摘要
目的观察益气止血方改善急性冠脉综合征患者经皮冠状动脉介入术(PCI)术后消化道出血的临床疗效。方法选择2020年12月—2022年1月PCI术后发生上消化道出血的患者88例,来自中国中医科学院望京医院、中国中医科学院广安门医院、首都医科大学附属北京朝阳医院,将其用随机数字表法分为观察组和对照组。观察组45例、对照组43例。观察组给予基础治疗+中药益气止血颗粒,对照组给予基础治疗+中药益气止血颗粒模拟剂,疗程均为7 d。对比2组治疗3、7、30 d的出血情况,治疗前后血栓弹力图(TEG)中二磷酸腺苷(ADP)抑制率最大振幅(MA)值及血瘀证评分,治疗期间发生的主要不良心脏事件(MACE)、药物不良事件及肝肾功能。结果治疗7 d观察组出血率低于对照组(P<0.05),治疗3、30 d观察组出血率与对照组比较差异无统计学意义(P>0.05)。治疗7 d观察组MA值较治疗前下降,对照组较治疗前升高,2组比较差异有统计学意义(P<0.05)。治疗后2组血瘀证评分均呈下降趋势,观察组改善情况显著优于对照组(P<0.05)。观察组发生不稳定性心绞痛1例,恶心、呕吐3例;对照组发生不稳定性心绞痛3例,恶心、呕吐4例。2组肝肾功检查未见异常,无严重药物不良事件发生。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论益气止血方对于急性冠脉综合征患者PCI术后上消化道出血的治疗,止血效果佳,可显著改善患者血瘀证证候,起到了一定的抗栓作用。
Objective To observe the clinical efficacy of supplementing Qi and Hemostasis Formula in the treatment of the PCI postoperative upper gastrointestinal bleeding in acute coronary syndrome.Methods 88 patients with upper gastrointestinal bleeding after PCI from Wangjing Hospital,China Academy of Chinese Medical Sciences,Guang'anmen Hospital of China Academy of Chinese Medical Sciences and Beijing Chaoyang Hospital affiliated to the Capital Medical University from December 2020 to January 2022 were selected and divided into treatment group of 45 cases and control group of 43 cases according to random number table method.The treatment group was given basic treatment plus Supplementing Qi and Hemostasis Granula,and the control group was given basic treatment plus Supplementing Qi and Hemostasis Granule mock-up.The course of treatment was 7 days.The bleeding rate at 3 days,at 7 days,and within 30 days,the MA value of thrombus elastic graph and the efficacy score of blood stasis evidence in Chinese medicine were observed in both groups.Results After 7 days of treatment,the bleeding rate in the observation group was lower than that in the control group(P<0.05).After 7 days of treatment,the MA value in the observation group was decreased compared with that before treatment,while that in the control group increased compared with that before treatment,and the difference between the two groups was statistically significant(P<0.05).Conclusion Basic treatment combined with supplementing Qi and Hemostasis Formula can efectively.treat upper gastrointestinal bleeding after PCI for acute coronary syndrome,significantly improve the TCM blood stasis syndrome of patients,without affecting the antiplatelet activity of clopidogrel,and so it can play a certain antithrombotic effect.
作者
徐玥
刘一颖
黄冬林
李晓东
林珑
王吟春
张辰浩
XU Yue;LIU Yi-ying;HUANG Dong-in;LIN Long;WANG Yin-chun;LI Xiao-dong;ZHANG Chen-hao(Emergency Department,Wangjing Hospital,China Academy of Chinese Medical Sciences,Bejing 100102,China)
出处
《北京中医药》
2023年第5期508-512,共5页
Beijing Journal of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程“重大攻关项目”课题(CI2021A02903)。
关键词
益气止血方
经皮冠状动脉介入术
上消化道出血
临床研究
Supplementing Qi and Hemostasis Formula
percutaneous coronary intervention
upper gastrointestinal hemorrhage
clinical research
