胺碘酮联合参附汤对风心病瓣膜置换术后患者的影响  

Effects of Amiodarone Combined with Shenfu Decoction on Patients with Rheumatic Heart Disease After Valve Replacement

作　　者：张文刚 王维亚 王少霞 栾佳祥 ZHANG Wengang;WANG Weiya;WANG Shaoxia;LUAN Jiaxiang(Luoyang Oriental Hospital,Luoyang 471003,China;Teaching and research section,Luoyang Polytechnic,Luoyang 471000,China)

机构地区：[1]洛阳东方医院,洛阳471003 [2]洛阳职业技术学院外科教研室,洛阳471000

出　　处：《世界中医药》2020年第18期2759-2763,共5页World Chinese Medicine

基　　金：河南省卫生厅2010年卫生政策研究课题(YWZY20100023)。

摘　　要：目的:探究胺碘酮联合参附汤对风心病瓣膜置换术后患者的影响。方法:选取2014年2月至2018年2月洛阳东方医院收治的风心病瓣膜置换术后患者60例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组30例。对照组予常规对症治疗,观察组在对照组基础上加用胺碘酮联合参附汤治疗,均治疗4周。观察2组患者治疗前后心脏结构、细胞黏附因子、炎性反应因子含量变化以及不良反应比较。结果:1)治疗后2组患者左房舒张末期直径(LAD)、右室内径(RVD)、右房内径(RAD)、左室射血分数(LVEF)、左室舒张末期直径(LVEDD)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、IL-6、C反应蛋白(CRP)、内皮细胞黏附因子(VCAM-1)、血清循环细胞黏附因子-1(ICAM-1)下降(P<0.05),观察组优于对照组(P<0.05)。2)治疗后2组患者在安全性1级、2级、3级、4级上比较差异无统计学意义(P>0.05)。结论:胺碘酮联合参附汤能抑制风心病瓣膜置换术后细胞黏附分子及炎性因子,重塑心脏结构,安全性高,疗效显著。Objective:To explore the effect of amiodarone combined with Shenfu decoction on patients with rheumatic heart disease after valve replacement.Methods:A total of 60 patients with rheumatic heart disease after valve replacement admitted to Luoyang Oriental Hospital from February 2014 to February 2018 were randomly divided into control group(n=30)and observation group(n=30).The control group was treated with symptomatic treatment,and the observation group was treated with amiodarone combined with Shenfu decoction,both for 4 weeks.The changes of cardiac structure,cell adhesion molecules,inflammatory factors and adverse reactions were observed between the two groups before and after treatment.Results:1)After treatment,left atrial end-diastolic diameter(LAD),right ventricular diameter(RVD),right atrial diameter(RAD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),tumor necrosis factor-α(TNF--α),interleukin-1(IL-1),IL-6,C-reactive protein(CRP),endothelial cell adhesion molecule(VCAM-1),Serum circulating cell adhesion molecule-1(ICAM-1)decreased in both groups.The observation group was better than the control group(P<0.05).2)There was no significant difference in safety level 1,2,3 and 4 between the two groups after treatment(P>0.05).Conclusion:Amiodarone combined with Shenfu decoction can inhibit cell adhesion molecules and inflammatory factors and reshape heart structure after valve replacement in patients with rheumatic heart disease,it is safe and effective.

关 键 词：胺碘酮 参附汤 风心病瓣膜置换术 心脏结构 细胞黏附分子 炎性因子 血管细胞黏附因子 安全性 

分 类 号：R256.21[医药卫生—中医内科学]