目的 探讨生脉饮联合胺碘酮治疗冠心病室性早搏的临床疗效。方法 选取2018年1月—2019年6月河南省人民医院省直第二医院收治的冠心病室性早搏患者162例，随机分为对照组和治疗组，每组各81例。对照组口服盐酸胺碘酮片，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。治疗组患者在对照组的基础上口服生脉饮，10 mL/次，3次/d。两组患者均治疗3周。观察两组患者临床疗效，同时比较治疗前后两组患者室性早搏次数，及室性早搏指数（VPI）、心率震荡（HRT）、一氧化氮（NO）和内皮素-1（ET-1）水平。结果 治疗后，对照组和治疗组临床有效率分别为74.07%和88.89%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组室性早搏次数均显著低于治疗前（P<0.05），VPI均高于治疗前（P<0.05），且治疗组室性早搏次数、VPI改善幅度更大（P<0.05）。治疗后，两组震荡初始（TO）减小（P<0.05），震荡斜率（TS）增大（P<0.05），且治疗组TO和TS指标均优于对照组治疗后水平（P<0.05）。治疗后，两组患者NO水平明显上升（P<0.05），ET-1水平明显下降（P<0.05），且治疗组NO、ET-1水平明显好于对照组（P<0.05）。结论 生脉饮联合胺碘酮可显著减少冠心病室性早搏患者24 h动态心电图室性早搏次数，改善自主神经功能，保护血管内皮功能，临床疗效较佳，且安全性较高。

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