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目的探讨稳心颗粒联合美托洛尔缓释片对慢性心力衰竭(CHF)合并室性心律失常(VA)患者心功能及心率变异性的影响。方法选择夏邑县人民医院76例慢性心力衰竭合并室性心律失常患者,随机分为观察组和对照组,每组38例。两组均予以常规治疗,对照组于此基础上采用美托洛尔缓释片治疗,观察组予以稳心颗粒+美托洛尔缓释片治疗,两组均持续治疗4周。检测对比两组治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]与心率变异(HRV)指标[5 min心搏间期均值的标准差(SDANN)、全部正常窦性心搏R-R间期的标准差(SDNN)与全程相邻R-R间期差值的均方根值(r MSSD)]水平,并统计对比两组总有效率及不良反应发生率。结果观察组治疗后LVEDD较对照组降低,LVEF较对照组升高,差异均有统计学意义(P<0.05);经治疗,观察组SDANN、SDNN与r MSSD水平均较对照组升高,差异有统计学意义(P<0.05);观察组治疗后总有效率为89.47%优于对照组的68.42%,差异有统计学意义(P<0.05);治疗期间,两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论对慢性心力衰竭合并室性心律失常患者联合应用稳心颗粒与美托洛尔缓释片治疗效果显著,可明显改善患者心功能及心率变异性,且安全性较高。
Objective To investigate the effects of Wenxin granule combined with metoprolol sustained-release tablets on cardiac function and heart rate variability in patients with chronic heart failure (CHF) complicated by ventricular arrhythmias (VA). Methods 76 patients with chronic heart failure and ventricular arrhythmia in Xiayi County People’s Hospital were randomly divided into observation group and control group with 38 cases in each group. The two groups were given routine treatment. The control group was treated with metoprolol sustained-release tablets on the basis. The observation group was given Wenxin granules + metoprolol sustained-release tablets. Both groups were treated for 4 weeks. The levels of cardiac function (left ventricular ejection fraction, left ventricular end-diastolic dimension, LVEDD) and heart rate variability (HRV) were compared between the two groups before and after treatment [5 min SDANN, The standard deviation of RR interval (SDNN) and rmsSD of all adjacent normal sinus beats in all normal sinus beats were compared. The total effective rate and incidence of adverse reactions were compared statistically. Results After treatment, the LVEDD in the observation group was lower than that in the control group, while the LVEF was higher in the observation group than in the control group (P <0.05). After treatment, the SDANN, SDNN and rMSSD levels in the observation group were significantly higher than those in the control group (P <0.05). The total effective rate of the observation group after treatment was 89.47%, which was significantly higher than that of the control group (68.42%), the difference was statistically significant (P <0.05). During the treatment, the incidence of adverse reactions , The difference was not statistically significant (P> 0.05). Conclusion The treatment of patients with chronic heart failure complicated by ventricular arrhythmia combined with Wenxin Keli and metoprolol sustained-release tablets has significant therapeutic effect, which can significantly improve the patients’ heart function and heart rate variability and is safe.