温阳益气通脉方联合瑞替普酶治疗急性ST段抬高型心肌梗死临床观察  

The Therapeutic Effect of Warming Yang and Benefiting Qi for Dredging Vessels Method Combined with Reteplase in the Treatment of Acute ST-segment Elevation Myocardial Infarction

作　　者：张丹[1] ZHANG Dan(Department of Emergency and Intensive Care Unit,Tai'an Hospital of Traditional Chinese Medicine,Shandong Province,Tai'an 271000,China)

机构地区：[1]泰安市中医医院急诊与重症医学科,山东泰安271000

出　　处：《光明中医》2022年第13期2406-2409,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：泰安市科学技术发展计划项目(No.2019NS202)。

摘　　要：目的探讨温阳益气通脉法联合瑞替普酶静脉溶栓治疗急性ST段抬高型心肌梗死的临床疗效及安全性。方法选取2019年1月—2021年5月收治的96例急性ST段抬高型心肌梗死患者,随机分为2组。对照组采用瑞替普酶静脉溶栓加常规治疗,观察组在对照组基础上同时给予参附注射液,序贯温阳益气通脉治法的中药汤剂治疗。比较2组血管再通率、不良事件、死亡事件的发生率及患者出血事件、临床疗效,监测心肌损伤指标变化。结果观察组的血管再通率,相对高于对照组,但差异无统计学意义(P>0.05);观察组患者的不良事件发生率明显低于对照组(P<0.05),尤其是严重的心律失常、梗死后心绞痛事件的发生率均明显低于对照组(P<0.05);2组患者的出血情况比较,差异无统计学意义(P>0.05);观察组的总有效率明显高于对照组(P<0.05);观察组患者治疗后的cTnI、NT-proBNP均显著低于对照组,LVEF显著高于对照组(P<0.05)。结论温阳益气通脉法联合瑞替普酶静脉溶栓治疗急性ST段抬高型心肌梗死疗效确切,更利于减少不良事件的发生,保护心肌,安全可靠。Objective To explore the clinical effect and safety of warming yang and benefiting qi for dredging vessels method combined with reteplase intravenous thrombolysis in the treatment of acute ST-segment elevation myocardial infarction.Methods 96 patients with acute STsegment elevation myocardial infarction from January 2019 to May 2021were selected and randomly divide into two groups.The control group received intravenous thrombolysis with reteplase and conventional treatment.On the basis of the control group,the observation group was received with the Chinese patent medicine Shenfu injection of warming yang and benefiting qi for dredging vessels,and then followed by the traditional Chinese medicine decoction treatment of warming yang and benefiting qi for dredging vessels therapy.The vascular recanalization rate,the incidence of adverse events and death events,the difference of bleeding events and clinical efficacy were compared between the two groups,and the changes of myocardial injury indexes were monitored.Results The revascularization rate of the observation group was higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of adverse events in observation group(25%)was significantly lower than that in control group(72.92%)(P<0.05),especially the incidence of serious arrhythmia and angina after infarction(P<0.05).There was no significant difference in bleeding between the two groups(P>0.05).The total effective rate of observation group was significantly higher than that of control group(P<0.05).After treatment,cTnI and NT-probNP in observation group were significantly lower than control group,and LVEF was significantly higher than control group(P<0.05).Conclusion Warming yang and benefiting qi for dredging vessels method combined with rteplase intravenous thrombolytic therapy in the treatment of acute ST-segment elevation myocardial infarction is effective and more conducive to reduce the occurrence of adverse events,protect the myocardial,and is safe and

关 键 词：温阳益气通脉法 瑞替普酶 静脉溶栓 急性心肌梗死 中西医结合疗法 

分 类 号：R542.22[医药卫生—心血管疾病]