中药涂擦法对急性冠脉综合征患者PCI后负性情绪及疼痛的影响

金丽; 唐杏

doi:10.16766/j.cnki.issn.1674-4152.003647

中药涂擦法对急性冠脉综合征患者PCI后负性情绪及疼痛的影响

doi: 10.16766/j.cnki.issn.1674-4152.003647

金丽,
唐杏^,

浙江中医药大学附属第三医院急诊科，浙江杭州 310000

基金项目:

浙江省中医药科技计划项目 2024ZL534

详细信息

通讯作者:
唐杏，E-mail：txokw@126.com

中图分类号: R543.3 R289.6
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出版历程
- 收稿日期: 2023-12-18

The effect of traditional Chinese medicine inunction on negative emotions and pain in patients with acute coronary syndrome after PCI

JIN Li,
TANG Xing^,

Department of Emergency, the Third Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang 310000, China

摘要

摘要: 目的负性情绪和疼痛是影响急性冠脉综合征患者预后的重要因素之一，本研究旨在探讨中药涂擦法在接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征患者中的价值，为改善急性冠脉综合征患者负性情绪及降低疼痛水平提供参考。方法回顾性收集2020年1月—2022年12月浙江中医药大学附属第三医院急诊科收治的急性冠脉综合征患者200例，根据患者是否接受中药涂擦法治疗，将其分为中药涂擦法组(90例)和对照组(110例)，所有患者均急诊接受PCI及常规治疗，同时中药涂擦法组术后给予中药涂擦治疗，比较2组患者负性情绪、疼痛和预后情况。结果 2组患者治疗前左心室射血分数、N末端B型利钠肽原(NT-proBNP)、疼痛视觉模拟评分、焦虑自我评分和抑郁自我评分等差异无统计学意义(P>0.05)。治疗后与对照组比较，中药涂擦法组左心室射血分数增高(P=0.001)；NT-proBNP降低(P < 0.001)；疼痛视觉模拟评分降低(P < 0.001)；焦虑自我评分降低(P < 0.001)；抑郁自我评分降低(P < 0.001)。与对照组比较，中药涂擦法组重大不良心血管事件发生率降低[1.11%(1/90) vs.9.09%(10/110), P=0.031]。结论中药涂擦法可改善急性冠脉综合征患者PCI术后负性情绪、降低疼痛水平，降低短期重大不良心血管事件的发生率。
- 中药涂擦法 /
- 急性冠脉综合征 /
- 负性情绪 /
- 疼痛 /
- 重大不良心血管事件
Abstract: Objective Negative emotions and pain are among the most important factors affecting the prognosis of patients with acute coronary syndrome. The aim of this study was to explore the value of traditional Chinese medicine (TCM) in the treatment of patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI), and to provide a reference for improving negative emotions and reducing pain levels in patients with acute coronary syndrome. Methods From January 2020 to December 2022, 200 patients with acute coronary syndrome who were treated at the Third Affiliated Hospital of Zhejiang Chinese Medicine University were retrospectively collected. Patients were divided into two groups according to whether they received TCM or not: the TCM inunction group (n=90) and the control group (n=110). All patients received emergency percutaneous coronary intervention (PCI) and conventional therapy, while the TCM treatment group received TCM inunction. The negative emotions, pain and prognosis of the two groups of patients were compared. Results There was no statistically significant difference in left ventricular ejection fraction, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), pre-treatment visual analogue scale, self-rating anxiety scale and self-rating depression scale between the two groups of patients before treatment (P>0.05). After treatment, compared with the control group, the left ventricular ejection fraction in the TCM inunction group was increased (P=0.001), NT-proBNP was decreased (P < 0.001), the visual analogue scale was reduced (P < 0.001), the self-rating anxiety scale was significantly decreased (P < 0.001), and the self-rating depression scale was also decreased (P < 0.001). Compared with the control group, the incidence of major adverse cardiovascular events was significantly reduced in the TCM inunction method group [1.11% (1/90) vs. 9.09% (10/110), P=0.031]. Conclusion TCM can improve negative emotions, reduce pain levels, and reduce the incidence of short-term major adverse cardiovascular events in patients with acute coronary syndrome after PCI.
- Traditional Chinese medicine inunction /
- Acute coronary syndrome /
- Negative emotions /
- Pain /
- Major adverse cardiovascular events
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表 1 2组急性冠脉综合征患者一般临床资料、合并症和病变特征比较

Table 1. Comparison of general clinical data, comorbidities, and lesion characteristics between the two groups of patients with acute coronary syndrome

变量	中药涂擦法组(n=90)	对照组(n=110)	统计量	P值
年龄(x±s，岁)	55.82±6.63	56.34±6.72	0.548^a	0.585
性别[例(%)]			0.253^b	0.615
男性	50(55.56)	65(59.09)
女性	40(44.44)	45(40.91)
BMI(x±s)	23.66±4.18	24.42±4.26	1.266^a	0.207
吸烟史[例(%)]	18(20.00)	23(20.91)	0.025^b	0.874
嗜酒史[例(%)]	16(17.78)	28(25.45)	1.700^b	0.192
家族史[例(%)]	3(3.33)	6(5.45)	0.142^b	0.706
高血压病[例(%)]	65(72.22)	88(80.00)	1.666^b	0.197
糖尿病[例(%)]	25(31.25)	33(30.00)	0.034^b	0.853
高脂血症[例(%)]	72(80.00)	90(81.82)	0.106^b	0.744
急性冠脉综合征类型[例(%)]			2.802^b	0.246
ST段抬高型心肌梗死	43(47.78)	40(36.36)
非ST段抬高型心肌梗死	32(35.56)	50(45.45)
不稳定型心绞痛	15(16.67)	20(18.18)
冠状动脉支架植入数目(x±s, 个)	3.03±0.90	2.86±0.82	1.396^a	0.164
注：^a为t值，^b为χ²值。

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表 2 2组急性冠脉综合征患者其他主要治疗措施比较[例(%)]

Table 2. Comparison of other major treatment measures between the two groups of patients with acute coronary syndrome [cases (%)]

治疗措施	中药涂擦法组(n=90)	对照组(n=110)	χ²值	P值
降压药物			2.385	0.303
未用	25(27.78)	22(20.00)
单一药物	40(44.44)	60(54.55)
联合用药	25(27.78)	28(25.45)
降糖药物			0.351	0.839
未用	65(72.22)	77(70.00)
单纯药物	20(22.22)	28(25.45)
药物联合胰岛素	5(5.56)	5(4.55)
降脂药物			0.106	0.744
未用	18(20.00)	20(18.18)
降脂药物	72(80.00)	90(81.82)
抗血小板治疗方案			1.941	0.164
双联抗血小板治疗	80(88.89)	90(81.82)
三联抗血小板治疗	10(11.11)	20(18.18)

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表 3 2组急性冠脉综合征患者治疗前后左心室射血分数、NT-proBNP比较(x±s)

Table 3. Comparison of left ventricular ejection fraction and NT-proBNP between the two groups of patients with acute coronary syndrome before and after treatment (x±s)

组别	例数	左心室射血分数(%)		NT-proBNP(pg/mL)
组别	例数	治疗前	治疗后7 d	治疗前	治疗后7 d
中药涂擦法组	90	53.37±5.62	58.92±4.91^b	1245.34±358.84	287.48±98.77^b
对照组	110	52.64±5.71	56.43±5.05^b	1274.47±403.82	385.34±89.67^b
统计量		0.906^a	3.895^c	0.533^a	8.985^c
P值		0.366	< 0.001	0.594	< 0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP < 0.05。

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表 4 2组急性冠脉综合征患者疼痛水平和负性情绪比较(x±s, 分)

Table 4. Comparison of pain levels and negative emotions between the two groups of patients with acute coronary syndrome (x±s, points)

组别	例数	疼痛视觉模拟评分		焦虑自我评分		抑郁自我评分
组别	例数	治疗前	治疗后7 d	治疗前	治疗后7 d	治疗前	治疗后7 d
中药涂擦法组	90	4.62±1.45	1.23±0.55^b	54.55±10.43	35.45±8.54^b	48.59±9.34	36.49±6.75^b
对照组	110	4.70±1.42	1.84±0.60^b	53.89±9.84	42.55±8.09^b	49.05±8.82	40.83±7.12^b
统计量		0.392^a	8.653^c	0.472^a	7.262^c	0.362^a	5.261^c
P值		0.694	< 0.001	0.624	< 0.001	0.749	< 0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP < 0.05。

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表 5 2组急性冠脉综合征患者重大不良心血管事件和院内死亡率比较[例(%)]

Table 5. Comparison of major adverse cardiovascular events and in-hospital mortality rates between the two groups of patients with acute coronary syndrome [cases (%)]

组别	例数	重大不良心血管事件	院内死亡
中药涂擦法组	90	1(1.11)	1(1.11)
对照组	110	10(9.09)	3(2.73)
χ²值		4.626	0.093
P值		0.031	0.761

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