养心定悸胶囊治疗伴长RR间期的心房颤动合并慢性心力衰竭的临床研究

目的观察养心定悸胶囊治疗伴长RR间期的心房颤动合并慢性心力衰竭患者的效果。方法将2016年5月1日—2018年6月1日就诊于河北省人民医院的104例伴长RR间期的心房颤动合并慢性心力衰竭患者随机分为试验组52例和对照组52例,2组均给予改善心功能、稳定心率在内的规范化治疗,试验组在此基础上加服养心定悸胶囊,6粒/次,2次/d。观察2组患者治疗12周后症状、心率、RR间期、心功能左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左房内径(LAD)、N端前脑钠肽(NT-proBNP)]及心率变异性指标窦性心率RR间期标准差(SDNN)、RR间期平均值标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)、窦性相邻RR间期之差>50 ms的计数占总RR间期数的百分比(PNN50)]的变化,记录2组不良反应发生情况。结果治疗12周后,试验组和对照组的临床症状总有效率分别为88.5%(46/52)和75.0%(39/52),试验组明显高于对照组(P<0.05);2组患者的24 h总心搏次数、心率及长RR间歇次数均显著少于治疗前,最长间歇时间均显著短于治疗前,且试验组最长间歇时间显著短于对照组,长RR间歇次数显著少于对照组,差异均有统计学意义(P均<0.05);2组患者的LVEF及均心率变异性各指标显著高于治疗前,LVEDD、LAD及NT-proBNP水平均显著低于治疗前,且试验组的变化都更为显著,差异均有统计学意义(P均<0.05)。治疗期间2组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论养心定悸胶囊辅助治疗可明显改善伴长RR间期的心房颤动合并慢性心力衰竭患者症状,有效稳定心率,缩短长间歇,改善心功能,调节心率变异性,且安全性高。

Clinical study on Yangxin Dingji capsule in the treatment of atrial fibrillation and chronic heart failure with long RR interval

Objective It is to observe the effect of Yangxin Dingji capsule in the treatment of patients with atrial fibrillation and chronic heart failure with long RR interval.Methods A total of 104 patients with atrial fibrillation and chronic heart failure with long RR interval who were treated at Hebei General Hospital from May 1,2016 to June 1,2018 were randomly divided into experimental group(n=52)and control group(n=52).Both groups were given standardized treatments including improving heart function and stabilizing heart rate.On the basis of this,the experimental group was given Yangxin Dingji capsules,6 capsules/time,2 times/d.The symptoms,heart rate,RR interval,cardiac functionleft ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left atrial inner diameter(LAD),and N-terminal forebrain natriuretic peptide(NT-proBNP)]and heart rate variability indicatorssinus rhythm RR interval standard deviation(SDNN),RR interval standard deviation(SDANN),root mean square of adjacent RR interval differences(RMSSD),the difference between sinus adjacent RR intervals>50 ms count as a percentage of total RR intervals(PNN50)]after 12 weeks of treatment were recorded,and the incidence of adverse reactions in the two groups was recorded.Results After 12 weeks of treatment,the total effective rates of clinical symptoms in the experimental group and the control group were 88.5%(46/52)and 75.0%(39/52),respectively,and the experimental group was significantly higher than the control group(P<0.05);The total 24-hour total heart rate,heart rate,and long RR interval times in the group were significantly less than those before treatment,and the longest interval time was significantly shorter than before treatment,and the longest interval time in the experiment group was significantly shorter than that in the control group,and the long RR interval times Significantly less than the control group,the differences were statistically significant(P<0.05);LVEF and mean heart rate variability of the two groups of patients were significantly higher and LVEDD,LAD,and NT-proBNP levels were significantly lower than those before treatment,the changes in the experimental group were more significant,and the differences were statistically significant(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Adjuvant therapy of Yangxin Dingji capsule can obviously improve the symptoms,effectively stabilize heart rate,shorten long intervals,improve heart function,regulate heart rate variability,and have high safety in the treatment of patients with atrial fibrillation and chronic heart failure with long RR interval.