目的 探討參松養(yǎng)心膠囊聯(lián)合鹽酸替羅非班注射液治療急性心肌梗死的臨床療效。方法 選取2018年7月-2020年3月天津市寧河區(qū)醫(yī)院心內科收治的84例急性心肌梗死患者作為本次研究對象，按照隨機數字表法將所有患者分為對照組和治療組，每組各42例。對照組靜脈滴注鹽酸替羅非班注射液，0.2 μg/（kg·min），連續(xù)治療72 h。治療組在對照組治療的基礎上口服參松養(yǎng)心膠囊，4粒/次，3次/d。兩組均在治療7 d。觀察兩組的臨床療效，比較兩組臨床癥狀改善情況、VAS評分、心功能指標、血管內皮功能指標。結果 治療后，治療組患者的臨床總有效率（95.24%）比對照組高（80.95%），差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的胸痛次數、每次持續(xù)時間、VAS評分顯著降低（P<0.05）；治療后，治療組的胸痛次數、每次持續(xù)時間、VAS評分比對照組低（P<0.05）。治療后，兩組左室射血分數（LVEF）、二尖瓣血流E峰和A峰最大充盈速度比值（E/A）、每搏量（SV）顯著高于治療前（P<0.05）；治療后治療組LVEF、E/A、SV比對照組高（P<0.05）。治療后，兩組一氧化氮（NO）水平顯著升高，N-端腦利鈉肽前體（NT-proBNP）、內皮素-1（ET-1）、心肌肌鈣蛋白I（cTnI）水平顯著降低（P<0.05）；治療后治療組的NO水平比對照組高，NT-proBNP、ET-1、cTnI水平比對照組低，差異有統(tǒng)計學意義（P<0.05）。結論 參松養(yǎng)心膠囊聯(lián)合鹽酸替羅非班注射液治療急性心肌梗死的療效顯著，可減輕臨床癥狀，改善心功能，調節(jié)血管內皮功能因子水平。

Objective To explore the clinical effect of Shensong Yangxin Capsules combined with Tirofiban Hydrochloride Injection in treatment of acute myocardial infarction. Methods Patients (84 cases) with acute myocardial infarction in Tianjin Ninghe Hospital from July 2018 to March 2020 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 0.2 μg/(kg·min), continuous treatment for 72 h. Patients in the treatment group were po administered with Shensong Yangxin Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the improvement of clinical symptoms, the VAS scores, the cardiac function indexes, and the vascular endothelial function indexes in two groups were compared. Results After treatment, the clinical total effective rate of the treatment group (95.24%) was higher than that of the control group (80.95%), and the difference was statistically significant (P < 0.05). After treatment, the number and duration of chest pain and the VAS score in two groups were significantly decreased (P < 0.05). After treatment, the number and duration of chest pain and the VAS score in treatment group were lower than those in the control group (P < 0.05). After treatment, LVEF, E/A, and SV of two groups were significantly higher than those before treatment (P < 0.05). After treatment, LVEF, E/A, and SV of the treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of NO in two groups were significantly increased, but the levels of NT-proBNP, ET-1, and cTnI were significantly decreased (P < 0.05). After treatment, the level of NO in the treatment group was higher than that in the control group, but the levels of NT-proBNP, ET-1, and cTnI in the treatment group were lower than those in the control group (P < 0.05). Conclusion Shensong Yangxin Capsules combined with Tirofiban Hydrochloride Injection has clinical curative effect in treatment of acute myocardial infarction, can relieve clinical symptoms, improve cardiac function and regulate the level of vascular endothelial function factor.

R972

廣西壯族自治區(qū)衛(wèi)生和計劃生育委員會中醫(yī)藥科技專項（GZLC16-22）