的疗效及对QT校正离散度的影响

Effect of Huoxue Huayu Decoction in the treatment of myocardial infarction with atrial fibrillation and its influence on QT correction dispersion

目的:探讨活血化瘀汤辅助常规疗法治疗心肌梗死(Myocardial infarction, MI)伴心房颤动(Atrial fibrillation, AF)的疗效及对QT校正离散度的影响。方法:前瞻性选取我院2020年8月—2023年3月收治的94例MI伴AF患者,按随机数表法分为观察组(n=47)、对照组(n=47)。对照组采用常规疗法治疗,观察组采用活血化瘀汤辅助常规疗法治疗。比较两组疗效,治疗前、治疗1个月后心功能指标(心排血量、左心室收缩末内径、舒张末内径、射血分数)、QT间期离散度[QT离散度(QTd)、校正的QT离散度(QTcd)]、炎症及氧化应激反应[超氧化物歧化酶(SOD)、NADPH氧化酶(NOX)、肿瘤坏死因子(TNF-α)]水平及不良反应发生情况。结果:观察组总有效率(95.74%,45/47)显著高于对照组(76.60%,36/47)(P<0.05);治疗1个月后观察组心排血量、左心室射血分数高于对照组,左心室收缩末内径、舒张末内径低于对照组(P<0.05);治疗1个月后观察组QTcd、QTd改善幅度大于对照组(P<0.05);治疗1个月后观察组SOD水平高于对照组,NOX、TNF-α水平均低于对照组(P<0.05);观察组不良反应总发生率为6.38%(3/47),与对照组的12.77%(6/47)相比,差异无统计学意义(P>0.05)。结论:采用活血化瘀汤辅助常规疗法治疗MI伴AF疗效显著,能有效抑制炎症、氧化应激反应,促进心功能、QT离散度改善,并能保障安全,利于预后病情转归。

Objective:To investigate the effect of Huoxue Huayu Decoction in the treatment of Myocardial infarction(MI) with Atrial fibrillation(AF)and its effect on QT correction dispersion.Methods:94 patients with MI and AF admitted to our hospital from August 2020 to March 2023 were prospectively selected and divided into observation group(n=47)and control group(n=47)according to random number table method.The control group was treated with conventional therapy,and the observation group was treated with Huoxue Huayu decoction.Compare the efficacy of the two groups,and compare the cardiac function indicators(cardiac output,left ventricular end systolic diameter,diastolic end diameter,ejection fraction),QT interval dispersion[QT dispersion(QTd),corrected QT dispersion(QTcd)],inflammation and oxidative stress response levels[superoxide dismutase(SOD),NADPH oxidase(NOX),tumor necrosis factor(TNF-α)]before and after 1 month of treatment,as well as the occurrence of adverse reactions between the two groups.Results:The total effective rate of observation group(95.74%,45/47)was significantly higher than that of control group(76.60%,36/47)(P<0.05).After 1 month of treatment,cardiac output and left ventricular ejection fraction in observation group were higher than those in control group,and left ventricular end-systolic diameter and end-diastolic diameter were lower than those in control group(P<0.05).After 1 month of treatment,the improvement of QTcd and QTd in the observation group was greater than that in the control group(P<0.05).After 1 month of treatment,the SOD level of observation group was higher than that of control group,the levels of NOX and TNF-αwere lower than that of control group(P<0.05).The total incidence of adverse reactions in the observation group was6.38%(3/47),compared with 12.77%(6/47)in the control group,the difference was not statistically significant(P>0.05).Conclusion:The use of Huoxuehuayu decoction as adjuvant therapy in the treatment of MI patients with AF has significant effect,which can effectively inhibit inflammation and oxidative stress,promote the improvement of cardiac function and QT dispersion,ensure safety,and facilitate prognosis.