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自拟活血舒痹汤治疗急性心肌梗死PCI术后缺血再灌注损伤的临床研究

郑祥 王审

郑祥, 王审. 自拟活血舒痹汤治疗急性心肌梗死PCI术后缺血再灌注损伤的临床研究[J]. 中华全科医学, 2023, 21(6): 966-969. doi: 10.16766/j.cnki.issn.1674-4152.003026
引用本文: 郑祥, 王审. 自拟活血舒痹汤治疗急性心肌梗死PCI术后缺血再灌注损伤的临床研究[J]. 中华全科医学, 2023, 21(6): 966-969. doi: 10.16766/j.cnki.issn.1674-4152.003026
ZHENG Xiang, WANG Shen. Clinical study of self-made Huoxue Shubi Decoction on the treatment of ischemia reperfusion injury after PCI in acute myocardial infarction[J]. Chinese Journal of General Practice, 2023, 21(6): 966-969. doi: 10.16766/j.cnki.issn.1674-4152.003026
Citation: ZHENG Xiang, WANG Shen. Clinical study of self-made Huoxue Shubi Decoction on the treatment of ischemia reperfusion injury after PCI in acute myocardial infarction[J]. Chinese Journal of General Practice, 2023, 21(6): 966-969. doi: 10.16766/j.cnki.issn.1674-4152.003026

自拟活血舒痹汤治疗急性心肌梗死PCI术后缺血再灌注损伤的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.003026
基金项目: 

浙江省中医药科技计划项目 2022ZB149

详细信息
    通讯作者:

    郑祥,E-mail: kinddoctorky@126.com

  • 中图分类号: R542.22

Clinical study of self-made Huoxue Shubi Decoction on the treatment of ischemia reperfusion injury after PCI in acute myocardial infarction

  • 摘要:   目的  探讨自拟活血舒痹汤对急性心肌梗死经皮冠状动脉介入术(PCI)后缺血再灌注损伤(IRI)的临床疗效、心室重塑、心血管不良事件的影响。  方法  选取2019年1月—2021年12月温州市中西医结合医院心血管内科急性心肌梗死PCI术后患者96例,根据随机数字表法,分为对照组(48例)和观察组(48例)。对照组给予阿司匹林和替格瑞洛治疗,观察组加服自拟活血舒痹汤治疗。比较2组临床疗效、中医证候积分、血小板聚集、心绞痛、心功能指标、心血管不良事件等。  结果  治疗2个月后,观察组有效率为95.83%(46/48),对照组为79.17%(38/48),2组比较差异有统计学意义(χ2=6.095, P=0.014)。治疗2个月后,观察组胸痛、心悸气短、乏力、自汗、舌质暗紫、脉虚无力等评分均低于对照组(均P<0.05)。治疗2个月后,2组血小板聚集率、心绞痛均改善,观察组均优于对照组(均P>0.05);2组左室射血分数(LVEF)、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)均改善,观察组均优于对照组(均P<0.05);2组心血管不良事件发生率比较差异无统计学意义(P>0.05)。  结论  在西医治疗基础上,加用自拟活血舒痹汤治疗急性心肌梗死PCI术后IRI效果显著,能促进症状改善,减少血小板聚集,缓解心肌重塑,且安全性高。

     

  • 表  1  2组急性心肌梗死PCI术后患者一般资料比较

    Table  1.   Comparison of general data of patients with acute myocardial infarction after PCI in 2 groups

    组别 例数 性别(例) 年龄(x±s,岁) 就诊时间[M(P25, P75),h] Killip分级(例) 基础疾病(例)
    男性 女性 高血压 高血脂 糖尿病
    对照组 48 25 23 65.53±11.30 2.90(2.51,3.73) 13 28 7 36 19 15
    观察组 48 28 20 64.91±12.66 3.02(2.65,3.59) 10 25 13 35 22 17
    统计量 0.379a 0.253b 0.404c 1.356c 0.054a 0.383a 0.188a
    P 0.538 0.801 0.688 0.175 0.816 0.536 0.665
    注:a为χ2值,bt值,cZ值。
    下载: 导出CSV

    表  2  2组急性心肌梗死PCI术后患者临床疗效比较[例(%)]

    Table  2.   Comparison of clinical efficacy between two groups of patients with acute myocardial infarction after PCI [cases (%)]

    组别 例数 显效 缓解 无效 总有效
    对照组 48 28(58.33) 10(20.83) 10(20.83) 38(79.17)
    观察组 48 36(75.00) 10(20.83) 2(4.17) 46(95.83)
    注:2组总有效率比较,χ2=6.095, P=0.014。
    下载: 导出CSV

    表  3  2组急性心肌梗死PCI术后患者中医临床症状量表积分比较(x±s,分)

    Table  3.   Comparison of TCM clinical symptom scale scores between the two groups of patients with acute myocardial infarction after PCI

    组别 例数 胸痛 气短心悸 乏力
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    对照组 48 2.52±0.25 1.65±0.22a 2.34±0.31 1.38±0.21a 2.02±0.31 1.51±0.36a
    观察组 48 2.59±0.31 0.73±0.13a 2.28±0.33 0.82±0.10a 2.11±0.35 1.01±0.22a
    t 1.218 24.943 0.918 16.681 1.334 8.211
    P 0.226 <0.001 0.361 <0.001 0.185 <0.001
    组别 例数 自汗 舌质暗紫 脉虚无力
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    对照组 48 2.22±0.45 1.65±0.32a 2.50±0.40 1.40±0.22a 2.31±0.30 1.21±0.25a
    观察组 48 2.17±0.33 1.01±0.28a 2.44±0.38 0.72±0.09a 2.20±0.28 0.07±0.15a
    t 0.621 10.428 0.753 19.820 1.857 27.090
    P 0.536 <0.001 0.453 <0.001 0.066 <0.001
    注:与同组治疗前比较,aP<0.05。
    下载: 导出CSV

    表  4  2组急性心肌梗死PCI术后患者血小板聚集率及心绞痛程度比较(x±s)

    Table  4.   The platelet aggregation rate and the degree of angina in patients with acute myocardial infarction after PCI were compared between the two groups (x±s)

    组别 例数 血小板聚集率(%) t P SAQ评分(分) t P
    治疗前 治疗后 治疗前 治疗后
    对照组 48 72.64±9.27 43.35±5.29 19.013 <0.001 272.32±51.68 387.46±58.71 10.199 <0.001
    观察组 48 71.33±9.36 32.19±4.87 25.701 <0.001 283.51±53.79 415.60±65.32 10.815 <0.001
    t 0.689 10.753 1.039 2.220
    P 0.493 <0.001 0.301 0.029
    下载: 导出CSV

    表  5  2组急性心肌梗死PCI术后患者心功能指标比较(x±s)

    Table  5.   Comparison of cardiac function indexes between the two groups of patients with acute myocardial infarction after PCI (x±s)

    组别 例数 LVEF(%) LVEDV(mL) LVESV(mL)
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    对照组 48 48.62±5.33 52.15±6.27a 135.32±15.21 120.39±10.35a 85.24±5.37 65.39±5.20a
    观察组 48 47.69±4.49 56.33±6.79a 135.68±13.76 115.95±9.21a 84.69±5.10 60.81±4.68a
    t 0.925 3.133 0.122 2.220 0.515 4.536
    P 0.358 0.002 0.904 0.029 0.608 <0.001
    注:与同组治疗前比较,aP<0.05。
    下载: 导出CSV

    表  6  2组急性心肌梗死PCI术后患者心血管不良事件比较[例(%)]

    Table  6.   Comparison of cardiovascular adverse events between the two groups of patients with acute myocardial infarction after PCI [cases (%)]

    组别 例数 严重心律失常 出血 再次心肌梗死 心力衰竭 死亡 合计
    对照组 48 4(8.33) 2(4.17) 1(2.08) 1(2.08) 2(4.17) 10(20.83)
    观察组 48 2(4.17) 2(4.17) 0 2(4.17) 1(2.08) 7(14.58)
    注:2组不良事件总发生率比较,χ2=0.643,P=0.423。
    下载: 导出CSV
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  • 收稿日期:  2023-02-13
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