揿针治疗不稳定型心绞痛介入术后心肌损伤临床研究

Clinical study on the improvement of myocardial injury after PCI in patients with unstable angina pectoris by pressing needle

目的:观察应用揿针对气虚血瘀型不稳定型心绞痛患者PCI后心肌损伤的保护作用。方法:选取我院急诊科收治的需要择期PCI治疗的气虚血瘀型不稳定型心绞痛患者60例,随机将其分为两组,每组30例。对照组予西医基础治疗,观察组在此基础治疗上予内关、膻中、膈腧、血海、足三里、公孙,双侧取穴,置入揿针治疗3 d。比较两组术前0.5 h、术后12 h超敏肌钙蛋白T(hs-TNT)、血浆肌酸激酶同工酶(CK-MB)、超敏C-反应蛋白(hs-CRP)水平;比较两组揿针治疗前及治疗后的中医症状积分。结果:两组患者hs-TNT在PCI术后较术前均有不同程度的升高,但观察组的hs-TNT显著低于对照组(P<0.05);两组患者CK-MB在术前术后变化不明显,两者比较无统计学意义(P>0.05);两组患者hs-CRP在PCI术后显著高于术前,但观察组的hs-CRP显著低于对照组(P<0.05)。治疗后观察组的中医症状积分显著低于对照组(P<0.05)。结论:术前应用揿针可减轻不稳定型心绞痛患者PCI术后心肌损伤的程度,减轻炎症反应,从而改善预后。内关、公孙、膻中、膈腧、血海、足三里治疗气虚血瘀型不稳定型心绞痛疗效较好。

Objective:To observe the protective effect of press on myocardial injury after PCI in patients with unstable angina pectoris of Qixu Xueyu type.Methods:60 patients with unstable angina pectoris of Qixu Xueyu type who need selective PCI treatment were selected.They were randomly divided into two groups,30 cases in each group.The control group was treated with western medicine,and the observation group was treated with Neiguan,Tanzhong,Geshu,Xuehai,Zusanli,Gongsun on the basis of basic treatment.The acupoints were taken from both sides and treated with pressing acupuncture for 3 days.The levels of hypersensitive troponin T(hs-TNT),plasma creatine kinase isozyme(CK-MB)and hypersensitive C-reactive protein(hs-CRP)were compared between the two groups at 0.5 h before and 12 h after operation.The TCM symptom scores before and after treatment were compared between the two groups.Results:The detection levels of hs-TNT of observation group was lower than that of control group(P<0.05).The CK-MB of two groups before and after the operation were compared,there was no statistically significant difference(P>0.05).The detection levels of hs-CRP of observation group was lower than that of control group(P<0.05).The TCM symptom scores of the observation group were significantly improved compared with the control group(P<0.05).Conclusions:The application of press needle before operation can reduce the degree of myocardial injury and inflammatory reaction in patients with unstable angina after PCI,so as to improve the prognosis.Neiguan,Gongsun,Tanzhong,Geshu,Xuehai and Zusanli are effective in the treatment of unstable angina pectoris of Qixu Xueyu type.