目的 研究冠心舒通膠囊預(yù)防急性心肌梗死經(jīng)皮冠狀動(dòng)脈介入治療(PCI)術(shù)后再狹窄的臨床療效.方法 選取2009年4月—2014年4月在西安醫(yī)學(xué)院第二附屬醫(yī)院接受PCI手術(shù)的156例患者,隨機(jī)分為對(duì)照組和治療組,每組78例.對(duì)照組采用西藥常規(guī)治療,治療組在對(duì)照組基礎(chǔ)上加服冠心舒通膠囊,3粒/次,3次/d.兩組均連續(xù)治療6個(gè)月.觀察兩組患者心絞痛復(fù)發(fā)率,比較兩組術(shù)前,治療1、6個(gè)月時(shí)氣虛血瘀證積分變化,同時(shí)比較兩組患者高敏C反應(yīng)蛋白(hs-CPR)和血清淀粉樣蛋白A(SAA)的水平變化.結(jié)果 對(duì)照組和治療組心絞痛復(fù)發(fā)率分別為4.35%、17.65%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).兩組患者在治療第1、6個(gè)月時(shí)肌酸激酶(CK)下降,在治療第1個(gè)月時(shí),治療組CK低于對(duì)照組(P< 0.05);治療組氣虛血瘀積分在治療第1、6個(gè)月時(shí)顯著下降且低于對(duì)照組,對(duì)照組在治療第6個(gè)月時(shí)下降.與手術(shù)前相比,術(shù)后前3 d兩組患者h(yuǎn)s-CPR和SAA水平均明顯升高(P< 0.05);術(shù)后第7天開始下降,且術(shù)后7 d、1個(gè)月時(shí)治療組hs-CPR和SAA水平顯著低于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).結(jié)論 冠心舒通膠囊對(duì)預(yù)防急性心肌梗死PCI術(shù)后再狹窄的發(fā)生有較好的療效,可改善患者的氣虛血瘀證,其作用機(jī)制可能是抑制血管內(nèi)皮的炎癥反應(yīng),改善心肌缺血.

Objective To investigate the clinical effect of Guanxin Shutong Capsules in prevention of acute myocardial infarction with PCI postoperative restenosis. Methods The patients with acute myocardial infarction with PCI (156 cases) of the Second Affiliated Hospital of Xi'an Medical University from March 2009 to March 2014 were randomly divided into control and treatment groups, and each group had 78 cases. The patients in the control group were accepted routine western medicine. The patients in treatment group were po administered with Guanxin Shutong Capsules, 3 grains/time, three times daily. Two groups were treated for six months. Angina recurrence rates in two groups were observed, and scores of Qixu Xueyu symptoms in two groups were compared before surgery and treatment of 1, 6 months. At the same time, the changes of hs-CPR and SAA were compared. Results The angina recurrence rates in the control and treatment groups were 4.35% and 17.65%, respectively, and there were differences between two groups (P <0.05). The level of creatine kinase (CK) in the treatment fell in the treatment of first, sixth months, and CK was lower than that in the control group in the treatment of one month (P <0.05). The score of Qixu Xueyu symptoms in the treatment group was reduced in the treatment of first, sixth months and lower than that in the control group (P <0.05), while the score of Qixu Xueyu symptoms in the control group reduced in the treatment of sixth month. The levels of hs-CPR and SAA in two groups were significantly higher first three days after operation, while they declined from the seventh day after operation. And 7 d and one month after operation, the levels of hs-CPR and SAA in treatment group were significantly lower than those in the control group, with significant difference between two groups (P <0.05). Conclusion Guanxin Shutong Capsules has the good clinical effect in prevention of acute myocardial infarction with PCI postoperative restenosis, and can improve Qixu Xueyu symptoms, while its mechanism may be inhibiting vascular endothelial inflammation and improve myocardial ischemia.