通心丸对单纯药物涂层球囊治疗STEMI术后气虚血瘀证患者血小板聚集及心功能的影响

    Effect of Tongxin Pill on platelet aggregation and cardiac function in patients with Qi deficiency and blood stasis after STEMI surgery treated with drug-coated balloon alone

    • 摘要:
      目的 探讨通心丸对单纯药物涂层球囊治疗ST段抬高型心肌梗死(STEMI)术后气虚血瘀证患者血小板聚集及心功能的影响。
      方法 选择2022年2月~2023年9月我院接诊的单纯药物涂层球囊治疗术后气虚血瘀证STEMI患者92例进行研究。患者以随机数字表法分为两组,各46例。患者均行单纯药物涂层球囊治疗,术后对照组予常规抗血小板和抗凝治疗;观察组在此基础上加以通心丸。比较两组临床疗效、中医证候评分、心功能指标、血小板聚集情况、炎症因子及不良反应。
      结果 观察组总有效率为91%,高于对照组的76%(P<0.05)。治疗后两组中医证候评分及BNP水平均明显下降,但观察组低于对照组;治疗后两组LVEF均升高,但观察组高于对照组(均P<0.01)。治疗后两组血小板聚集率均下降,且观察组低于对照组;治疗后两组血小板抑制率均高于治疗前,且观察组高于对照组(均P<0.01)。治疗后,两组IL-1β、IL-8及SCD40L水平均下降,且观察组均低于对照组(均P<0.01)。对照组共出现2例 4.35% 不良反应,观察组出现3例 6.52%,两组差异无统计学意义。
      结论 通心丸可提高单纯药物涂层球囊治疗STEMI术后气虚血瘀证患者疗效,改善患者中医证候评分及心功能指标,降低抑制血小板聚集,其机制可能与降低炎症因子水平有关。

       

      Abstract:
      AIM To investigate the effect of Tongxin Pill on platelet aggregation and cardiac function in patients with ST-segment elevation myocardial infarction (STEMI) treated with drug-coated balloon therapy alone in the postoperative period of Qi deficiency and blood stasis.
      METHODS Ninety-two STEMI patients with qi deficiency and blood stasis after drug-coated balloon therapy alone in our hospital from February 2022 to September 2023 were selected for the study. The patients were divided into 2 groups by randomized numerical table method, each with 46 cases. All the patients were treated with simple drug-coated balloon therapy. The control group was treated with conventional antiplatelet and anticoagulation therapy after surgery and the observation group was treated with Tongxin pill on the basis of the treatment of the control group. Clinical efficacy, TCM evidence scores, cardiac function indexes, platelet aggregation, inflammatory factors and adverse reactions were compared between the two groups.
      RESULTS The total effective rate in the observation group was 91%, higher than that in the control group, 76% (P<0.05). The TCM evidence scores and BNP levels decreased significantly in both groups after treatment, but the TCM evidence scores in the observation group was lower than those in the control group. LVEF increased in both groups after treatment, but LVEF in the observation group was higher than that in the control group (all P<0.01). Platelet aggregation rate decreased in both groups after treatment, and the platelet aggregation rate in the observation group was lower than that in the control group. Platelet inhibition rate was higher in both groups after treatment, and the platelet inhibition rate in the observation group was higher than that in the control group (all P<0.01). After treatment, the levels of IL-1β, IL-8 and SCD40L decreased in both groups and the levels in the observation group was lower than those in the control group (all P<0.01). A total of 2 cases (4.35%) of adverse reactions occurred in the control group and 3 cases (6.52%) in the observation group, and the difference between the two groups was not statistically significant.
      CONCLUSION Tongxin Pill can improve the efficacy of drug-coated balloon therapy alone in STEMI patients with postoperative qi deficiency and blood stasis, improve the patients’ Chinese medicine symptom scores and cardiac function indexes and reduce the inhibition of platelet aggregation, the mechanism of which may be related to the reduction of the level of inflammatory factors.

       

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