目的 探討復(fù)方丹參滴丸聯(lián)合普羅帕酮治療室性心律失常的臨床療效。方法 回顧性分析2020年1月—2021年6月在河北大學(xué)附屬醫(yī)院進(jìn)行治療的300例室性心律失常患者的臨床資料，根據(jù)用藥差別分成對(duì)照組和治療組，每組各150例。對(duì)照組口服鹽酸普羅帕酮片，150 mg/次，4次/d；治療組在對(duì)照組治療基礎(chǔ)上口服復(fù)方丹參滴丸，10丸/次，3次/d。兩組連續(xù)治療2周。觀察兩組的臨床療效，比較兩組心率變異性指標(biāo)、相關(guān)量表評(píng)分、心電圖指標(biāo)和血清學(xué)指標(biāo)的變化情況。結(jié)果 治療后，治療組總有效率是98.67%，顯著高于對(duì)照組的85.33%（P＜0.05）。治療后，兩組全程每5分鐘NN節(jié)段竇性RR間期標(biāo)準(zhǔn)差（SDANN）、RR間期的標(biāo)準(zhǔn)差（SDNN）、全程相鄰RR之差的均方根（RMSSD）值、差值大于50 ms RR間期與心動(dòng)周期次數(shù)的比值（PNN50）均較治療前顯著升高（P＜0.05）；并以治療組改善更明顯（P＜0.05）。治療后，兩組改良Barthel指數(shù)（MBI）評(píng)分、生活質(zhì)量綜合評(píng)定問卷-74（GQOL-74）評(píng)分均顯著升高（P＜0.05），并以治療組改善更明顯（P＜0.05）。治療后，兩組心電圖QT散度（QTd）較治療前顯著降低，而QT間期最小值（QTmin）、矯正的QT間期（QTc）均顯著提高（P＜0.05），并以治療組改善最為明顯（P＜0.05）。經(jīng)治療，兩組患者血清同型半胱氨酸（Hcy）、可溶性CD40配體（CD40L）、腫瘤壞死因子-α（TNF-α）、半乳糖凝集素-3（Gal-3）、肌酸激酶同工酶（CK-MB）水平均較治療前顯著降低（P＜0.05），并以治療組降低更明顯（P＜0.05）。結(jié)論 復(fù)方丹參滴丸聯(lián)合普羅帕酮治療室性心律失常具有較好的臨床療效，能夠改善患者心率變異性和細(xì)胞因子，有利于提高患者生活質(zhì)量，有著良好的臨床應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Compound Danshen Dropping Pills combined with propafenone in treatment of ventricular arrhythmias. Methods The clinical data of 300 patients with ventricular arrhythmia treated in Affiliated Hospital of Hebei University from January 2020 to June 2021 were retrospectively analyzed. According to the difference of medication, they were divided into control group and treatment group, with 150 cases in each group. Patients in the control group were po administered with Propafenone Hydrochloride Tablets, 150 mg/time, four times daily. Patients in the control group were po administered with Compound Danshen Dropping Pills on the basis of the control group, 10 pills/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of heart rate variability, related scale scores, electrocardiogram and serological indexes were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.67%, significantly higher than 85.33% in the control group (P < 0.05). After treatment, the standard deviation of NN segment sinus RR interval (SDANN), standard deviation of RR interval (SDNN), root mean square (RMSSD) value of the difference between adjacent RR intervals and the ratio of RR interval to cardiac cycle number (PNN50) over 50 ms were significantly increased in both groups compared with before treatment (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). After treatment, the improved Barthel index (MBI) score and quality of life Questionnaire (GQOL-74) score in both groups were significantly increased (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the ECG QT dispersion (QTd) of two groups was significantly decreased compared with before treatment, while the minimum QT interval (QTmin) and corrected QT interval (QTc) were significantly increased (P < 0.05), and the improvement was most obvious in the treatment group (P < 0.05). After treatment, the serum levels of homocysteine (Hcy), soluble CD40 ligand (CD40L), tumor necrosis factor -α (TNF-α), galactose lectin-3 (Gal-3), and creatine kinase isoenzyme (CK-MB) in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more obvious in the treatment group (P < 0.05). Conclusion Compound Danshen Dropping Pills combined with propafenonehas good clinical effect in treatment of ventricular arrhythmias, and can improve heart rate variability and cytokines, and is beneficial to improve patients' life quality, which has good clinical application value.

R972

保定市科技計(jì)劃項(xiàng)目(2041ZF312)