2024 年第 9 期 第 0 卷

活血通脉片联合阿替普酶治疗急性心肌梗死的临床研究

Clinical study of Huoxue Tongmai tablets combined with alteplase in the treatment of acute myocardial infarction

作者：张晶露1李长青2包秋红1

英文作者：Zhang Jinglu1 Li Changqing2 Bao Qiuhong1

单位：1内蒙古医科大学附属医院老年医学中心，呼和浩特010030；2内蒙古医科大学附属医院心内科，呼和浩特010030

英文单位：1Geriatrics Center the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010030 China; 2Department of Cardiology the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010030 China

关键词：急性心肌梗死；活血通脉片；阿替普酶

英文关键词：Acutemyocardialinfarction;HuoxueTongmaitablets;Ateplase

• 摘要：

• 目的 探讨活血通脉片联合阿替普酶治疗急性心肌梗死的效果。方法 将内蒙古医科大学附属医院2021年11月至2023年12月收治的84例急性心肌梗死患者纳入本研究。将患者按照随机数字表法分为对照组（42例）和观察组（42例）。对照组采用阿替普酶进行溶栓治疗，观察组采用活血通脉片联合阿替普酶进行治疗。比较2组的治疗效果、中医症状改善时间、心功能指标、血液流变学指标以及不良反应。结果 观察组的总有效率明显高于对照组［97.6%（41/42）比85.7%（36/42）］（P=0.048）。观察组的心胸满闷、胸部刺痛、舌质紫暗改善时间均短于对照组［（4.3±1.2）d比（5.1±1.5）d、（2.5±1.1）d比（3.5±1.2）d、（6.3±1.5）d比（8.6±1.9）d］，差异均有统计学意义（均P＜0.05）。治疗后，2组心肌肌钙蛋白I、N末端B型脑钠肽前体、肌酸激酶同工酶水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。治疗后，2组血浆黏度、高切全血黏度、纤维蛋白原水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。2组均未出现明显不良反应。结论 活血通脉片联合阿替普酶治疗急性心肌梗死可获得较好的效果，能有效改善患者心肌受损情况以及血液流变学指标，且安全性较好。

• Objective To investigate the effect of Huoxue Tongmai tablets combined with alteplase in the treatment of acute myocardial infarction. Methods A total of 84 patients with acute myocardial infarction admitted to the Affiliated Hospital of Inner Mongolia Medical University from November 2021 to December 2023 were included in this study. The patients were divided into control group (42 cases) and observation group (42 cases) according to the random number table method. The control group was treated with alteplase thrombolytic therapy, and the observation group was treated with Huoxue Tongmai tablets combined with alteplase. The therapeutic effect, traditional Chinese medicine symptom improvement time, cardiac function index, hemorheology index and adverse reactions were compared between the two groups. Results The total effective rate of observation group was obviously higher than that of control group ［97.6%（41/42） vs 85.7%（36/42）］(P=0.048). The improvement time of chest tightness, chest tingling and dark tongue in the observation group were shorter than those in the control group ［(4.3±1.2)d vs (5.1±1.5)d, (2.5±1.1)d vs (3.5±1.2)d, (6.3±1.5)d vs (8.6±1.9)d］(all P＜0.05). After treatment, the levels of cardiac troponin I, N-terminal pro-brain natriuretic peptide and creatine kinase isoenzyme in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). After treatment, the plasma viscosity, high-cut whole blood viscosity and fibrinogen levels of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P＜0.05). There were no obvious adverse reactions in the two groups. Conclusion Huoxue Tongmai tablets combined with alteplase in the treatment of acute myocardial infarction can achieve good therapeutic effect, which can effectively improve the myocardial damage and hemorheological indicators of patients, and has good safety.