四逆汤配合常规溶栓药物治疗急性心肌梗死缺血再灌注损伤52例

Fifty-two Cases of Ischemia-Reperfusion Injury in Acute Myocardial Infarction Treated with Frigid Extremities Decoction in Combination with Routine Thrombolytic Drugs

目的:观察四逆汤配合常规溶栓药物治疗急性心肌梗死缺血再灌注损伤的临床疗效。方法:将104例急性心肌梗死患者按照随机数字表法分为观察组和对照组,每组各52例。对照组患者入院后即给予常规溶栓药物治疗,观察组在对照组的基础上加用四逆汤加减。比较两组患者的临床疗效、治疗后心电图ST段回落情况、冠状动脉再通效果、溶栓后72 h内再灌注心律失常发生情况以及并发症发生情况。结果:对照组有效率为67.3%,观察组有效率为92.3%,两组临床疗效比较,差异具有统计学意义(P<0.05)。观察组治疗后抬高的ST段回落最大幅度显著高于对照组,ST段回落最大幅度所需时间显著低于对照组,差异具有统计学意义(P<0.05);观察组患者胸痛缓解率高于对照组,差异具有统计学意义(P<0.05);两组冠状动脉再通率及心肌酶峰提前率比较,差异无统计学意义(P>0.05)。观察组患者溶栓后72 h内室性期前收缩、阵发性室性心动过速、窦性心动过缓、高度房室传导阻滞发生率显著低于对照组,差异具有统计学意义(P<0.05)。观察组患者心力衰竭、梗死后心绞痛、出血、休克及死亡率均显著低于对照组,差异具有统计学意义(P<0.05)。结论:四逆汤配合常规溶栓药物治疗急性心肌梗死效果明确,可有效降低缺血再灌注损伤风险。

Objective:To observe the clinical curative effect of Frigid Extremities Decoction in combination with routine thrombolytic drugs on ischemia-reperfusion injury in acute myocardial infarction.Methods:A total of 104 patients with acute myocardial infarction were divided into the observation group and the control group according to random number table method,with 52 cases in each group.The patients in the control group were treated with routine thrombolytic drugs immediately after admission,while the ones in the observation group were treated with Modified Frigid Extremities Decoction on the basis of the control group.Then the clinical efficacy,ST-segment depression of electrocardiogram after treatment,coronary artery recanalization,reperfusion arrhythmia and complications within 72 hours after thrombolysis were compared between the two groups.Results:The effective rate was 67.3% in the control group and 92.3% in the observation group.There was a significant difference between the two groups(P<0.05).After the treatment,the maximum range of ST segment depression in the observation group was significantly higher than that in the control group,and the time required for the maximum range of ST segment depression in the observation group was significantly lower than that in the control group,and there was statistical significance(P<0.05).The relief rate of chest pain in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in coronary artery recanalization rate and myocardial enzyme peak advance rate between the two groups(P>0.05).Within 72 hours after thrombolysis,the incidence of ventricular premature contraction,paroxysmal ventricular tachycardia,sinus bradycardia and high atrioventricular block in the observation group was significantly lower than that in the control group(P<0.05).Heart failure,post-infarction angina pectoris,hemorrhage,shock and mortality in the observation group were significantly lower than those in the control group,and all the differences were statistically significant(P<0.05).Conclusion:Frigid Extremities Decoction in combination with routine thrombolytic drugs has a remarkable efficacy on acute myocardial infarction,can significantly reduce the risk of ischemia-reperfusion injury.