| Purpose: To observe the clinical efficacy of Jianpi Yiqi,Huayu Qutan method in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI)after PCI without reflow.To explore the rationality of Jianpi Yiqi,Huayu Qutan method in the treatment of no reflow after PCI.Method:This trial used a randomized,controlled method.70 patients with STEMI who underwent PCI in our hospital from October 2017 to May 2019 were selected,and no reflow occurred.Randomly divided into 36 cases in the control group,including 30 males and 6females,with an average age of 59.76 years,with an age range of 38 to 84 years,and 34 cases in the experimental group,with 25 males and 9 females,with an average age of 60.24 years and an age range of 33 ? 82 years old.The experimental group was treated with the traditional Chinese medicine Huayu Qutan Granules,which had the effects of Jianpi Yiqi,Huayu Qutan,while the control group was treated with placebo.Followed up for 3 months.The baseline data of all cases in the experimental group and the control group were recorded in detail,the cardiac ultrasound results at week 0(immediately before the drug intervention)and the third month(after the drug intervention),and the quantitative index A value,? value,A × ? value and qualitative index myocardial perfusion score(PS)of myocardial contrast echocardiography at the third month,and recorded the Seattle Angina Questionnaiire(SAQ)score at week 0,week 2,and week 4.Before and after drug intervention,blood,urine,stool routine,blood lipids,liver and kidney function and other physical and chemical examination results and headache,diarrhea,stomach upset(nausea,vomiting),allergies and other adverse reactions.Result:1.Comparison of baseline data between the two groups of cases:Demographic characteristics such as gender,age,height,weight;risk factors of coronary heart disease such as smoking history,history of hypertension,history of diabetes,history of dyslipidemia,history ofprevious myocardial infarction,history of previous PCI and laboratory physical and chemical tests such as white blood cell count,Alanine aminotransferase,Aspartate aminotransferase,Low density lipoprotein,creatinine and troponin I?There was no statistically significant difference between the groups(P> 0.05),and it was clinically comparable.2.Comparison of cardiac ultrasound results : There was no significant difference in left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)between the experimental group and the control group immediately before drug intervention(P> 0.05).At the third month after drug intervention,the LVEF of the experimental group was60.72 ± 5.21%,and the LVEF of the control group was 57.64 ± 7.00%.There was a statistically significant difference between the groups(P <0.05).The LVEDD of the experimental group was 46.75 ± 8.08 mm,and the LVEDD of the control group was 51.11 ±7.35 mm.There was a statistically significant difference between the groups(P <0.05).3.Comparison of myocardial contrast echocardiography(MCE)results:At the third month after the drug intervention,the qualitative index of myocardial perfusion score(PS)of MCE in the experimental group and the control group was 1.25 ± 0.44 vs 1.5 ± 0.56,respectively,and the difference was statistically significant(P <0.05).The MCE qualitative indicators ?value and A × ? value of the experimental group and the control group were 1.85 ± 0.82 vs1.41 ± 0.64,60.20 ± 27.85 vs 33.60 ± 6.35,and the differences were statistically significant(P<0.05).The comparison of ? value between the two groups was 32.75 ± 4.11 vs 32.60 ± 6.35,and the difference was not statistically significant(P> 0.05).4.Comparison of Seattle Angina Questionnaiire(SAQ)score : There were statistically significant differences between the two groups in terms of treatment satisfaction(TS)and angina pectoris frequency(AF)at the 2nd and 4th week(P <0.05).The increase of AF score was larger than that of the control group.There was no significant difference between the two groups in terms of physical activity limitation(PL),angina steady state(AS),and disease awareness(DP)at 2th week(P> 0.05).At 4th week,there was a statistically significant difference between the groups(P <0.05).5.The occurrence of adverse reactions:The two groups of patients were tested and compared with physical and chemical indexes such as blood,urine,stool routine,blood lipids,liver and kidney function before and after drug intervention,and no abnormal changes occurred.There were 4 patients in the control group,and 5 patients in the experimental group had adverse reactions.Chi-square test found that ?2 = 0.202,p = 0.653,there was no statistically significant difference between the groups.Conclusion:1.The method of Jianpi Yiqi,Huayu Qutan can obviously improve the clinical symptoms of no reflow after PCI in STEMI patients,improve cardiac function,and have good safety.2.The method of Jianpi Yiqi,Huayu Qutan can obviously improve the scores of Seattle angina questionnaire for patients without reflow after PCI,increase patients' treatment satisfaction and awareness of disease,and reduce the number of angina attacks. |
PDF Full Text Request