愈梗通瘀汤加减联合体外反搏治疗急性心肌梗死伴心功能不全患者的临床效果  

Clinical Effect of Yugeng Tongyu Decoction Combined with External Counterpulsation in the Treatment of Acute Myocardial Infarction with Cardiac Insufficiency

作　　者：吕永飞[1] 史大卓[2] 王利民[1] 吴桂玲[1] 陈爱莲[1] LÜYongfei;SHI Dazhuo;WANG Limin;WU Guilin;CHEN Ailian(Department of Cardiology,Chinese Medicine Hospital of Puyang,Puyang 457000,China;Department of Cardiology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 10000,China)

机构地区：[1]濮阳市中医院心内科,河南濮阳457000 [2]中国中医科学院西苑医院心血管科,北京10000

出　　处：《河南医学研究》2023年第16期3034-3038,共5页Henan Medical Research

摘　　要：目的分析愈梗通瘀汤加减联合体外反搏治疗急性心肌梗死(AMI)伴心功能不全患者的临床效果。方法选取2021年3月至2023年2月濮阳市中医院收治的112例AMI伴心功能不全患者为研究对象,将患者随机分为A组(体外反搏治疗,56例)和B组(愈梗通瘀汤加减联合体外反搏治疗,56例)。两组患者均接受常规治疗,包括PCI介入术,并给予控制血压、抗血小板凝集、抗心肌缺血、调脂等相关药物对症治疗。分析两组临床疗效,并比较治疗前后血清学指标[超敏C反应蛋白(hs-CRP)、心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白T(cTnT)及脑钠肽(BNP)],心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]变化情况,并记录患者血液流变学改善情况及治疗期间的不良反应发生率。结果B组临床总有效率高于A组(P<0.05)。治疗后两组hs-CRP、H-FABP、cTnT及BNP水平均有所下降(P<0.05),且B组hs-CRP、H-FABP、cTnT及BNP水平低于A组(P<0.05)。治疗后B组LVESD、LVEDD均低于A组,LVEF高于A组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论愈梗通瘀汤加减联合体外反搏对AMI伴心功能不全患者的疗效显著,能有效减少血清hs-CRP、H-FABP、cTnT及BNP的释放,促进患者心功能恢复。Objective To analyze the clinical efficacy of Yugeng Tongyu Decoction combined with external counterpulsation in the treatment of acute myocardial infarction(AMI)with cardiac insufficiency.Methods A total of 112 patients with AMI with cardiac insufficiency admitted to Chinese Medicine Hospital of Puyang from March 2021 to February 2023 were selected as the study objects.The patients were randomly divided into group A(external counterpulsation therapy,56 cases)and group B(Yugeng Tongyu decoction combined with external counterpulsation therapy,56 cases).Both groups received conventional treatment,including PCI intervention,and symptomatic treatment with related drugs such as blood pressure control,anti-platelet agglutination,anti-myocardial ischemia and lipid regulation.The clinical efficacy of the two groups was analyzed,and the serological indexes[hypersensitive C-reactive protein(hs-CRP),heart-type fatty acid binding protein(H-FABP)and cardiac troponin T(cTnT),brain natriuretic peptide(BNP)]were compared before and after treatment.The changes of cardiac function indicators[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)]were recorded,and the improvement of hemorheology of patients and the incidence of adverse reactions during treatment were recorded.Results The total effective rate of group B was higher than that of group A(P<0.05).After treatment,the levels of hs-CRP,H-FABP,cTnT and BNP were decreased in both groups(P<0.05),and the levels of hs-CRP,H-FABP,cTnT and BNP in group B were lower than those in group A(P<0.05).After treatment,LVESD and LVEDD of group B were lower than those of group A,while LVEF of group B was higher than that of group A(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Yugeng Tongyu decoction combined with extracorporeal counterbeating has a significant effect on AMI patients with cardiac insufficiency,which can effectively reduce the rele

关 键 词：愈梗通瘀汤 体外反搏 急性心肌梗死 心功能不全 

分 类 号：R541[医药卫生—心血管疾病]