中西医结合治疗急性心肌梗死心绞痛临床观察
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摘要
目的:观察中西医结合治疗急性心肌梗死心绞痛的临床疗效。方法:将急性心肌梗死心绞痛患者94例随机分为对照组及中西组各47例,对照组采用西药常规治疗,中西组在对照组治疗的基础上予血府逐瘀汤加减治疗,1剂/d,早晚分服。2组疗程均为2周。比较2组患者心绞痛症状、心电图疗效,治疗前后血液流变学水平、血脂水平及不良反应发生情况。结果:中西组心绞痛症状总有效率为91.5%、心电图总有效率为85.1%,分别高于对照组的74.5%、63.8%(P<0.05)。中西组血液流变学各指标水平较治疗前改善(P<0.05),且高于治疗后对照组(P<0.05);甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)等指标低于治疗前,且低于治疗后对照组(P<0.05);患者心绞痛发作次数及持续时间低于治疗前,且低于治疗后对照组(P<0.05);2组治疗期间均未见明显不良反应。结论:中西医结合治疗急性心肌梗死心绞痛疗效确切,有助于改善临床症状,降低血脂,改善血液流变学指标,而且用药安全。
Objective: To observe clinical effects of integrative medicine in treating acute myocardial infarction angina pectoris. Methods: All 94 patients were randomized into the control group and the group of integrative medicine, 47 cases each group, the control group adopted conventional therapy of Western medicine, the group of integrative medicine took modified XueFu ZhuYu decoction, one dose each day, taking in the morning and evening. The course was two weeks. The conditions of adverse reaction, the level of blood lipid, the level of hemorheology before and after treating, clinical effects of ECG, the symptoms of angina pectoris of the patients were observed between both groups. Results: Total effective rate of the group of integrative medicine was 91.5%, total effective rate of ECG was 85.1%, respectively higher than 74.5% and 63.8% of the control group(P<0.05). Com pared with before treating, the levels of different indexes of hemorheology of the group of integrative medicine improved(P<0.05), and higher than these of the control group after treating(P<0.05); the indexes of TG, LDL-C,TC and others were lower than before treating, and lower than these of the control groupafter treating(P<0.05); the incidence of angina pectoris attacks and duration of the patients were lower than these before treating, and lower than these of the control group after treating(P <0.05); no obvious adverse reaction happened during therapeutic period. Conclusion: Integrative medicine could obtain definite effects in treating acute myocardial infarction angina pectoris, and it's helpful to improve clinical symptom, lower blood lipid, raise the indexes of hemorheology with good medication safety.
Objective: To observe clinical effects of integrative medicine in treating acute myocardial infarction angina pectoris. Methods: All 94 patients were randomized into the control group and the group of integrative medicine, 47 cases each group, the control group adopted conventional therapy of Western medicine, the group of integrative medicine took modified XueFu ZhuYu decoction, one dose each day, taking in the morning and evening. The course was two weeks. The conditions of adverse reaction, the level of blood lipid, the level of hemorheology before and after treating, clinical effects of ECG, the symptoms of angina pectoris of the patients were observed between both groups. Results: Total effective rate of the group of integrative medicine was 91.5%, total effective rate of ECG was 85.1%, respectively higher than 74.5% and 63.8% of the control group(P<0.05). Com pared with before treating, the levels of different indexes of hemorheology of the group of integrative medicine improved(P<0.05), and higher than these of the control group after treating(P<0.05); the indexes of TG, LDL-C,TC and others were lower than before treating, and lower than these of the control groupafter treating(P<0.05); the incidence of angina pectoris attacks and duration of the patients were lower than these before treating, and lower than these of the control group after treating(P <0.05); no obvious adverse reaction happened during therapeutic period. Conclusion: Integrative medicine could obtain definite effects in treating acute myocardial infarction angina pectoris, and it's helpful to improve clinical symptom, lower blood lipid, raise the indexes of hemorheology with good medication safety.
引文
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[8]赵凯明,蒋崇博,白玉蓉,等.葛根素注射液治疗急性心肌梗死后心绞痛的临床观察[J].中国现代医生,2014,52(11):53-55.
[9]张耀明.中西医结合治疗冠心病心绞痛疗效观察[J].浙江中医杂志,2013,48(1):55.
[10]郭玉凡.血府逐瘀汤加味治疗急性心肌梗死后心绞痛42例临床观察[J].中医临床研究,2011,3(18):56.
[11]徐萍.血府逐疲汤临床应用心得[J].吉林中医药,2011,31(3):246.
[12]赵磊.血府逐瘀汤加减治疗冠心病心绞痛临床观察[J].中国中医急症,2013,22(8):1415-1416.
[13]万志全.血府逐瘀汤加减治疗冠心病心绞痛48例的临床观察[J].按摩与康复医学,2012,3(8):181-182.
[14]张秋雁,苏剑峰,邓冰湘,等.超微血府逐瘀汤对急性心肌缺血大鼠心肌梗死面积及血清NO、ET的影响[J].中医药导报,2010,16(5):111-112.
[15]程德新.血府逐疲汤的近代研究[J].北京中医,1993(6):39.
[16]李娟.补肾活血法治疗冠心病心绞痛疗效评价[J].湖南中医杂志,2016,32(6):162-163.
[17]苏继朝.观察活血定痛汤联合西药治疗心脉瘀阻型冠心病心绞痛的疗效[J].中西医结合心血管病杂志,2015,3(8):142-143.
[2]肖进.血府逐瘀汤加减治疗急性心肌梗死后心绞痛45例[J].河南中医,2015,35(6):1245-1247.
[3]史艳菊.急性心肌梗死后发生心绞痛的危险因素分析[J].贵阳中医学院学报,2013,35(6):129-130.
[4]中华医学会.临床诊疗指南·急诊医学分册[M].北京:人民卫生出版社,2009:204.
[5]田德禄.中医内科学[M].北京:人民卫生出版社,2009:95.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:68-73.
[7]王丹,庞敏.血府逐瘀汤联合舒血宁治疗冠心病不稳定型心绞痛90例[J].河南中医,2016,36(4):614-616.
[8]赵凯明,蒋崇博,白玉蓉,等.葛根素注射液治疗急性心肌梗死后心绞痛的临床观察[J].中国现代医生,2014,52(11):53-55.
[9]张耀明.中西医结合治疗冠心病心绞痛疗效观察[J].浙江中医杂志,2013,48(1):55.
[10]郭玉凡.血府逐瘀汤加味治疗急性心肌梗死后心绞痛42例临床观察[J].中医临床研究,2011,3(18):56.
[11]徐萍.血府逐疲汤临床应用心得[J].吉林中医药,2011,31(3):246.
[12]赵磊.血府逐瘀汤加减治疗冠心病心绞痛临床观察[J].中国中医急症,2013,22(8):1415-1416.
[13]万志全.血府逐瘀汤加减治疗冠心病心绞痛48例的临床观察[J].按摩与康复医学,2012,3(8):181-182.
[14]张秋雁,苏剑峰,邓冰湘,等.超微血府逐瘀汤对急性心肌缺血大鼠心肌梗死面积及血清NO、ET的影响[J].中医药导报,2010,16(5):111-112.
[15]程德新.血府逐疲汤的近代研究[J].北京中医,1993(6):39.
[16]李娟.补肾活血法治疗冠心病心绞痛疗效评价[J].湖南中医杂志,2016,32(6):162-163.
[17]苏继朝.观察活血定痛汤联合西药治疗心脉瘀阻型冠心病心绞痛的疗效[J].中西医结合心血管病杂志,2015,3(8):142-143.