目的 探讨芪苈强心胶囊联合硫酸氢氯吡格雷片治疗急性心肌梗死的临床疗效。方法 选取2022年3月—2024年7月在开封市中心医院就诊的102例急性心肌梗死患者，按随机数字表法将患者分为对照组和治疗组，每组各51例患者。对照组口服硫酸氢氯吡格雷片，2片/次，1次/d。治疗组在对照组基础上口服芪苈强心胶囊，4粒/次，3次/d。两组均治疗1个月。比较两组的治疗效果、心功能指标、运动耐力和血清指标。结果 对照组的总有效率为84.31%，治疗组的总有效率为96.08%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的左室射血分数（EF）、心脏指数（CI）升高，左室舒张末期容积（EDV）降低（P＜0.05）；治疗组的EF、CI高于对照组，EDV低于对照组（P＜0.05）。治疗后，两组的6 min步行距离试验（6WMT）均升高（P＜0.05），且治疗组的6WMT高于对照组（P＜0.05）。治疗后，两组的血清肌酸激酶同工酶（CK-MB）、N末端钠尿肽前体（NT-proBNP）、同型半胱氨酸（HCY）、白细胞介素-6（IL-6）水平显著降低（P＜0.05）；治疗组的血清CK-MB、NT-proBNP、HCY、IL-6水平低于对照组（P＜0.05）。结论 芪苈强心胶囊联合硫酸氢氯吡格雷片可提高急性心肌梗死的疗效，进一步改善患者心功能，降低心肌的炎性损伤。

Objective To explore the clinical efficacy of Qili Qiangxin Capsules combined with Clopidogrel Bisulfate Tablets in treatment of acute myocardial infarction. Methods 102 Patients with acute myocardial infarction who visited Kaifeng Central Hospital from March 2022 to July 2024 were selected and divided into control group and treatment group using a random number table method, with 51 cases in each group. Patients in the control group took Clopidogrel Bisulfate Tablets orally, 2 tablets/time, once daily. Patients in the treatment group were po administered with Qili Qiangxin Capsules on the basis of the control group, 4 capsules/time, 3 times daily. Both groups were treated for one month. The therapeutic effects, cardiac function indicators, exercise endurance, and serum indicators were compared between two groups. Results The total effective rates of the control group and the treatment group were 84.31% and 96.08%, with statistical significance (P < 0.05). After treatment, EF and CI in two groups were increased, while EDV was decreased (P < 0.05). EF and CI of the treatment group were higher than those of the control group, but EDV was lower than that of the control group (P < 0.05). After treatment, 6WMT distance of two groups were increased (P < 0.05), and 6WMT distance of the treatment group was higher than that of the control group (P < 0.05). After treatment, the serum levels of CK-MB, NT-proBNP, HCY, and IL-6 in two groups were significantly decreased (P < 0.05), and those in the treatment group were lower than those in the control group (P < 0.05). Conclusion Qili Qiangxin Capsules combined with Clopidogrel Bisulfate Tablets can improve the therapeutic effect of acute myocardial infarction, further improve patients' cardiac function, and reduce myocardial inflammatory damage.

R972

河南省医学科技攻关计划项目（LHGJ20220927）