摘要
目的观察愈梗通瘀汤联合西药常规治疗对急性心肌梗死患者半年预后的影响。方法采用回顾性队列研究方法,将97例2009年1月-2010年10月在中国中医科学院西苑医院住院的急性心肌梗死患者,分为愈梗通瘀汤组(49例)、辨证论治汤药组(27例)和单纯西药组(21例)。在西医标准治疗基础上辨病论治应用愈梗通瘀汤加减方为愈梗通瘀汤组,应用愈梗通瘀汤外辨证论治的其他汤药为证论治汤药组,未服用任何汤药的为单纯西药组。随访6个月患者的心血管事件发生情况,并评价生活质量。结果与单纯西药组比较,愈梗通瘀汤组6个月内脑卒中和再住院(因心绞痛、心律失常、心力衰竭原因)发生率降低(P=0.015,P=0.033),联合终点事件发生率降低(P=0.018),辨证论治汤药组脑卒中发生率降低(P=0.012);在西雅图心绞痛量表评分方面,与单纯西药组比较,愈梗通瘀汤组躯体活动受限程度、心绞痛发作情况、治疗满意程度、疾病认知程度评分均较高,辨证论治汤药组躯体活动受限程度、治疗满意程度、疾病认知程度评分亦较高(P<0.05,P<0.01)。愈梗通瘀汤组与辨证论治汤药组在各方面比较,差异均无统计学意义(P>0.05)。结论愈梗通瘀汤对急性心肌梗死后的患者有减少半年内脑卒中和因心绞痛、心律失常、心力衰竭原因再住院发生率,改善急性心肌梗死患者半年生活质量的作用。结果显示了辨病论治的有效性与合理性。
Objective To explore the effect of Yugeng Tongyu Decoction(YGTYD)on 6-month prognosis and quality of life in patients with acute myocardial infarction(AMI).Methods A retrospective cohort study was conducted to observe 97 patients with AMI hospitalized in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2009 to October 2010,the patients were assigned to YGTYD group(49 cases),syndrome differentiation group(27 cases)and routine Western medicine group(21 cases).The YGTYD group was treated with YGTYD on the basis of routine Western medicine;the syndrome differentiation group was treated with decoction prescribed according to syndrome typing on the basis of routine Western medicine;the routine Western medicine group was not treated with any decoction.Patients were followed up for 6 months for cardiovascular events and quality of life assessment.Results Compared with the routine Western medicine group,the incidence of stroke and re-hospitalization in YGTYD group decreased in 6 months(P=0.015,P=0.033),and the incidence of combined endpoint events also decreased(P=0.018).The incidence of stroke in the routine differentiation group was lower than that in the standard Western medicine group(P=0.012).In the scores of Seattle Angina Questionnaire(SAQ),compared with the standard Western medicine group,the scores on physical limitation,anginal frequency,treatment satisfaction,disease perception of YGTYD group was higher,the scores on physical limitation,treatment satisfaction,disease perception of routine differentiation group was also higher(P<0.05,P<0.01).There was no statistical difference between YGTYD group and syndrome differentiation group in all aspects(P>0.05).Conclusions YGTYD can reduce the incidence of stroke and re-hospitalization within 6 months after AMI,and improve the short-term quality of life.The research shows the effectiveness and rationality of disease differentiation and treatment.
作者
李思铭
徐凤芹
LI Si-ming;XU Feng-qin(Cardiovascular Diseases Center,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091;Institute of Gerontology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2019年第8期927-931,共5页
Chinese Journal of Integrated Traditional and Western Medicine
关键词
急性心肌梗死
愈梗通瘀汤
生活质量
辨病论治
acute myocardial infarction
Yugeng Tongyu Decoction
quality of life
treatment by differentiation of diseases
