益气通冠方对冠心病介入术后患者的影响

目的:探讨益气通冠方辅助治疗对冠心病介入(PCI)术后患者心功能、生活质量、再狭窄及主要心血管事件的影响。方法:110例PCI术后患者随机按数字表法分为西药组53例和观察组57例。西药组术后采用低分子肝素抗凝治疗1周;口服硫酸氢氯吡格雷片,75 mg/次,1次/d,疗程9个月;拜阿司匹林肠溶片,100 mg/次,1次/d,晚餐后服用;辛伐他汀片,80 mg/次,1次/d,晚餐后服用;连续治疗2个月。观察组在西药组治疗的基础上加服益气通冠方,1剂/d,疗程3个月。两组共进行12月的随访。采用西雅图心绞痛量表(SAQ)评价患者生活质量;进行超声心动图检测,计算左室射血分数(LVEF)和每搏输出量(SV);心功能分级采用纽约心脏协会心功能分级(NYHA);记录再狭窄事件及心源性死亡、心肌梗死、不稳定型心绞痛、心功能衰竭、再行PCI术或搭桥等主要心血管事件。结果:治疗后观察组SAQ量表活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度4个维度评分及总分高于西药组(P<0.05或P<0.01);治疗后观察组LVEF和SV均明显高于西药组(P<0.01);两组治疗后NYHA心功能分级均比治疗前有所改善(P<0.05或P<0.01),治疗后组间差异无统计学意义;观察组再狭窄发生率为5.26%,低于西药组的11.32%,但差异无统计学意义;观察组联合心血管事件发生率为14.03%,低于西药组的35.84%(P<0.01)。结论:益气通冠方辅助治疗PCI术后患者,能改善患者心功能,减少再狭窄发生的趋势,促进了患者的康复,改善患者的预后。

Influence of Adjuvant Therapy of Yiqi Tongguan Decoction on Clinical Outcome After Percutaneous Coronary Intervention

Objective: To investigate influence of adjuvant therapy of Yiqi Tongguan decoction on cardiac function, quality of life, restenosis and major adverse cardiac event in patients after percutaneous coronary intervention (PCI) operation. Method: One hundred and ten patients with PCI were randomly divided into western medicine group (53 cases) and observation group (57 cases) by random number table. Patients in western medicine group received anti-coagulant medication of low molecular weight heparin for 1 week, 5 mg clopidogrel hydrogen sulphate tablets once daily for 9 months, 100 mg aspirin enterie ccoated tablets once daily after dinner and 80 mg simvastatin tablets once daily for 2 months after the PCI operation. Based on the treatment of western medicine group, patients in observation group added Yiqi Tongguan decoction 1 dose daily for 3 months. Patients in both groups received 12 month follow-up. The qualities of life in PCI patients were evaluated by Seattle angina questionnaire (SAQ). Echocardiogram was recorded, left ventricular ejection fraction (LVEF) and stroke volume (SV) were calculated. Heart function class was graded by New York heart association (NYHA). Major cardiovascular events of cardiac, cardiac death, unstable angina pectoris, heart failure, PCI operation and bypass were recorded. Result: Composite scores of SAQ scale of level of limitation of motion, anginal stability, seizure of stenocardia and degree of satisfaction with treatment and total scores in observation group were higher than those in western medicine group after treatment (P<0.05 or P<0.01). LVEF and SV in observation group were higher than those in western medicine group (P<0.01). Cardiac function class of NYHA in both groups ameliorated after treatment (P<0.05 or P<0.01), and there was no statistically significant difference from two groups. Occurrence rate of restenosis in observation group was 5.26%, which is lower than that in western medicine group 11.32% with no statistically significant difference. Combined occurrence rate of cardiovascular events in observation group was 14.03%, which is lower than that in western medicine group 35.84% (P<0.01). Conclusion: Adjuvant therapy of Yiqi Tongguan decoction could improve heart function and quality of life, decrease the incidence rate of the main cardiovascular events and restenosis, improve the prognosis and promote the rehabilitation of patients with PCI.