芪苈强心胶囊联合替格瑞洛和阿司匹林治疗陈旧性心肌梗死的临床研究

Clinical study of Qiliqiangxin Capsules combined with ticagrelor and aspirin in treatment of old myocardial infarction

目的探究芪苈强心胶囊联合替格瑞洛和阿司匹林治疗陈旧性心肌梗死的疗效。方法选取2016年1月—2018年2月扬州大学医学院附属兴化市人民医院60例陈旧性心肌梗死患者作为研究对象,采用随机数字法将患者分为对照组和观察组,每组30例。对照组患者口服替格瑞洛片,初始剂量采用单次负荷剂量180 mg,此后90 mg/次,2次/d。同时口服阿司匹林肠溶片,1片/次,1次/d。观察组在对照组基础上给予芪苈强心胶囊,4粒/次,3次/d。两组均治疗和观察周期为12个月。比较两组患者的血清超敏-C反应蛋白(hs-CRP)、白血胞介素6(IL-6)水平、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末期容积(LVESV),主要心脑血管不良事件(MACE)、出血事件的发生情况。结果治疗后,hsCRP、IL-6的水平均较治疗前显著下降(P<0.05),且观察组hs-CRP、IL-6水平显著低于对照组(P<0.05)。治疗后,两组患者的LVEF均较治疗前上升,LVEDD和LVESV均较治疗前降低(P<0.05),且观察组变化幅度均大于对照组(P<0.05)。治疗期间,观察组患者的MACE发生率低于对照组(P<0.05);观察组出血事件与对照组相比,差异无统计学意义。结论芪苈强心胶囊联合替格瑞洛和阿司匹林治疗陈旧性心肌梗死疗效显著,可有效缓解陈旧性心肌梗死患者的血管炎性反应,使心功能得到显著改善,降低MACE的发生率。

Objective To explore the efficacy of Qiliqiangxin Capsules combined with ticagrelor and aspirin in treatment of old myocardial infarction.Methods A total of 60 patients with old myocardial infarction in Xinghua People’s Hospital affiliated to Yangzhou University Medical College from January 2016 to February 2018 were selected as the research objects,and the patients were divided into control group and observation group by random number method,with 30 patients in each group.Patients in the control group were po administered with Ticagrelor Tablets,the initial dose was 180 mg with a single load,then 90 mg/time,twice daily.At the same time,Aspirin Enteric-coated Tablets were taken,one tablet/time,once daily.Patients in the observation group were po administered with Qiliqiangxin Capsules on the basis of the control group,4 grains/time,three times daily.Both groups were treated and observed for 12 months.After treatment,the serum levels of hs-CRP,IL-6,LVEF,LVEDD,LVESV,MACE,and bleeding events were in two groups were compared.Results After treatment,the levels of hs-CRP and IL-6 were significantly decreased compared with those before treatment(P<0.05),and the levels of hs-CRP and IL-6 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,LVEF in two groups were increased compared with that before treatment,LVEDD and LVESV were decreased(P<0.05),and the change amplitude of patients in the observation group was greater than that in the control group(P<0.05).During treatment,the incidence of MACE in the observation group was lower than that in the control group(P<0.05).There was no significant difference in bleeding events between the observation group and the control group.Conclusion Qiliqiangxin Capsules combined with ticagrelor and aspirin in treatment of old myocardial infarction is significant,can effectively alleviate vascular inflammatory response,so that the heart function has been significantly improved,and reduce the incidence of MACE.