枳实薤白桂枝汤联合曲美他嗪片治疗急性心肌梗死患者的疗效观察

Observation of Efficacy of Zhishi Xiebai Guizhi Decoction Combined with Trimetazidine Tablets in the Treatment of Patients with Acute Myocardial Infarction

探讨枳实薤白桂枝汤联合曲美他嗪片治疗急性心肌梗死患者的临床疗效。方法:选取符合纳入标准的96例急性心肌梗死并进行PCI术治疗患者为研究对象,采用随机数字表分为对照组与观察组,患者术前30 min均予以曲美他嗪片,术后两组均长期服用曲美他嗪,同时予以抗血小板聚集、抗凝等综合治疗,观察组加用枳实薤白桂枝汤,两组均干预12周。疗程结束后评估其疗效,并检测其血脂、心功能,及中医症状改善情况。结果:治疗后对照组TC、LDL-C依次为(4. 23±0. 82) mmol/L、(2. 76±0. 34) mmol/L,均显著高于观察组(3. 87±0. 78) mmol/L、(2. 23±0. 28) mmol/L(P <0. 05),但两组TG、HDL-C水平无显著性差异(P> 0. 05);干预后对照组LVEF(46. 3±9. 2)%显著低于观察组(52. 8±9. 7)%(P <0. 05); LVEDV、LVESV依次为(168. 5±21. 3) m L、(86. 7±14. 5) m L,均显著高于观察组(151. 3±18. 6) m L、(80. 3±12. 1) m L(P <0. 05);治疗后对照组CRP(9. 7±1. 5) g/L、ET(7. 4±1. 1) ng/m L均显著高于观察组(6. 3±1. 1) g/L、(5. 6±0. 9) ng/m L,NO水平为(46. 8±7. 2)μmol/L显著低于观察组(53. 9±7. 8)μmol/L(P <0. 05);对照组中医证候总积分(11. 2±1. 7)分,显著高于观察组(8. 1±1. 3)分(P <0. 05);且治疗期间两组均未出现头晕、恶心呕吐等不良反应。结论:枳实薤白桂枝汤联合曲美他嗪片治疗急性心肌梗死患者可显著改善心肌梗死患者临床症状,且未增加不良反应,具有较高的临床应用价值。

Objective: To explore the clinical efficacy of Zhishi Xiebai Guizhi Decoction combined with Trimetazidine Tablets in the treatment of acute myocardial infarction. Methods: 96 cases of patients with acute myocardial infarction treated with PCI were selected for the study and were randomly divided into the control group and the observation group. The patients in the two groups were treated with Trimetazidine Tablets 30 min before the operation and were given long-term administration of Trimetazidine after the operation,and the treatments of antiplatelet aggregation and anticoagulation were applied at the same time;on which basis,the observation group was also intervened with Zhishi Xiebai Guizhi Decoction. The intervention was 12 weeks. The efficacy was evaluated,and the blood lipid,cardiac function and the improvement of TCM symptoms were detected after the intervention. Results: After the treatment,the levels of TC and LDL-C were(4. 23 ± 0. 82) mmol/L and(2. 76 ± 0. 34) mmol/L in the control group respectively,which were significantly higher than(3. 87 ±0. 78) mmol/L and(2. 23 ± 0. 28) mmol/L in the observation group(P < 0. 05);but there were no significant differences in the levels of TG and HDL-C between two groups(P > 0. 05). The level of LVEF was(46. 3 ± 9. 2) % in the control group,which was significantly lower than(52. 8 ± 9. 7) % in the observation group(P < 0. 05). The levels of LVEDV and LVESV were(168. 5 ± 21. 3) m L and(86. 7 ± 14. 5) m L in the control group,which were significantly higher than(151. 3 ± 18. 6) m L and(80. 3 ± 12. 1) m L in the observation group(P < 0. 05). The CRP level was(9. 7 ± 1. 5) g/L and ET level was(7. 4 ± 1. 1) ng/m L in the control group,which were higher than(6. 3 ± 1. 1) g/L and(5. 6 ± 0. 9) ng/m L in the observation group(P <0. 05). The NO level was(46. 8 ± 7. 2) mol/L in the control group,which was significantly lower than(53. 9 ± 7. 8) mol/L in the observation group(P < 0. 05). The total score of TCM syndromes was(11. 2 ±1. 7) in the control group,which was significantly higher than(8. 1 ± 1. 3) in the observation group(P <0. 05). There were no adverse reactions,such as dizziness,nausea and vomiting,in the two groups during the treatment. Conclusion: Zhishi Xiebai Guizhi Decoction combined with Trimetazidine Tablets can significantly improve the clinical symptoms,without increasing the adverse reactions,in the treatment of acute myocardial infarction,and it has high value in clinical application.