参松养心胶囊联合胺碘酮治疗心力衰竭合并心律失常的疗效观察

目的 探讨参松养心胶囊联合胺碘酮对心力衰竭合并心律失常的治疗效果、心率变异性及NT-proBNP的影响。方法 选择2015年1月—2019年1月周口市中心医院接受治疗的600例心力衰竭并心律失常患者作为研究对象。根据入院的顺序，将患者随机分为对照组（n=300例）和观察组（n=300例）。对照组患者口服盐酸胺碘酮片，第1周0.2 g/次，3次/d，第2周改为0.2 g/次，2次/d，第3周改为0.1 g/次，1次/d。观察组患者在对照组的基础上口服参松养心胶囊，1.2 g/次，3次/d。两组均连续治疗2个月。观察两组患者的治疗效果，同时比较治疗前后两组的心功能指标、24 h动态心电图变化、心率变异性及N末端B型利钠肽原（NT-proBNP）水平。结果 治疗后，观察组治疗总有效率为94.33%，显著高于对照组的79.33%（P<0.05）。治疗后，两组患者各心功能指标和NT-proBNP水平较治疗前均明显改善（P<0.05），且观察组显著优于对照组（P<0.05）。治疗后，两组患者室性期前收缩发生频率及ST段压低持续时间较治疗前均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗后，两组患者各心率变异性指标较治疗前均显著升高（P<0.05），且观察组显著高于对照组（P<0.05）。结论 参松养心胶囊联合胺碘酮可有效的改善心力衰竭合并心律失常患者的心功能与心电图，降低NT-proBNP水平，提高心率变异性，临床疗效显著，具有较高临床推广应用价值。

Clinical observation on Shensong Yangxin Capsules combined with amiodarone in treatment of heart failure and arrhythmia

Objective To explore influence of Shensong Yangxin Capsules combined with amiodarone on treatment effect, heart rate variability, and NT-proBNP in patients with heart failure and arrhythmia. Methods Patients (600 cases) with heart failure and arrhythmia in Zhoukou Central Hospital from January 2015 to January 2019 were selected as research object. According to the principle of randomization, the subjects were divided into the control group and observation group, and each group had 300 cases. Patients in the control group were po administered with Amiodarone Hydrochloride Tablets, 0.2 g/time and three times daily in the first week, 0.2 g/time and twice daily in the second week, 0.1 g/time and once daily in the third week. Patients in the observation group were po administered with Shensong Yangxin Capsules on the basis of the control group, 1.2 g/time, three times daily. Both groups were treated continuously for 2 months. After treatment, the treatment effect in two groups was observed, and cardiac function indicators, 24 h dynamic electrocardiogram changes, heart rate variability, and NT-proBNP levels before and after the treatment were compared. Results After treatment, the total effective rate in the observation group was 94.33%, which was significantly higher than 79.33% of the control group (P<0.05). After treatment, cardiac function indexes and NT-proBNP level in two groups were significantly improved compared with before treatment (P<0.05), and the observation group was significantly better than control group (P<0.05). After treatment, the frequency of ventricular prephase contraction and the duration of STsegment depression in two groups were significantly lower than those before treatment (P<0.05), and the observation group was significantly lower than control group (P<0.05). After treatment, the indicators of heart rate variability in two groups were significantly higher than that before treatment (P<0.05), and the observation group was significantly higher than control group (P<0.05). Conclusion Shensong Yangxin Capsules combined with amiodarone can effectively improve the heart function and electrocardiogram of patients with heart failure complicated with arrhythmia, reduce the level of NT-proBNP, improve heart rate variability, and clinical efficacy is significant, has higher clinical popularization and application value.