目的 探讨瓜蒌皮注射液联合替罗非班治疗急性心肌梗死患者的临床疗效。方法 选取2022年5月—2024年5月武汉市中医医院心血管科收治的68例行PCI术的急性心肌梗死患者，依据随机数字法将患者分为对照组和治疗组，每组各34例。对照组静脉滴注盐酸替罗非班氯化钠注射液，100 mL/次，1次/d。治疗组在对照组的治疗基础上静脉滴注瓜蒌皮注射液，4 mL加入生理盐水100 mL中混合，2次/d。两组连续用药7 d。观察两组患者的临床疗效，比较两组治疗前后心肌酶指标、心功能指标、舒适度与生活质量综合评定表（GQOLI-74）评分、血清炎性因子水平的变化情况。结果 治疗后，治疗组总有效率94.12%，显著高于对照组的73.53%（P＜0.05）。治疗后，两组心肌肌钙蛋白（cTnI）、肌酸激酶同工酶（CK-MB）水平均显著低于同组治疗前（P＜0.05）；治疗后，治疗组cTnI、CK-MB水平低于对照组（P＜0.05）。治疗后，两组患者左心室射血分数（LVEF）显著升高，而左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）水平降低（P＜0.05）；治疗后，治疗组LVEF高于对照组，而LVEDD、LVESD水平低于对照组（P＜0.05）。治疗后，两组GQOLI-74评分升高，Sgarblssa评分降低（P＜0.05）；治疗后，治疗组GQOLI-74评分高于对照组，Sgarblssa评分低于对照组（P＜0.05）。治疗后，两组内皮细胞特异性分子1（Endocan）、半乳糖凝集素9（Galectin-9）、白细胞介素17（IL-17）均显著降低，而摄食抑制因子1（Nesfatin-1）水平显著升高（P＜0.05）；治疗后，治疗组Endocan、Galectin-9、IL-17低于对照组，而Nesfatin-1水平高于对照组（P＜0.05）。结论 瓜蒌皮注射液联合替罗非班治疗急性心梗患者疗效显著，显著降低机体内炎性反应，提高患者生活质量，值得借鉴与应用。

Objective To investigate the therapeutic effect of Gualoupi Injection combined with tirofiban in treatment of acute myocardial infarction. Methods Sixty-eight patients with acute myocardial infarction who underwent PCI in cardiovascular department of Wuhan Hospital of Traditional Chinese Medicine from May 2022 to May 2024 were selected and divided into control group and treatment group according to random number method, with 34 patients in each group. Patients in control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, 100 mL/time, once daily. Patients in the treatment group were iv administered with Gualoupi Injection on the basis of control group, 4 mL added into 100 mL of normal saline and mixed, twice daily. Both groups were treated continuously for 7 d. The clinical effects of two groups were observed, and the changes of myocardial enzyme indexes, cardiac function indexes, GQOLI-74 scores of comfort and quality of life and serum inflammatory factors before and after treatment were compared between two groups. ResultsAfter treatment, the total effective rate of the treatment group was 94.12%, which was significantly higher than that of control group (73.53%, P < 0.05). After treatment, the levels of cardiac troponin (cTnI) and creatine kinase isoenzyme (CK-MB) in two groups were significantly lower than before treatment (P < 0.05). After treatment, cTnI and CK-MB levels in treatment group were lower than those in control group (P < 0.05). After treatment, LVEF was significantly increased, but LVEDD and LVESD levels were decreased in two groups (P< 0.05). After treatment, LVEF levels in treatment group were higher than those in control group, but LVEDD and LVESD levels were lower than those in control group (P < 0.05). After treatment, GQOLI-74 score was increased, but Sgarblssa score was decreased (P < 0.05). After treatment, the GQOLI-74 score of treatment group was higher than that of control group, and the Sgarblssa score was lower than that of control group (P< 0.05). After treatment, Endocan, Galectin-9, and IL-17 were significantly decreased in both groups, but Nesfatin-1 levels were significantly increased in both groups (P < 0.05). After treatment, Endocan, Galectin-9 and IL-17 levels in the treatment group were lower than those in the control group, but Nesfatin-1 level was higher than that in control group (P < 0.05). Conclusion Gualoupi Injection combined with tirofiban has remarkable curative effect in treatment of acute myocardial infarction, and can significantly reduce the inflammatory response in the body and improve life quality of patients, which is worth learning and applying.

R972

中医药科研立项项目（ZY2021Z008）