双参通冠胶囊治疗急性心肌梗死直接PCI术后患者的临床观察

Clinical Efficacy Evaluation of Shuangshen Tongguan Capsule on Acute Myocardial Infarction Patients after Direct Percutaneous Coronary Intervention

目的评价双参通冠胶囊治疗急性心肌梗死直接经皮冠状动脉介入(PCI)术后患者的临床疗效。方法采用随机对照研究方法,对心电图ST段抬高急性心肌梗死急诊直接PCI治疗成功后的病例,随机分两组,实际纳入对照组62例,治疗组67例。在西医规范治疗的基础上,治疗组加双参通冠胶囊,对照组加双参通冠胶囊安慰剂,每次4粒,每日3次。治疗6个月后评价中医证候改善积分,静息及负荷状态下的心功能以及微循环血流灌注速度,西雅图心绞痛量表积分的变化。结果两组共失访5例,失访率为3.88%。在治疗6个月后,治疗组与对照组比较,中医证候积分明显降低(P<0.05),中医证候改善的疗效增高(P<0.05);负荷态的左室射血分数(LVEF)和正常心肌百分比明显增加(P<0.05),微循环血流灌注k值增加的前壁心肌梗死节段数增多(P<0.05);西雅图心绞痛量表的总积分以及治疗满意程度与疾病认识程度的积分显著增高(P<0.05)。结论双参通脉胶囊能够改善急性心肌梗死直接PCI术后患者的心绞痛症状,提高心功能,具有一定改善心肌微循环血流灌注的作用,提高患者生活质量。

Objective To evaluate the therapeutic efficacy of Shuangshen Tongguan Capsule （STC） on acute myocardial infarction （AMI） patients after direct percutaneous coronary intervention （PCI）. Methods Using a randomized controlled method, AMI patients with elevated ST segment after successful direct PCI were randomly assigned to the control group （62 cases） and the treatment group （67 cases）. On the basis of the standard Western medical treatment, patients in the treatment group took STC, while those in the control group took STC placebos, 4 pills each time, three times daily. The Chinese medicine syndrome integrals, the cardiac function in the resting and loading states, the microcirculation perfusion rate, and the changes of Seattle Angina Scale score were evaluated after 6 months of treatment. Results Five cases were lost, accounting for 3.88%. Six months later the Chinese medicine syndrome integrals obviously decreased, the efficacy of Chinese medicine syndrome was enhanced, the LVEF in the loading state and the percentage of normal myocardium obviously in- creased, anterior myocardial infarction segments with increased k value of the microcirculation perfusion in- creased, the total score of Seattle Angina score, the satisfactory degree of the treatment, and the integrals for the disease recognition degree were significantly enhanced （all P〈0.05）. Conclusions STC could improve the angina symptoms of AMI patients after direct PCI and elevate their heart functions. It has certain roles in improving microcirculation perfusion of myocardium, thus elevating patients＇ quality of life.