| Objective:to investigate the effect of "kangshuanyihao" on non-reflow and slow blood flow in patients with acute st-segment elevation myocardial infarction after PCI.Methods:in this study,48 cases of STEMI patients admitted to jiangsu provincial hospital of traditional Chinese medicine and undergoing direct PCI were selected consecutively.26 patients in the experimental group and 22 patients in the control group,the experimental group were treated with conventional treatment plus "kangshuanyihao",while the control group was treated with conventional treatment.Baseline indicators,medical history data,intraoperative radiography data,ADP inhibition rate,AA inhibition rate,liver and kidney function of the patients were recorded after enrollment.In this study,ADP inhibition rate,AA inhibition rate and liver and kidney function were reviewed after 1 week of treatment after 4 weeks of observation.After 4 weeks of treatment,the liver and kidney function indexes were reviewed,the Seattle angina pectoris scale and TCM syndrome score were completed,the incidence of adverse reactions and MACE were observed,and the clinical efficacy and safety of "kangshuanyihao" treatment for patients with no reflow or slow blood flow after PCI were observed.Results:there was no significant difference between the control group and the treatment group in general clinical data and previous medical history(P>0.05).(1)comparison of TEG:The ADP inhibition rates of the experimental group were 75.51±25.71,82.53±16.81,77.82±15.35,71.38±29.91,87.56±12.63,90.14±8.91,and 63.39±34.87,66.71±24.57,and 66.51±24.21,respectively,before and after the treatment,and 7(±2)days after the treatment,respectively,in the experimental group.AA inhibition rate were 65.75±32.08,89.93±12.31,88.26±13.84,in the two groups of comparisons,24 h after surgery and postoperative 7(±2)days of ADP inhibition rate than the group of the day,there was no statistically significant difference(P>0.05),the control group 24 h after surgery and postoperative day 7(±2)AA inhibition rate is relatively higher into the group on the same day,statistically significant difference,the treatment group of seven(±2)days after AA inhibition rate is relatively higher into the group on the same day,statistically significant difference(P<0.05).Compared with the control group,the ADP inhibition rate of the treatment group was increased 24 hours after surgery,and the difference was statistically significant(P<0.05).Although the ADP inhibition rate of the treatment group was increased 7 days after surgery,and the AA inhibition rate of the treatment group 24 hours after surgery and 7 days after surgery was increased to different degrees compared with the control group,the difference was not statistically significant(P>0.05).(2)Comparison of no reflow or slow blood flow:Initial respectively on two groups of patients with surgery and postoperative the number of frames,the blood flow velocity,The initial frame number(TFC)of the control group was 7.4±12.5frames;the postoperative frame number was 20.1±8.4 frames;the initial flow rate was 21.780±38.262mm/s;the postoperative flow rate was 123.764±73.527mm/s;the initial frame number(TFC)of the experimental group was 7.4±12.0 frames;the postoperative frame number was 18.1±6.9 frames;the initial flow rate was 35.725±57.573mm/s;the postoperative flow rate was 159.998±71.290mm/s.the results of the two group was not statistically significant(P>0.05).(3)Efficacy of Seattle angina pectoris(SAQ)scale and TCM syndrome score:The SAQ scale of the experimental group at 28 days after treatment was PL38.75±3.06,AS90.0±14.1,AF89.3±10.8,TS74.3±5.7,and DP71.95±8.87,respectively.The control group was PL36.90±3.28,AS80.0±20.1,AF84.7±11.1,TS74.3±5.4,and DP71.39±9.94,respectively.The score of TCM syndrome was 3.1±1.4 in the experimental group and 4.1±1.7 in the control group at 28 days after treatment,and the difference was statistically significant(P<0.05).(4)Patients in the experimental group ERY positie 4 cases,fecal occult blood positive 0 cases,the control group ERY positie in 2 cases,fecal occult blood positive in 1 case,1 cases of acute heart failure in both group,treatment group 0 cases died,the control group 2 cases died,there was no statistically significant difference(P>0.05),no serious injury of liver and kidney function,malignant arrhythmia,stent restenosis and other adverse reactions and the occurrence of adverse events.Conclusion:Standardized treatment in combination western medicine with "kagshuanyihao" on patients with STEMI,by strengthening the AA inhibition rate,antiplatelet effect,further improve the high platelet reactivity phenomenon,and can improve the coronary blood flow,can improve the postoperative SAQ rating scale,lower TCM symptom score,improve the patients quality of life,no obvious function of liver and kidney damage,does not increase the risk of major MACE events occur. |
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