目的 探討通心絡(luò)膠囊聯(lián)合硫酸氫氯吡格雷片治療急性心肌梗死的臨床療效。方法 選取2015年1月—2017年7月?lián)犴樖兄行尼t(yī)院收治的急性心肌梗死患者92例為對(duì)象研究，所有患者隨機(jī)分為對(duì)照組和治療組，每組各46例。對(duì)照組口服硫酸氫氯吡格雷片，首次劑量300 mg/次，之后75 mg/次，1次/d；治療組在對(duì)照組的基礎(chǔ)上口服通心絡(luò)膠囊4粒/次，3次/d。兩組患者均連續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組的心功能指標(biāo)、炎性因子、心肌酶學(xué)指標(biāo)、QRS積分和心肌梗死面積。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為78.3%、91.3%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組左室收縮期末內(nèi)徑（LVESD）、左室舒張期末內(nèi)徑（LVEDD）、左室收縮末期容積（LVESV）和左室舒張末期容積（LVEDV）均明顯降低，左室射血分?jǐn)?shù)（LVEF）明顯升高，同組治療前后比較差異具有統(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，兩組高敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）和白細(xì)胞介素-18（IL-18）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）。治療后，兩組血清腦鈉肽（BNP）、心肌肌鈣蛋白T（cTnT）、乳酸脫氫酶（LDH）和肌酸激酶同工酶（CK-MB）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）。治療后，兩組QRS積分、心肌梗死面積均顯著降低，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 通心絡(luò)膠囊聯(lián)合硫酸氫氯吡格雷片治療急性心肌梗死具有較好的臨床療效，可改善心功能，降低炎性反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical effect of Tongxinluo Capsules combined with Clopidogrel Hydrogen Sulphate Tablets in treatment of acute myocardial infarction. Methods Patients (92 cases) with acute myocardial infarction in Fushun Central Hospital from January 2015 to July 2017 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, initial dose 300 mg/time, then 75 mg/time, once daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, inflammatory factors, myocardial enzymology indexes, QRS scores, and myocardial infarction area in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.3% and 91.3%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVESD, LVEDD, LVESV, and LVEDV in two groups were significantly decreased, but the LVEF 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 better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of hs-CRP, IL-6, and IL-18 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). After treatment, the levels of BNP, cTnT, LDH, and CK-MB 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). After treatment, QRS scores and myocardial infarction area 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 Tongxinluo Capsules combined with Clopidogrel Hydrogen Sulphate Tablets has clinical curative effect in treatment of acute myocardial infarction, can improve cardiac function, decrease inflammatory response, which has a certain clinical application value.