补阳还五汤联合阿司匹林和氯吡格雷治疗心肌梗死的疗效  

Effect of Buyang Huanwu Decoction combined with aspirin and clopidogrel on myocardial infarction

作　　者：王金会[1] 周新福[1] 殷晓宁[1] WANG Jin-hui;ZHOU Xin-fu;YIN Xiao-ning(Weihai Municipal Hospital,Weihai Shandong 264200)

机构地区：[1]威海市立医院,山东威海264200

出　　处：《世界中西医结合杂志》2020年第4期678-681,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：山东省医药卫生科技发展计划项目(2015WS0131)。

摘　　要：目的探究补阳还五汤辅助阿司匹林和氯吡格雷对心肌梗死后患者心脏重塑及心功能改善的作用。方法将90例心肌梗死患者分为对照组和治疗组各45例,对照组在常规治疗的基础上给予阿司匹林和氯吡格雷,治疗组在对照组的基础上加服补阳还五汤,比较两组临床疗效、治疗前后中医证候积分、左心室舒张期内径(LVDd)、左心室收缩期内径(LVDs)、左心室后壁厚度(LVP-WT)、左心室心肌重量(LVM)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、每搏输出量(SV)、心搏量(CO)、射血分数(EF)、二尖瓣E波峰值流速/A波峰值流速(E/A)。结果治疗后,对照组的总有效率为75.55%(34/45),治疗组的总有效率93.33%(42/45),两组比较差异有统计学意义(P<0.05)。两组患者治疗后中医证候积分均显著低于治疗前(P<0.05);且治疗组治疗后中医证候积分显著低于对照组(P<0.05)。两组患者治疗后LVDd、LVDs、LVPWT、LVM心脏重塑指标均低于治疗前(P<0.05);且治疗组患者治疗后LVDd、LVDs、LVPWT、LVM心脏重塑指标均显著低于对照组(P<0.05)。两组患者治疗后心脏功能指标LVESV和LVEDV均显著性低于治疗前(P<0.05),SV、CO、EF、E/A均显著性高于治疗前(P<0.05);且治疗组患者治疗后LVESV和LVEDV均显著低于对照组(P<0.05),SV、CO、EF、E/A均显著高于对照组(P<0.05)。治疗组的总有效率显著大于对照组(P<0.05);治疗组患者治疗后的中医证候积分显著低于对照组患者治疗后(P<0.05);治疗组患者治疗后的LVDd、LVDs、LVPWT、LVM均显著小于对照组患者治疗后(P<0.05);治疗组患者治疗后的LVESV和LVEDV均显著小于对照组治疗后,治疗组患者治疗后的SV、CO、EF、E/A均显著大于对照组治疗后(P<0.05)。结论在阿司匹林和氯吡格雷的基础上加服补阳还五汤治疗心肌梗死患者时,改善心脏重塑和心脏功能的作用更理想,具有临床应用的重要意义。Objective To explore the effect of Buyang Huanwu Decoction with aspirin and clopidogrel on cardiac remodeling and cardiac function improvement in myocardial infarction.Methods 90 patients with myocardial infarction were divided into the control group and the treatment group,with 45 patients in each group.The control group was given aspirin and clopidogrel on the basis of conventional treatment while the treatment group was given Buyang Huanwu Decoction on the basis of the control group.The Clinical efficacy,TCM syndrome score,left ventricular diastolic diameter(LVDd),left ventricular systolic diameter(LVDs),left ventricular posterior wall thickness(LVP-WT),left ventricular myocardial weight(LVM),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),stroke volume(SV),stroke volume(CO),ejection fraction(EF)and mitral E wave peak flow rate/A wave peak flow rate(E/A)of the two group were compared.Results After treatment,the total effective rate of the treatment group was 93.33%and the total effective rate of the control group was 75.55%,with significant differences(P<0.05).The TCM syndrome scores of both groups decreased significantly(P<0.05)and the scores in the treatment group were significantly lower than those in the control group(P<0.05).The cardiac remodeling indexes of LVDd,LVDs,LVPWT,and LVM of the patients in both groups were significantly lower than those before treatment(P<0.05)and the indexes in the treatment group were significantly lower than those in the control group(P<0.05).The cardiac function indexes of LVESV and LVEDV were significantly lower than those before treatment(P<0.05)and SV,CO,EF,E/A were significantly higher than those before treatment(P<0.05).LVESV and LVEDV in the treatment group were significantly lower than the control group(P<0.05)and SV,CO,EF,E/A were significantly higher than the control group(P<0.05).Conclusions There is a satisfactory effect and application value of Buyang Huanwu Decoction combined with aspirin and clopidogrel for patients wit

关 键 词：补阳还五汤 阿司匹林 氯吡格雷 心肌梗死 心脏重塑 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]