参松养心胶囊联合美托洛尔治疗慢性心功能不全合并快速型心律失常临床效果观察

摘要

目的：观察参松养心胶囊联合美托洛尔治疗慢性心功能不全合并快速型心律失常患者的临床效果及安全性。方法选取2011年8月至2013年2月在该院心内科诊断为慢性心功能不全合并快速性心律失常的住院患者120例，随机分为治疗组和对照组，各60例。两组患者均予以强心、利尿等常规治疗，治疗组予参松养心胶囊和美托洛尔联合治疗，对照组常规应用美托洛尔治疗。随访6个月，比较两组患者临床疗效及严重心脏不良事件（MACE）和不良反应发生情况。结果治疗4周时，治疗组心室率达标时间[（7.5±2.3）d]优于对照组[（15.0±3.5）d]，差异有统计学意义（P＜0.05）；治疗组24 h内室性早搏次数[（105.7±12.3）次]明显少于对照组[（276.5±16.2）次]，差异有统计学意义（P＜0.05）；治疗6个月后，治疗组在左心室射血分数[（44.7±8.6）%、6 min步行试验（>150 m为51例）]方面均优于对照组[（39.2±8.2）%，>150 m为35例]，差异有统计学意义（P＜0.05），而两组MACE并发症发生率比较，差异无统计学意义（P>0.05）。两组患者均未发生严重不良反应。结论参松养心胶囊联合美托洛尔是治疗慢性心功能不全合并快速型心律失常的有效临床方法，较单用美托洛尔疗效显著，值得进一步临床研究。%Objective To observe clinical efficacy and safety of shensong yangxin capsule combined with metoprolol therapy in patients with chronic cardiac insufficiency and rapid arrhythmia. Methods A total of 120 impatients received from August 2011 to February 2013 in this hospital were diagnosed chronic cardiac insufficiency and rapidity of arrhythmia and ran-domly divided into the treatment group and the control group ,60 of each group.The both groups were given the conventional treat-ments such as cardiotonics and diuretics. In addition ,the treatment group were given shensong yangxin capsule combined with metoprolo orally,while the control group with metoprolol in routine. Followed up for 6 months ,the clinic efficacy,major adverse cardiovascular events(MACE) and complications of the two groups were compared. Results After 4-week treatment,the standard time of ventricular rate [(7.5±2.3)d] in the treatment group was superior to that of the control group [(15.0±3.5)d]. The difference was statistically significant(P<0.05). The times of 24-hour oventricular premature beat in the treatment group [(105.7±12.3)times]were significantly less than that in the control group [(276.5±16.2)times]. The difference was statistically significant (P<0.05),After 6-month treatment,the treatment group was more excellent in EF values(44.7±8.6)%,6-minute walk testing(51 cases over 150 m)than those of the control group[(39.2±8.2)%,35 cases over 150 m]. The difference was statistically significant (P<0.05). there was no statistically significant difference between them in major events such as cardiac complications (P>0.05). Conclusion Shensong yangxin capsule in combination with metoprolol on chronic cardiac insufficiency and type rapid arrhythmia patients is one of effec-tive clinical treatments,whose efficacy is better significantly than sole metoprolol,being worthy to further clinical research.