目的 探討參仙升脈口服液聯(lián)合鹽酸尼非卡蘭治療室性心律失常的臨床療效。方法 回顧性分析2018年12月—2020年12月在平頂山市第一人民醫(yī)院進(jìn)行治療的52例室性心律失?；颊邽檠芯繉?duì)象，根據(jù)用藥差別將所有患者分為治療組和對(duì)照組，每組各26例。對(duì)照組給予注射用鹽酸尼非卡蘭，0.3 mg/kg，溶入0.9%氯化鈉注射液20 mL中，在連續(xù)心電監(jiān)護(hù)下，5 min內(nèi)注射完畢；治療組在對(duì)照組基礎(chǔ)上口服參仙升脈口服液，20 mL/次，2次/d。兩組均治療2周進(jìn)行效果對(duì)比。觀察兩組的臨床療效，比較兩組心率變異性指標(biāo)、心電圖指標(biāo)和血清學(xué)指標(biāo)。結(jié)果 經(jīng)治療，治療組患者總有效率是96.15%，顯著高于對(duì)照組的80.77%（P＜0.05）。經(jīng)治療，兩組所有正常RR間期的標(biāo)準(zhǔn)差（SDNN）、全程每5 min NN節(jié)段竇性RR間期標(biāo)準(zhǔn)差（SDANN）及全程相鄰RR之差的均方根（rMSSD）均較治療前顯著升高（P＜0.05），且治療組改善更顯著（P＜0.05）。經(jīng)治療，兩組QT散度（QTd）較治療前顯著降低，但QT間期最小值（QT_min）、矯正的QT間期（QTc）均顯著升高（P＜0.05），且治療組心電圖指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。經(jīng)治療，兩組血清同型半胱氨酸（Hcy）、心肌肌鈣蛋白I（cTnI）、N末端B型腦鈉肽（NT-proBNP）、肌酸激酶同工酶（CK-MB）水平均較治療前顯著降低（P＜0.05），且治療后治療組降低更加顯著（P＜0.05）。結(jié)論 參仙升脈口服液聯(lián)合鹽酸尼非卡蘭治療室性心律失常具有較好的臨床療效，可有效改善患者心率變異性，改善心電圖指標(biāo)及血清細(xì)胞因子水平，有著良好臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Shenxian Shengmai Oral Liquid combined with nifekalant hydrochloride in treatment of ventricular arrhythmia.Methods Fifty-two patients with ventricular arrhythmia treated in Pingdingshan First People's Hospital from December 2018 to December 2020 were retrospectively analyzed. All patients were divided into treatment group and control group according to medication difference, with 26 patients in each group. Patients in the control group were given Nifekalan Hydrochloride for injection, 0.3 mg/kg, dissolved into 0.9% sodium chloride injection 20 mL, and the injection was completed within 5 min under continuous ECG monitoring. Patients in the treatment group were po administered with Shenxian Shengmai Oral Liquid on the basis of the control group, 20 mL/time, twice daily. The two groups were treated for 2 weeks. The clinical efficacy of the two groups was observed, and the heart rate variability, electrocardiogram and serological indexes were compared between the two groups.Results After treatment, the total effective rate of treatment group was 96.15%, significantly higher than that of control group 80.77% (P < 0.05). After treatment, the standard deviation of all normal RR intervals (SDNN), the standard deviation of segmental sinus RR intervals (SDANN) and the root mean square of difference between adjacent RR intervals (rMSSD) were significantly increased in two groups compared with before treatment (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). After treatment, the QT dispersion (QTd) in both groups was significantly decreased compared with before treatment, but the minimum QT interval (QT_min) and corrected QT interval (QTc) were significantly increased (P < 0.05), and the ECG index improvement in treatment group was better than that in control group (P < 0.05). After treatment, the levels of serum homocysteine (Hcy), cardiac troponin I (cTnI), N-terminal B-type brain natriuretic peptide (NT-probNP) and creatine kinase isoenzyme (CK-MB) in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more significant after treatment (P < 0.05).Conclusion Shenxian Shengmai Oral Liquid combined with nifekalant hydrochloride has good clinical effect in treatment of ventricular arrhythmia, and can effectively improve patients' heart rate variability, ECG indexes and serum cytokine level, which has good clinical application value.

R972

河南省科技攻關(guān)項(xiàng)目（LHGJ20141851）