益气活血养心汤对急性ST段抬高型心肌梗死早期溶栓患者炎症因子、心功能及预后的影响

Effect of Yiqi Huoxue Yangxin Decoction on Inflammatory Factors,Heart Function and Prognosis of Patients with Acute ST-Elevation Myocardial Infarction in Early Stage

目的:观察益气活血养心汤对急性ST段抬高型心肌梗死(ASTEMI)早期溶栓患者炎症因子、心功能及预后的影响。方法:回顾性选取68例ASTEMI患者为研究对象,根据治疗方式不同分为对照组及观察组各34例。对照组应用早期溶栓,观察组在早期溶栓基础上应用益气活血养心汤治疗。比较2组临床疗效、冠状动脉恢复情况及不良反应发生率,比较2组治疗前后炎症因子[前列腺素E2(PGE2)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)]、心功能[左室射血分数(LVEF)、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)]、中医症状评分的变化。结果:观察组总有效率为94.12%,对照组为76.47%,2组比较,差异有统计学意义(P<0.05)。治疗48 h后,2组PGE2、IL-6、hs-CRP水平均较治疗前下降(P<0.05),观察组PGE2、IL-6、hs-CRP水平均低于对照组(P<0.05)。治疗2周后,2组LVEF指标值均较治疗前上升(P<0.05),LVEDV、LVESV指标值均较治疗前下降(P<0.05);观察组LVEF指标值高于对照组(P<0.05),LVEDV、LVESV指标值均低于对照组(P<0.05)。治疗2周后,2组中医症状评分均较治疗前下降(P<0.05),观察组中医症状评分低于对照组(P<0.05)。治疗2周后,观察组ST段与血小板聚集率下降例数均多于对照组,差异有统计学意义(P<0.05);2组再灌注心律失常、心肌酶峰值提前、冠状动脉再通比较,差异均无统计学意义(P>0.05)。观察组不良反应发生率为8.82%,对照组为23.53%,2组比较,差异有统计学意义(P<0.05)。结论:益气活血养心汤治疗ASTEMI早期溶栓患者,能提高临床疗效,降低炎症反应,提高心功能,缓解临床症状,用药安全性高,预后较好。

Objective:To observe the effect of Yiqi Huoxue Yangxin Decoction on the inflammatory factors,heart function and prognosis of patients with acute ST-elevation myocardial infarction(ASTEMI)in early stage.Methods:A total of 68 ASTEMI patients were retrospectively selected as the study subjects and divided into the control group and the observation group according to different treatment methods,with 34 cases in each group.The control group was given earlier thrombolysis,and the observation group was treated with Yiqi Huoxue Yangxin Decoction based on the treatment of the control group.The clinical effects,recovery of coronary artery,incidence of adverse reactions,and the changes of inflammatory factors,including prostaglandin E2(PGE2),interleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP),indexes of heart function,including left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV),and traditional Chinese medicine(TCM)symptom scores were compared before and after treatment between the two groups.Results:The total effective rate was 94.12%in the observation group and 76.47%in the control group,the difference being significant(P<0.05).After treatment of 48 hours,the levels of PGE2,IL-6 and hs-CRP in both groups were decreased when compared with those before treatment(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05).After two weeks of treatment,the LVEF levels in the two groups were increased when compared with those before treatment(P<0.05),and the levels of LVEDV and LVESV were decreased when compared with those before treatment(P<0.05);the LVEF level in the observation group was higher than that in the control group(P<0.05),and the levels of LVEDV and LVESV were lower than those in the control group(P<0.05).After two weekst of reatment,the TCM symptom scores in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After two weeks of treatment,the number of patients with decrease in ST segment and platelet aggregation rate in the observation group was more than that in the control group,the difference being significant(P<0.05).There was no significant difference being found in the comparisons of reperfusion arrhythmia,premature peak value of myocardial enzyme and patency of coronary artery between the two groups(P>0.05).The incidence of adverse reactions was 8.82%in the observation group and 23.53%in the control group,the difference being significant(P<0.05).Conclusion:Yiqi Huoxue Yangxin Decoction enhance the clinical effect on ASTEMI patients receiving earlier thrombolysis,which can reduce the inflammatory responses and mitigate the clinical symptoms with good medication safety and prognosis.