稳心颗粒联合西药治疗老年阵发性心房颤动的疗效及对心功能和血清hs CRP、BNP水平的影响

摘要

Objective To investigate the clinical efficacy of Wenxin granules(WXG)and western medicine on cardiac function,serum high sensitive C-reaction protein(hs-CRP)and B-type natriuretic peptide(BNP)levels in elderly patients with paroxysmal atrial fibrillation(PAF).Methods One hundred and sixty-two elderly patients with PAF from January 2016 to January 2017 were randomly divided into two groups:control group(n=81)treated with routine treatment,and observation group(n=81)treated with WXG and western medicine routine treatment for 6 months.The clinical efficacy,frequency and duration of AF outbreak before and after treat-ment,changes of heart function and serum hs-CRP,BNP levels,and the occurrence of adverse reactions were observed and com-pared between two groups.Results The frequency and duration of AF outbreak after 6 months of treatment significantly decreased compared with those before treatment(P<0.01),and the improvement in observation group was more significant than that in the control group(P<0.01).The total clinical effective rate was significantly higher in observation group than that in control group(95.1% vs 80.2%,P<0.05).Compared with those before treatment,the values of left ventricular ejection fraction (LVEF),left ventricular end diastolic/sys-tolic diameter (LVEDD/LVESD)and P wave dispersion(Pd)in two groups after treatment were improved remarkably (P<0.01), and the improvement in the observation group was more significant (P<0.01).The serum hs-CRP and BNP levels in two groups after treatment were obviously lower than those before treatment (P<0.01),and the improvement in the observation group was more significant (P<0.01).There was no difference in the of incidence adverse reaction between two groups(6.17% vs 3.70%,P>0.05).Conclusion WXG and western medicine routine treatment can greatly improve the cardiac function and lower serum hs-CRP and BNP levels in elderly patients with PAF.%目的 探讨稳心颗粒联合西药治疗老年阵发性心房颤动(PAF)的疗效及对病人心功能和血清超敏 C-反应蛋白(hs-CRP)、B型尿钠肽(BNP)水平的影响.方法 选取西安交通大学第一附属医院2016年1月—2017年1月收治的162例老年 PAF病人,采用随机数字表法分为两组,每组81例.对照组采用盐酸胺碘酮片与马来酸依那普利片治疗,观察组在对照组基础上加用稳心颗粒治疗.比较两组临床疗效,观察两组治疗前后 AF发作次数、AF持续时间、心功能指标及血清 hs-CRP、BNP水平变化,不良反应情况.结果 与治疗前相比,两组治疗6个月后 AF发作次数显著降低(P<0.01),AF持续时间缩短(P<0.01),且观察组改善较对照组更显著(P<0.01).治疗6个月后,观察组总有效率为95.1%,高于对照组的80.2%,差异有统计学意义(P<0.01).与治疗前相比,两组治疗6个月后左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、P波离散度(Pd)值均显著改善(P<0.01),且观察组改善更显著(P<0.01).与治疗前相比,两组治疗6个月后血清 hs-CRP、BNP水平均显著降低(P<0.01),且观察组降低更显著(P<0.01).对照组和观察组不良反应发生率比较差异无统计学意义(6.17%和3.70%,P>0.05).结论 老年 PAF应用稳心颗粒联合西药治疗效果显著,可有效改善病人心功能,降低血清 hs-CRP、BNP水平.