加味黄芪桂枝五物汤联合麝香保心丸治疗急性心肌梗死的临床效果评估

目的探讨加味黄芪桂枝五物汤联合麝香保心丸治疗急性心肌梗死(AMI)的临床效果。方法选择2016年1月至2019年1月收治的96例AMI患者为研究对象。采用随机数字表法将其分为观察组和对照组,每组48例。两组均行经皮冠状动脉介入术(PCI)并予以常规治疗,对照组在常规治疗基础上增加麝香保心丸,观察组在对照组基础上使用加味黄芪桂枝五物汤。分析治疗前、治疗1个月后两组症状体征积分,左心室功能[左心室舒张早期充盈峰(E)、左心室舒张晚期充盈峰(A)、E/A、氨基末端B型脑利钠肽原前体(NT-ProBNP)]、凝血功能[纤维蛋白原(FIB)、凝血酶原时间(PT)、D-二聚体(D-D)]、炎性因子[C反应蛋白(CRP)、白细胞介素-10(IL-10)]水平。结果治疗1个月后,两组症状体征积分均低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。治疗1个月后,两组E/A水平均高于治疗前(P<0.05),两组NT-ProBNP水平均低于治疗前(P<0.05),观察组E/A、NT-ProBNP水平与对照组比较,差异有统计学意义(P<0.05);两组E水平均高于治疗前(P<0.05),两组A水平均低于治疗前(P<0.05),但两组E水平、A水平比较,差异无统计学意义(P>0.05)。治疗1个月后,两组FIB、D-D水平均低于治疗前(P<0.05),两组PT水平均高于治疗前(P<0.05),且治疗后观察组FIB、D-D、PT水平比较,差异有统计学意义(P<0.05)。治疗1个月后,两组CRP水平均低于治疗前(P<0.05),两组IL-10水平均高于治疗前(P<0.05),且治疗后两组CRP、IL-10水平比较,差异有统计学意义(P<0.05)。结论加味黄芪桂枝五物汤联合麝香保心丸治疗AMI效果较好,有一定临床应用价值,可推广使用。

Clinical effects of Jiawei Huangqi Guizhi Wuwu decoction combined with Shexiang Baoxin pill in the treatment of acute myocardial infarction of coronary heart disease

Objective To explore the clinical effects of Jiawei Huangqi Guizhi Wuwu decoction combined with Shexiang Baoxin pill in the treatment of acute myocardial infarction(AMI)of coronary heart disease.Methods A total of 96 patients with AMI of coronary heart disease who were admitted to the hospital from January 2016 to January 2019 were divided into observation group and control group according to the random number table method,with 48 cases in each group.The two groups were given percutaneous coronary intervention(PCI)and routine treatment,and control group was given Shexiang Baoxin pill on the basis of routine treatment,and observation group was added with Jiawei Huangqi Guizhi Wuwu decoction on the basis of control group.The scores of symptoms and signs,left ventricular function[left ventricular diastolic early filling peak(E),left ventricular end-diastolic peak(A),E/A,N-terminal pro brain natriuretic peptide(NT-ProBNP)],coagulation function[fibrinogen(FIB),prothrombin time(PT),D-dimer(D-D)]and inflammatory factors[C-reactive protein(CRP),interleukin-10(IL-10)]were evaluated in the two groups before treatment and after one month of treatment.Results After one month of treatment,the scores of symptoms and signs in the two groups were lower than those before treatment(P<0.05),and the scores in observation group were significantly lower than that of control group(P<0.05).After one month of treatment,the E/A levels in the two groups were higher than that before treatment(P<0.05),while the level of NT-ProBNP in the two groups was lower than that before treatment(P<0.05),and the levels of E/A,NT-ProBNP of observation group had statistical difference with those in control group(P<0.05).The E levels in the two groups were higher than that of before treatment(P<0.05),while the A levels in the two groups were lower than that before treatment(P<0.05),and there were no significant differences after treatment between the two groups(P>0.05).After one month of treatment,the levels of FIB and D-D in the two groups were lower than those before treatment(P<0.05),while the PT level in the two groups was higher than that before treatment(P<0.05),and the differences of FIB,D-D and PT in observation group and control group were statistically significant(P<0.05).After one month of treatment,the CRP levels in the two groups was lower than that before treatment(P<0.05),while the IL-10 levels in the two groups were higher than that before treatment(P<0.05),and the differences of CRP and IL-10 between observation group and control group were statistically significant(P<0.05).Conclusion Jiawei Huangqi Guizhi Wuwu decoction combined with Shexiang Baoxin pill has good effects on AMI,and has certain clinical application value,which is worthy of promotion.