愈梗通瘀汤对急性心肌梗死患者PCI术后血脂、cTnT及BNP水平的影响

Effect of Yugeng Tongyu Decoction on Levels of Blood Lipids,cTnT and BNP in Patients with AMI after PCI

目的:探讨愈梗通瘀汤联合西药对急性心肌梗死(acutemyocardialinfarction,AMI)患者血脂、心肌肌钙蛋白T(cardiactroponinT,cTnT)及脑钠肽(Brainnatriureticpeptide,BNP)水平的影响。方法:选择符合纳入标准的79例AMI患者,依据随机数字表随机分为对照组(40例)和观察组(39例)。对照组采用尼可地尔滴注治疗,观察组在对照组基础上联合愈梗通瘀汤治疗。记录两组患者治疗前后的血脂、cTnT、BNP水平及中医症状积分,并对比两组患者的不良反应发生率和终点事件发生率。结果:治疗后,两组患者血脂指标TC、TG、LDL-C以及cTnT、BNP水平均明显降低,HDL-C水平无明显变化(P>0.05),且观察组TC、TG、LDL-C、cTnT及BNP水平优于对照组(P<0.05);治疗后,两组患者胸痛、气短、乏力、心悸出汗、胸闷等中医症状积分均明显降低(P<0.05),且观察组明显低于对照组(P<0.05);在治疗期间,观察组发生不良反应9例(23.08%),对照组发生不良反应13例(32.5%),组间比较无统计学意义(P>0.05);治疗后随访6个月,观察组出现脑卒中、二次住院发生率明显低于对照组,组间比较具有统计学意义(P<0.05)。结论:愈梗通瘀汤可以在常规西药治疗基础上有效降低AMI患者血脂及cTnT、BNP水平,缓解临床症状,减少终点事件发生率,具有临床应用价值。

Objective:To investigate the effects of Yugeng Tongyu Decoction combined with western medication on the levels of blood lipids,cardiac troponin T(cTnT)and brain natriuretic peptide(BNP)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:A total of 79 AMI patients,who met the inclusion criteria,were randomly divided into the control group(n=40)and the observation group(n=39).The control group was treated with Nicorandil;on which basis,the observation group was also treated with Yugeng Tongyu Decoction.Both groups were treated for three months and followed up for six months.The levels of blood lipids,cTnT and BNP,as well as the scores of TCM symptoms were compared between before and after the treatment in the two groups.The adverse reactions rate and the end-point event rate were compared between the two groups.Results:The levels of TC,TG,LDL-C,cTnT and BNP were significantly decreased(P<0.05);after the treatment in the two groups of which the improvements were more significant in the observation group than those in the control group(P<0.05);there was no statistical difference in the level of HDL-C(P>0.05).The scores of TCM syndromes,such as chest pain,shortness of breath,fatigue,palpitations,sweating and chest tightness,were significantly reduced after the treatment in the two groups(P<0.05);the reductions were more significant in the observation group than those in the control group(P<0.05).The adverse reactions rate was 23.08%(9/39)in the observation group,it was 32.5%(13/40)in the control group,and there was no statistical difference between the two groups(P>0.05).During the follow-up,the incidence of stroke and second hospitalization was less in the observation group than that in the control group(P<0.05).Conclusion:Yugeng Tongyu Decoction can effectively reduce the levels of blood lipids,cTnT and BNP,improve clinical symptoms and reduce end-point events in the treatment of AMI based on western medication.The therapy has a significant clinical application value.