养心定悸胶囊联合盐酸胺碘酮片治疗冠心病合并心律失常的效果及对心率变异性的影响

Effect of Yangxin Dingji capsules combined with amiodarone hydrochloride tablets in the treatment of coronary heart disease complicated with arrhythmia and the impact on heart rate variability

目的 观察养心定悸胶囊联合盐酸胺碘酮片治疗冠心病合并心律失常的效果及对心率变异性的影响。方法 选取2022年12月—2023年10月北京市怀柔区中医医院收治的冠心病合并心律失常患者90例,按照电脑随机法分为西药组45例和联合中药组45例。在基础治疗上,西药组患者给予盐酸胺碘酮片,联合中药组患者在西药组基础上给予养心定悸胶囊,2组患者均持续治疗30 d。比较2组临床疗效,治疗前后心功能指标、血清炎性因子、心率变异性指标,不良反应。结果 联合中药组治疗总有效率为97.78%,高于西药组的77.78%(χ^(2)=8.839,P=0.004)。治疗30 d后,2组左室舒张末期内径、左室收缩末期内径减小,左室射血分数升高,血清超敏C反应蛋白、肿瘤坏死因子-α、白介素-6水平降低,且联合中药组各指标变化幅度大于西药组(P<0.01);2组窦性心律RR间期标准差、相邻RR间期差值≥50 ms的百分比、24 h内每5分钟窦性心律RR间期平均值标准差升高,且联合中药组高于西药组(P<0.01)。联合中药组与西药组不良反应总发生率比较,差异无统计学意义(4.44%vs. 8.89%,χ^(2)=0.714,P=0.398)。结论 采用养心定悸胶囊联合盐酸胺碘酮片治疗冠心病合并心律失常可显著改善患者心功能,提高心脏自主神经调节功能,减轻炎性反应,可增强疗效,且安全性高。

Objective To observe the effect of Yangxin Dingji capsules combined with amiodarone hydrochloride tablets in the treatment of coronary heart disease complicated with arrhythmia and the impact on heart rate variability.Methods A total of 90 cases of coronary heart disease patients complicated with arrhythmia were selected from December 2022 to October 2023 in Beijing Huairou Hospital of Traditional Chinese Medicine,who were divided into the western medicine group and the TCM group,45 cases in each group.Patients were given basic therapy,and patients in the western medicine group were given amiodarone hydrochloride tablets,patients in the TCM group were given Yangxin Dingji capsules based on the western medicine group,both groups were treated for 30 days.Clinical effect,cardiac function indexes,serum inflammatory factors and heart rate variability indexes before and after treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate of the TCM group was 97.78%,which was higher than 77.78%of the western medicine group(χ^(2)=8.839,P=0.004).After 30 days of treatement,LVEDD,LVESD of the two groups were less than those before treatment,LVEF was higher than that before treatment,serum levels of hs-CRP,TNF-α,IL-6 were lower than those before treatment,and the TCM group were better than those of the western medicine group(P<0.01);SDNN,pNN50,SDANN of the two groups were higher than those before treatment,and the TCM group were higher than those of the western medicine group(P<0.01).There was no significant difference of the incidence of adverse reactions between the TCM group and the western medicine group(4.44%vs.8.89%,χ^(2)=0.714,P=0.398).Conclusion Yangxin Dingji capsules combined with amiodarone hydrochloride tablets can effectively improve the cardiac function of coronary heart disease patients complicated with arrhythmia,improve the regulation function of cardiac autonomic nerve,reduce inflammatory reactions,enhance the curative effect,and the drug has high safety.