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[中国26家三级甲等中医医院急性心肌梗死住院患者的临床特征及治疗情况调查]

[Clinical features of acute myocardial infarction inpatients in 26 level three class A Chinese medicine hospitals in China and the investigation of treatment].

作者信息

Tian Jing-Feng, Li Jun-De, Lei Yan

机构信息

Department of Medical Affairs, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Mar;32(3):329-32.

Abstract

OBJECTIVE

To study the therapeutic state of acute myocardial infarction (AMI) inpatients in 26 level three class A Chinese medicine (CM) hospitals in China.

METHODS

The case report form (CRF) was designed and used in this study. Totally 1 094 AMI patients were recruited from 26 level three class A CM hospitals from January 2006 to December 2006. The onset, the heart function, complications, previous history, and CM syndrome types were observed in AMI patients. Treatment by Western medicine (WM), CM intravenous preparation, CM decoction, and Chinese patent medicine were also observed in AMI patients.

RESULTS

Blood stasis syndrome (854 cases, 78.06%) and stagnant phlegm syndrome (470 cases, 42.96%) were dominated in the CM sthenia syndrome. Qi deficiency syndrome (683 cases, 62.43%) and Xin-yin deficiency syndrome (231 cases, 21.12%) were dominated in the CM asthenia syndrome. Totally 355 patients (32.45%) received reperfusion. Of them, 224 (20.48%) received percutaneous coronary intervention (PCI). The top 5 often used Western drugs covered aspirin (1001 cases, 91.50%), low molecular heparin (917 cases, 83.82%), blood lipids regulators (833 cases, 76.14%), ACEI/ARB (822 cases, 75.14%), and nitrates (773 cases, 70.66%). Totally 946 patients (86.47%) used CM intravenous preparations. The CM intravenous preparations with the use frequency more than 5% were sequenced as Shenmai Injection (520 times, 54.97%), Salvia miltiorrhizae preparations (305 times, 32.24%), sanchi preparations (185 times, 19.56%), Shenfu Injection (68 times, 7.19%), Scutellarin Injection (64 times, 6.77%), and Acanthopanax Injection (29 times, 3.07%). Totally 575 patients (52.56%) used CM decoction. The main therapeutic methods covered activating blood circulation therapy (477 cases), qi benefiting therapy (332 cases), and phlegm resolving therapy (303 cases). Commonly used recipes covered Shengmai Powder, Taohong Siwu Decoction, Gualou Xiebai Baijiu Decoction, Erchen Decoction, and Sijunzi Decoction. Totally 394 patients (36.01%) used Chinese patent medicines.

CONCLUSIONS

Qi deficiency syndrome and blood stasis syndrome were dominated in AMI patients. Great achievements have taken place in AMI reperfusion treatment and standardized treatment in CM hospitals. CM are extensively used. Clinical studies on treating AMI by CM should be further strengthened.

摘要

目的

研究我国26家三级甲等中医医院急性心肌梗死(AMI)住院患者的治疗状况。

方法

本研究设计并使用了病例报告表(CRF)。2006年1月至2006年12月期间,从26家三级甲等中医医院招募了1094例AMI患者。观察了AMI患者的发病情况、心功能、并发症、既往史及中医证型。同时也观察了AMI患者接受西药、中药静脉制剂、中药汤剂及中成药的治疗情况。

结果

实证中血瘀证(854例,78.06%)和痰浊证(470例,42.96%)为主。虚证中气阴两虚证(683例,62.43%)和心阴亏虚证(231例,21.12%)为主。共有355例患者(32.45%)接受了再灌注治疗。其中,224例(20.48%)接受了经皮冠状动脉介入治疗(PCI)。常用的前5种西药包括阿司匹林(1001例,91.50%)、低分子肝素(917例,83.82%)、血脂调节剂(833例,76.14%)、ACEI/ARB(822例,75.14%)和硝酸盐类(773例,70.66%)。共有946例患者(86.47%)使用了中药静脉制剂。使用频率超过5%的中药静脉制剂依次为参麦注射液(520次,54.97%)、丹参制剂(305次,32.24%)、三七制剂(185次,19.56%)、参附注射液(68次,7.19%)、灯盏细辛注射液(64次,6.77%)和刺五加注射液(29次,3.07%)。共有575例患者(52.56%)使用了中药汤剂。主要治疗方法包括活血化瘀法(477例)、益气法(332例)和化痰法(303例)。常用方剂包括生脉散、桃红四物汤、瓜蒌薤白白酒汤、二陈汤和四君子汤。共有394例患者(36.01%)使用了中成药。

结论

AMI患者以气虚证和血瘀证为主。中医医院在AMI再灌注治疗和规范化治疗方面取得了很大成绩。中药得到广泛应用。应进一步加强中医治疗AMI的临床研究。

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