十全大补汤加减联合硝酸甘油治疗急性心肌梗死后心力衰竭的临床效果分析

Clinical effect of Shiquan Dabu Decoction combined with nitroglycerin on acute heart failure after myocardial infarction

目的探讨十全大补汤加减联合硝酸甘油治疗急性心肌梗死后心力衰竭的临床效果.方法选择2016年1月至2017年6月丽水市中医医院心内科收治的急性心肌梗死后心力衰竭患者110例为研究对象,采用随机数字表法分为观察组和对照组各55例,其中对照组应用硝酸甘油常规治疗方案,观察组在硝酸甘油常规治疗基础上应用十全大补汤加减治疗,治疗1周后观察两组治疗效果.结果观察组治疗总疗效92.73%,明显高于对照组的78.18%,组间差异有统计学意义(χ^2=4.681,P<0.05);治疗后,观察组心率(HR)(82.5 ±6.5)次/min,明显低于对照组的(102.6 ±3.9)次/min( t=19.655,P<0.01),观察组收缩压(SBP)[(116.5 ±6.4) mmHg]、血氧饱和度( SpO2 )[( 95.2 ±1.6 )%],明显高于对照组[ SBP (108.8 ± 5.2)mmHg、SpO2 (92.5 ±1.2)%],组间差异有统计学意义( t=6.925、10.012,均P<0.01);观察组不良反应率(10.91%)高于对照组(3.64%),但差异无统计学意义(χ^2=2.157,P>0.05).结论对于急性心肌梗死后心力衰竭患者来说,临床常规治疗中联合应用中药十全大补汤加减辨证治疗的效果明显优于单纯西医治疗疗效,值得推广使用.

Objective To summarize and discuss the clinical effect of Shiquan Dabu Decoction combined with nitroglycerin in the treatment of heart failure after acute myocardial infarction. Methods From January 2016 to June 2017, 110 patients with heart failure after acute myocardial infarction admitted to the Department of Cardiology of Lishui Hospital of Traditional Chinese Medicine were selected as study objects.The patients were randomly divided into observation group and control group according to the digital table, with 55 cases in each group.The control group was treated with routine nitroglycerin therapy, while the observation group was treated with routine nitroglycerin therapy combined with Shiquan Dabu Decoction.The therapeutic effect of the two groups after one week of treatment was observed. Results The total effective rate in the observation group was 92.73%, which was significantly higher than that of the control group(78.18%), and the difference between the two groups was statistically significant(χ2=4.681, P<0.05). The HR level of the observation group[(82.5±6.5)times/min] was significantly lower than that of the control group[(102.6±3.9)times/min](t=19.655, P<0.01). The levels of SBP[(116.5±6.4)mmHg]and SpO2[(95.2±1.6)%] in the observation group were significantly higher than those in the control group[(108.8±5.2)mmHg,(92.5±1.2)%], there were statistically significant differences between the two groups(t=6.925, 10.012, all P<0.01). The incidence of adverse reaction in the observation group was 10.91%, which was higher than that in the control group(3.64%), but there was no statistically significant difference (χ2=2.157, P>0.05). Conclusion For patients with heart failure after acute myocardial infarction, the combination of traditional Chinese medicine Shiquan Dabu Decoction in clinical routine treatment has better effect and is worthy of popularizing.