Early Chinese Medicine Intervention Retrospective Study Of Long-term Prognosis Of Acute Myocardial Infarction

The thesis on acute myocardial infarction (AMI) consists of both the part of introduction of concerned discourses, and the part of exposition of the clinical research.There are three concerned discourses introduced in the former part. The achievement and development on the AMI study in the Traditional Chinese Medical Science (TCMS) is discussed in the first discourse, which from TCMS perspective explains the pathology and pathogenesis of AMI, treatment with Chinese medicines and other treatments for AMI, and laboratory research on AMI. The second discourse deals with Western Medicine's achievement and development on the AMI study. It detailed the usage of angiotensin converting enzyme inhibitors (ACEI), thromblytic therapy and percutaneous intervention, on which more research was done in recent years. In the last discourse, many domestic and abroad clinical trials of recent years in multi-center and massive-sample, randomized-controlled and compared are collected according to standards of evidence-based medicine; and based on the collection the long-term prognosis effects caused by the recent AMI treatments are explored: the application of ACEI and 3 -blocker can reduce both short-term and long-term mortality, the thromblitic treatment should be used in early stage of the onset of this disease, even be of most benefit if being used before hospitalization, however the long-term effect of percutaneous transluminal coronary angioplasty (PTC A) is yet to be confirmed.To explore the effects of Chinese medicine on long-term prognosis of AMI, we collect 157 patients who were still alive after the acute stage for a retrospective study. They are divided into two groups according to the treatment, those who were treated only with common Western Medicine are in control group (28 patients) while those treated with integrated Chinese Medicine and Western Medicine are in CM group (129 patients). The long-term cardiogenic mortality in CM group is lower than in control group, 7.75% vs 1429%, and the cardiogenic mortality in CM group is 45.8% lower than in control group, but it has no statistic significance (P=0.122). The mortality of the patients with cardiogenic shock in CM group is much lower than in control group, which shows statistic significance (P=0.027*). The incidence of target events including reinfarction, cardiac arrest, heart failure, cerebral infarction, cerebral hemorrhage is lower than in control group, 12.4% vs 14.29%, which has gained statistic significance (P=0.005*). The main treatment principles of the CM group are removing blood, supplementing Qi and transforming phlegm. This study indicates that Chinese Medicine can reduce the incidence of severe cardio-cerebrovascular events, improve the long-term prognosis, it also implies that the maladjustment of Qi and Blood in AM.