目的 探討生脈飲聯(lián)合胺碘酮治療冠心病室性早搏的臨床療效。方法 選取2018年1月—2019年6月河南省人民醫(yī)院省直第二醫(yī)院收治的冠心病室性早搏患者162例，隨機(jī)分為對(duì)照組和治療組，每組各81例。對(duì)照組口服鹽酸胺碘酮片，第1周，0.2 g/次，3次/d；第2周，0.2 g/次，2次/d；第3周，0.2 g/次，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服生脈飲，10 mL/次，3次/d。兩組患者均治療3周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者室性早搏次數(shù)，及室性早搏指數(shù)（VPI）、心率震蕩（HRT）、一氧化氮（NO）和內(nèi)皮素-1（ET-1）水平。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為74.07%和88.89%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組室性早搏次數(shù)均顯著低于治療前（P<0.05），VPI均高于治療前（P<0.05），且治療組室性早搏次數(shù)、VPI改善幅度更大（P<0.05）。治療后，兩組震蕩初始（TO）減?。?i>P<0.05），震蕩斜率（TS）增大（P<0.05），且治療組TO和TS指標(biāo)均優(yōu)于對(duì)照組治療后水平（P<0.05）。治療后，兩組患者NO水平明顯上升（P<0.05），ET-1水平明顯下降（P<0.05），且治療組NO、ET-1水平明顯好于對(duì)照組（P<0.05）。結(jié)論 生脈飲聯(lián)合胺碘酮可顯著減少冠心病室性早搏患者24 h動(dòng)態(tài)心電圖室性早搏次數(shù)，改善自主神經(jīng)功能，保護(hù)血管內(nèi)皮功能，臨床療效較佳，且安全性較高。

Objective To explore the clinical effect of Shengmaiyin combined with amiodarone in treatment of ventricular extrasystole of coronary heart disease. Methods Patients (162 cases) with ventricular extrasystole of coronary heart disease in the Second Hospital of Henan Province People's Hospital from January 2018 to June 2019 were randomly divided into control and treatment groups, and each had 81 cases. Patients in the control group were po administered with Amiodarone Hydrochloride Tablets, 0.2 g/time for the 1st week, three times daily, 0.2 g/time for the 2nd week, twice daily, 0.2 g/time for the 3rd week, once daily. Patients in the treatment group were po administered with Shengmaiyin on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 3 weeks. After treatment, the clinical efficacy was evaluated, and the frequency of ventricular premature beats, and the level of VPI, HRT, NO and ET-1 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 74.07% and 88.89% respectively, and there were differences between two groups (P<0.05). After treatment, the frequency of ventricular premature beats in two groups were significantly decreased (P<0.05), but VPI was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, TO in two groups was significantly decreased (P<0.05), but TS was significantly increased (P<0.05), and the indicators TO and TS in the treatment group were significantly better than those in the control group (P<0.05). After treatment, NO level in two groups was significantly increased (P<0.05), but ET-1 level was significantly decreased (P<0.05), the level of NO and ET-1 in the treatment group was significantly better than those in the control group (P<0.05). Conclusion Shengmaiyin combined with amiodarone in treatment of ventricular extrasystole of coronary heart disease can significantly reduce the frequency of 24 h ambulatory ECG, improve autonomic nervous function, and protect vascular endothelial function, which has good clinical efficacy and high safety.

R972