参松养心胶囊联合美托洛尔及中度有氧运动对肥胖伴心房颤动患者炎症和氧化应激指标的影响

Effect of Shensong Yangxin Capsule Combined with Metoprolol and Moderate Aerobic Exercise on Inflammation and Oxidative Stress in Obese Patients with Atrial Fibrillation

关键词:  参松养心胶囊  中度有氧运动  美托洛尔  肥胖  心房颤动  炎症  氧化应激

Key words:  Shensong Yangxin capsule  moderate aerobic exercise  metoprolol  obesity  atrial fibrillation  inflammation  oxidative stress

摘要:

目的 研究参松养心胶囊联合美托洛尔及中度有氧运动对肥胖伴心房颤动患者疗效及对患者炎症和氧化应激反应的影响。方法 80例肥胖伴心房颤动患者随机分为对照组和实验组（各40例），对照组患者在常规治疗基础上给予美托洛尔治疗和中度有氧运动治疗，实验组患者在对照组治疗基础上给予参松养心胶囊治疗，连续治疗6个月。观察并记录治疗前后房颤发作次数及持续时间，及治疗后1个月窦性心律维持效果；分别于治疗前后，行超声心动图检查测定左心房内径（left atrial diameter，LAD）、左室射血分数（left ventricular ejection fractions，LVEF）及室间隔厚度（interventricular septal thickness，IVST）；进行6 min步行试验；测定脑钠肽（brain natriuretic peptide，BNP）、N-末端B型脑钠肽（NT-proBNP）水平，测定超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）、白细胞介素-6（interleukin 6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、脂联素（adiponectin，APN）炎症因子和同型半胱氨酸（（homocysteine，Hcy）氧化应激因子水平。结果 治疗后，实验组房颤发作次数和持续时间均显著小于治疗前和对照组（P<0.05）；窦性心律维持率显著高于对照组（P<0.05）。实验组总有效率显著高于对照组（92.5%vs 75.0%，P<0.05）。治疗后，与对照组比较，实验组LAD、BNP和NT-proBNP均显著降低（P<0.05），LVEF显著升高（P<0.05）；实验组6 min步行距离均显著增加（P<0.05）。实验组IL-6、TNF-α、hs-CRP、APN炎症指标和氧化应激指标Hcy水平均显著降低（P<0.05）。结论 参松养心胶囊联合美托洛尔及中度有氧运动可以改善肥胖伴心房颤动患者炎症和氧化应激反应，改善患者心功能，提高疗效。

Abstract:

OBJECTIVE To study the effects of Shensong Yangxin capsule combined with metoprolol and moderate aerobic exercise on obesity patients with atrial fibrillation and their effects on inflammation and oxidative stress factors. METHODS Eighty patients with obesity and atrial fibrillation were randomly divided into the control group and the experimental group (40 cases in each group). The control group received metoprolol treatment and moderate aerobic exercise based on conventional treatment. The experimental group received Shensong Yangxin capsule based on the control group. Continuous treatment 6 months. Observed and recorded the number and duration of atrial fibrillation before and after treatment, and the sinus rhythm maintenance effect after 1 month of treatment. Before and after treatment, echocardiography was performed to determine left atrial diameter(LAD), left ventricular ejection fraction(LVEF), and interventricular septum thickness (IVST). Six min walk test was adopted. Brain natriuretic peptide(BNP), N-terminal B brain natriuretic peptide (NT-proBNP) levels, hs-CRP, IL-6, TNF-α and APN inflammatory factors and Hcy oxidative stress factor levels were determined. RESULTS After treatment, the number and duration of atrial fibrillation in the experimental group were significantly lower than those before treatment and the control group(P<0.05); the sinus rhythm maintenance rate was significantly higher than that in the control group(P<0.05). The total effective rate of the experimental group was significantly higher than that of the control group(92.5% vs 75.0%, P<0.05). Compared with control group, LAD was significantly decreased(P<0.05), LVEF was significantly increased(P<0.05) in the experimental group; experimental BNP and NT-proBNP were significantly decreased(P<0.05). The IL-6, TNF-α, hs-CRP and APN inflammation indexes and oxidative stress index Hcy levels in the experimental group were significantly lower(P<0.05). CONCLUSION Shensong Yangxin capsule combined with moderate aerobic exercise and metoprolol can improve inflammation and oxidative stress in patients with obesity and atrial fibrillation, improve heart function and improve efficacy.