| Objective:To observe the improved effect of clinical symptoms with optimized treatment of Traditional Chinese Medicine(TCM)in patients after percutaneous coronary intervention(PCI)therapy in acute stage of acute myocardial infarction(AMI),and approach that optimized treatment of TCM has protective and improved effect for damaged myocardium.Methods:1.63 patients in acute stage of AMI who were in hospitalization at ICU or Cardiac center of Guangdong Province Hospital of TCM and experienced PCI therapy were selected during August 2006 to March 2008,and divided into in two groups randomly,31 patients in optimized group of TCM(optimized group) and 32 patients in control group of TCM(control group).2.The two groups' therapeutic schedule was according to the regulation of clinical pathway of AMI with PCI therapy.The optimized group's therapeutic measure of TCM was accordance with the optimized treatment of TCM,while the control group's was coming from the clinical experience of doctor in charge.3.Observe the variance of TMP,ECG and marker of myocardial damage after PCI in two groups.4.Observe the major adverse cardiac events(MACE,including death, non-fatal myocardial infarction and target vessel revascularization),the lesser adverse cardiac events(including incidence rate and the degree of angina pectoris,heart dysfunction and arrhythmia),curative effect of TCM and the occurrence of complication in duration of hospital stay.5.Observe the incidence rate of major adverse cardiac events and lesser adverse cardiac events,and appraise heart function of the two groups by examination of the Color Doppler Echocardiography(CDE)at 90 days after PCI.Results:1.Comparing the two groups,patients who reached TMP3,∑STR≥50%and T wave inversion were more in optimized group,P＜0.05.The density of marker of myocardial damage after PCI such as CK-MB and cTnT was obvious lower in optimized group than in control group,P＜0.05.And the density of CK-MB and myoglobin descended more quickly to normal in optimized group too,P＜0.05.2.During in hospital,there was no significant difference of the incidence rate and degree of the MACE in two groups.But there was significant difference of the incidence rate and degree of lesser adverse cardiac events in the two groups,such as angina pectoris and heart dysfunction,the optimized group was more slighter than the control group,P＜0.05.And the optimized group had more higher total effective rate than the control group in curative effect of TCM(93.5%vs 71.9%),P＜0.05.3.90 days after PCI,there was no significant difference of the incidence rate of the MACE and readmission between the two groups,P＞0.05,but the incidence rate of lesser adverse cardiac events,such as angina pectoris and heart dysfunction,was fewer in optimized group,P＜0.05.Comparing 90 days after PCI with in duration of hospital stay,the examination of CDE showed that except for LVEDV,there was more improvement of LVESV,SV and LVEF in the control group,P＜0.05 or＜0.01,while all the index of CDE improved in the optimized group,P＜0.05 or＜0.01.The improvement of LVESV,SV and LVEF had more significantly in the optimized group,P＜0.05.Conclusion:1.The optimized treatment of TCM can significantly improve the TMP, increase the patients whose ECG reaches∑STR≥50%and T wave inversion, descend the density of CK-MB and cTnT,shorten the time of the density of CK-MB and myoglobin descending to normal,improve the micro irrigation of myocardium and protect the myocardium more preferably.2.The optimized treatment of TCM can obviously reduce of the lesser adverse cardiac events during in hospital,significantly descend the incidence rate of angina pectoris and heart dysfunction,and improve the index of heart function by Color Doppler Echocardiography examination at 90 days after PCI.3.The optimized treatment of TCM is established according to the Chinese medical pathogenesis of asthenia in origin and asthenia in superficiality of AMI before and after PCI,so it has significant curative effect and can obviously improve the symptoms of TCM.
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