从肝论治急性心肌梗死后心功能障碍的临床研究

目的探讨从肝论治急性心肌梗死（AMI）后心功能障碍的临床疗效。方法68例AMI患者随机分为2组,对照组33例给予单纯西医常规治疗,治疗组35例在对照组治疗基础上,予中药方剂代替血管紧张素转换酶抑制剂（ACEI）和β-受体阻滞剂,每日1剂,水煎服。2组均以2个月为1疗程。应用超声心动图检测2组AMI后15d和1个疗程后的各项心功自岂指标。结果2组AMI后15d的各项心功能指标比较差异无统计学意义（P〉0．05）;1个疗程后,2组二尖瓣前叶振幅（DE）、左室每搏量（SV）、每分钟排血量（CO）、左室射血分数（LVEF）、左室短轴缩短率（FS）、二尖瓣前叶斜率（MVEF）和二尖瓣口多普勒舒张早期最大流速与舒张末期最大流速比率（E／A）均明显改善,平均左室周径缩短率（MVCF）速度加快,左室舒张期及收缩期内径、二尖瓣前叶E峰与室间隔左室面的距离（EPSS）缩小,2组心功能改善情况比较差异有统计学意义（P〈0．05）,治疗组优于对照组。结论ACEI和β-受体阻滞剂与中药方剂均能改善AMI后心功能,中药从肝论治优于ACEI和β-受体阻滞剂。

Treatment of cardiac dysfunction post-acute myocardial infarction by liver-based therapy theory

Objective To observe the effect of cardiac dysfunction post-acute myocardial infarction treated by liver-based therapy theory. Methods 68 cases of acute myocardial infarction (AMI) were randomly divided into two groups. Patients in control group (n=33) were treated by routine western medicine (ACEI and β-receptor blocker). Patients in treatment group (n=35) were treated by Chinese herbal medicine prescription. The course was two months in two groups. Indexes of cardiac function in two groups were measured by echocardiography 15 days after AMI and post-course. Results There was no significant difference between two groups indexes of cardiac function 15 days after AMI (P>0.05). After a course cardiac function indexes including DE, SV, CO, LVEF, FS, MVEF and E/A were improved obviously, MVCF was accreted and EPSS was shorted in two groups. Improvement of cardiac function in treatment group was superior to that in control group (P<0.05). Conclusion ACEI, β-receptor blocker and Chinese herbal medicine prescription can improve heart function post-AMI, and the effect of Chinese herb of liver-based therapy theory was superior to ACEI and β-receptor blocker.