急性心肌梗死现代治疗证据碰撞和结合医学优势

Sparks of Conventional Treatment for Acute Myocardial Infarction and the Superiority of Integrative Medicine

近30年来,我国急性心肌梗死(acute myocardial infarction,AMI)血运重建迅速普及,药物干预更加规范化,但血运重建后仍有25%~35%的AMI患者不能获得心肌组织的灌注,AMI仍是心血管病的主要死亡原因之一。活血化瘀中药具有促进心肌毛细血管再生、抗栓、抗炎、改善心室重构等作用。结合西医常规治疗可进一步降低AMI住院并发症和死亡的发生率。但是,AMI是一个全身代谢性疾病,其涉及的病理生理变化远非影像学显示的局部狭窄程度和斑块大小所能解释。如何将强化降脂、抗血小板的不良反应和风险效益比,如何发挥结合医学优势并将其转化应用于AMI临床应用,皆须今后逐步明确。

In nearly three decades, both rapid popularization of revascularization and normaliza- tion of pharmacological intervention facilitate the treatment of acute myocardial infarction （AMI） in China. However, 25% -35% of patents with AMI can not regain myocardial tissue perfusion, and AMI is still a leading cause of death among cardiovascular diseases. Chinese herbal medicine of activating blood cir- culation and eliminating stasis plays key roles in myocardial capillary regeneration, anti-inflammation, anti-thrombosis, and improvement of ventricular remodeling. Furthermore, Integrative Medicine can re- duce the AMI in-hosptical complications and the rate of death. AMI is a systemic metabolic disease, and its pathological and physiological changes can not be elucidated by local stenosis degree and lesion size, which are diagnosed by imageology. How to strengthen the lipid lowering-drugs and anti-platelet agents through weighing their adverse reactions and risk benefit ratio, and how to take advantage of Integrative Medicine in AMI clinical applications, those are all need to be clarified in the future.