The Effect Of Qingrehuoxue Combined Yiqiyangyin On Cardiac Function Of PCI Patients With Acute Myocardial Infarction And Follow-up Study

ObjectiveWith a prospective observation, to observe that how cooling heat and promoting blood circulation combined with benefiting qi and nourishing Yin can affect the heart function of AMI after PCI, so that to provide references that preventing and treating cardiac functional insufficiency after AMIhttp://fanyi.baidu.com/?aldtype=16047-## with PCI.MethodsSelecting 100 patients admitted in The First Affiliated Hospital Of Guangzhou University Of TCM from JUN 1st,2015 to JAN 1st,2016 who http://fanyi.baidu.com/?aldtype= 16047-##met the inclusion criteria and dividing randomly into three group, including the control group(pure western medicine group), the first experimental group (western medicine with Qingre Huoxue Fang) and the second experimental group(western medicine with Qingre Huoxue Fang and the Yixin Huoxue Pills). Focus on the TCM score, clinical symptoms in the Killip and the NYHA, variety of BNP, ALT, AST, UREA, CREA and ultrasonic cardiogram, including EF、LA、LVESD、LVEDD、E、A and E/A.Results(1)With the western medicine treatment program strictly, we can significantly improve the TCM symptom of AMI patients after PCI, such as chest tightness, chest pain, shortness of breath and so on. With cooling heat and promoting blood circulation combined with benefiting qi and nourishing Yin, on the basis of the western medicine treatment program, we can further improve the symptom of traditional Chinese medicine.(2) With the western medicine treatment program strictly, we can significantly improve the heart function and prognosis. With cooling heat and promoting blood circulation combined with benefiting qi and nourishing Yin, on the basis of the western medicine treatment program, we can further improve the heart function in a short term.(3) Patients with acute myocardial infarction undergoing revascularization and receiving Western medicine treatment can reduce serum BNP, which may be related to the timely recovery of blood supply, reduce the area of necrotic myocardium and inhibit the early ventricular remodeling. With cooling heat and promoting blood circulation combined with benefiting qi and nourishing Yin,we can further reduced BNP.(4) This study observed in EF as indicators of evaluation of contractile function, e, a, EA ratio as an index of evaluation of cardiac diastolic function, the results suggest that, after 1 month standard western medicine treatment, three groups of EF, e, E/a compared with those before treatment improved. But e/a by the fluid mechanics of large, may appear the phenomenon of "pseudo normalization", and can not fully reflect the diastolic function of heart in patients with AMI and requires a combination of S/D, TDI, Tei index can better for evaluation of cardiac diastolic function. On receiving the standard treatment of Western medicine is based, with heat clearing and blood activating Chinese medicine is on cardiac systolic and diastolic contraction function improvement is more obvious; traditional Chinese medicine and use Qingre Huoxue Method Combined with Supplementing Qi and nourishing Yin intervention can be further enhanced after AMI after PCI in patients with cardiac diastolic function.(5)In this study, LA and LVED were used as indicators for evaluating ventricular remodeling, and the results showed that there was no significant change in LA after operation, but the overall upward trend was found in AMI patients. The LVESD and LVEDD of the patients had different degrees of increase, which suggested that ventricular remodeling occurred after acute myocardial infarction, and the effect of ventricular remodeling was not affected by revascularization (thrombolysis, PCI, CABG). The use of guidelines to recommend drugs can only slow the pace of progress, and rarely completely inhibit or even reverse the process of ventricular remodeling. Therapeutic effect of Western medicine combined with heat clearing and blood activating herbs and the simple use of Western medicine is similar, but on this basis and usufruct heart Huoxue pill can inhibit ventricular remodeling and prompt after acute myocardial infarction ventricular remodeling may and heart qi loss, yin deficiency of heart and kidney essence loss.(6) Alt, urea, crea compared with those before treatment were not significantly increased, tips for a short period of time to accept the treatment of secondary prevention of coronary heart disease drug, Qingre Huoxue Decoction and benefit heart and activating blood circulation pill, not the patient’s liver and kidney function impact, over the use of drug treatment in patients with acute myocardial infarction (AMI) with safety. Among them, Yixin Huoxue pill components including Radix Polygoni Multiflori, the side that the short term according to the prescribed doses of Polygonum multiflorum preparation is safe. Compared with before treatment, AST decreased significantly (P< 0.01). AST is myocardial enzymology markers, this study enrolled to within 12h, AST in the majority of cases has exceeded normal value even more than 3 times above, after treatment, myocardial infarction condition is stable, so ast returned to normal levels.(7)During the follow-up, excluding the deaths,there is no case that occurred adverse reactions.Conclusions:With cooling heat and promoting blood circulation combined with benefiting qi and nourishing Yin and western medicine treatment, we can further reduce the serum BNP level and promote the recovery of PCI postoperative cardiac function in patients with acute myocardial infarction during a short period. What’s more,it does not damage the function of liver and renal, and the compliance of patients is superior to the one who receive traditional Chinese medicine medicinal broth on the basis of western medicine.What most important is that there is no obvious adverse reactions during the medication.