中医治疗对急性心肌梗死行介入治疗者心肌保护的临床研究

目的:将PCI和中医治疗相结合,探讨其对受损心肌的保护作用。方法:将AMI急性期且有PCI适应症的患者63例,随机分为中医组31例和对照组32例,两组均予西医治疗,中医组在此基础上加用中医治疗。观察PCI术中TMP分级、PCI前后心肌受损标记物及PCI术后心电图变化,治疗前后血浆BNP浓度变化。结果:中医组PCI术中达到TMP2级、3级,PCI术后出现∑STR≥50%以及T波倒置的患者明显多于对照组(P<0.05),术后CK-MB、cTnT浓度较对照组明显下降(P<0.05或<0.01),术后30天,中医组血浆BNP浓度显著下降(P<0.05)。结论:根据PCI前后中医病机变化,在PCI基础上配合中医治疗能够更好地改善AMI患者的心肌再灌注,促进心肌血液循环,缩小心肌梗死面积,改善心功能,起到良好的心肌保护作用。

The Clinical Research of Myocardial Preservation with The Therapy of Traditional Chinese Medicine to the Patients of Acute Myocardial Infarction and undergo Percutaneous Coronary Intervention

Objective： To combine the therapy of Traditional Chinese Medicine （ TCM） and percutaneous coronary intervention （ PCI） in acute myocardial infarction（ AMI） ,and approach the protective effect for the damaged myocardium.Methods： 63 patients who were in acute stage of AMI and had the indication for PCI were divided into in two groups randomly,31 patients in TCM group and 32 patients in control group.The two groups had the same therapy of western medicine,and the TCM group added the therapy of TCM.To observe the variance of TMP,ECG,the marker of myocardial damage and the density of B-type natriuretic peptide brain natriuretic peptide （ BNP） before and after PCI in two groups.Results： Comparing the two groups,patients who reached TMP2、3,∑STR≥50% and T wave inversion were more in TCM group,P 0.05.The density of marker of myocardial damage after PCI such as CK-MB and cTnT was obvious lower in TCM group than in control group,P 0.05 or P 0.01.Thirty days later,the density of BNP was significantly lower in TCM group,P 0.05.Conclusion： According to the variation of Chinese medical pathogenesis before and after PCI,the combination with the therapy of TCM and PCI in patients who had AMI,can improve myocardial reperfusion,advance myocardial blood circulation,decreased infarct size,improve heart function,so play an important part in myocardial preservation.