益气活血中药对急性冠脉综合征患者经皮冠状动脉介入术后左室重构及心功能的影响

Influence of Chinese Herbal Medicine Nourishing qi and Removing Blood Stasis on Left Ventricular Remodeling and Cardiac Function in the Treatment of Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention

目的:探究益气活血中药对行经皮冠状动脉介入术(PCI)的急性冠脉综合征(ACS)患者术后左室重构及左心功能的影响。方法:选取2013年8月至2016年8月辽宁省阜新市矿业集团平安医院住院并行PCI的ACS患者79例,按照随机数字表法分为对照组(n=39)和观察组(n=40),术后对照组患者给予常规治疗,观察组患者在对照组的基础上给予益气活血中药治疗,2组均连续治疗6个月,统计2组临床疗效,比较2组血瘀证积分及中医证候积分改善情况;检测并比较2组治疗前后左室重构指标及左心功能指标的变化。结果:治疗后6个月观察组临床总有效率为85.00%,显著高于对照组的66.67%,差异有统计学意义(P<0.01);治疗后3个月及6个月2组中医证候积分及血瘀证积分均较治疗前降低(P<0.01),治疗后6个月2组中医证候积分及血瘀证积分均较治疗后3个月降低(P<0.05或P<0.01),且治疗后3个月观察组血瘀证积分显著低于对照组,治疗后6个月观察组中医症候积分及血瘀证积分均显著低于对照组(P<0.01);与治疗前比较,治疗后6个月2组LVEDs及LVEDd均明显降低,对照组LVMI显著升高,且观察组LVEDs、LVEDd及LVMI均显著低于对照组(P<0.01);治疗后6个月2组FS及LVEF均明显升高,且观察组显著高于对照组(P<0.01);2组IVST于治疗前后及组间差异均无统计学意义(P>0.05);与治疗前比较,治疗后6个月2组NYHA心功能分级Ⅰ级患者比例均显著升高(P<0.05或P<0.01),且观察组显著高于对照组(P<0.05),此外,观察组NYHA心功能分级Ⅲ级患者比例也显著升高(P<0.01)。结论:益气活血中药心悦胶囊及复方川芎胶囊可显著抑制行PCI术后ACS患者左室重构,改善患者心功能,临床疗效较术后常规治疗显著提高。

Objective： To explore the influence of Chinese herbal medicine nourishing qi and removing blood stasis on left ventricular remodeling and cardiac function in the treatment of acute coronary syndrome（ ACS） patients after percutaneous coronary intervention（ PCI）. Methods： A total of 79 cases of ACS patients after PCI in our hospital from August 2013 to August 2016 were selected and divided into control group（ n = 39） and treatment group（ n = 40） by random number table. Control group were treated with conventional therapy,while treatment group were treated with Chinese herbal medicine nourishing qi and removing blood stasis on the basis of control group. Both groups were treated for 6 months continuously. The clinical efficacy was calculated,and the blood stasis syndrome integral and TCM syndrome integral were compared. The left ventricular remodeling and cardiac function indexes in 2 groups before and after treatment were detected and compared. Results： The clinical efficacy of treatment group was 85.00% 6 months after treatment,which was higher than that 66. 67% of control group significantly（ P〈0. 01）; The blood stasis syndrome integral and TCM syndrome integral of 2 groups 3 and 6 months after treatment decreased significantly compared with before treatment（ P〈0. 01）,and the blood stasis syndrome integral of treatment group 3 months after treatment were lower than that of control group. The blood stasis syndrome integral and TCM syndrome integral of treatment group 6 months after treatment were lower than that of control group（ P〈0. 01）; Compared with before treatment,the LVEDs,LVEDd of 2 groups decreased,and the LVMI increased significantly 6 months after treatment,and the LVEDs,LVEDd and LVMI were lower than that of control group（ P〈0. 01）; The FS and LVEF of 2 groups increased significantly 6 months after treatment,and treatment group was higher than control group（ P〈0. 01）; The IVST of 2 groups had no significant difference between before and after treatment as well as 2 groups（ P〈0. 05）. The proportion of NYHA Ⅰ class patients increased significantly（ P〈0. 05 or P〈0. 01）,and treatment group was higher than control group（ P〈0. 05）. Besides,the proportion of NYHA Ⅲ class patients increased significantly（ P〈0. 01）. Conclusion： Chinese herbal medicine nourishing qi and removing blood stasis can restrain the left ventricular remodeling of ACS patients after PCI significantly,and improve cardiac function,and the clinical efficacy is significantly enhanced comparing with conventional therapy.