四妙勇安汤合抵当汤加减治疗老年无痛性急性非ST段抬高型心肌梗死临床研究

摘要

Objective To observe the clinical effects of modified Simiao Yong'an decoction and Didang decoction in the treatment of senile painless acute non-ST segment elevation myocardial infarction (NSTEMI). Methods 60 patients with painless acute NSTEMI were randomly divided into two groups according to the random number table method. 30 cases in control group were treated by routine western medicine. 30 cases in treatment group were treated by modified Simiao Yong'an decoction and Didang decoction on the basis of the control group. The clinical efficacy was calculated after 2 weeks of treatment in both groups, and the changes of troponin I (c TNI) maximum value, c TNI recovery time, plasma B-type brain natriuretic peptide (BNP) and C-reactive protein (CRP) were observed in the two groups. Results The total effective rate was 93. 33％ in treatment group and 76. 67％ in control group, there was no significant difference between the two groups (P＞ 0. 05). The maximum value of c TNI in the treatment group was lower than that in the control group (P ＜ 0. 05), and the recovery time of c TNI in the treatment group was shorter than that in the control group (P ＜ 0. 05). After treatment, BNP and CRP in both groups were lower than those before treatment (P ＜ 0. 05), and the treatment group were lower than those in the control group (P ＜0. 05). Conclusion The modified Simiao Yong'an decoction and Didang decoction is effective in the treatment of painless acute NSTEMI in the elderly. It has obvious advantages in improving the degree of myocardial ischemia injury, controlling acute inflammatory reaction and improving cardiac function.%目的 观察四妙勇安汤合抵当汤加减治疗老年无痛性急性非ST段抬高型心肌梗死(NSTEMI)的临床疗效.方法 将60例无痛性急性非ST段抬高型心肌梗死患者按照随机数字表法分为2组.对照组30例予西医常规治疗;治疗组30例在对照组治疗基础上加用四妙勇安汤合抵当汤治疗.2组均治疗2周后统计临床疗效,并观察2组有效病例肌钙蛋白I(c TNI)最大值、c TNI恢复正常时间、血浆B型脑钠肽(BNP)及C反应蛋白(CRP)的情况.结果 治疗组总有效率93.33％,对照组总有效率76.67％,2组比较差异无统计学意义(P＞ 0.05).治疗组有效病例c TNI最大值低于对照组(P ＜0.05),c TNI恢复正常时间短于对照组(P ＜0.05).2组有效病例治疗后BNP、CRP均低于本组治疗前(P ＜0.05),且治疗组低于对照组(P ＜0.05).结论 四妙勇安汤合抵当汤加减治疗老年无痛性急性非ST段抬高型心肌梗死疗效确切,在改善心肌缺血损伤程度、控制急性炎性反应、改善心功能等方面有明显优势.