养心通痹汤对急性心肌梗死行经皮冠状动脉介入术患者中医证候积分及心肌酶谱的影响

Effects of Yangxin Tongbi Decoction on TCM Syndrome Scores and Myocardial Enzyme Spectrum in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

目的探讨养心通痹汤对急性心肌梗死行经皮冠状动脉介入术(PCI)患者中医证候积分及心肌酶谱的影响。方法将2016年12月至2017年12月于辽宁省抚顺市中医院接受治疗的88例急性心肌梗死行PCI患者按照随机数字表法分为对照组和观察组,每组44例。对照组患者给予西医常规治疗,在此基础上,观察组加用养心通痹汤进行治疗,比较两组患者治疗前后中医证候积分、心肌酶谱指标水平及心血管不良事件发生情况。结果治疗前,两组患者中医证候积分比较,差异无统计学意义(P>0.05);治疗后,观察组患者胸闷憋气、心悸气短、舌质暗紫及脉弦细涩积分均低于对照组,差异有统计学意义(P<0.05);治疗前,两组患者心肌酶谱指标水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)水平均低于对照组,差异有统计学意义(P<0.05);随访时,观察组患者心血管不良事件发生率为9.09%,显著低于对照组的40.91%,差异有统计学意义(P<0.05)。结论使用养心通痹汤治疗急性心肌梗死行PCI患者,可以有效改善患者中医证候积分及心肌酶谱指标水平,同时还能够降低心血管不良事件发生率。

Objective To investigate the effects of Yangxin Tongbi Decoction on TCM syndrome scores and myocardial enzyme spectrum in patients undergoing percutaneous coronary intervention,with acute myocardial infarction(AMI).Methods A total of 88 patients with acute myocardial infarction undergoing PCI treated in Fushun Hospital of Traditional Chinese Medicine from December 2016 to December 2017 were divided into control group and observation group with 44 cases in each group.The patients in the control group were given routine Western medicine treatment.On this basis,the observation group was treated with Yangxin Tongbi Decoction.TCM syndrome scores,myocardial enzyme spectrum index level and cardiovascular adverse events were compared between the 2 groups before and after treatment.Results Before treatment,TCM syndromes of the 2 groups of patients were compared and the difference was not statistically significant(P>0.05).After treatment,the scores of chest tightness and shortness of breath,palpitation shortness of breath,dark purple of tongue and fine astringency of pulse string in the observation group were significantly lower than those in the control group and the difference was statistically significant(P<0.05);but there was no significant difference in the level of myocardial zymogram between the 2 groups before treatment(P>0.05),and there was no significant difference in the scores of myocardial zymogram between the 2 groups before treatment(P>0.05).After treatment,the levels of CK,CK-MB in the observation group were lower than those in the control group(P<0.05),and the incidence of cardiovascular events in the observation group was 9.09%,which was significantly lower than that in the control group(40.91%).The difference was statistically significant(P<0.05).Conclusion Using Yangxin Tongbi Decoction to treat PCI patients with acute myocardial infarction can effectively improve the TCM syndrome scores and myocardial enzyme spectrum index level,and also can reduce the incidence of cardiovascular adverse events.