自拟逐瘀汤防治冠脉支架术后再狭窄临床研究

目的探讨自拟逐瘀汤对冠脉支架术后再狭窄的防治作用。方法选择2014年1月—2017年10月在本院接受冠状动脉介入术(PCI)的急性冠脉综合征患者60例,随机分为治疗组(30例)与对照组(30例)。对照组常规给予氯吡格雷、阿司匹林等西药治疗。治疗组在对照组的用药基础上服用自拟逐瘀汤。对2组患者均于手术后72h、3个月、6个月进行随访。结果治疗组的患者支架内再狭窄的发病率为0%;对照组的患者支架内再狭窄的发病率约为6.7%,治疗组患者的再狭窄发病率明显要低于对照组(P<0.05),并且发现治疗组患者的心绞痛症状复发率及发生不良心脏事件的比率低于对照组(P<0.05)。2组患者治疗后总有效率比较无统计学差异。对照组治疗前后血瘀证积分无统计学差异,治疗组经过治疗后血瘀证积分是明显低于治疗前,两者具有统计学方面的差异,与对照组患者比较结果是治疗后患者的血瘀积分是明显减低的。结论在常规西药治疗的基础上加用自拟逐瘀汤对冠心病患者支架术后再狭窄有一定的预防作用。

Clinical Study on Self-made Stasis-expelling Decoction for Prevention and Treatment of Restenosis after Coronary Stent Operation

Objective:To study the prevention and treatment effects of self-made Stasis-expelling Decoction on restenosis after coronary stenting.Methods:60 patients with acute coronary syndrome who underwent percutaneous coronary intervention(PCI)in our hospital from January 2014 to October 2017 were randomly divided into a treatment group(30 cases)and a control group(30 cases).The control group was routinely given clopidogrel,aspirin and other western medicines and the treatment group took self-made Stasis-expelling Decoction in the baseline of the medication of the control group.The patients in both groups were followed up for 72 hours,3 months and 6 months after surgery.Results:The incidence of in-stent restenosis in the treatment group was 0%and the incidence of in-stent restenosis in the control group was about 6.7%.The incidence of restenosis in the treatment group was significantly lower than that in the control group(P<0.05),and the findings showed the recurrence rate of angina symptoms and the rate of adverse cardiac events in the treatment group were lower than those in the control group(P<0.05).There was no statistical difference in the total effective rate between the two groups after treatment.The scores of blood stasis syndrome in the control group before and after treatment were not statistically different.The scores of the blood stasis syndrome in the treatment group after treatment were significantly lower than those before treatment.There was a statistical difference between the two groups.The blood stasis score significantly reduced.Conclusion:On the basis of conventional western medicine treatment,the self-made Stasis-expelling Decoction has a certain preventive effect on restenosis after stenting in patients with coronary heart disease.