Objective To observe the distribution and evolution of traditional Chinese medieinc ( TCM) syndrome elements in acutc eoronary syndrome ( ACS) patients treated with Chinese herbs for nourishing qi and aetivating blood eireulation ( XQABC) be fore and after pereutaneous eoron.iry intervention (PCI). Methods Two hundred and forty-one patients with ACS confirmed by eor onary angiography w-ere treated by stenting and randomly divided into two groups :Control group treated by western medieine routine treatment,and Chinese herbs treatment group treated by Chinese herbs for XQABC on the basis of routine treatment after PCI for 6 months. Followed up for 12 months,whc frequency analysis were used for TCM syndrome elements in ACS patients after PCI at four time points, which were respectively before enrolled into group and the 3rd, 6th, 12th month after enrolled into group. Chi square test and Fisher's exact probability test were used for the comparison of TCM syndrome elements between control group and Chinese herbs treatment group. Results The blood - stasis syndrome occupied the highest proportion of TCM excess syndrome in ACS pa tients after PDI without treatment of Chinese herbs for XQABC at four time points, accounted respectively for 87.7%,56.5% , 60. 5 % , 18. 3 % , the highest proportion of TCM deficiency syndrome was qi - deficiency syndrome, accounted respectively for 62. 2 % , 67. 6 % , 58. 1 % .38. 3 %. The turbid phlegm syndrome and qi stagnation syndrome had not significant change. The proportions of blood -stasis syndrome,qi- deficiency syndrome and yang - deficiency syndrome were lower significantly in Chinese herbs treatment group than that in control group at the 3rd , 6th month(P<0.05 or P<0. 01). At the 12th month,the proportions of blood -stasis syndrome and yang-deficiency syndrome were lower significantly in Chinese herbs treatment group than that in control group (P<0. 01) ,qi - deficiency syndrome was also lower, but had not different significantly. Conclusion Blood - stasis and qi - deficiency run through the whole course of disease of ACS during one year after PCI Chinese herbs might be the effective therapy method on blood - stasis,qi - defi ciency syndrome and yang - deficiency syndrome in ACS patients after PCI.%目的 探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗前后中医证候要素分布特点及应用益气活血中药干预后中医证候要素的演变规律.方法 将经冠状动脉造影证实的241例ACS患者随机分为两组,两组均行支架植入术.术后对照组给予西医常规治疗,益气活血组在西医常规治疗基础上加用益气活血中药干预6个月.两组患者均随访12个月,使用SPSS软件对ACS介入患者入组前,入组后3个月、6个月及12个月中医证候要素进行频数分析,应用卡方检验和Fisher's精确概率法进行益气活血干预组和对照组两组中医证候要素的比较.结果 未应用益气活血中药干预的ACS介入患者在入组前及入组后第3个月、6个月、12个月时间点的中医证候要素比例分布:实证以血瘀为主,分别占87.7%、56.5%、60.5%、38.3%,虚证以气虚为主,分别占62.2%、67.6%、58.1%、38.3%.痰浊和气滞在四个时点的比例未有明显的升降.入组后第3个月、6个月,与对照组相比,益气活血干预组中血瘀、气虚、阳虚所占比例均显著降低(P<0.05或P<0.01),入组后第12个月,与对照组相比,益气活血干预组中血瘀和阳虚均显著降低(P<0.01),气虚也有下降,但差异无统计学意义.结论 血瘀、气虚贯穿于ACS介入术后1年的整个病程,益气活血中药可有效干预ACS介入术后患者血瘀、气虚及阳虚证候要素.
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