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胺碘酮联合养心归草汤治疗心房纤颤临床效果分析 预览

Clinical Curative Effect of Amiodarone Combined with Yang Xin Guicao Decoction in Treatment of Atrial Fibrillation
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摘要 目的:回顾性分析胺碘酮联合养心归草汤治疗心房纤颤的临床效果,左室射血分数(LVEF)、左室内径变化及对血清可溶性CD40配体(sCD40L)、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)及肌钙蛋白T(cTnT)水平的影响。方法:82例心房纤颤住院患者,分两组(各41例)进行治疗。对照治疗组予以基础治疗加口服胺碘酮片, 0.2g/次,3次/天,7天后调整为2次/天,21天后为1次/天,30天后改为隔天1次,持续3个月。联合治疗组在对照组治疗基础上加服养心归草汤,早晚各温服1次,100ml,持续3个月。比较两组临床总有效率,心梗事件发生率和窦性心律维持率,治疗前后LVEF和左室内径及血清sCD40L、hs-CRP、BNP和cTnT水平变化,以及药物不良反应发生率。结果:联合治疗组总有效率高于对照治疗组(87.80% Vs 65.85%,P〈0.01),心梗事件发生率低于对照治疗组(2.43% Vs 14.63%,P〈0.05),窦性心律维持率高于对照治疗组(73.17% Vs 51.22%,P〈0.05)。治疗前,两组间LVEF、左室内径和sCD40L、hs-CRP、BNP、cTnT水平差异无统计学意义(P〉0.05);治疗后,上述指标均较同组治疗前显著改善,联合治疗组较对照治疗组改善更明显(P〈0.01)。两组不良反应发生率无统计学差异(9.76% Vs 4.78%,P〉0.05)。结论:胺碘酮联合养心归草汤可通过改善心功能,降低sCD40L、hs-CRP、BNP及cTnT水平,提高心房纤颤患者的临床治疗效果。 Objective: To retrospective analyze the clinical curative effect of amiodarone combined with Yang Xin Guicao Decoction in treatment of atrial fibrillation,and left ventricular ejection fraction (LVEF) change,and the serum levels of amiodarone combination medication on soluble CD40 ligand (sCD40L), hypersensitive creactive protein (hs-CRP) ,cerebral sodium peptide (BNP),and troponin T(cTnT). Method: 82 cases of atrial fibrillation was divided into two group(each n =41), control group oral amiodarone tablets basis of conventional treatment, 0.2g/ time, 3 times/day, 7 days after was adjusted to a single 2 times/day, 21 days after the dose was adjusted to a single 1 times/day, after 30 days and changed to the next day, continued 3 months. Combined treatment group was treated with Yangxin Guicao Decoction on the basis of control group. On the basis of treatment, warm clothing 100mL in morning and evening, continued 3 months. Then clinical total effective rate, serum levels of sCD40L, hs-CRP,BNP, LVEF, the incidence of myocardial infarction and the retention rate of sinus rhythm, LVEF and left ventricular diameter before and after treatment, and the incidence of adverse events between two group were compared. Results: Clinical total effective rate of the combined treatment group was higher than the control group (87.80% Vs 65.85%, P 〈0.01), the incidence of myocardial infarction (MI) was lower than that of the control group (2.43% Vs14.63%, P 〈0.05), and the sinus rhythm maintenance rate was higher than that of the control group (73.17% Vs 51.22%, P〈0.05).Before treatment, LVEF, left atrial diameter and sCD40L, hs-CRP, BNP and cTnT levels in both group were no statistically significant difference (P〉0.05). After treatment, the above indexes were significantly improved after treatment, and the improvement of the combined treatment group was more significant (P〈0.01). The incidence of adverse reactions in both groups was no statistically significant 9.76% Vs
作者 李嘉 苗昌荣 郑志君 马丽梅 王晓蕊 LI Jia,MIAO Changrong,ZHENG Zhijun,MA Limei,WANG Xiaorui(Department of Cardiovascular Medicine, Union Hospital of Tangshan City, Tangshan 063000, China)
出处 《微循环学杂志》 2018年第2期18-22,共5页 Chinese Journal of Microcirculation
关键词 心房纤颤 胺碘酮联合养心归草汤 临床效果 心功能 心肌损伤指标 炎性指标 Atrial fibrillation Amiodarone combined with Yang Xin Guicao Tang Clinical effect Heart function Myocardial injury index Inflammatory index
作者简介 李嘉(1980-),男,汉族,主治医师,主要从事心血管内科常见病、多发病的临床诊断及治疗.
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