中西医结合治疗气虚血瘀型急性ST段抬高型心肌梗死35例临床观察

Clinical Study on Integrated Traditional Chinese and Western Medicine in Treating35 Cases of Acute ST-segment Elevation Myocardial Infarction with Qi Deficiency and Blood Stasis

目的:应用参七汤颗粒剂观察其对改善气虚血瘀型STMI患者心肌灌注的有效性。方法:选择我院70例气虚血瘀型STMI患者,随机分为观察组和对照组,两组各35例,两组均行急诊PCI及常规抗血小板聚集、调脂药物治疗,观察组在对照基础上加用参七颗粒剂,观察两组的术中慢血流、无复流发生率、术后校正TIMI帧数、心电图ST段回落大于50%比例及手术前后胸闷痛积分的差异。结果:观察组术中慢血流、无复流发生率低于对照组;观察组术后校正TIMI帧数少于对照组;观察组心电图ST段回落大于50%比例高于对照组;观察组手术后胸痛积分均值低于对照组,差异均有统计学意义(P<0.05)。结论:参七颗粒有改善STEMI患者心肌灌注作用,能减少心肌缺血范围及时间、减轻患者胸痛症状,但在远期预后及机制方面,仍待进一步研究。

Objective To observe the effectiveness of Shenqi decoction in improving myocardial perfusion in STMI patients with qi deficiency and blood stasis by changing the dosage form into Shenqi granule.Methods 70 STMI patients with qi deficiency and blood stasis in our hospital were randomly divided into observation group(n=35)and control group(n=35).Both groups were treated with emergency PCI and routine anti-platelet aggregation and lipid-regulating drugs.Shenqi granule was added in observation group to observe the intraoperative slow blood flow,the incidence of no reflow,the number of postoperative corrected TIMI frames,the proportion of ECG ST segment falling more than 50%and the difference of chest tightness score before and after operation.Results the incidence of slow blood flow and no reflow in the observation group was lower than that in the control group;the number of corrected TIMI frames in the observation group was less than that in the control group;the proportion of ECG ST segment falling more than 50%in the observation group was higher than that in the control group;and the average score of chest pain in the observation group was lower than that in the control group.Conclusion Shenqi granule can improve myocardial perfusion in STEMI patients,reduce the range and time of myocardial ischemia and relieve the symptoms of chest pain,but the long-term prognosis and mechanism need to be further studied.