四逆汤联合主动脉球囊反搏治疗心肌梗死合并心源性休克患者的临床研究  

Clinical Study on Sini Decoction Combined with Aortic Balloon Counterpulsation in the Treatment of Myocardial Infarction Complicated with Cardiogenic Shock

作　　者：刘杰[1] 梁春玲[1] 张宗耀 刘祖发[1] 张然[1] LIU Jie;LIANG Chun-ling;ZHANG Zong-yao;LIU Zu-fa;ZHANG Ran(Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100102)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《世界中西医结合杂志》2021年第12期2280-2284,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：北京中医药科技发展资金项目(JJ2018-93);中国中医科学院资助项目(WJYY2018-09)。

摘　　要：目的观察四逆汤联合主动脉球囊反搏治疗心肌梗死合并心源性休克患者的临床疗效。方法选取2014年1月—2021年1月期间于中国中医科学院望京医院治疗的92例心肌梗死合并心源性休克患者,按随机数字表法分为对照组和研究组,每组各46例。对照组给予主动脉球囊反搏治疗,研究组在对照组基础上给予四逆汤治疗。于治疗前、后检测两组患者乳酸脱氢酶(Lactate dehydrogenase,LDH)、降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin 6,IL-6)、超氧化物歧化酶(Superoxide dismutase,SOD)、心肌肌钙蛋白I(Cardiac troponin I,cTnI)、脑钠肽(Brain natriuretic peptide,BNP)、低密度脂蛋白(Low-density lipoproteins cholesterol,LDL-C)、甘油三酯(Triglycerides,TG)、高密度脂蛋白(High-density lipoprotein,HDL-C)水平,统计两组患者中医证候积分,采用生活质量简表[The World Health Organization Quality of Life(WHOQOL)-BREF,WHOQOL-BREF]评价两组患者生活质量,比较两组患者临床疗效及不良心血管事件发生率。结果治疗后两组患者LDL-C、TG水平均较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且研究组LDL-C、TG水平较对照组降低,HDL-C水平较对照组升高,差异有统计学意义(P<0.05)。治疗后两组患者PCT、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组PCT、IL-6水平均较对照组降低,差异有统计学意义(P<0.05)。治疗后两组患者cTnI、LDH、BNP水平均较治疗前降低,SOD水平较治疗前升高,差异有统计学意义(P<0.05);且研究组cTnI、LDH、BNP水平均较对照组降低,SOD水平较对照组升高,差异有统计学意义(P<0.05)。治疗后两组患者中医证候评分均较治疗前降低,WHOQOL-BREF评分均较治疗前升高,差异有统计学意义(P<0.05);且研究组患者中医证候评分较对照组降低,WHOQOL-BREF评分较对照组升高,差异有统计学意义(P<0.05)。治疗后研究组总有效率95.65%(44/Objective To observe the clinical efficacy of Sini Decoction combined with aortic balloon counterpulsation in the treatment of patients with myocardial infarction and cardiogenic shock.Methods A total of 92 patients with myocardial infarction combined with cardiogenic shock who were treated in Wangjing Hospital of China Academy of Chinese Medical Sciences from January 2014 to January 2021 were selected and divided into control group and study group according to a random number table,with 46 cases in each group.The control group was treated with aortic balloon counterpulsation,while the study group was treated with Sini Decoction on the basis of the control group.Lactate dehydrogenase(LDH),procalcitonin(PCT),interleukin-6(IL-6),superoxide dismutase(SOD),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),low density lipoprotein(LDL-C),triglyceride(TG),high density lipoprotein(HDL-C)were detectedbefore and after treatment.The TCM syndrome score of the two groups was counted.The quality of life of the two groups was evaluated by WHOQOL-BREF.The clinical efficacy and incidence of adverse cardiovascular events of the two groups were compared.Results After treatment,the levels of LDL-C and TG in the two groups were lower than before treatment,and the levels of HDL-C were higher than before treatment.The difference was statistically significant(P<0.05);and the levels of LDL-C and TG in the study group were higher than before.The control group decreased,and the HDL-C level was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of PCT and IL-6 in the two groups were lower than before treatment,and the difference was statistically significant(P<0.05);and the levels of PCT and IL-6 in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of cTnI,LDH,and BNP in the two groups were lower than before treatment,and the levels of SOD were higher than before treatment,the

关 键 词：四逆汤 主动脉球囊反搏 心肌梗死合并心源性休克 炎症 脂质过氧化反应 心功能 不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病] R541.64[医药卫生—内科学]