参附注射液联合西药在急性冠脉综合征社区卫生院急救标准化流程应用多中心随机平行对照研究

Shenfu Injection Combined with Western Medicine on Acute Coronary Syndrome of Prehospital Emergency Application of Standardization in the Process

[目的]观察参附注射液联合西药治疗急性冠脉综合征疗效。[方法]使用多中心随机平行对照方法，将100例门诊患者按就诊顺序号法简单随机分两组。对照组50例根据病史、症状、体征和心电图等，危险性初步评估为高、中、低三度；高危：立即口服拜阿司匹林、氯吡格雷各300mg，血压不低使用硝酸甘油舌下或静脉应用，等；中度：内科强化治疗：心电监护，监测心电图及心肌标志物变化，吸氧及呼吸支持，等；低危：留院观察，期间未再发生心绞痛，心电图无缺血改变、无左心衰竭的临床证据、留院观察12～24h期间未发现CK-MB升高、肌钙蛋白正常，留院观察24—48h后出院。治疗组50例参附注射液50mL＋5％葡萄糖100mL，静滴；糖尿病加用胰岛素；西药治疗同对照组。连续治疗3d为1疗程。观测临床症状、疗效指数、不良反应。治疗1疗程，判定疗效。[结果]治疗组临床痊愈O例，显效17例，有效24例，无效9例，总有效率82．00％。对照组临床痊愈0例，显效20例，有效11例，无效19例，总有效率62．00％。治疗组疗效优于对照组（P〈0．05）。[结论]参附注射液联合西药治疗急性冠脉综合征，疗效满意，无严重不良反应，值得推广。

[Objective] To observe the effect of Shenfu injection combined with western medicine in the treatment of acute coronary syndrome. [Methods] Using a multi center randomized and parallel control method, 100 patients were randomly divided into two groups： simple random number method. The control group of 50 cases according to the history, symptoms, signs and ECG, preliminary assessment of risk is high, low, in three degrees; high risk： immediate oral aspirin, clopidogrel 300mg, not lower blood pressure using nitroglycerin sublingual or intravenous, etc.; moderate： Department of internal medicine intensive treatment： ECG, ECG monitoring and changes of cardiac markers, oxygen inhalation and respiratory support, etc.; low risk： during the stay in hospital for observation, no recurrence of angina peetoris, ECG isehemia, no change of left heart failure clinical evidence, hospitalized 12-24h was found during CK-MB, elevated troponin normal, hospital stay in hospital for observation after 24-48h. The treatment group of 50 cases of Shenfu injection 50mL＋5% glucose 100mL, intravenous insulin plus; diabetes mellitus; western medicine treatment with the control group. 3D continuous treatment for 1 course of treatment. Observation of clinical symptoms, curative effect, adverse reaction index. [ course of treatment, treatment to determine efficacy. 0 cases were cured after treatment in the treatment group.[Result]17 cases were markedly effective, 24 cases effective, 9 cases ineffective, the total efficiency of 82%. The control group clinical cure in 0 cases, 20 cases were markedly effective, 11 cases effective, 19 cases ineffective, the total efficiency of 62%. The treatment group than the control group （P〈0.05）. [Conclusion] Shenfu injection combined with western medicine in the treatment of acute coronary syndrome, the curative effect is satisfied, no serious adverse reactions, worthy of promotion