世界中医药

目的：观察通心络胶囊联合硫酸氢氯吡格雷对急性心肌梗死经皮冠状动脉介入治疗（PCI）术后心脏功能、炎症指标、血液流变学的影响。方法：选取2018年7月至2020年7月在河北以岭医院心内科治疗的急性心肌梗死（AMI）行PCI术后患者100例作为研究对象，随机分为观察组和对照组，每组50例。对照组给予心内科常规治疗和硫酸氢氯吡格雷，观察组在此基础上加用通心络胶囊，2组均治疗4周。观察治疗后2组患者临床治疗总有效率、中医证候评分、健康调查简表（SF-36）评分、左室射血分数(LVEF)、每搏量(SV)、左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、纤维蛋白原（FIB）、红细胞沉降率（ESR）、血浆黏度（PV）、全血低切黏度（NBL）、全血高切黏度（NBH）。结果：治疗后，观察组总有效率为96.0%（48/50）、对照组总有效率为72.0%（36/50），2组治疗总有效率差异有统计学意义（P<0.05）。治疗后2组患者中医证候评分、LVEDV、LVESV、hs-CRP、IL-6、TNF-α、FIB、ESR、PV、NBL、NBH水平明显低于治疗前，且观察组上述指标均低于对照组，差异均具有统计学意义（均P<0.05）。治疗后2组患者SF-36评分、LVEF、SV水平明显高于治疗前，且观察组上述指标均高于对照组，差异均具有统计学意义（均P<0.05）。结论：通心络胶囊联合硫酸氢氯吡格雷对急性心肌梗死PCI术后患者临床疗效显著，能够有效改善心功能、血液流变学指标，并且降低炎症水平。

English Summary:

To observe the effects of Tongxinluo Capsules combined with clopidogrel bisulfate on cardiac function,inflammatory indexes and hemorheology after PCI in patients with acute myocardial infarction.Methods:From July 2018 to July 2020,a total of 100 patients with acute myocardial infarction treated in the Department of Cardiology of Hebei Yiling Hospital after PCI were selected as the research objects and were randomly divided into a control group(n＝50) and an observation group(n＝50).The control group was given routine treatment of cardiology and clopidogrel hydrogen bisulfate,while the observation group was treated with Tongxinluo Capsules plus cardiology and clopidogrel hydrogen bisulfate.Both groups were treated for 4 weeks.The total effective rate,traditional Chinese medicine syndrome score,SF-36 score,left ventricular ejection fraction(LVEF),stroke volume(SV),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),fibrinogen(FIB),tumor necrosis factor-α(TNF-α),Fibrinogen(FIB),erythrocyte sedimentation rate(ESR),plasma viscosity(PV),whole blood low shear viscosity(NBL),whole blood high shear viscosity(NBH) were observed.Results:After treatment,the total effective rate of the observation group was 96.0%(48/50) and that of the control group was 72.0%(36/50).There was a significant difference in the total effective rate between the 2 groups(P<0.05).After treatment,the scores of TCM syndrome,LVEDV,LVESV,hs-CRP,IL-6,TNF-α,FIB,ESR,PV,NBL and NBH in the 2 groups were significantly lower than those before treatment,and the above-mentioned indexes in the observation group were significantly lower than those in the control group,the differences are statistically significant(all P<0.05).After treatment,the SF-36 score,LVEF and SV levels in the 2 groups were significantly higher than those before treatment,and the above-mentioned indexes in the observation group were significantly higher than those in the control group,the differences are statistically significant(all P<0.05).Conclusion:Tongxinluo Capsules combined with clopidogrel bisulfate is effective in the treatment of acute myocardial infarction after PCI,which can effectively improve cardiac function,hemorheology and reduce the level of inflammation.

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