中国临床药学杂志

目的探讨沙库巴曲缬沙坦联合参松养心胶囊治疗阵发性房颤(PAF)合并慢性心力衰竭(心衰)的临床研究。方法选择于2017年6月至2019年12月收治的PAF合并慢性心衰患者162例,依据随机数字表法随机分为观察组与对照组,各81例。对照组患者给予沙库巴曲缬沙坦治疗,观察组患者予沙库巴曲缬沙坦联合参松养心胶囊治疗。比较2组治疗前与治疗3个月后心功能指标[左室射血分数(LVEF)、左室收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)],血浆C反应蛋白(CRP),N-端脑钠肽前体(NT-proBNP),PAF发作持续时间和心室率,并评估2组的临床疗效。结果治疗3个月后,观察组总有效率显著高于对照组(91.84%vs 73.47%,P <0.05);心功能改善程度优于对照组[LVEF:(46.58±3.10)%vs(42.36±2.29)%,P <0.05;LVESD:(45.63±3.28)mm vs(48.91±2.89)mm,P <0.05;LVEDD(53.29±4.54)mm vs(58.39±3.46)mm,P <0.05]。2组治疗后血浆CRP和NT-proBNP均较治疗前显著降低,且观察组显著低于对照组(P <0.05);观察组PAF发作持续时间较对照组缩短,且心室率较对照组更低。结论沙库巴曲缬沙坦联合参松养心胶囊治疗PAF合并慢性心衰的临床疗效良好,可改善患者心功能,降低PAF发作,降低血浆CRP和NT-proBNP水平,且不良反应少,安全性良好。

AIM To investigate the clinical effects of sarkubatrovalsartan combined with Shensongyangxin capsule on paroxysmal atrial fibrillation(PAF) complicated with chronic heart failure. METHODS Totally 162 PAF complicated with chronic heart failure patients from June 2017 to December 2019 were selected and randomly divided into observation group(n=81) and control group(n=81) according to random number table method. Patients in the control group were treated with sakubatravalsartan, while patients in the observation group were treated with sakubatravalsartan combined with Shensongyangxin capsule. The cardiac function(LVEF, LVESD and LVEDD), plasma C-reactive protein(CRP), N-terminal pro brain natriuretic peptide(NT-proBNP), duration of PAF attack and ventricular rate were compared between 2 groups before and after 3 months of treatment. RESULTS After 3 months of treatment, the total effective rate of the observation group was higher than that of the control group(91.84% vs 73.47%, P < 0.05), and the improvement of cardiac function in the observation group was better than that in the control group[LVEF:(46.58±3.10)% vs(42.36±2.29)%, P < 0.05; LVESD:(45.63±3.28) mm vs(48.91±2.89) mm, P < 0.05; LVEDD:(53.29±4.54) mm vs(58.39±3.46) mm, P < 0.05]. The plasma CRP and NT-proBNP in 2 groups after treatment were significantly lower than those before treatment, and those of the observation group was significantly lower than those of the control group(P < 0.05); the duration of PAF attack in the observation group was shorter than that in the control group, and the ventricular rate was lower than that in the control group. CONCLUSION The curative effect of sakubatrovalsartan combined with Shensongyangxin capsule in the treatment of PAF with chronic heart failure is good, which can improve the cardiac function of patients, reduce the attack of PAF, and reduce the levels of CRP and NT-proBNP in plasma, with less adverse drug reactions and good safety.