步长稳心颗粒并美托洛尔对慢性心力衰竭伴心房颤动的疗效

目的:探讨步长稳心颗粒联用美托洛尔对慢性心力衰竭(CHF)伴慢性心房颤动(AF)患者的疗效。方法:选择CHF伴慢性AF98例,随机分为治疗组(50例)和对照组(48例)。两组均常规使用地高辛等常规用药,治疗组加用美托洛尔(12.5~50mg/d)及步长稳心颗粒(27g/d)。观察两组1月疗效,并随访半年心脏原因所致再住院率、死亡率。结果:治疗1月后,治疗组患者静息心室率(HR)和运动前、后即刻心室率差值(HD)显著降低,6min步行距离(m),左室射血分数(LVEF)显著增加,心功能NYHA分级,生活质量(QOL)显著改善(P<0.05~<0.01)。对照组的上述参数除HD外亦有显著改善(P<0.05),但HR、HD、6min步行距离改善显著次于治疗组(P<0.05)。随访半年,和对照组相比,治疗组患者因心力衰竭再住院率较低(14.0%∶27.1%,P<0.05),死亡率亦较低(6%∶14.6%,P<0.05);NYHA分级、6min步行距离、LVESV、LVEDV、LVEF、QOL评分明显优于对照组(P<0.05)。结论:对于慢性心力衰竭合并心房颤动患者,在常规治疗的基础上,步长稳心颗粒联用美托洛尔1个月仅HR,HD,6min步行距离改善显著优于对照组,而半年后心功能、生活质量都明显优于对照组。

Effects of wenxin keli combine with metoprolol on chronic heart failure patients with chronic atrial fibrillation

Objective:To investigate the short-term effects and long-term prognosis of wenxin keli with metoprolol on chronic heart failure (CHF) patients with chronic atrial fibrillation (AF).Methods:Ninety-eight patients with CHF and AF were randomly divided into the treatment group treated with wenxin keli (27 g/d) and metoprolol(12.5~50 mg/d,50 cases),and the control group (48 cases).The general therapy included digoxin etc.was performed in two groups.Results:The ventricular rates at rest (HR) decreased,the walking distance of 6 min and LVEF(left ventricular ejection fraction) increased,the NYHA heart function class and quality of life(QOL) improved obviously (P<0.05~<0.01) in treatment group one month after treatment.Above station parameters also obviously improved (P<0.05) in control group,but HR,the diversity of ventricular rate before and after walk (HD) and walking distance of 6 min less than those of treatment group(P<0.05).In 6 months follow up period,the rehospitalization rate(14%) and mortality(6%) were less than those of control group (P<0.05);the improved of walking distance of 6 min,NYHA heart function class,LVESV,LVEDV and QOL were more than those of control group in treatment group(P<0.05).Conclusion:Based on the routine therapy the wenxin keli with metoprolol can improve the short-term effects and long-term prognosis on CHF patients with AF, but the long-term prognosis is obviously better than that of control group.