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目的:探讨四逆加人参汤改善心肌梗死后无症状性心肌缺血(SMI)的临床价值。方法:将80例心肌梗死后无症状性心肌缺血患者随机分为观察组和对照组各40例,对照组患者采用常规西医治疗,观察组患者在常规治疗的基础上加用四逆加人参汤治疗,比较两组患者的临床疗效。结果:经过治疗,观察组患者SMI发作次数、总持续时间、缺血总负荷分别为(31.3±2.7)次、(71.9±8.8)min、(80.8±9.4)mm/s,均显著低于治疗前,差异具有统计学意义(P<0.01);对照组患者治疗后各指标亦明显改善,但改善程度低于观察组,组间比较差异具有统计学意义(P<0.01)。两组患者治疗前后心率、收缩压及舒张压比较差异无统计学意义(P>0.05);经过治疗,观察组患者室性早搏(102.1±9.6)次/日,较治疗前显著降低(P<0.01),而对照组患者下降幅度低于观察组,组间比较差异具有统计学意义(P<0.01)。结论:四逆加人参汤治疗心肌梗死后无症状性心肌缺血临床疗效显著,可有效降低发作次数,减少早搏发生,值得临床推广应用。
Objective: To investigate the clinical value of Sini and Ginseng Decoction in ameliorating asymptomatic myocardial ischemia (SMI) after myocardial infarction. Methods: Eighty patients with asymptomatic myocardial ischemia after myocardial infarction were randomly divided into observation group and control group, 40 cases in each group. Patients in the control group were treated with routine western medicine. Patients in the observation group were treated with Sini and Ginseng Tang treatment, the clinical efficacy of two groups were compared. Results: After treatment, the number of SMI episodes and the total duration of ischemia in the observation group were (31.3 ± 2.7), (71.9 ± 8.8) min and (80.8 ± 9.4) mm / s, respectively, which were significantly lower than those in the treatment group (P <0.01). The indexes in the control group were also significantly improved after treatment, but the improvement was lower than that in the observation group. The difference between the two groups was statistically significant (P <0.01). The heart rate, systolic blood pressure and diastolic blood pressure had no significant difference between the two groups before and after treatment (P> 0.05). After treatment, ventricular premature beats in the observation group (102.1 ± 9.6) times / day were significantly lower than those before treatment (P < 0.01), while the decrease in the control group was lower than that in the observation group, the difference was statistically significant (P <0.01). Conclusion: Sini and Ginseng Decoction can significantly reduce the incidence of asymptomatic myocardial ischemia after myocardial infarction, which can effectively reduce the number of seizures and reduce the occurrence of premature beats. It is worthy of clinical application.