摘要
目的:研究宣痹通脉汤联合美托洛尔对急性心肌梗死(AMI)后早期心室重构和心脏功能的影响。方法:纳入本院96例AMI患者随机分组,48例给予美托洛尔治疗者归为对照组,48例给予宣痹通脉汤+美托洛尔治疗者归为治疗组,治疗4周。比较两组疗效,治疗前后中医证候积分、左心室参数、心功能、心肌钙蛋白(c TnⅠ)和氨基前端脑钠肽(Nt-pro BNP)变化。结果:治疗组治疗总有效率91.67%,对照组75%,差异具有统计学意义(P<0.05);治疗后,两组胸痛、胸闷、心悸、眩晕、乏力、气短积分均显著降低,左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)显著上升,左心室舒张末内径(LVEDD)显著下降,每搏输出量(SV)、心脏指数(CI)显著提升,心功能显著提升,且治疗组提升或降低幅度大于对照组,差异具有统计学意义(P<0.05);治疗后,两组c TnⅠ和Nt-pro BNP水平显著下降,且治疗组下降幅度大于对照组,差异具有统计学意义(P<0.05)。结论:宣痹通脉汤联合美托洛尔可显著改善AMI患者临床证候表现,改善早期心室重构和提升心功能,减小心肌梗死面积,疗效显著,值得临床推广。
Objective： To study the effect of Xuanbi Tongmai Decoction combined with metoprolol on early ventricular remodeling and cardiac function after acute myocardial infarction（ AMI）. Methods： A total of 96 cases of AMI patients in our hospital were randomly grouped. Forty-eight cases treated with metoprolol were included into the control group,while 48 cases treated with Xuanbi Tongmai Decoction combined with metoprolol were included into the treatment group. All patients were treated for 4weeks. The clinical effect,TCM syndrome scores before and after treatment,left ventricular parameters,cardiac function,cardiac troponin（ c Tn I） and N-terminal pro brain natriuretic peptide（ Nt-pro BNP） were compared between the two groups. Results：The total effective rate of treatment was 91. 67% in the treatment group and 75% in the control group（ P〈0. 05）. After treatment,the scores of chest pain,chest tightness,heart palpitations,dizziness,fatigue and shortness of breath were decreased significantly,left ventricular ejection fraction（ LVEF）,left ventricular end diastolic volume（ LVEDV） and left ventricular end systolic volume（ LVESV） were increased significantly,left ventricular end diastolic diameter（ LVEDD） was decreased significantly,stroke volume（ SV） and cardiac index（ CI） were significantly improved. Changes were more significant in the treatment group than those of the control group（ P〈0. 05）. After treatment,the levels of c Tn and Nt-pro BNP in the two groups were significantly decreased,and the decrease was more significant in treatment group than that of the control group（ P〈0. 05）. Conclusion： Xuanbi Tongmai Decoction combined with metoprolol can significantly relieve clinical symptoms,improve the early ventricular remodeling and cardiac function and reduce the area of myocardial infarction in patients with AMI. The efficacy is significant.
出处
《辽宁中医杂志》
CAS
北大核心
2017年第9期1917-1920,共4页
Liaoning Journal of Traditional Chinese Medicine
关键词
宣痹通脉汤
美托洛尔
急性心肌梗死
早期心室重构
Xuanbi Tongmai Decoction
metoprolol
acute myocardial infarction
early ventricular remodeling
