桃仁红花煎联合伊伐布雷定治疗血络瘀阻型持续性房颤的临床效果

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摘要目的观察并探讨桃仁红花煎联合伊伐布雷定治疗血络瘀阻型持续性房颤的临床效果。方法选取2020年4～8月湖北省中西医结合医院心内科收治的120 例血络瘀阻型持续性房颤患者作为研究对象。按照采用治疗方法的不同将患者分为治疗组（65 例）和对照组（55 例）。两组患者均给予基础对症治疗，对照组患者单用伊伐布雷定治疗，治疗组患者实施桃仁红花煎联合伊伐布雷定治疗。比较两组患者的临床疗效；比较两组患者治疗前后的动态心电图心室率各指标（静息心室率、24 h 平均心室率、24 h 最快心室率、24 h 最慢心室率）、6 min 步行实验距离、心功能指标[左房前后径（LAD1）、左室射血分数（LVEF）]及血清学指标[肌钙蛋白（cTn）、高敏C 反应蛋白（hs-CRP）、N 末端B 型利钠肽前体（NT-proBNP）、醛固酮（Ald）]水平；比较两组患者的安全性监测结果。结果治疗后，治疗组患者的治疗总有效率为92.31%，高于对照组的78.18%，差异有统计学意义（P<0.05）。治疗后，两组患者的静息心室率、24 h 平均心室率、24 h 最快心室率、24 h 最慢心室率低于治疗前，6 min 步行实验距离长于治疗前，差异有统计学意义（P<0.05）；治疗后，治疗组患者的静息心室率、24 h 平均心室率、24 h 最快心室率、24 h 最慢心室率低于对照组，6 min 步行实验距离长于对照组，差异有统计学意义（P<0.05）。治疗后，治疗组患者的LAD1 小于治疗前，LVEF 大于治疗前，差异有统计学意义（P<0.05）；治疗后，治疗组患者的LAD1 小于对照组，LVEF 大于对照组，差异有统计学意义（P<0.05）；治疗后，两组患者的hs-CRP、NT-proBNP、Ald、cTn 水平均低于治疗前，差异有统计学意义（P<0.05）；且治疗组患者治疗后的hs-CRP、NT-proBNP、Ald、cTn 水平均低于对照组，差异有统计学意义（P<0.05）；两组患者的不良反应发生情况比较，差异无统计学意义（P>0.05）。结论桃仁红花煎联合伊伐布雷定治疗血络瘀阻型持续性房颤患者的临床效果优于单用伊伐布雷定，值得临床推广应用。

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	谭巨浪
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关键词 ：桃仁红花煎, 伊伐布雷定, 持续性房颤, 中西医结合疗法

Abstract：Objective To observe and explore the clinical effect of Taoren Honghua Decoction combined with Ivabradine in the treatment of persistent atrial fibrillation of blood collateral stasis type. Methods A total of 120 patients with persistent atrial fibrillation of blood collateral stasis type admitted to the Department of Cardiology of Hubei Integrated Traditional and Western Medicine Hospital from April to August 2020 were selected as the research subjects. According to the different treatment methods,the patients were divided into treatment group (65 cases) and control group (55 cases).Patients in both groups were given basic symptomatic treatment. Patients in the control group were treated with Ivabradine alone, and patients in the treatment group were treated with Taoren Honghua Decoction combined with Ivabradine.The clinical efficacy of the two groups was compared. The indexes of dynamic electrocardiograph ventricular rate (resting ventricular rate, 24 h mean ventricular rate, 24 h fastest ventricular rate, 24 h slowest ventricular rate), the 6 min walking distance, cardiac function indexes (left atrial diameter [LAD1], left ventricular ejection fraction[LVEF]), serological indexes (troponin [cTn], high-sensitive C-reactive protein [hs-CRP], N-terminal B-type natriuretic peptide precursor [NT-proBNP], aldosterone [Ald]) before and after treatment were compared between the two groups.The results of safety monitoring were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 92.31%, which was higher than that of the control group (78.18%), the difference was statistically significant (P<0.05). After treatment, the resting ventricular rate, 24 h mean ventricular rate, 24 h fastest ventricular rate and 24 h slowest ventricular rate in the two groups were lower than those before treatment, and the 6 min walking distance was longer than that before treatment, with statistically significant differences (P<0.05). After treatment, the resting ventricular rate, 24 h mean ventricular rate, 24 h fastest ventricular rate and 24 h slowest ventricular rate in the treatment group were lower than those in the control group, and the 6 min walking distance was longer than that in the control group, with statistically significant differences (P<0.05). After treatment, LAD1 in the treatment group was less than that before treatment, and LVEF was greater than that before treatment, with statistically significant differences (P<0.05). After treatment, LAD1 in the treatment group was lower than that in the control group, and LVEF in the treatment group was greater than that in the control group, with statistically significant differences (P<0.05). After treatment, the levels of hs-CRP, NT-proBNP, Ald and cTn in the two groups were all lower than those before treatment, with statistically significant differences (P<0.05). The levels of hs-CRP, NT-proBNP, Ald and cTn in the treatment group were all lower than those in the control group after treatment, with statistically significant differences (P<0.05). There was no statistical significance in the incidence of adverse drug reaction between the two groups (P>0.05).Conclusion The clinical effect of Taoren Honghua Decoction combined with Ivabradine in the treatment of patients with persistent atrial fibrillation of blood collateral stasis type is better than that of Ivabradine alone, which is worthy of clinical application.

Key words： Taoren Honghua Decoction Ivabradine Persistent atrial fibrillation Integrated traditional Chinese and Western medicine

作者简介: 谭巨浪（1994-），男，湖北人，湖北中医药大学第一临床学院2019 级中西医结合专业在读硕士研究生，研究方向：中西医结合治疗心脑血管病

引用本文:

谭巨浪；胡晓军；张臻；赵代鑫. 桃仁红花煎联合伊伐布雷定治疗血络瘀阻型持续性房颤的临床效果[J]. 中国当代医药, 2021, 28(16): 178-183.
TAN Ju-lang； HU Xiao-jun； ZHANG Zhen；ZHAO Dai-xin. Clinical effect of Taoren Honghua Decoction combined with Ivabradine in the treatment of persistent atrial fibrillation of blood collateral stasis type. 中国当代医药, 2021, 28(16): 178-183.

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