目的 探討參松養(yǎng)心膠囊聯(lián)合胺碘酮對(duì)心力衰竭合并心律失常的治療效果、心率變異性及NT-proBNP的影響。方法 選擇2015年1月—2019年1月周口市中心醫(yī)院接受治療的600例心力衰竭并心律失?；颊咦鳛檠芯繉?duì)象。根據(jù)入院的順序，將患者隨機(jī)分為對(duì)照組（n=300例）和觀察組（n=300例）。對(duì)照組患者口服鹽酸胺碘酮片，第1周0.2 g/次，3次/d，第2周改為0.2 g/次，2次/d，第3周改為0.1 g/次，1次/d。觀察組患者在對(duì)照組的基礎(chǔ)上口服參松養(yǎng)心膠囊，1.2 g/次，3次/d。兩組均連續(xù)治療2個(gè)月。觀察兩組患者的治療效果，同時(shí)比較治療前后兩組的心功能指標(biāo)、24 h動(dòng)態(tài)心電圖變化、心率變異性及N末端B型利鈉肽原（NT-proBNP）水平。結(jié)果 治療后，觀察組治療總有效率為94.33%，顯著高于對(duì)照組的79.33%（P<0.05）。治療后，兩組患者各心功能指標(biāo)和NT-proBNP水平較治療前均明顯改善（P<0.05），且觀察組顯著優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者室性期前收縮發(fā)生頻率及ST段壓低持續(xù)時(shí)間較治療前均顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）。治療后，兩組患者各心率變異性指標(biāo)較治療前均顯著升高（P<0.05），且觀察組顯著高于對(duì)照組（P<0.05）。結(jié)論 參松養(yǎng)心膠囊聯(lián)合胺碘酮可有效的改善心力衰竭合并心律失?；颊叩男墓δ芘c心電圖，降低NT-proBNP水平，提高心率變異性，臨床療效顯著，具有較高臨床推廣應(yīng)用價(jià)值。

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.

R972

陜西省教育廳專項(xiàng)科研計(jì)劃項(xiàng)目（16JK1206）