目的 探讨参松养心胶囊联合盐酸替罗非班注射液治疗急性心肌梗死的临床疗效。方法 选取2018年7月-2020年3月天津市宁河区医院心内科收治的84例急性心肌梗死患者作为本次研究对象，按照随机数字表法将所有患者分为对照组和治疗组，每组各42例。对照组静脉滴注盐酸替罗非班注射液，0.2 μg/（kg·min），连续治疗72 h。治疗组在对照组治疗的基础上口服参松养心胶囊，4粒/次，3次/d。两组均在治疗7 d。观察两组的临床疗效，比较两组临床症状改善情况、VAS评分、心功能指标、血管内皮功能指标。结果 治疗后，治疗组患者的临床总有效率（95.24%）比对照组高（80.95%），差异有统计学意义（P<0.05）。治疗后，两组的胸痛次数、每次持续时间、VAS评分显著降低（P<0.05）；治疗后，治疗组的胸痛次数、每次持续时间、VAS评分比对照组低（P<0.05）。治疗后，两组左室射血分数（LVEF）、二尖瓣血流E峰和A峰最大充盈速度比值（E/A）、每搏量（SV）显著高于治疗前（P<0.05）；治疗后治疗组LVEF、E/A、SV比对照组高（P<0.05）。治疗后，两组一氧化氮（NO）水平显著升高，N-端脑利钠肽前体（NT-proBNP）、内皮素-1（ET-1）、心肌肌钙蛋白I（cTnI）水平显著降低（P<0.05）；治疗后治疗组的NO水平比对照组高，NT-proBNP、ET-1、cTnI水平比对照组低，差异有统计学意义（P<0.05）。结论 参松养心胶囊联合盐酸替罗非班注射液治疗急性心肌梗死的疗效显著，可减轻临床症状，改善心功能，调节血管内皮功能因子水平。

Objective To explore the clinical effect of Shensong Yangxin Capsules combined with Tirofiban Hydrochloride Injection in treatment of acute myocardial infarction. Methods Patients (84 cases) with acute myocardial infarction in Tianjin Ninghe Hospital from July 2018 to March 2020 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 0.2 μg/(kg·min), continuous treatment for 72 h. Patients in the treatment group were po administered with Shensong Yangxin Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the improvement of clinical symptoms, the VAS scores, the cardiac function indexes, and the vascular endothelial function indexes in two groups were compared. Results After treatment, the clinical total effective rate of the treatment group (95.24%) was higher than that of the control group (80.95%), and the difference was statistically significant (P < 0.05). After treatment, the number and duration of chest pain and the VAS score in two groups were significantly decreased (P < 0.05). After treatment, the number and duration of chest pain and the VAS score in treatment group were lower than those in the control group (P < 0.05). After treatment, LVEF, E/A, and SV of two groups were significantly higher than those before treatment (P < 0.05). After treatment, LVEF, E/A, and SV of the treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of NO in two groups were significantly increased, but the levels of NT-proBNP, ET-1, and cTnI were significantly decreased (P < 0.05). After treatment, the level of NO in the treatment group was higher than that in the control group, but the levels of NT-proBNP, ET-1, and cTnI in the treatment group were lower than those in the control group (P < 0.05). Conclusion Shensong Yangxin Capsules combined with Tirofiban Hydrochloride Injection has clinical curative effect in treatment of acute myocardial infarction, can relieve clinical symptoms, improve cardiac function and regulate the level of vascular endothelial function factor.

R972

广西壮族自治区卫生和计划生育委员会中医药科技专项（GZLC16-22）