基于“三辨诊疗模式”联合西医常规治疗在冠心病经皮冠状动脉介入术后患者应用的临床观察研究

Clinical observation and study on the application of"three discrimination diagnosis and treatment mode"combined with conventional western medicine in patients with coronary heart disease after percutaneous coronary intervention

目的探讨“三辨诊疗模式”联合西医常规治疗冠状动脉粥样硬化性心脏病(CHD)经皮冠状动脉介入(PCI)术后患者的临床疗效。方法选取2021年3月至12月湖南中医药大学附属醴陵市中医院收治的90例行PCI治疗的CHD患者作为研究对象,按照随机数字表法分为对照组与观察组,每组45例。其中对照组患者给予常规双联抗血小板及调脂治疗,观察组患者在对照组基础上加用“三辨模式”中医药治疗。治疗12个月后比较分析两组患者治疗前后心电图改善情况、左室射血分数(LVEF)、N末端B型脑钠肽前体(NT-proBNP)、主要不良心血管事件(MACE)、生活质量改善情况及不良反应情况。结果治疗后观察组的心电图疗效总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后观察组的NT-proBNP水平低于对照组,差异有统计学意义(P<0.05)。治疗后观察组的MACE总发生率低于对照组,差异有统计学意义(P<0.05)。观察组的明尼苏达生活质量评分低于对照组,差异有统计学意义(P<0.05)。观察组的平和体质转化率高于对照组,差异有统计学意义(P<0.05)。两组的主要不良反应总发生率比较,差异无统计学意义(P>0.05)。结论CHD患者PCI术后使用“三辨诊疗模式”联合西医常规治疗可有效保护心脏功能,提高生活质量,并有助于预防心血管事件发生,且安全性可靠。

Objective To explore the clinical efficacy of"Three differentiation diagnosis and treatment model"combined with western medicine in the treatment of patients with coronary atherosclerotic heart disease(CHD)after percutaneous coronary intervention(PCI).Methods From March to December 2021,90 patients with CHD who were treated by PCI in Liling Hospital of Traditional Chinese Medicine affiliated to Hunan University of Traditional Chinese Medicine were selected as the research objects,and they were divided into control group and observation group by random number table method,45 patients in each group.The patients in the control group were treated with conventional dual antiplatelet and lipid-regulating therapy,while the patients in the observation group were treated with"three differentiation mode"Chinese medicine on the basis of the control group.After 12 months of treatment,the electrocardiogram improvement,left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),major adverse cardiovascular events(MACE),quality of life improvement and adverse reactions of the two groups were compared and analyzed.Results After treatment,the total effective rate of electrocardiogram in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,the level of NT-proBNP in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the total incidence of MACE in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The Minnesota quality of life score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The conversion rate of peace constitution in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of major adverse reactions between the two groups(P>0.05).Conclusion The use of"three differentiation diagnosis and treatment mode"combined with routine western medicine for CHD patients after PCI can effectively protect cardiac function,improve quality of life,and help prevent cardiovascular events,and is safe and reliable.