通脉胶囊联合单硝酸异山梨酯治疗急性心肌梗死的临床研究

目的探究通脉胶囊联合单硝酸异山梨酯注射液治疗急性心肌梗死的临床疗效。方法选取2015年10月—2016年10月郑州市第六人民医院收治的急性心肌梗死患者115例作为研究对象,所有患者在随机分组的原则下分为对照组(57例)和治疗组(58例)。对照组患者静脉滴注单硝酸异山梨酯注射液,5 m L加入到葡萄糖注射液250 m L中,初始剂量为2 mg/h,然后根据患者表现调整实际剂量;治疗组在对照组的基础上口服通脉胶囊,5粒/次,2次/d。两组患者均治疗1周。观察两组的临床疗效,比较两组的心率、血压、心功能指标和心衰标志物水平。结果治疗后,对照组和治疗组的总有效率分别为78.95%、96.55%,两组比较差异有统计学意义(P0.05)。治疗后,心率和收缩压均明显上升,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组左心室射血分数(LVEF)和左心室高峰充盈率(LVPFR)均显著升高,左心室舒张末期内径(LVEDD)显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组N端-前脑利钠肽(NT-pro BNP)、肌酸激酶(CK)和内皮素-1(ET-1)水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论通脉胶囊联合单硝酸异山梨酯注射液治疗急性心肌梗死具有较好的临床疗效,能改善临床症状,调节心功能指标和心衰标志物水平,安全性较好,具有一定的临床推广应用价值。

Clinical study on Tongmai Capsules combined with isosorbide mononitrate in treatment of acute myocardial infarction

Objective To explore the clinical efficacy of Tongmai Capsules combined with Isosorbide Mononitrate Injection in treatment of acute myocardial infarction. Methods Patients (115 cases) with acute myocardial infarction in the Sixth People''s Hospital of Zhengzhou from October 2015 to October 2016 were randomly divided into the control group (57 cases) and the treatment group (58 cases). Patients in the control group were iv administered with Isosorbide Mononitrate Injection, 5 mL added into glucose solution 250 mL, twice daily. Patients in the treatment group were po administered with Tongmai Capsules on the basis of the control group, 5 grains/time, twice daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacies were evaluated, and heart rate, blood pressure, heart function indexes, and heart failure markers in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.95% and 96.55%, respectively, and there was difference between two groups (P<0.05). After treatment, heart rate and systolic pressure in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVEF and LVPFR in two groups were significantly increased, but the LVEDD in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NT-proBNP, CK, and ET-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05).And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongmai Capsules combined with Isosorbide Mononitrate Injection has clinical curative effect in treatment of acute myocardial infarction, can improve clinical symptom, and regulate heart function index and heart failure markers, with good safety, which has a certain clinical application value.