急心梗PCI治疗前后中医证候心功能的变化

目的:探讨PCI治疗对急性心肌梗死下称"急心梗"中医证候积分及心功能变化的影响。方法:30例行PC I治疗的AMI患者在术前、术后3天及术后3个月观察中医证候量化积分及LVEDV、LVESV、SV、LVEF等心功能指标的变化情况。结果:PCI治疗前胸痛、胸闷、烦躁、心悸等标实证积分显著升高,同时LVEDV、LVESV升高,SV、LVEF降低;PCI术后3天上述标实证积分与术前比较有明显降低,差异有显著性意义(P<0.05或0.01);但气短、乏力、纳呆、面色、自汗等本虚证积分与术前比较未见明显变化,差异无统计学意义(P>0.05),LVEDV、LVESV、SV、LVEF亦较术前无变化;PCI术后3个月各项证候积分较术前均有明显降低,差异有显著意义(P<0.01);其中本虚证候积分与PCI术后3天比也有明显下降,两者有显著性差异(P<0.01),同时LVESV、SV、LVEF等指标与术前及术后3天比较亦有明显改善(P<0.05或0.01)。结论:PCI治疗对急性心肌梗死中医证候的传变有明显的影响,术前以标实证为著,术后随标实证的改善,本虚证更加突出。

Influence of PCI Therapy on the Variance of Chinese Medical Syndrome and Heart Function in Patients who Suffer from AMI

Objective:To approach the influence of PCI therapy on the variance of integral of Chinese medical syndrome and heart function in patients who suffer from AMI.Methods:Thirty patients of AMI who experience PCI therapy are observed the variance of integral of Chinese medical syndrome and heart functional parameter such as LVEDV,LVESV,SV and LVEF ahead,after three days and after three months of PCI.Results:The patients' integral of superficial excess type such as chest pain,chest distress,restlessness and palpitation elevates significantly before PCI,meanwhile LVEDV and LVESV upgrade,SV and LVEF degrade.Compare to before PCI,the integral of superficial excess type degrades obviously after three days of PCI,which has significant difference(P<0.05 or 0.01),but the integral of original deficiency type,for example short breath,debility,anorexia,complexion and spontaneous perspiration has no apparent variance(P>0.05),LVEDV,LVESV,SV and LVEF has no variance too(P>0.05).After three months of PCI,the integral of each symptom degrades compare to before PCI,and the integral of original deficiency type also cut down apparently compare to after three days of PCI(P<0.01),at the same time LVESV,SV and LVEF have apparent improvement too(P<0.05 or 0.01).Conclusion:PCI therapy has a obvious influence on the transmission of Chinese medical syndrome in patients who has AMI,superficial excess type seem apparent before PCI,but after PCI the original deficiency type turns outstanding as the improvement of superficial excess type.While diagnosis and treatment in Chinese medicine,we must considerate such rule,grasp the opportunity and degree of the "through" and "reinforcing" methods.