芪红颗粒辅助西医干预急性冠脉综合征经皮冠状动脉介入术后(气虚血瘀证)的疗效研究

目的观察芪红颗粒辅助西医干预急性冠脉综合征(ACS)经皮冠状动脉介入(PCI)术后(气虚血瘀证)患者疗效及对炎症反应的影响。方法将90例ACS行PCI治疗患者随机分为观察组与对照组各45例。对照组患者于PCI及冠脉支架植入术后给予阿司匹林、氯吡格雷、阿托伐他汀等药物治疗;观察组在对照组基础上加用芪红颗粒辅助治疗。以术后1个月为评估终点,比较两组临床疗效、炎症因子等指标。结果术后1个月两组胸痛胸闷、心悸气短、神疲乏力、面色紫暗、舌脉和总分均低于本组术后1 d,且观察组均低于对照组(P<0.05);术后1个月两组超敏C蛋白(hs-CRP)、细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)、B型脑钠肽(BNP)、肌钙蛋白Ⅰ(cTnⅠ)和CK-MB均低于本组术后1 d,且观察组均低于对照组(P<0.05);观察组总有效率82.22%,高于对照组的66.67%(P<0.05);术后1个月内,观察组心血管不良事件(MACE)发生率为2.22%,低于对照组的15.56%(P<0.05)。观察组轻度出血事件发生率为13.33%,对照组为17.78%,无显著差异(P>0.05)。结论芪红颗粒辅助西医干预PCI术后患者疗效确切,安全性高,能够降低hsCRP、ICAM-1、VCAM-1、BNP、cTnⅠ、CK-MB水平,控制炎症反应,改善内皮功能,保护心肌细胞。

Qihong Granules Assisted with Western Medicine in the Treatment of Acute Coronary Syndrome with Qi Deficiency and Blood Stasis Syndrome after PCI

Objective:To explore the effect of Qihong Granules assisted with western medicine on the patients with acute coronary syndrome(ACS)of qi deficiency and blood stasis syndrome after PCI and its effect on inflammation.Methods:90 patients with ACS undergoing PCI were randomly divided into the experimental group and control group.The control group was treated with aspirin,clopidogrel,atorvastatin after PCI and coronary stent implantation,without any traditional Chinese medicine or decoction for invigorating qi and activating blood circulation;the experimental group was treated with Qihong Granules assisted with western medicine intervention.1 month after operation,the clinical efficacy and inflammatory factors of the two groups were compared.Results:1 month after operation,the chest pain,chest distress,palpitation,shortness of breath,fatigue,purple face,tongue,pulse and total score of the two groups were lower than those of the control group(P<0.05);the levels of hypersensitive C protein(hs-CRP),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),type B brain natriuretic peptide(BNP),troponinⅠ(c TnⅠ)and CK-MB were lower than those indicators in postoperative 1 d of this group,and the levels in the observation group were lower than those in the control group(P<0.05);the total effective rate was 82.22%in the experimental group and 66.67%in the control group with statistically significant difference(P<0.05);the incidence of MCAE was 2.22%in the experimental group and 15.56%in the control group within 1 month after operation,with statistical difference(P<0.05).There were no moderate or severe bleeding events in the 2 groups.The incidence of mild bleeding events in the experimental group was 13.33%and that in the control group was 17.78%(P>0.05).Conclusion:Qihong Granules assisted with western medicine can reduce the levels of hs-CRP,ICAM-1,VCAM-1,BNP,cTnⅠand CK-MB,control inflammatory reaction,improve endothelial function and protect myocardial cells.