经皮冠状动脉内介入治疗对急性心肌梗塞患者中医证候及心功能变化.docVIP

经皮冠状动脉内介入治疗对急性心肌梗塞患者中医证候及心功能变化 　【摘要】 　　目的探讨经皮冠状动脉内介入治疗（PCI）对急性心肌梗塞患者中医证候积分及心功能的变化的影响。方法30例行PCI治疗的AMI患者在术前、术后 3 d及术后 3 月观察中医证候量化-积分及 LVEDV，LVESV，SV，LVEF 等心功能指标的变化情况。结果PCI 治疗前患者胸痛、胸闷、烦躁、心悸等标实证候积分显著升高，同时 LVEDV，LVESV升高，SV，LVEF 降低；PCI 术后 3 d患者上述标实证积分与术前比较有明显降低，差异有显著性意义（P＜0.05或0.01）；但气短、乏力、纳呆、面色、自汗等本虚证积分与术前比较未见明显变化，差异无统计学意义（P＞0.05），LVEDV，LVESV，SV，LVEF 亦较术前无变化；PCI 术后 3个月各项证候积分较术前均有明显降低，差异有显著意义（P＜0.01）；其中本虚证候积分与 PCI 术后 3 d比也有明显下降，两者有显著性差异（P＜0.01），同时 LVESV，SV，LVEF 等指标与术前及术后 3 d比较亦有明显改善（P＜0.05或0.01）。结论PCI 治疗对急性心肌梗塞中医证候的传变有明显的影响，术前以标实证候为著，术后随标实证候的改善，本虚证候更加突出。在中医辨治上要考虑到这种传变规律，掌握好“通”和“补”的时机和度。 【关键词】 急性心肌梗塞 经皮冠状动脉内介入治疗 中医证候 心功能 　　Abstract：Objective：To study the influence of PCI therapy on the variance of integral of Chinese medical syndrome and heart function in patients with AMI.Methods：The variance of integral of Chinese medical syndrome and heart function such as LVEDV,LVESV,SV and LVEF before and after three, days and after three months of PCI were observed in patients with AMI treated by PCI. Results：Compared with that before PCI，the integral of superficial excess type was decreased obviously after three days of PCI，which had significant difference（P＜0.05 or 0.01），but the integral of original deficiency type, for example, short breath ,debility, anorexia , complexion and spontaneous perspiration had no significant difference（P＞0.05），LVEDV，LVESV，SV and LVEF had no difference either（p＞0.05）. After three months of PCI，the integral of each symptom was decreased as，and the integral of original deficiency type also reduced apparently compared with that after three days of PCI（P＜0.01），at the same time LVESV，SV and LVEF had apparent improvement too（p＜0.05 or 0.01）.Conclusion：PCI therapy has obvious influence on the transmission of Chinese medical syndrome in patients with AMI, superficial excess type seem apparent before PCI, but after PCI the original deficiency type turns outstanding as the improvement of superficial excess type. While diagnosis and treatment in Chinese medicine，