益气活血法配合序贯八段锦在急性心肌梗死PCI术后患者中的应用

Application of therapy for replenishing qi and activating blood with sequential eight trigrams boxing in patients with acute myocardial infarction after PCI

目的 探讨益气活血法配合序贯八段锦对急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)患者的作用。方法 选取2021年7月—2022年7月在柳州市中医医院行急诊PCI的90例AMI患者作为研究对象,随机将患者分为康复组和对照组各45例,2组患者均行急诊PCI和临床常规治疗,康复组在以上治疗基础上进行益气活血法配合序贯八段锦心脏康复治疗12周。比较2组患者中医证候疗效及治疗前后SF-36生活质量评分、主要心脑血管不良事件发生率。结果 康复组患者中医证候总有效率明显高于对照组[95.6%(43/45)比82.2%(37/45),P<0.05]。治疗后康复组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康、健康变化评分及对照组躯体疼痛、一般健康状况、社会功能、精神健康、健康变化评分均明显高于治疗前(P均<0.05),且康复组生理机能、生理职能、躯体疼痛、一般健康状况、精力、精神健康、健康变化评分均明显高于对照组(P均<0.05)。康复组脑梗死、心绞痛发作、再发急性心肌梗死、靶血管血运重建、心源性死亡、全因死亡发生率与对照组比较差异均无统计学意义(P均>0.05),但总的心脑血管不良事件发生率较对照组低[15.6%(7/45)比35.6%(16/45),P<0.05]。结论 益气活血法配合序贯八段锦的中西医结合心脏康复方案可以有效改善AMI急诊PCI术后患者症状,提高患者生活质量,改善预后。

Objective It is to explore the effect of therapy for replenishing qi and activating blood with sequential eight trigrams boxing in patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI).Methods Ninety AMI patients who underwent emergency PCI in Liuzhou Hospital of Traditional Chinese Medicine from July 2021 to July 2022 were selected as the study subjects,and were randomly divided into rehabilitation group and control group,with 45 cases in each group.The patients of the two groups were given emergency PCI and routine clinical treatment,additionally,the rehabilitation group was treated with Chinese medicine for replenishing qi and activating blood combined with cardiac rehabilitation of sequential eight trigrams boxing for 12 weeks.The efficacy of Chinese medicine symptoms,scores of SF-36 quality of life before and after treatment,and the incidence of major cardiovascular and cerebrovascular adverse events were compared between the two groups.Results The total effective rate of Chinese medicine symptoms in the rehabilitation group was significantly higher than that in the control group[95.6%(43/45)vs.82.2%(37/45),P<0.05].The scores of physiological function,physiological function,somatic pain,general health status,energy,social function,emotional function,mental health,and health change of the rehabilitation group and the scores of somatic pain,general health status,social function,mental health,and health change of the control group were significantly higher than those before the treatment(all P<0.05),and the scores of physiological function,physiological function,somatic pain,general health status,energy,mental health,and health change were significantly higher than those of the control group(all P<0.05).The differences in the incidence of cerebral infarction,angina attack,recurrent acute myocardial infarction,target vessel revascularization,cardiac death,and all-cause death were not statistically significant between the rehabilitation group and control group(all P>0.05),but the total incidences of cardiovascular and cerebral vascular adverse events of the rehabilitation group were lower than those of the control group[15.6%(7/45)vs.35.6%(16/45),P<0.05].Conclusion The combination of Chinese and Western medicine cardiac rehabilitation program of replenishing qi and activating blood with sequential in the rehabilitation group can effectively improve the symptoms,quality of life and prognosis of patients with AMI after emergency PCI.