| Purpose: To observe the clinical efficacy of Huayu Granule in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI)after PCI without reflow turbidity and blood stasis syndrome,and to provide new treatment for Chinese medicine in the treatment of no reflow after PCI Diagnosis and treatment ideas.Material and method:A prospective,randomized,controlled method was used to consecutively select no reflow after emergency PCI in acute ST-segment elevation myocardial infarction(STEMI)from the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2017 to November 2018.Of the 60 patients,the diagnosis was consistent with phlegm and blood stasis syndrome,including 49 males(81.67%)and 11females(18.33),with an average age of 59.8 years and an age range of 33-87 years.They were randomly divided into the experimental group of 30 patients(conventional drugs +Huayu granules)and the control group of 30 patients(conventional drugs + placebo).They were given aspirin 300 mg,clopidogrel 600 mg or ticagrelor 180 mg before surgery.Emergency PCI was performed and selected according to the recovery of target blood flow.The conventional drug therapy for acute myocardial infarction was treated with a study drug(chemical phlegm or placebo)for one week,followed by a third month after surgery.The baseline data of the two groups,cardiac ultrasound within 1 week after surgery,myocardial contrast angiography results after 3 months,and TCM syndrome evaluation scale were recorded.All data were statistically processed using the SPSS 22.0 statistical software package.P < 0.05 was considered statistically significant.Result:1.Baseline data of gender,age,smoking history,history of hypertension,history of diabetes,history of previous myocardial infarction,previous PCI history,white blood cell count,blood lipids,and troponin were not statistically significant.2.Cardiac Function: There were no significant differences in left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)between the two groups at admission.At 3 months follow-up,the left ventricular ejection fraction of the experimentalgroup was 60.60%±5.56%,and the left ventricular ejection fraction of the control group was57.62%±6.76%,P<0.05,and the ejection fraction of the two groups at the 3-month follow-up.Both were significantly higher than postoperative;The left ventricular end-diastolic diameter(mm)of the experimental group was 51.08±5.81,and the left ventricular end-diastolic diameter(mm)of the control group was 54.08±7.78,P<0.05.The difference was statistically significant.3.Myocardial contrast echocardiography: There was no significant difference in the wall motion score(WMS)and perfusion score(MCE)between the experimental group and the control group during the third month of follow-up.4.Total efficiency: The total effective number was 12% in the experimental group at 1 week,and the total effective rate was 40%.The total effective number was 5 in the control group at1 week,the total effective rate was 16.7%,c2 =4.002,P<0.05.The total effective number was15 in the month,and the total effective rate was 50%.The total effective number was 7 in the control group at 3 months after operation.The total effective rate was 23.3%,c2= 4.593,P<0.05.The difference was statistically significant.5.TCM syndrome scores: There was a statistically significant difference between the test group and the control group at 1 week after chest pain(P=0.038)and chest tightness(P=0.045).The symptoms of chest pain(P=0.020),chest tightness(P=0.035),shortness of breath(P=0.016)and limb weight(P=0.035)were statistically significant in the experimental group and the control group at 3 months after operation.Conclusion: Huayuqutan granules can significantly improve the ejection fraction of patients without reflow after PCI,delay ventricular remodeling,and improve clinical symptoms. |
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