董小英

【摘要】 目的：探討稳心颗粒配合胺碘酮治疗阵发性心房颤动的临床疗效。方法：选取99例阵发性心房颤动患者为研究对象，根据其入院顺序分成A组、B组。B组采用盐酸胺碘酮片口服方案，A组采用盐酸胺碘酮片联合稳心颗粒口服方案。进行为期半年随访，比较两组患者临床治疗效果及不良反应发生的情况，记录其治疗前后心室率、房颤发作次数、左室舒张末内径（LVEDD）、左心房内径（LAd）、左房最大容积（LAVmax）、P波最大时限（Pmax）、P波离散度（Pd）、A峰峰值流速（VA）等指标变化情况，对比复律时间、胺碘酮用量等指标差异。结果：（1）A组总有效率为92.0%，明显高于B组的75.5%（P<0.05）；（2）治疗后，两组患者VA均较治疗前明显提升，心室率、房颤发作次数、LVEDD、LAd、LAVmax、Pmax、Pd等指标则较治疗前明显降低（P<0.05），且A组变化幅度大于B组（P<0.05）；（3）A组复律时间、胺碘酮用量及不良反应发生率均显著低于B组（P<0.05）。结论：对阵发性房颤患者予以胺碘酮及稳心颗粒联合用药方案，疗效确切，值得临床推广。

【关键词】 稳心颗粒； 胺碘酮； 阵发性心房颤动

中图分类号 R541.7 文献标识码 A 文章编号 1674-6805（2016）5-0008-03

【Abstract】 Objective：To investigate the clinical curative effect of Wenxin Granules combined with Amiodarone on paroxysmal atrial fibrillation Method：99 patients with paroxysmal atrial fibrillation were selected as the research object.According to the order of admission into the hospital，they were divided into two groups.Group B was received the plan of orally taking Amiodarone Hydrochloride Tablets while group A was Amiodarone Hydrochloride Tablets combined with Wenxin Granules.In the phase of behavior，there was half-year follow-up.And the situation of adverse reactions and clinical curative effect of two groups were compared.The differences of following indexes were recorded before and after the treatment，such as the ventricular rate，the times of atrial fibrillation episodes，left ventricular end-diastolic diameter（LVEDD），left atrial diameter（LAd），left atrial maximal volume（LAVmax），maximum time limitation of P wave（Pmax），P wave dispersion（Pd） and flow velocity of A peak value（VA）.The time of cardioversion and the dosage of amiodarone were compared.Result：（1）The total effective rate of group A was 92.0% which was significantly higher than that of group B which was 75.5%（P<0.05）.（2）After the treatment，VA of two groups improved obviously compared with the number before the treatment while the ventricular rate and the number of atrial fibrillation，LVEDD，Lad，LAVmax，Pmax，Pd and other indexes were significantly lower than those before the treatment（P<0.05）.And the changes of group A were greater than the group B（P<0.05）.（3）The cardioversion time，the dosage of amiodarone and the incidence of adverse reactions in group A were significantly lower than those in group B（P<0.05）.Conclusion：The curative effect of plan to treat patients with paroxysmal atrial fibrillation with Amiodarone and Wenxin Granules is accurate and worth the clinical promotion.

【Key words】 Wenxin Granules； Amiodarone； Paroxysmal atrial fibrillation

First-authors address：Wujiang Fourth Peoples Hospital of Suzhou，Suzhou 215231，China

doi：10.14033/j.cnki.cfmr.2016.5.004

阵发性心房颤动是一种以心房为起搏点的异位性心动过速疾病，以有器质性心脏病的成年人为主要患病群体[1]，若长期反复性发作存在发展成持久性房颤风险[2]，于患者生命健康安全威胁较大。临床研究证实，阵发性房颤可引起血流动力学障碍，严重时可诱发心梗、心衰或心源性休克，甚至危及患者生命，及时复律及治疗后防病情反复是提高其预后的关键[3]。胺碘酮作为一种临床应用范围较广的Ⅲ类抗心律失常药物，可通过延长心脏纤维动作电位及不应期、消除折返激动、减慢窦房、房内和结区传导等方式平稳血流动力学[4]，达到及时复律的效果。随着相关研究的深入，越来越多学者在报告中指出，虽胺碘酮对阵发性心房颤动治疗效果突出，但患者在长期用药或大剂量用药后易出现严重心外副作用[5]，于其预后提升不利。……