益气通脉汤辩证加味对急性心肌梗死经皮冠状动脉介入术后患者脂代谢和心肌酶谱的影响  

Impact of modified Yiqi tongmai decoction on lipid metabolism and myocardial enzyme profilesin patients with acute myocardial infarction post-percutaneous coronary intervention

作　　者：刘纲 刘志红[1] 许绍信 Liu Gang;Liu Zhihong;Xu Shaoxin(Department of Cardiology,Lu'an Hospital of Traditional Chinese Medicine,Lu'an 237005,China)

机构地区：[1]六安市中医院心血管内科,237005

出　　处：《中华保健医学杂志》2024年第5期573-576,共4页Chinese Journal of Health Care and Medicine

基　　金：安徽省中医药传承创新科研项目(2022CCYB22)。

摘　　要：目的观察益气通脉汤辩证加味对急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)术后患者脂代谢和心肌酶谱的影响。方法选取2020年1月~2022年12月六安市中医院收治的80例接受PCI术的AMI患者,随机数表法分为对照组39例和治疗组41例,其中对照组术后给予规范西药治疗,治疗组在对照组的基础上术后给予益气通脉汤辨证加味治疗,均连续治疗8周。比较两组患者的中医证候积分、脂代谢情况、心肌酶谱及安全性。结果治疗8周后,治疗组患者的胸痛胸闷、动则加重、心悸气短、神倦乏力、汗出、面色紫暗证候的积分均低于对照组,差异均有统计学意义(t=12.150、6.660、8.312、26.651、14.804、10.873,P<0.05)。治疗8周后,治疗组患者的胆固醇(TC)、甘油三酯(TG)、脂蛋白(a)[LP(a)]、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组;高密度脂蛋白胆固醇(HDL-C)水平高于对照组,差异均有统计学意义(t=15.203、7.801、2.073、7.382、5.662,P<0.05)。治疗8周后,治疗组患者的肌酸激酶(CK)、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、肌酸激酶同工酶(CKMB)水平均低于对照组,差异均有统计学意义(t=4.468、3.130、5.502、5.232,P<0.05)。治疗组患者的总有效率为95.12%(39/41),高于对照组患者的79.49%(31/39),差异有统计学意义(χ^(2)=4.467,P<0.05)。结论在基础西药治疗的基础上结合益气通脉汤辨证加味对经PCI治疗的AMI患者术后的疗效较好,能明显降低患者中医证候积分,降低患者血脂,减轻心肌损伤,安全性良好。Objective This study aimed to evaluate the impact of the modified Yiqi Tongmai Decoction on lipid metabolism and myocardial enzyme profiles in patients who underwent percutaneous coronary intervention(PCI)following acute myocardial infarction(AMI).Methods A cohort of 80 AMI patients post-PCI was randomly assigned to either the control group(n=39)or the treatment group(n=41).The control group received standard Western medical treatment,while the treatment group received the modified Yiqi Tongmai Decoction in addition to the standard treatment for a period of 8 weeks.The Traditional Chinese Medicine(TCM)syndrome scores,lipid metabolism,myocardial enzymes,and safety were assessed for both groups.Results After 8 weeks of treatment,the TCM syndrome scores for chest pain,chest distress,palpitations,shortness of breath,fatigue,sweating,and dark complexion in the treatment group were significantly lower than those in the control group(P<0.05).The treatment group also exhibited lower levels of cholesterol,triglycerides,lipoprotein(a),and low-density lipoprotein cholesterol,and higher levels of highdensity lipoprotein cholesterol compared to the control group(P<0.05).Additionally,the treatment group had reduced levels of creatine kinase,lactate dehydrogenase,aspartate transaminase,and creatine kinase isozyme compared to the control group(P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion The combination of standard Western medical treatment with the modified Yiqi Tongmai Decoction is effective in improving outcomes for AMI patients post-PCI.It significantly reduces TCM syndrome scores,lipid levels,and myocardial damage,and demonstrates a favorable safety profile.

关 键 词：益气通脉汤 急性心肌梗死 经皮冠状动脉介入术 脂代谢 心肌酶谱 

分 类 号：R54[医药卫生—心血管疾病]