摘要
目的：探讨护心胶囊联合胺碘酮治疗非瓣膜病心房颤动优越性及逆转心房心肌重构的作用。
方法：选择68例非瓣膜性房颤患者随机分为治疗组(N=36)，对照组(N=32)。两组患者2周内均给胺碘酮负荷量7g，第3周开始予以维持量200mg，治疗组在此基础上应用护心胶囊5粒日三次。随访6个月。治疗前后行心电图、心脏彩超、肝肾功能及甲状腺检查，出院后嘱患者每2个月复查上述项目一次。
结果：治疗第3周及第6个月疗效比较显示，治疗组的显效率分别为88.8％、77.8％优于对照组75％、56％，总有效率明显高于对照组，差异显著(P＜0.05)；同时对照组被迫停药率显著高于治疗组(P＜0.05)。随访1、3、6月两组患者左房直径均渐缩小，左心室舒张早期经二尖瓣血流的最大值(E峰)，左心房收缩时经二尖瓣血流的最大值(A峰)，及E／A均增大，两组同期比较在第1月间差异显著(P＜0.05)，第3、6月间无明显差异(P＞0.05)，说明治疗组较对照组能够更早、更快地改善左房血流动力学，恢复左房功能，从而逆转心房重构。
结论：护心胶囊与胺碘酮具有协同作用，可以防止应用胺碘酮时出现窦性心动过缓而被迫停药；护心胶囊具有转复房颤及维持窦律的作用；对房颤复发及逆转心房心肌重构安全有效。
Objective: To observe the effect of "Huxin" capsule and amiodarone on reversion of atrial remodeling and this treatment's superiority in patients with NRN-AF. Methods : 68 patients with AF were randomized into treated group (n=36) and control group (n=32).The two groups underwent the sandaral loading amiodarone administration (7g) in two weeks and from the thrid week they all underwent the maintaining amiodarone administration (200mg) . Monger, the treated group underwent "Huxin" capsule administration (2.0tid 6months) based on above treatment. Electrocardiogram (ECG) and wltrasonography of heart, liver function, ren-al function and throid function were measured at before treatment and once in a month after treatment period respectively .Results :At the third weed and six month after treatment period, there was a significant higher effect in the treated group than the control group (P<0.05) .At the same time ,there was a significant higher ratio of passive stopping treatment in the control group than the tre
ated group .Moreover ,the-re were a smaller left atrial diameter ,a higher peak value of blood flow viamitral valve at early left ventricular diadtole period (E value) ,a higher peak value of blood flow viamitral value at left atrial diastole period (A value) and a higher E/A ratio at 1,3,6 month after treatment period than before treatment respectively in both groups. But there was an earlier and faster effect in improving left atrial blood flow dynamics and recovering left atrial function in the treated group than the control group .Conclusion :There was an cooperation between "huxin"capsule and amiodarone, "Huxin" capsule can prevent the ratio of passively stopping amiodarone ,because of sinus bradycardia. It is safe and effective on reversion of atrial remodeling and maintenance of normal sinus rhythm in patients
with atrial fibrillation .
引文
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