目的 评估注射用益气复脉（冻干）联合盐酸替罗非班治疗急性心肌梗死的临床效果。方法 纳入2020年8月—2024年8月芜湖市中医医院收治的100例急性心肌梗死患者，利用随机数字表法分为对照组和治疗组，每组各50例。对照组接受替罗非班单药治疗，初始30 min静脉滴注速率0.4 μg/(kg·min)，后续调整为0.1 μg/(kg·min)维持72 h。治疗组在对照组基础上加用益气复脉冻干粉（5.2 g溶解于250 mL 0.9%氯化钠注射液），以40滴/min速率静脉滴注，每日1次。两组疗程均为14 d 。比较两组临床疗效、治疗前后相关评分及心功能指标变化。结果 治疗后，治疗组总有效率达92.00%，显著高于对照组的78.00%（P＜0.05）；两组患者治疗后CRUSADE、GRACE及VAS评分均显著降低，治疗组评分降幅大于对照组（P＜0.05）；两组超敏心肌肌钙蛋白I（hs-cTnT）、N末端脑钠肽前体（NT-proBNP）、肌酸激酶同工酶（CK-MB）水平治疗后均显著下降（P＜0.05），治疗组降幅优于对照组（P＜0.05）。治疗后，两组左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）均显著降低，左心室射血分数（LVEF）均显著升高（P＜0.05），治疗组各指标改善程度均优于对照组（P＜0.05）。结论 注射用益气复脉联合替罗非班注射液治疗急性心肌梗死展现出显著的疗效，不仅能够显著改善心功能指标并减轻心肌损伤水平，而且明显降低患者出血和死亡风险并降低患者疼痛程度。

Objective To explore the clinical efficacy of Yiqifumai (freeze-dried) for injection combined with tirofiban in the treatment of acute myocardial infarction.Methods 100 Patients with acute myocardial infarction admitted to Wuhu Traditional Chinese Medicine Hospital from August 2020 to August 2024 were selected as the research objects. They were divided into control group and treatment group by the random number table method, with 50 cases in each group. Patients in control group were iv administered with Tirofiban Hydrochloride Injection, initial intravenous infusion 0.4 μg/(kg·min) for 30 min, then 0.1 μg/(kg·min) for 72 h. Patients in treatment group were iv administered with Yiqifumai Injection (freeze-dried) on the basis of control group (5.2 g dissolved in 250 mL 0.9% sodium chloride injection) via intravenous infusion (40 drops/min, once daily). Both groups were treated for 14 d. Clinical efficacy, relevant scores, and cardiac function indicators were compared.Results After treatment, the total effective rate of treatment group reached 92.00%, significantly higher than 78.00% of control group (P < 0.05). After treatment, the CRUSADE, GRACE and VAS scores of both groups of patients decreased significantly, and the score reduction in the treatment group was greater than that in control group (P < 0.05). The levels of hs-cTnT, NT-proBNP, and CK-MB in both groups decreased significantly after treatment (P < 0.05), and the reduction in treatment group was better than that in control group (P < 0.05). After treatment, LVEDD and LVESD in both groups decreased significantly, but LVEF increased significantly (P < 0.05). The improvement degrees of each index in treatment group were better than those in control group (P < 0.05).Conclusion Yiqifumai (freeze-dried) for injection combined with tirofiban has shown significant therapeutic effects in treatment of acute myocardial infarction, and can not only significantly improve cardiac function indicators and reduce the level of myocardial injury, but also significantly reduce the risk of bleeding and death for patients and the degree of pain.

R972

安徽省中医药传承创新科研项目（2022CCZD02）