步长稳心颗粒联合贝那普利治疗心力衰竭合并心房纤颤的疗效

目的探索步长稳心颗粒联合贝那普利治疗心力衰竭合并心房纤颤的疗效。方法将121例心力衰竭合并心房纤颤的患者随机分为治疗组和常规组。治疗组除常规治疗并加用贝那普利基础上,再给予步长稳心颗粒1包/次,3次/d冲服。治疗前及治疗后1个月分别行常规超声心动图,临床评价心功能。结果治疗组心房纤颤转复率为91.53%,常规组心房纤颤转复率75.81%。差异有统计学意义(P0.05)。治疗组心功能分级(NYHA)及左室射血分数(LVEF)较常规有明显改善。结论步长稳心颗粒联合贝那普利不仅明显改善心力衰竭症状,而且大大减少心房纤颤复发率。     

美托洛尔联合步长稳心颗粒治疗心律失常的临床疗效

目的评价美托洛尔联合步长稳心颗粒治疗心律失常的疗效。方法将215例心律失常的患者随机分为3组：治疗组（A组）71例,给予口服美托洛尔12.5mg/次,2次/d,稳心颗粒9g/次,3次/d;对照组分为B组和C组,B组72例,口服美托洛尔12.5mg/次,2次/d;C组72例,口服稳心颗粒9g/次,3次/d。疗程均为4周,治疗前后均做心电图及动态心电图检查,以判断疗效并作对比分析。结果治疗4周后,美托洛尔联合步长稳心颗粒治疗组的有效率为91.5%,明显优于单用美托洛尔及步长稳心颗粒对照组,差异有统计学意义（P〈0.05）。结论美托洛尔联合步长稳心颗粒治疗心律失常疗效满意,不良反应少,具有明确的临床意义。     

稳心颗粒与美托洛尔联用治疗缺血性快速心房纤颤的临床观察

目的观察步长稳心颗粒与美托洛尔联用治疗缺血性心脏病合并快速心房纤颤(缺血性快速房颤)的临床疗效和不良反应。方法将61例缺血性快速房颤患者随机分成两组,治疗组30例,对照组31例。治疗组予步长稳心颗粒9g/次,3次/d,冲服;美托洛尔12.5mg/次,2次/d,口服。对照组予美托洛尔12.5mg/次,2次/d,口服。两组疗程均为4周。观察用药前后疗效与不良反应。结果症状疗效:治疗组总有效率96.67%,对照组总有效率77.42%,两组比较差异有统计学意义(P<0.05);快速房颤情况疗效比较:治疗组总有效率90.00%,对照组总有效率67.74%,两组比较差异有统计学意义(P<0.05);药物不良反应发生率:治疗组6.67%,对照组12.90%,两组比较差异无统计学意义(P>0.05),其中对照组发生2例致心律失常(1例房颤合并Ⅱ度Ⅱ型房室传导阻滞,1例房颤合并高度房室传导阻滞),治疗组未见此情况发生。两组治疗后实验室检查无明显变化。结论步长稳心颗粒与美托洛尔联用治疗缺血性快速房颤不但安全有效,而且步长稳心颗粒还能有效减少西药抗心律失常药物所引起的不良反应。     

步长稳心颗粒治疗心律失常的疗效观察

目的观察步长稳心颗粒治疗心律失常的疗效及安全性。方法将90例心律失常患者随机分为治疗组和对照组。治疗组患者给予步长稳心颗粒1包（9g），3次／d，口服，对照组常规服用心律平100mg／次，3次／d，口服，治疗4周后，观察临床疗效及24h Holter动态心电图的变化，以评估其安全性。结果两组患者心电图疗效、临床疗效差异有显著性意义（P〈0．05）。结论步长稳心颗粒治疗心律失常与对照组比较疗效显著，使用简单安全，效果显著。     

胺碘酮治疗心力衰竭合并心房纤颤的疗效观察

目的探讨胺碘酮治疗心力衰竭合并心房纤颤的临床疗效。方法选择我院2010年1月—2013年9月收治的心力衰竭合并心房纤颤患者45例,随机分为研究组23例和对照组22例。两组患者均给予常规治疗,对照组患者在常规治疗基础上采用西地兰缓慢静脉推注,0.4 mg/次,1次/d,连续治疗3 d;之后使用地高辛静脉滴注,0.250 mg/次,1次/d,1周后减量至0.125 mg/次,1次/d。研究组患者在常规治疗基础上采用胺碘酮150 mg溶入10%葡萄糖溶液150 ml静脉滴注,30 min内滴注完,连续治疗7 d;之后给予胺碘酮片口服,0.2 g/次,1次/d。治疗1个月后观察两组患者临床疗效及不良反应情况。结果研究组患者总有效率为91.30%,高于对照组的63.64%(χ2=4.98,P0.05)。研究组不良反应发生率为8.70%,对照组为0,两组患者不良反应发生率比较,差异无统计学意义(χ2=2.00,P0.05)。结论胺碘酮治疗心力衰竭合并心房纤颤疗效较好,安全可靠,值得临床推广应用。     

步长稳心颗粒治疗Gavers病窦性心动过速的疗效观察

目的观察步长稳心颗粒治疗Gavers病窦性心动过速的疗效和不良反应。方法将60例Gavers病窦性心动过速患者随机分为两组,治疗组30例,对照组30例,均予以常规的抗甲亢基础治疗（抗甲状腺药物治疗）,对照组30例在此基础上服用普奈洛尔片,10mg/次,3次/d。治疗组30例在对照组基础上服用步长稳心颗粒,1包（9g）/次,3次/d。疗程均为2周。1周及2周后分别检查心电图,并观察临床疗效及不良反应。结果对照组总有效率为93.3%,治疗组总有效率为70%。两组不良反应无明显差异。结论步长稳心颗粒冲剂与普奈洛尔联用治疗Gavers病窦性心动过速显效更快,有效率更高,无明显不良反应。     

稳心颗粒治疗心律失常56例临床疗效观察

目的观察稳心颗粒治疗心律失常的临床效果。方法选择经心电图和(或)动态心电图证实有房性期前收缩、室性期前收缩、心房纤颤等心律失常患者110例,随机分为治疗组56例和对照组54例,治疗组服用步长稳心颗粒,每次1包,3次/d,温开水冲服;对照组口服胺碘酮0.2g,3次/d,连用5d,改为每次0.2g,3次/d,应用5～7d,以后视病情调整剂量。两组对原发病的用药不变,疗程均为4周。治疗前检查常规心电图、动态心电图,血、尿常规及肝、肾功能,此后每周做一次常规心电图,4周后复查动态心电图,血、尿常规及肝、肾功能;记录心慌、胸闷等症状及不良反应。结果治疗组显效37例,对照组显效36例。治疗组出现口干3例,头昏2例,对照组口干2例,头昏5例,上腹部不适4例,两组均未停药。结论稳心颗粒可用于治疗多种心律失常,尤其是对室性及室上性期前收缩有显著疗效,其效果与胺碘酮基本相同。     

步长稳心颗粒治疗心律失常疗效观察

目的 观察心律失常患者应用步长稳心颗粒后心律失常控制情况.方法 将160例心律失常患者随机分为治疗组80例,对照组80例,治疗组应用稳心颗粒口服,1袋∕次,3次/d,治疗4周;对照组口服心律平150mg,3次/d,治疗4周.结果 两组临床症状改善比较,治疗组总有效率为92.5%,高于对照组的81.0%(P＜0.05);动态心电图疗效比较,治疗组总有效率为90.0%,对照组为72.5%,差异有统计学意义(P＜0.05).结论 步长稳心颗粒对各种心律失常均有较好的疗效,且无明显的不良反应,可作为治疗心律失常的首选中成药物.     

步长稳心颗粒治疗心律失常50例临床疗效观察

目的观察步长稳心颗粒治疗心律失常的临床效果。方法将100例心律失常患者随机分成两组:对照组50例,在常规治疗的基础上加用复方丹参片,3片/次,3次/d;治疗组50例,在常规治疗的基础加用步长稳心颗粒,1袋/次,3次/d,疗程均为6周。结果治疗组患者心律失常消失或减少为92%,对照组为65%,治疗组疗效明显优于对照组,差异有统计学意义(P0.01)。结论步长稳心颗粒对各种原因引起的心律失常均有显著的治疗效果。     

阿托伐他汀钙联合胺碘酮治疗阵发性心房纤颤的临床疗效观察

目的观察阿托伐他汀钙联合胺碘酮治疗阵发性心房纤颤的临床疗效。方法选取72例阵发性心房纤颤患者,随机分为对照组和治疗组,各36例。两组患者均给予积极治疗原发病,对照组给予胺碘酮治疗,治疗组在对照组用药基础上联合应用阿托伐他汀钙。随访12个月,观察两组的疗效。结果治疗组总有效率高于对照组(92.2%与76.6%),差异有统计学意义(P<0.05)。治疗后,治疗组的左心房内径小于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀钙联合胺碘酮能缩短心房纤颤患者的左心房内径,减少心房纤颤的复发和持续性心房纤颤的发生。     

步长稳心颗粒联合心律平治疗房性期前收缩临床观察

目的 观察步长稳心颗粒与心律平联合治疗房性期前收缩的疗效与不良反应.方法 将62例房性期前收缩患者随机分为两组,治疗组32例采用步长稳心颗粒联合心律平治疗;对照组30例单纯应用心律平治疗.观察临床疗效及心室率的变化.结果 治疗组总有效率为93.8%,对照组总有效率为80.0%,两组治疗效果比较,差异有统计学意义(P＜0.01).结论 步长稳心颗粒联合心律平治疗房性期前收缩疗效明显、安全性好.     

Propafenone treatment of symptomatic paroxysmal supraventricular arrhythmias. A randomized, placebo-controlled, crossover trial in patients tolerating oral therapy

OBJECTIVE: To test the hypothesis that propafenone, administered orally, prevents symptomatic paroxysmal supraventricular arrhythmias. DESIGN: a 6-month, open-label, dose-finding phase followed by a randomized, double-blind, placebo-controlled, crossover phase, with each treatment period lasting up to 60 days. SETTING: An outpatient clinic. PATIENTS: Thirty-three patients with either paroxysmal supraventricular tachycardia (n = 16) or paroxysmal atrial fibrillation (n = 17) were enrolled. Their arrhythmias were documented by electrocardiogram before enrollment. Twenty-three patients (14 with paroxysmal supraventricular tachycardia and 9 with paroxysmal atrial fibrillation) were randomized and the data obtained from these patients were used in the efficacy analysis. INTERVENTION: Propafenone (300 mg three times daily in 19 patients, 300 mg twice daily in 3 patients, and 150 mg twice daily in 1 patient) and matching placebo tablets were administered in a randomized sequence. MEASUREMENTS: Symptomatic arrhythmia was documented by telephone transmission of the electrocardiogram. MAIN RESULTS: The time to first recurrence was prolonged for the overall group of 23 patients while they received propafenone (P = 0.004). The recurrence rate of arrhythmia during treatment with propafenone was estimated to be approximately one fifth of the recurrence rate during treatment with placebo. CONCLUSIONS: Propafenone is effective in reducing symptomatic paroxysmal supraventricular arrhythmias.     

Comparisons of oral propafenone and quinidine as an initial treatment option in patients with symptomatic paroxysmal atrial fibrillation: a double-blind, randomized trial

Objective. The main aim of the study was to evaluate the safety and efficacy of propafenone versus quinidine as an initial choice in treatment of symptomatic paroxysmal atrial fibrillation. Design. The study consisted of a 3-month treatment with oral propafenone hydrochloride or quinidine sulphate in patients with paroxysmal symptomatic atrial fibrillation, according to a double-blind randomized system. Setting. The study was performed in the out-patient clinic of university hospital. Main outcome measures. The effects of the two drugs on attack frequency, ventricular rate and symptoms of symptomatic paroxysmal atrial fibrillation. Results. In the oral propafenone group (n=48), two patients (4%) discontinued the treatment because of dizziness. In the 46 patients who continued the treatment, the attack frequency decreased from 11±3 times per week at baseline to 1±1 times per week after treatment (P<0.01). Forty (87%) out of the 46 patients had effective response to oral propafenone (more than 75% reduction of symptomatic arrhythmic attacks) on a mean dose of 615±10 mg day^-1; the decrease in attack frequency was from 10±3 to 1±1 times per week. Twenty-three (50%) patients were free from recurrence of symptomatic paroxysmal atrial fibrillation. Comparisons of symptom scores for patients (n=23) with attacks of paroxysmal atrial fibrillation after oral propafenone treatment showed that there was a significantly lower symptom score of palpitation, asthenia, effort dyspnea, dizziness, rest dyspnea and chest oppression in attacks of paroxysmal atrial fibrillation after propafenone treatment (11.05±3.78 versus 7.60±3.46, P<0.01). From the oral quinidine group (n=48), two patients (4%) discontinued treatment because of gastrointestinal discomfort. In the 46 patients who continued the treatment, the attack frequency decreased from 11±4 times per week at baseline to 3±2 times per week after treatment (P<0.01). Twenty-one (46%) out of the 46 patients had effective response to oral quinidine on a mean dose of 1067±462 mg day^-1, with a decrease in attack frequency from 12±3 to 1±1 times per week. Only 10 (22%) patients were free from recurrence of paroxysmal atrial fibrillation. Comparisons of symptom scores for patients (n=36) with attacks of paroxysmal atrial fibrillation after quinidine treatment showed that there was no significant decrease of symptom score in attacks of atrial fibrillation (10.65±3.92 versus 10.20±3.80, P=0.57). Furthermore, the percentage decrease of ventricular rate during atrial fibrillation was significantly greater in patients with propafenone (-25±4% versus -8±3%, P<0.01). Conclusions. Oral propafenone appeared to be more effective than quinidine in suppressing attacks and alleviating symptoms of paroxysmal atrial fibrillation.     

An open label, randomised, crossover study comparing sotalol and atenolol in the treatment of symptomatic paroxysmal atrial fibrillation

OBJECTIVE: To compare sotalol and atenolol in the treatment of symptomatic paroxysmal atrial fibrillation. DESIGN: Prospective, randomised, open label, crossover study. SETTING: University hospital. PATIENTS: 47 subjects aged over 50 years were recruited from the hospital outpatient department following ECG documentation of paroxysmal atrial fibrillation that coincided with symptoms. Six patients withdrew and 41 completed the trial. INTERVENTIONS: Patients were randomised to one month's treatment with sotalol 80 mg twice daily or atenolol 50 mg once daily. Treatment arms were then crossed over. Patients underwent 72 hour Holter monitoring before randomisation and repeat studies were carried out at the end of both treatment periods. Symptom assessments were completed using linear analogue scales and the Nottingham health profile. MAIN OUTCOME MEASURE: Frequency of paroxysmal atrial fibrillation; secondary outcome measures included average and total duration of paroxysmal atrial fibrillation, total ectopic count, and symptom assessments. RESULTS: A reduction in the number and duration of episodes of paroxysmal atrial fibrillation was noted following treatment with sotalol and atenolol. There was no difference in frequency of paroxysmal atrial fibrillation during treatment with sotalol or atenolol (median difference 0; 95% confidence interval (CI) 0 to 1; p = 0.47). There was no difference in total duration of paroxysmal atrial fibrillation (median difference 0 min; 95% CI -1 to 2; p = 0. 51) or in average duration (median difference 0 min; 95% CI 0 to 1; p = 0.31). No difference was found in total ectopic count between sotalol and atenolol (median difference -123; 95% CI -362 to 135; p = 0.14). Treatments were equally tolerated with no difference in linear analogue scores for symptoms of paroxysmal atrial fibrillation (median difference -5; 95% CI -20 to 5; p = 0.26) or in all categories of the Nottingham health profile. CONCLUSIONS: No difference was found in terms of ECG or symptomatic control of paroxysmal atrial fibrillation between prescribing sotalol 80 mg twice daily and atenolol 50 mg once daily. There was an improvement in paroxysmal atrial fibrillation from baseline following treatment with either sotalol or atenolol.     

Effect of cibenzoline on atrial vulnerability and value of electrophysiological methods in the treatment of paroxysmal atrial fibrillation

The effects of intravenous cibenzoline (1,5 mg/kg) on atrial vulnerability and electrophysiology were assessed in 25 patients with documented paroxysmal atrial fibrillation, in whom sustained (greater than 30 s) atrial fibrillation/-flutter was induced by programmed atrial stimulation. In seven patients atrial fibrillation persisted despite the application of cibenzoline; in eight patients induction of atrial fibrillation was not prevented. In 10 patients the induction of sustained atrial fibrillation was prevented by cibenzoline. Intraatrial conduction time and shortest ventricular cycle length during atrial fibrillation were increased by cibenzoline (p less than or equal to 0.01). The effective refractory period of the right atrium was not significantly affected. Eight patients with frequent episodes of paroxysmal atrial fibrillation received oral cibenzoline (320 mg/day) for control of paroxysmal atrial fibrillation irrespective of the efficacy of intravenous cibenzoline. Prevention of stimulation-induced atrial fibrillation predicted successful treatment of paroxysmal AF. In conclusion, cibenzoline might be effective in the treatment of atrial tachyarrhythmias. Programmed atrial stimulation seems to be helpful in the prediction of the efficacy of an antiarrhythmic treatment of paroxysmal atrial fibrillation.     

急性心肌梗死合并心房颤动心脏复律后的辛伐他汀治疗

目的 探讨不同剂量辛伐他汀治疗急性心肌梗死合并阵发性心房颤动心脏复律后的近期疗效。方法 选用急性心肌梗死合并阵发性心房颤动113例,分3组：对照组38例;辛伐他汀按剂量分2组,分别为40mg组35例、20mg组40例。随访6个月,观察血脂、心房颤动和缺血性事件。结果 ①辛伐他汀两组改善血脂优于对照组（P〈0．05）,40mg组优于20mg组（P〈0．05）;②辛伐他汀两组减少心房颤动复发和转为持续性发生率优于对照组（P〈0．05）,40mg组优于20mg组（P〈0．05）;③辛伐他汀两组减少缺血性事件发生率优于对照组（P〈0．05）。结论 辛伐他汀治疗急性心肌梗死发生阵发性心房颤动病人,可降低血脂、减少心房颤动复发和转为持续性心房颤动的发生率、减少缺血性事件．而且较大剂量效果更明显。     

阿托伐他汀对血脂正常的病窦综合征患者心房颤动复发的影响

目的探讨阿托伐他汀对血脂正常的病窦综合征(SSS)患者心房颤动(AF)复发的防治作用。方法选择62例SSS合并阵发性AF(PAF)未行心脏永久起搏器植入术且血脂正常的患者,随机分为对照组(常规治疗组)和治疗组(常规治疗基础上加阿托伐他汀20 mg/d),随访观察12个月,观察AF发作次数、AF持续时间及血浆C反应蛋白(CRP)水平、血脂水平的变化。结果治疗后治疗组AF的发作次数、AF持续时间虽没有明显降低但显著低于对照组(13.4±2.8次/年vs 16.2±3.6次/年,62.4±7.2小时/年vs 66.3±4.7小时/年),血CRP水平显著降低(7.95±0.87 mg/L vs 9.52±1.31 mg/L)且显著低于对照组(7.95±0.87 mg/L vs 10.02±1.37mg/L)。治疗组的血脂在治疗12个月时较治疗前明显改善(P<0.05),而对照组的上述指标则无明显改善。结论阿托伐他汀对血脂正常、未行心脏永久起搏器植入术的SSS患者AF的复发具有明显的防治作用。其机制可能与他汀类药物抑制炎症反应及调脂有关。     

顿服普罗帕酮治疗非瓣膜性阵发性心房颤动疗效观察

目的研究顿服普罗帕酮转复非瓣膜性阵发性心房颤动(房颤)的临床疗效和安全性。方法有症状的阵发性心房颤动患者78例,无严重心肌缺血、充血性心力衰竭和电解质紊乱,并排除瓣膜性心脏病和肝、肾功能损害。随机分为普罗帕酮组和毛花甙C组:普罗帕酮组一次顿服普罗帕酮负荷量300-600 mg(6-8 mg／kg);毛花甙C组静推西地兰0．4 mg,4 h后仍为心房颤动则追加0．2 mg。在心电监护下密切观察患者心律、速率、血压及症状变化,记录从给药到心房颤动转复的时间及转复瞬间心电图情况。比较两组患者4 h、8 h和12 h内房颤转复率及转复时间。结果普罗帕酮组39例,其中4 h内转复21例(53．85％);毛花甙C组共39例,其中4 h内转复10例(25．64％)。4 h内普罗帕酮组房颤动转复率明显高于毛花甙C组(P<0．05),4 h内平均转复时间亦有明显差异(P<0．05)。结论对于不伴有心力衰竭、严重心肌缺血的非瓣膜性阵发性心房颤动,顿服普罗帕酮是简便、安全、有效的方法。     

胺碘酮联合普罗帕酮治疗室性期前收缩的临床研究

目的 观察胺碘酮联合普罗帕酮治疗室性期前收缩的疗效及安全性。方法将291例室性期前收缩患者随机分成3组,A组（65例）给予普罗帕酮片150mg口服,1次／8h。B组（68例）给予胺碘酮200mg口服,3次／d,1周后改为200mg口服,2次／d,再1周后改为200mg口服,1次／d。C组（68例）开始给予胺碘酮200mg口服,3次／d,普罗帕酮片150mg口服,1次/8h,治疗1周后,停用普罗帕酮片,同时胺碘酮改成200mg口服,2次／d,再1周后,胺碘酮改为200mg口服,1次／d。治疗周期均为3个月。结果住院期间,c组在控制室性期前收缩的时间上明显短于B组;出院后,c组在停药后的3个月里室性期前收缩复发率远低于A组。结论联合使用胺碘酮及普罗帕酮治疗室性期前收缩是安全有效的。     

缬沙坦对病窦综合征双腔起搏术后阵发性心房颤动的影响

目的评价缬沙坦对病窦综合征(SSS)双腔起搏后阵发性心房颤动(AF)的作用。方法双腔起搏器植入术的患者,术后随访时选出有阵发性AF者81例,将其随机分为治疗组(n=41)和对照组(n=40)。在治疗基础疾病的基础上,治疗组给予缬沙坦80 mg,每晚顿服,对照组不予血管紧张素Ⅱ受体阻滞剂类药物治疗。随访1年,观察AF发作次数、AF负荷及左房内径。结果治疗组起搏术后1年AF发作次数、AF负荷、左房内径明显低于对照组(4.2±1.9次/天vs 9.5±3.4次/天,0.395±0.285 h/d vs 0.860±0.316 h/d,35.9±2.7 mm vs 40.7±3.8mm,P均<0.05),亦低于用药前(P<0.01),而对照组上述指标无变化。结论缬沙坦可有效抑制SSS双腔起搏后阵发性AF的发生。