目的 探究通脈膠囊聯(lián)合單硝酸異山梨酯注射液治療急性心肌梗死的臨床療效。方法 選取2015年10月-2016年10月鄭州市第六人民醫(yī)院收治的急性心肌梗死患者115例作為研究對(duì)象，所有患者在隨機(jī)分組的原則下分為對(duì)照組（57例）和治療組（58例）。對(duì)照組患者靜脈滴注單硝酸異山梨酯注射液，5 mL加入到葡萄糖注射液250 mL中，初始劑量為2 mg/h，然后根據(jù)患者表現(xiàn)調(diào)整實(shí)際劑量；治療組在對(duì)照組的基礎(chǔ)上口服通脈膠囊，5粒/次，2次/d。兩組患者均治療1周。觀察兩組的臨床療效，比較兩組的心率、血壓、心功能指標(biāo)和心衰標(biāo)志物水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為78.95%、96.55%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，心率和收縮壓均明顯上升，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組左心室射血分?jǐn)?shù)（LVEF）和左心室高峰充盈率（LVPFR）均顯著升高，左心室舒張末期內(nèi)徑（LVEDD）顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組N端-前腦利鈉肽（NT-proBNP）、肌酸激酶（CK）和內(nèi)皮素-1（ET-1）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 通脈膠囊聯(lián)合單硝酸異山梨酯注射液治療急性心肌梗死具有較好的臨床療效，能改善臨床癥狀，調(diào)節(jié)心功能指標(biāo)和心衰標(biāo)志物水平，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Tongmai Capsules combined with Isosorbide Mononitrate Injection in treatment of acute myocardial infarction. Methods Patients (115 cases) with acute myocardial infarction in the Sixth People's Hospital of Zhengzhou from October 2015 to October 2016 were randomly divided into the control group (57 cases) and the treatment group (58 cases). Patients in the control group were iv administered with Isosorbide Mononitrate Injection, 5 mL added into glucose solution 250 mL, twice daily. Patients in the treatment group were po administered with Tongmai Capsules on the basis of the control group, 5 grains/time, twice daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacies were evaluated, and heart rate, blood pressure, heart function indexes, and heart failure markers in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.95% and 96.55%, respectively, and there was difference between two groups (P<0.05). After treatment, heart rate and systolic pressure in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVEF and LVPFR in two groups were significantly increased, but the LVEDD in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NT-proBNP, CK, and ET-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05).And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongmai Capsules combined with Isosorbide Mononitrate Injection has clinical curative effect in treatment of acute myocardial infarction, can improve clinical symptom, and regulate heart function index and heart failure markers, with good safety, which has a certain clinical application value.