中国26家三级甲等中医医院急性心肌梗死住院患者临床特征及治疗状况调查  

Clinical Features of Acute Myocardial Infarction Inpatients in 26 Level Three Class A Chinese Medicine Hospitals in China and the Investigation of Treatment

作　　者：田静峰[1] 李俊德[2] 雷燕[3] 王硕仁[4] 尚菊菊[5] 刘红旭[5] 

机构地区：[1]中国中医科学院望京医院医务科,北京100102 [2]中华中医药学会,北京100029 [3]中国中医科学院科研处,北京100700 [4]北京中医药大学东直门医院中心实验室,北京100700 [5]首都医科大学附属北京中医医院心血管科,北京100010

出　　处：《中国中西医结合杂志》2012年第3期329-332,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：首都医学发展科研基金北京医学卫生科技联合攻关项目(No.2003-I-4);北京市中医局重点学科51510项目(No.JJ-2006-56;No.JJ2007-031)

摘　　要：目的研究国内部分中医三级甲等医院急性心肌梗死(acute myocardial infarction,AMI)患者临床治疗状况。方法设计并采用病例报告表(case report form,CRF),收集2006年1—12月国内26家三级甲等中医医院住院AMI患者1094例,观察AMI患者发病情况、心功能、并发症、既往史及中医证型,观察AMI患者西药治疗情况,以及中药静脉制剂、中药汤剂、中成药使用情况。结果中医证型实证以血瘀、痰阻为主,分别为854例(78.06%)、470例(42.96%);虚证以气虚、心阴虚为主,分别为683例(62.43%)、231例(21.12%)。接受再灌注治疗患者355例(32.45%),其中急诊经皮冠状动脉成形术(percutaneous coronary intervention,PCI)224例(20.48%)。西药使用率前5位依次为:阿司匹林[1001例(91.50%)]、低分子肝素[917例(83.82%)]、调脂药[833例(76.14%)]、ACEI及ARB[822例(75.14%)]、硝酸酯类[773例(70.66%)]。使用中药静脉制剂患者946例(86.47%),其中使用频率>5%的中药静脉制剂依次为生脉注射液[520次(54.97%)]、丹参类注射制剂[305次(32.24%)]、三七类注射液[185次(19.56%)]、参附注射液[68次(7.19%)]、灯盏花素注射液[64次(6.77%)]及刺五加参附注射液[29次(3.07%)]。使用中药汤剂患者575例(52.56%),治法主要为:活血法(477例)、益气法(332例)、化痰法(303例),常用方剂为:生脉散、桃红四物汤、栝蒌薤白白酒汤、二陈汤和四君子汤。使用中成药患者394例(36.01%)。结论中医医院AMI患者显示中医证型以气虚血瘀为主,中医医院在AMI再灌注及规范化治疗方面不断取得进步,中医药得到广泛应用,应进一步加强AMI中医药治疗临床研究。Objective To study the therapeutic state of acute myocardial infarction（AMI） inpatients in 26 level three class A Chinese medicine（CM） hospitals in China.Methods The case report form（CRF） was designed and used in this study.Totally 1 094 AMI patients were recruited from 26 level three class A CM hospitals from January 2006 to December 2006.The onset,the heart function,complications,previous history,and CM syndrome types were observed in AMI patients.Treatment by Western medicine（WM） ,CM intravenous preparation,CM decoction,and Chinese patent medicine were also observed in AMI patients.Results Blood stasis syndrome（854 cases,78.06%） and stagnant phlegm syndrome（470 cases,42.96%） were dominated in the CM sthenia syndrome.Qi deficiency syndrome（683 cases,62.43%） and Xin-yin deficiency syndrome（231 cases,21.12%） were dominated in the CM asthenia syndrome.Totally 355 patients（32.45%） received reperfusion.Of them,224（20.48%） received percutaneous coronary intervention（PCI） .The top 5 often used Western drugs covered aspirin（1 001 cases,91.50%） ,low molecular heparin（917 cases,83.82%） ,blood lipids regulators（833 cases,76.14%） ,ACEI/ARB（822 cases,75.14%） ,and nitrates（773 cases,70.66%） .Totally 946 patients（86.47%） used CM intravenous preparations.The CM intravenous preparations with the use frequency more than 5% were sequenced as Shenmai Injection（520 times,54.97%） ,Salvia miltiorrhizae preparations（305 times,32.24%） ,sanchi preparations（185 times,19.56%） ,Shenfu Injection（68 times,7.19%） ,Scutellarin Injection（64 times,6.77%） ,and Acanthopanax Injection（29 times,3.07%） .Totally 575 patients（52.56%） used CM decoction.The main therapeutic methods covered activating blood circulation therapy（477 cases） ,qi benefiting therapy（332 cases） ,and phlegm resolving therapy（303 cases） .Commonly used recipes covered Shengmai Powder,Taohong Siwu Decoction,Gualou Xiebai Baijiu Decoction,Erchen Decoction,and Sijunzi Decoction.

关 键 词：中医医院 急性心肌梗死 治疗状况 

分 类 号：R259[医药卫生—中西医结合]