目的 探討穩(wěn)心顆粒聯(lián)合鹽酸決奈達隆片治療老年陣發(fā)性房顫的臨床療效。方法 選取2018年11月-2020年1月在開封市人民醫(yī)院治療的108例老年陣發(fā)性房顫患者為研究對象，按照隨機數(shù)字表法將所有患者分為對照組和治療組，每組各54例。對照組口服鹽酸決奈達隆片，1片/次，2次/d。治療組在對照組治療基礎上口服穩(wěn)心顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療6個月。觀察兩組的臨床療效，比較兩組的房顫發(fā)作、心率情況、心功能指標和不良反應情況。結(jié)果 治療后，對照組總有效率為74.07%，治療組總有效率為90.74%，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組房顫發(fā)作次數(shù)、靜息心率顯著降低，房顫持續(xù)時間顯著縮短（P<0.05）；但治療組改善的更多，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者左室射血分數(shù)（LVEF）顯著升高，左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期內(nèi)徑（LVESD）、P波離散度（Pd）均顯著下降（P<0.05）；但治療組心功能指標改善更多，差異有統(tǒng)計學意義（P<0.05）。治療后，對照組不良反應發(fā)生率為27.78%，治療組不良反應發(fā)生率為5.56%，差異有統(tǒng)計學意義（P<0.05）。結(jié)論 穩(wěn)心顆粒聯(lián)合鹽酸決奈達隆片治療老年陣發(fā)性房顫具有較好的臨床療效，能夠降低房顫發(fā)作和心率，顯著改善患者心功能，安全性好。

Objective To explore the clinical efficacy of Wenxin Granules combined with Dronedarone Hydrochloride Tablets in treatment of paroxysmal atrial fibrillation in the elderly. Methods Elderly patients (104 cases) with paroxysmal atrial fibrillation in Kaifeng People's Hospital from November 2018 to January 2020 were randomly divided into control and treatment groups, and each group had 54 cases. Patients in the control group were po administered with Dronedarone Hydrochloride Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Wenxin Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and atrial fibrillation attack, heart rate, cardiac function indexes, and adverse reactions in two groups were compared. Results After treatment, the total effective rate of the control group was 74.07%, that of the treatment group was 90.74%, and the difference was statistically significant (P<0.05). After treatment, the frequency of atrial fibrillation and the heart rate in two groups were significantly reduced, and the duration of atrial fibrillation in two groups was significantly shortened (P<0.05); and the indexes of the treatment group were better than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the LVEF in two groups was significantly increased, but the LVEDD, LVESD, and Pd in two groups were significantly decreased (P<0.05). And the cardiac function indexes in the treatment group were better than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the incidence of adverse reactions in the control and treatment groups were 27.78% and 5.56%, respectively, and the difference was statistically significant (P<0.05). Conclusion Wenxin Granules combined with Dronedarone Hydrochloride Tablets has clinical curative effect in treatment of paroxysmal atrial fibrillation in the elderly, can reduce atrial fibrillation attack and heart rate, and significantly improve the heart function of patients with good safety.

R972