中西医结合治疗前壁ST段抬高型急性心肌梗死临床研究

The Clinical Study of Integrative Medicine Therapy on Anterior Wall Type St-elevation Acute Myocardial Infarction

目的分析评价四妙勇安汤合失笑散治疗急性心肌梗死(AMI)近期预后的影响。方法将第一次前壁ST段抬高型AMI且经尿激酶溶栓治疗的患者随机分成两组,治疗组采用在规范化西医治疗(不包括PCI及冠脉搭桥术):休息、吸氧、止痛、抗栓、ACEI、β受体阻制剂、他汀类药物、硝酸酯类药物等以及予尿激酶溶栓基础上,加用四妙勇安汤合失笑散口服,对照组采用单纯规范化西医治疗。结果治疗组患者体温、WBC、CK-MB平均值均较单纯规范化西医治疗组降低、再发心梗、再发心绞痛、充血性心力衰竭、心源性死亡、心律失常、等不良心血管事件的发生率明显低于对照组,而血管再通率高于对照组。结论四妙勇安汤合失笑散治疗AMI有抗炎减轻心室重塑和缩小梗死面积控制梗死延展的作用,可以提高血管再通率,改善AMI患者的预后。

Objective： To analyse and evaluate the effect of Simiaoyong＇an Decoction and Shixiao Powder on AMI prognosis.Methods： 60 patients with the first AMI with ST up who had received urokinase thrombolysis treatment were assigned randomly into two group.The treatment group were given standardized treatment of western medicine and oral Simiaoyong＇an Decoction and Shixiao Powder.The control groups were only given standardized treatment of western medicine.Results： The average value of control groups in body temperature、WBC、CK-MB were decreased,which were lower than those of control group.The incidence of myocardial infarction recurrent,stable angina,congestive heart-failure,cardiac death,arrhythmia and so in treatment were lower obviously than those of control group,while the rate of blood vessels was more higher than that of control group.Conclusion：Simiaoyong＇an Decoction and Shixiao Powder plays a part in anti-inflammatory,reducing ventricular remodeling and reducing myocardial infarction area,which can improving the rate of blood vessels and the prognosis of patients with AMI.