中西医结合治疗急性心肌梗塞304例临床观察

目的：对本院１９７８年１月～１９９７年１２月中西医结合治疗３０４例急性心肌梗塞（ＡＭＩ）的临床疗效和中医辨证论治规律进行回顾性总结分析。方法：对３０４例ＡＭＩ病案进行逐项统计，包括年龄、性别、梗塞部位、并发症、死亡原因以及中医证候、治则、方药等。结果：本组心律失常、泵衰竭、栓塞等并发症发生率分别为６８７５％、３６８４％、０６６％。而国内文献报告分别为８６％～１００％、５０％、２％。实行静脉溶栓治疗后，病死率由１７３２％（３５／２０２例）降低为１０７８％（１１／１０２例）。中医辨证以气虚、血瘀、痰浊为主。治法以益气、活血、豁痰为主。结论：中西医结合治疗ＡＭＩ明显降低心律失常、泵衰竭、栓塞等并发症的发生率；静脉溶栓治疗显著降低了ＡＭＩ住院病死率；总结了ＡＭＩ的常见中医证型及其相应的治法方药

英文摘要:

Objective: To make a retrospective survey study on clinical effect and regular pattern of TCM treatment based on Syndrome Differentiation in treating patients of acute myocardial infarction (AMI), admitted in Xiyuan Hospital from January 1978 to December 1997 with integrated traditional Chinese and western medicine. Methods: Statistical analysis was made in the following items of 304 patients: age, sex, location of infarction, complication, cause of death, mortality, as well as TCM Syndrome, principle of treatment, prescription and medicinal herbs used. Results: The incidences of complications in this group for arrhythmia, pump failure, thrombosis were 68.75%, 36.84% and 0.66% respectively, while those in patients treated with western medicine reported by literature in China were 86%～100%, 50% and 2% respectively. Mortality in this group after using thrombolytic therapy was reduced from 17.32%(35/202) to 10.78%(11/102). Types of disease, according to Syndrome Differentiation of TCM, were mainly the Qi deficiency type, blood stasis type and turbid phlegm type. And the principle of TCM treatment was mainly to supplement Qi, activate blood circulation and resolve phlegm. Conclusion: Integrated traditional Chinese and western medicine treatment of AMI could reducing incidence of complications, such as arrhythmia, pump failure and thrombosis, and thrombolytic therapy could reduce mortality of patients. The frequently encountered TCM Syndrome types and the corresponding therapeutic methods and prescriptions used in treating AMI have also been summarized in this paper.

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