益气活血法治疗气虚血瘀型急性心肌梗死患者的疗效及对心功能、左心室重构、血清可溶性人基质裂解素2、脑钠肽水平的影响  

Clinical Efficacy of Replenishing Qi and Activating Blood Method on Patients with Acute Myocardial Infarction with Qi Deficiency and Blood Stasis Syndrome and Effects on Cardiac Function,Left Ventricular Remodeling,and Serum sST2 and BNP Levels

作　　者：辛玲[1] 贾云云 杨艳[1] XIN Ling;JIA Yun-yun;YANG Yan(Jinan Munieipal Hospital of Traditional Chinese Medicine,Jinan Shandong 250000)

机构地区：[1]济南市中医医院,山东济南250000

出　　处：《世界中西医结合杂志》2022年第4期787-791,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：山东省中医药科技发展计划(2019-0559)。

摘　　要：目的探讨益气活血法对气虚血瘀型急性心肌梗死(Acute myocardial infarction,AMI)患者的疗效及对心功能、左心室重构、血清可溶性人基质裂解素2(soluble suppression of tumorigenicity 2,sST2)、脑钠肽(Brain natriuretic peptide,BNP)水平的影响。方法选取2017年1月—2020年3月期间济南市中医医院收治的105例AMI患者,按随机数字表法分为对照组52例、研究组53例。对照组予以经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)及术后对症支持治疗,在此基础上,研究组术后配合益气活血方治疗。观察比较两组患者临床疗效、治疗前后的中医证候积分、超声心动图指标[左室射血分数(Left ventricular ejection fraction,LVEF)、每搏量(Stroke volume,SV)、心输出量(Cardiac output,CO)、血管阻力(Systemic vascular resistance,SVR)、左室收缩末期容积(Left ventricular end-systolic volume,LVESV)、左室舒张末期容积(Left ventricle end-diastolic volume,LVEDV)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左室舒张末期内径(Left ventricular end diastolic dimension,LVEDD)]、血清sST2、BNP水平,及术后6个月内发生的心脏不良事件。结果治疗后研究组总有效率91.84%(45/49)明显高于对照组76.00%(38/50),差异有统计学意义(P<0.05)。治疗后两组患者胸痛、心悸、胸闷气短、乏力证候积分均低于治疗前,差异有统计学意义(P<0.05);且研究组均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者LVEF、SV、CO指标均高于治疗前,SVR、LVESV、LVEDV、LVESD、LVEDD指标均低于治疗前,差异有统计学意义(P<0.05);且研究组超声心动图指标均较对照组改善明显,差异有统计学意义(P<0.05)。治疗后两组患者血清sST2、BNP水平均低于治疗前,差异有统计学意义(P<0.05);且研究组血清sST2、BNP水平均明显低于对照组,差异有统计学意义(P<0.05)。术后6个月内研究组心脏不良事件发生Objective To explore the clinical efficacy of the replenishing qi and activating blood method on patients with acute myocardial infarction(AMI)with qi deficiency and blood stasis syndrome and its effects on cardiac function,left ventricular remodeling,and serum levels of soluble suppression of tumorigenicity 2(sST2)and brain natriuretic peptide(BNP).Methods A total of 105 AMI patients admitted to the Jinan Municipal Hospital of Traditional Chinese Medicine from January 2017 to March 2020 were enrolled and divided into a control group(n=52)and a treatment group(n=53)according to a random number table.All patients received percutaneous coronary intervention(PCI)and postoperativesymptomatic supportive treatment,while those in the treatment group received additional treatment with Yiqi Huoxue Formula.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,echocardiographic indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),systemic vascular resistance(SVR),left ventricular end-systolic volume(LVESV),left ventricle end-diastolic volume(LVEDV),left ventricular end systolic diameter(LVESD),and left ventricular end diastolic dimension(LVEDD)],and serum sST2 and BNP levels before and after treatment were compared between the two groups.Adverse cardiac events in the heart of the two groups within 6 months after surgery were recorded.Results The total effective rate of the treatment group was 91.84%(45/49),higher than 76.00%(38/50)of the control group(P<0.05).After treatment,the scores of chest pain,palpitations,chest tightness,shortness of breath,and fatigue in the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,LVEF,SV,and CO in the two groups were higher and SVR,LVESV,LVEDV,LVESD,and LVEDD were lower than those before treatment(P<0.05),and the treatment group was superior to the control group in improving echocardiographic indexes(P<0.05).The post-treatment serum sST2 and BNP levels

关 键 词：急性心肌梗死 气虚血瘀型 益气活血法 心功能 左心室重构 可溶性人基质裂解素2 脑钠肽 

分 类 号：R541.4[医药卫生—心血管疾病]