中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
4期
262-265
,共4页
李景君%孙红娟%陶愈婷%王国蕾%黄积存%李亮%苏会钦
李景君%孫紅娟%陶愈婷%王國蕾%黃積存%李亮%囌會欽
리경군%손홍연%도유정%왕국뢰%황적존%리량%소회흠
非ST段抬高型急性冠脉综合征%消化道出血%麒麟心痛舒%临床疗效%中西医结合疗法
非ST段抬高型急性冠脈綜閤徵%消化道齣血%麒麟心痛舒%臨床療效%中西醫結閤療法
비ST단태고형급성관맥종합정%소화도출혈%기린심통서%림상료효%중서의결합요법
Non-ST segment elevation acute coronary syndrome%Gastrointestinal bleeding%Qilin Xintongshu pill%Therapeutic effect%Integrated traditional Chinese and western medicine therapy
目的：观察自拟中药组方麒麟心痛舒对非ST段抬高型急性冠脉综合征（NSTE-ACS）合并消化道出血（GIB）患者的临床疗效。方法采用前瞻性随机对照研究方法，选择海南省琼海市中医院心内科收治的67例NSTE-ACS合并GIB患者，按随机数字表法分为治疗组（35例）和对照组（32例）。两组在常规给予内科治疗（除抗凝外）的基础上，治疗组给予麒麟心痛舒丸（由三七、血竭、枳实等药物组成），每次5 g，每日3次口服；对照组给予硫酸氯吡格雷每次75 mg，每日1次口服，两组均治疗30 d。比较两组治疗后主要心血管事件发生率（包括死亡、新发心肌梗死、再梗死、顽固性缺血）和消化道大出血事件的发生率，并观察不良反应发生情况。结果治疗后治疗组心血管事件和消化道大出血发生率均较对照组明显降低〔心血管事件发生率：8.57%（3/35）比28.13%（9/32），消化道大出血发生率：2.86%（1/35）比21.88%（7/32），均P＜0.05〕。两组均未见不良反应发生，治疗前后血尿常规及肝肾功能未见异常。结论麒麟心痛舒丸能有效降低NSTE-ACS合并GIB患者30 d内的心血管事件和消化道大出血事件的发生率，是NSTE-ACS合并GIB患者理想的治疗药物。
目的：觀察自擬中藥組方麒麟心痛舒對非ST段抬高型急性冠脈綜閤徵（NSTE-ACS）閤併消化道齣血（GIB）患者的臨床療效。方法採用前瞻性隨機對照研究方法，選擇海南省瓊海市中醫院心內科收治的67例NSTE-ACS閤併GIB患者，按隨機數字錶法分為治療組（35例）和對照組（32例）。兩組在常規給予內科治療（除抗凝外）的基礎上，治療組給予麒麟心痛舒汍（由三七、血竭、枳實等藥物組成），每次5 g，每日3次口服；對照組給予硫痠氯吡格雷每次75 mg，每日1次口服，兩組均治療30 d。比較兩組治療後主要心血管事件髮生率（包括死亡、新髮心肌梗死、再梗死、頑固性缺血）和消化道大齣血事件的髮生率，併觀察不良反應髮生情況。結果治療後治療組心血管事件和消化道大齣血髮生率均較對照組明顯降低〔心血管事件髮生率：8.57%（3/35）比28.13%（9/32），消化道大齣血髮生率：2.86%（1/35）比21.88%（7/32），均P＜0.05〕。兩組均未見不良反應髮生，治療前後血尿常規及肝腎功能未見異常。結論麒麟心痛舒汍能有效降低NSTE-ACS閤併GIB患者30 d內的心血管事件和消化道大齣血事件的髮生率，是NSTE-ACS閤併GIB患者理想的治療藥物。
목적：관찰자의중약조방기린심통서대비ST단태고형급성관맥종합정（NSTE-ACS）합병소화도출혈（GIB）환자적림상료효。방법채용전첨성수궤대조연구방법，선택해남성경해시중의원심내과수치적67례NSTE-ACS합병GIB환자，안수궤수자표법분위치료조（35례）화대조조（32례）。량조재상규급여내과치료（제항응외）적기출상，치료조급여기린심통서환（유삼칠、혈갈、지실등약물조성），매차5 g，매일3차구복；대조조급여류산록필격뢰매차75 mg，매일1차구복，량조균치료30 d。비교량조치료후주요심혈관사건발생솔（포괄사망、신발심기경사、재경사、완고성결혈）화소화도대출혈사건적발생솔，병관찰불량반응발생정황。결과치료후치료조심혈관사건화소화도대출혈발생솔균교대조조명현강저〔심혈관사건발생솔：8.57%（3/35）비28.13%（9/32），소화도대출혈발생솔：2.86%（1/35）비21.88%（7/32），균P＜0.05〕。량조균미견불량반응발생，치료전후혈뇨상규급간신공능미견이상。결론기린심통서환능유효강저NSTE-ACS합병GIB환자30 d내적심혈관사건화소화도대출혈사건적발생솔，시NSTE-ACS합병GIB환자이상적치료약물。
Objective To observe the therapeutic effect of Qilin Xintongshu pill for treatment of patients with non-ST segment elevation acute coronary syndromes(NSTE-ACS)accompanied by gastrointestinal bleeding (GIB). Methods A prospective randomized controlled trial was conducted. A total of 67 hospitalized patients in Cardiovascular Department of Qionghai City Hospital of Traditional Chinese Medicine were divided into therapy group(35 cases)and control group(32 cases). Both groups were given conventional medical treatment(except anti-coagulative agent). In the therapy group,the patients received Qilin Xintongshu pill(the ingredients consisting of panax pseudo-ginsen,dragon's blood,immature orange fruit,etc.)oral administration,once 5 mg and 3 times a day,while in the control group,the patients accepted clopidogrel orally,once 75 g and once a day,the therapeutic course in both groups being 30 days. The major cardiovascular events(such as death,a newly-happened myocardial infarction(MI),MI secondary,obstinately ischemia)and incidence of massive hemorrhage of gastrointestinal tract were compared between the two groups,and the adverse events were observed. Results After treatment,the incidence of cardiovascular events and massive hemorrhage of gastrointestinal tract in the therapy group were decreased significantly compared to those in the control group 〔incidence of cardiovascular events:8.57%(3/35)vs. 28.13%(9/32), incidence of massive hemorrhage of gastrointestinal tract:2.86%(1/35)vs. 21.88%(7/32),both P<0.05〕. Adverse events were not observed in both groups,and the examinations of blood,urine,liver and renal functions were of no abnormalities before and after treatment. Conclusion Qilin Xintongshu pill can effectively reduce the incidences of cardiovascular events and massive hemorrhage of gastrointestinal tract in patients with NSTE-ACS accompanied by GIB in the therapeutic course of 30 days,therefore this traditional Chinese herbal medicine is an ideal agent for treatment of such disease.
