通心络胶囊联合替罗非班治疗急性心肌梗死PCI围手术期临床研究
|
摘要
目的:观察通心络胶囊治疗急性心肌梗死PCI患者的临床疗效。方法:将急性心肌梗死患者78例随机分为观察组和对照组,每组39例。对照组患者术前予阿司匹林及硫酸氢氯吡格雷片口服,盐酸替罗非班推注治疗36～48 h。观察组患者在对照组的基础上加用通心络胶囊治疗,2组均持续治疗4周;观察患者临床疗效及治疗前后中医证候评分、生活质量躯体活动功能(PF)、躯体功能对角色功能的影响(RP)、身体疼痛(BP)、健康总体自评(GH)、活力(VT)、社会功能(SF)、情绪对角色功能的影响(RE)、精神健康(MH)评分,并记录心血管不良事件发生率。结果:总有效率观察组为97.44%,对照组为82.05%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者胸痛、胸闷、心悸、疲倦、畏寒、自汗等中医证候评分及总分较均治疗前降低(P <0.05),且观察组患者疲倦、畏寒、自汗评分及总分明显低于对照组义(P <0.05)。治疗后,2组患者PF、RP、BP、GH、VT、SF、RE、MH评分均较治疗前升高(P <0.05),且观察组各项评分升高较对照组更显著(P <0.05)。观察组患者心绞痛、心力衰竭、室性心律失常发生率显著低于对照组,差异均有统计学意义(P <0.05);2组患者支架再狭窄发生率比较,差异无统计学意义(P> 0.05)。结论:通心络胶囊治疗急性心肌梗死PCI患者临床疗效显著,能明显改善其临床症状及生活质量,减少心血管不良事件的发生率。
Objective: To observe the clinical effect of Tongxinluo capsules for patients with acute myocardial infarction PCI. Methods: Divided 78 cases of patients with acute myocardial infarction randomly into the observation group and the control group, 39 cases in each group. Patients in the control group were given the oral administration of aspirin and clopidogrel hydrogen sulfate before operation, and tirofiban hydrochloride was given by bolus injection for 36 to 48 hours.Patients in the observation group were additionally treated with Tongxinluo capsules. Both groups were treated for 4 weeks.Observed the clinical effect of patients, Chinese medicine syndrome scores before and after treatment, and scores of the quality of life, physical function(PF), the effect of physical function on role function(RP), body pain(BP), general health self-assessment(GH),vitality(VT),social function(SF),emotional effect on role function(RE),and mental health(MH),and recorded the incidence of adverse cardiovascular events. Results: The total effective rate was 97.44% in the observation group and 82.05% in the control group,compared the two groups,difference being significant(P < 0.05). After treatment,the Chinese medicine syndrome scores such as chest pain,chest distress,palpitations,fatigue,aversion to cold,spontaneous sweating and the total scores in the two groups were decreased when compared with those before treatment(P < 0.05);the scores of fatigue, aversion to cold, spontaneous sweating and the total score of patients in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,the scores of PF,RP,BP,GH,VT,SF,RE and MH in the two groups were increased when compared with those before treatment(P < 0.05); each score in the observation group was evidently higher than that in the control group(P < 0.05). The incidence of angina pectoris,heart failure and ventricular arrhythmia in the observation group was significantly lower than that in the control group, differences being significant(P < 0.05);there was no significant difference being found in the comparison of the incidence of in-stent restenosis between the two groups(P > 0.05). Conclusion:The application of Tongxinluo capsules has obvious clinical effect in treating patients with acute myocardial infarction after PCI. It can significantly improve the clinical symptoms and quality of life in patients and reduce the incidence of adverse cardiovascular events.
Objective: To observe the clinical effect of Tongxinluo capsules for patients with acute myocardial infarction PCI. Methods: Divided 78 cases of patients with acute myocardial infarction randomly into the observation group and the control group, 39 cases in each group. Patients in the control group were given the oral administration of aspirin and clopidogrel hydrogen sulfate before operation, and tirofiban hydrochloride was given by bolus injection for 36 to 48 hours.Patients in the observation group were additionally treated with Tongxinluo capsules. Both groups were treated for 4 weeks.Observed the clinical effect of patients, Chinese medicine syndrome scores before and after treatment, and scores of the quality of life, physical function(PF), the effect of physical function on role function(RP), body pain(BP), general health self-assessment(GH),vitality(VT),social function(SF),emotional effect on role function(RE),and mental health(MH),and recorded the incidence of adverse cardiovascular events. Results: The total effective rate was 97.44% in the observation group and 82.05% in the control group,compared the two groups,difference being significant(P < 0.05). After treatment,the Chinese medicine syndrome scores such as chest pain,chest distress,palpitations,fatigue,aversion to cold,spontaneous sweating and the total scores in the two groups were decreased when compared with those before treatment(P < 0.05);the scores of fatigue, aversion to cold, spontaneous sweating and the total score of patients in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,the scores of PF,RP,BP,GH,VT,SF,RE and MH in the two groups were increased when compared with those before treatment(P < 0.05); each score in the observation group was evidently higher than that in the control group(P < 0.05). The incidence of angina pectoris,heart failure and ventricular arrhythmia in the observation group was significantly lower than that in the control group, differences being significant(P < 0.05);there was no significant difference being found in the comparison of the incidence of in-stent restenosis between the two groups(P > 0.05). Conclusion:The application of Tongxinluo capsules has obvious clinical effect in treating patients with acute myocardial infarction after PCI. It can significantly improve the clinical symptoms and quality of life in patients and reduce the incidence of adverse cardiovascular events.
引文
[1]田国芳,宋玉勤,程宇彤,等.急性心肌梗死介入治疗术后的康复运动疗法研究进展[J].心脏杂志,2016,27(4):492-495.
[2]郑霞飞,何丹丹,顾利丹.急诊经皮冠状动脉介入治疗围手术期并发心室电风暴22例的救治及护理[J].中华危重症医学杂志(电子版),2017,10(2):143-144.
[3]许倡涛.TXNIP介导的心肌微血管内皮细胞NLRP3炎性小体活化在心肌缺血再灌注损伤中的机制研究[D].西安:第四军医大学,2015.
[4]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[6] Ware JE.The MOS-36-item short-from health survey(SF-36)[J].Medical Care,1992,30:473-481.
[7]王燕,金虎,黄时伟,等.血管性血友病因子基因多态性与冠状动脉粥样硬化性心脏病的相关研究[J].中华医学遗传学杂志,2016,33(2):235-239.
[8]宋蕾,丁蕊,等.老年大面积急性心肌梗死行PCI患者早期使用主动脉球囊反搏(IABP)安全性、有效性及预后分析[J].医学影像学杂志,2015,25(8):1365-1369.
[9]尤士杰,杨跃进,陈可冀,等.通心络胶囊在急性心肌梗死血运重建后的有效性和安全性研究[J].疑难病杂志,2004,3(4):193-196.
[10]段丙军,林德智,熊富权,等.通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制[J].疑难病杂志,2016,15(10):1065-1068.
[2]郑霞飞,何丹丹,顾利丹.急诊经皮冠状动脉介入治疗围手术期并发心室电风暴22例的救治及护理[J].中华危重症医学杂志(电子版),2017,10(2):143-144.
[3]许倡涛.TXNIP介导的心肌微血管内皮细胞NLRP3炎性小体活化在心肌缺血再灌注损伤中的机制研究[D].西安:第四军医大学,2015.
[4]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[6] Ware JE.The MOS-36-item short-from health survey(SF-36)[J].Medical Care,1992,30:473-481.
[7]王燕,金虎,黄时伟,等.血管性血友病因子基因多态性与冠状动脉粥样硬化性心脏病的相关研究[J].中华医学遗传学杂志,2016,33(2):235-239.
[8]宋蕾,丁蕊,等.老年大面积急性心肌梗死行PCI患者早期使用主动脉球囊反搏(IABP)安全性、有效性及预后分析[J].医学影像学杂志,2015,25(8):1365-1369.
[9]尤士杰,杨跃进,陈可冀,等.通心络胶囊在急性心肌梗死血运重建后的有效性和安全性研究[J].疑难病杂志,2004,3(4):193-196.
[10]段丙军,林德智,熊富权,等.通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制[J].疑难病杂志,2016,15(10):1065-1068.