麝香通心滴丸对STEMI患者PCI术后心肌血流再灌注影响的疗效观察  

Efficacy observation on effects of Shexiang Tongxin Dropping Pill on myocardial reperfusion in STEMI patients after PCI surgery

作　　者：朱岩峰[1] 樊民[1] 樊荣 姚望[1] 邓中龙[1] 钱佳[1] ZHU Yanfeng;FAN Min;FAN Rong;YAO Wang;DENG Zhonglong;QIAN Jia(Department of Cardiology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院心内科,上海200437

出　　处：《上海中医药杂志》2018年第11期39-41,53,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81300391)

摘　　要：目的观察麝香通心滴丸对急性ST段抬高型心肌梗死(STEMI)患者冠状动脉介入(PCI)术后心肌血流再灌注的影响。方法将160例STEMI并拟行PCI治疗的患者随机分为治疗组与对照组,每组80例。两组PCI术前及术后均予常规西药,同时治疗组于冠脉造影前舌下含服麝香通心滴丸以及PCI术后继续口服本药,对照组以同样方法给予安慰剂。两组术后疗程均为1个月,观察术中介入指标,比较术后心肌血流再灌注相关指标及术后1个月左室射血分数(LVEF)的情况。结果 (1)最终完成试验者153例,治疗组75例,对照组78例。(2)两组PCI术中用药(替罗非斑、肝素)、抽吸导管使用、梗死相关动脉、植入支架数情况比较,差异均无统计学意义(P>0.05)。(3)两组PCI术后ST段回落率比较,治疗组明显高于对照组(P<0.05);两组校正TIMI帧数比较,治疗组明显低于对照组(P<0.05)。(4)术后1个月与术后3天组内比较,治疗组LVEF水平明显升高(P<0.05)。组间术后1个月比较,治疗组LVEF水平明显高于对照组(P<0.05)。结论麝香通心滴丸可明显改善STEMI患者PCI术后的心肌血流再灌注,提高其近期心功能。Objective To observe the effects of Shexiang Tongxin Dropping Pill( STDP) on the myocardial reperfusion in patients with acute ST elevation myocardial infarction( STEMI) after percutaneous coronary intervention( PCI). Methods 160 patients with STEMI before undergoing PCI were randomly divided into the treatment group and control group,80 cases in each group. Both groups were treated with routine western medicine before and after PCI. The treatment group was treated with STDP by sublingual administration before coronary arteriography and oral administration after PCI,and the control group was treated with placebo by the same methods,with a course of one month. The intervention indicators during operation were observed,the postoperative myocardial reperfusion indicators and the left ventricular ejection fraction( LVEF) one month after operation were compared. Results(1)Finally,153 patients including 75 patients in the treatment group and 78 patients in the control group completed the trial.(2) There were no statistically significant differences on PCI intraoperative medication( tirofiban and heparin),application of suction catheter,infarction related artery and number of implanted stents between the two groups( P>0.05).(3)The ST segment fall rate in the treatment group was significantly higher than that in the control group( P<0.05),while the corrected TIMI frame count( c TFC) in the treatment group was significantly lower than that in the control group( P<0.05).(4)Compared with 3 days after operation,the LVEF level was obviously increased in the treatment group one month after operation( P<0.05). One month after operation,the LVEF level in the treatment group was obviously higher than that in the control group( P<0.05). Conclusion Shexiang Tongxin Dropping Pill can significantly improve the myocardial reperfusion and enhance the short-term cardiac function in STEMI patients after PCI surgery.

关 键 词：心肌梗死 心肌血流再灌注 冠状动脉介入术 麝香通心滴丸 安慰剂 

分 类 号：R259[医药卫生—中西医结合]