Clinical Study Of Wenyang Yiqi Tongmai Method Combined With Reteplase Intravenous Thrombolysis In The Treatment Of Acute Myocardial Infarction (Syndrome Of Cold Coagulation And Blood Stasis)

Objective: To study the effect of Wenyang Yiqi Tongmai method therapy combined with intravenous thrombolysis with reteplase on acute myocardial infarction(Syndrome of cold coagulation and blood stasis),and to evaluate its safety and application value.To improve cardiac function,reduce complications and improve prognosis.Methods: 90 patients with STEMI admitted to our hospital from October 2020 to October 2022 were randomly divided into control group,experimental group A and experimental group B.The control group was treated with conventional western medicine,the experimental group A was treated with conventional western medicine and Shenfu injection,and the experimental group B was treated with conventional western medicine,Shenfu injection and Wenyang Yiqi Tongmai prescription.The general information,efficacy indicators and safety indicators of patients in each group before and after treatment were recorded,including the effective rate of TCM syndrome,TCM syndrome score,recanalization rate,LVEF,LVDD,killip cardiac function classification,NT-pro BNP,incidence of complications and adverse reactions.SPSS software was used for data processing.Results: According to the exclusion and drop-out criteria,87 cases were included,including 30 cases in experimental group A,29 cases in experimental group B and 27 cases in control group.1.Vascular recanalization rate:(1)The vascular recanalization rate of test group A was 86.67%,that of test group B was 89.65%,and that of control group was 81.48%,and there was no significant difference among the three groups(P> 0.05).(2)There was no significant difference in the proportion of TIMI grade 3 flow among the three groups(P> 0.05).There was no difference in the efficacy among the three groups.2.Cardiac function indicators:(1)LVEF: After treatment,all three groups increased,and the increase in experimental group B was greater than that in experimental group A and control group,and the difference was statistically significant(P <0.05).(2)LVDD: There was no significant difference between before and after treatment(P>0.05).(3)NT-pro BNP:NT-pro BNP levels were decreased in the three groups after 7 days and 14 days of treatment,and the decrease in experimental group B was more obvious,and the difference was statistically significant(P <0.05),suggesting that experimental group B could improve LVEF and reduce NT-pro BNP levels faster,and the efficacy of experimental group B was superior to that of control group and experimental group A after 14 days of treatment;But it does not improve LVDD.3.TCM syndrome score and effective rate:(1)After treatment,TCM syndrome score of the three groups decreased,and the improvement of the experimental group B was better than that of the experimental group A and the control group;The difference was statistically significant(P <0.05).(2)After treatment,the effective rate of TCM syndrome in group B(93.10%)was higher than that in group A(76.67%)and control group(66.67%),and the difference was statistically significant(P<0.05).The treatment group B can reduce the TCM syndrome score and improve the TCM syndrome effective rate,and the effect is better than that of the treatment group A and the control group.4.Incidence of complications:(1)Comparison of complications(heart failure,arrhythmia,cardiogenic shock),P> 0.05,the difference was not statistically significant.The total incidence of complications in group B(10.34%)was significantly lower than that in group A(16.66%)and control group(22.22%)(P <0.05).Test group B can reduce the total incidence of complications,and the effect is better than that of test group A and control group.5.Adverse reactions: The incidence of bleeding events in test group B was lower than that in test group and control group.No adverse reaction related to traditional Chinese medicine was found during the treatment,which indicated that the method of Wenyang Yiqi Tongmai was safe in the treatment of acute myocardial infarction.Conclusion: Wenyang Yiqi Tongmai method combined with intravenous thrombolytic therapy with reteplase can reduce the score of TCM syndrome,improve the effective rate of TCM syndrome and improve the symptoms of patients with acute myocardial infarction(Syndrome of cold coagulation and blood stasis).improve LVEF,reduce NT-pro BNP level,improve cardiac function and prognosis of patients,reduce the incidence of complications,improve the quality of life of patients,and have good safety.