1.山东中医药大学附属医院,山东省济南市历下区经十路16369号,250011
2.山东省潍坊市中医院
3.中国中医科学院广安门医院
通讯作者:gamyylj@163.com
收稿:2026-01-05,
修回:2026-04-27,
录用:2026-03-09,
纸质出版:2026-06-02
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杨春昆,朱勤伟,潘清泉等.心梗2号颗粒剂对ST段抬高型心肌梗死PCI术后气虚血瘀证患者左心室重构的影响——开放标签随机对照试验[J].中医杂志,2026,67(11):1178-1184.
YANG Chunkun,ZHU Qinwei,PAN Qingquan,et al.Effect of Xingeng No.Ⅱ Granules (心梗2号颗粒剂) on Left Ventricular Remodeling in Patients of ST-Segment Elevation Myocardial Infarction with Qi Deficiency and Blood Stasis Syndrome after PCI:An Open-Labbled Randomized-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(11):1178-1184.
杨春昆,朱勤伟,潘清泉等.心梗2号颗粒剂对ST段抬高型心肌梗死PCI术后气虚血瘀证患者左心室重构的影响——开放标签随机对照试验[J].中医杂志,2026,67(11):1178-1184. DOI: 10.13288/j.11-2166/r.2026.11.009.
YANG Chunkun,ZHU Qinwei,PAN Qingquan,et al.Effect of Xingeng No.Ⅱ Granules (心梗2号颗粒剂) on Left Ventricular Remodeling in Patients of ST-Segment Elevation Myocardial Infarction with Qi Deficiency and Blood Stasis Syndrome after PCI:An Open-Labbled Randomized-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(11):1178-1184. DOI: 10.13288/j.11-2166/r.2026.11.009.
目的
2
观察心梗2号颗粒剂防治ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术后气虚血瘀证患者左心室重构的有效性与安全性。
方法
2
采用随机对照试验方法,将经PCI术的STEMI气虚血瘀证患者按1∶1比例随机分为治疗组和对照组各66例。对照组术后仅接受西医常规治疗,治疗组术后在西医常规治疗基础上加服心梗2号颗粒剂,每次8g,每日2次,两组疗程均为8周。主要结局指标为术后6个月内左心室重构的发生率;次要结局指标包括6个月内主要心脑血管不良事件(MACCE)发生率、全因死亡率、支架血栓形成率、出血学术研究联合会(BARC)Ⅲ和V型出血事件发生率、因急性心力衰竭再住院率、STEMI严重并发症发生率;分别在术后1天及术后1、2、6个月时对患者进行中医证候评分。记录研究期间不良事件发生情况评价安全性。
结果
2
治疗组和对照组各脱落6例。全分析集分析显示,治疗组左心室重构发生率为16.67%(11/66),显著低于对照组的40.91%(27/66,
P
=0.004)。符合方案集分析显示,治疗组左心室重构发生率为20.37%(11/54),显著低于对照组的49.09%(27/55,
P
=0.002)。术后6个月内,治疗组因急性心力衰竭再入院率为0,对照组为6.67%(4/60),对照组显著高于治疗组(
P
=0.042)。两组患者均未出现再次心肌梗死、靶血管重建、支架内血栓形成及STEMI严重并发症。两组患者脑卒中发生率、心源性死亡率、全因死亡率、BARCⅢ和V型出血发生率比较,差异均无统计学意义(
P
>0.05)。术后1天,两组患者中医证候积分差异无统计学意义(
P
>0.05),在术后1个月、2个月和6个月,治疗组的中医证候积分显著均低于对照组(
P
<0.05)。安全数据集分析显示,治疗组不良事件发生率为7.41%(4/60),对照组为16.36%(9/57),两组患者不良事件发生率比较差异无统计学意义(
P
=0.117)。
结论
2
在西医常规治疗基础上,联合心梗2号颗粒剂可降低PCI术后STEMI气虚血瘀证患者左心室重构的发生率和因急性心力衰竭再入院率,且安全性较好。
Objective
2
To observe the effectiveness and safety of
Xingeng No.Ⅱ Granules
(心梗2号颗粒剂) in preventing and treating left ventricular remodeling in patients with
qi
deficiency and blood stasis syndrome following percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
Methods
2
In this randomized controlled trial, patients with
qi
deficiency and blood stasis syndrome after PCI for STEMI were randomly assigned to treatment group and control group at a 1∶1 ratio, with 66 patients in each group. In the control group, patients only received conventional western medicine after surgery, while the treatment group additionally received the granules (8 g per dose, twice daily), for a treatment duration of 8 weeks in both groups. The primary outcome was the incidence of left ventricular remodeling within 6 months after surgery. The secondary outcomes were the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 6 months, all-cause mortality, stent thrombosis, BARC Ⅲ and V bleeding events, rehospitalization due to acute heart failure, and severe complications of STEMI. Traditional Chinese medicine (TCM) syndrome scores at 1 day and 1, 2, and 6 months after surgery was evaluated. Adverse events during the study were recorded to evaluate safety.
Results
2
Six cases dropped out from both the treatment group and the control group. The full analysis set (FAS) analysis showed that the incidence of left ventricular remodeling in the treatment group was 16.67% (11/66), significantly lower than 40.91% (27/66) in the control group (
P
=0.004). The per protocol set (PPS) analysis also showed lower incidence of left ventricular remodeling in the treatment group (20.37%, 11/54) than in the control group (49.09%, 27/55) with significant differe
nce (
P
=0.002). Within 6 month after surgery, 0 patients in the treatment group and 4 out of 60 patients (6.67%) in the control group were readmitted to hospital for acute heart failure, with significantly higher rate in the control group (
P
=0.042). Neither group of patients experienced recurrent myocardial infarction, target vessel revascularization, in-stent thrombosis, or severe complications of STEMI. There was no statistically significant difference between groups in the incidence of stroke, cardiovascular mortality, all-cause mortality, BARC Ⅲ and V bleeding events (
P
>0.05). At 1 day after surgery, there was no statistically significant difference in TCM syndrome score between the groups (
P
>0.05); while 1, 2 and 6 months after surgery, TCM syndrome score in the treatment group was significantly lower than that in the control group (
P
<0.05). Analysis of the safety dataset (SS) showed that the incidence of adverse events in the treatment group was 7.41% (4/60), while in the control group it was 16.36% (9/57), showing no statistically significant difference (
P
= 0.117).
Conclusion
2
In addition to conventional western medicine,
Xingeng No.Ⅱ Granules
can reduce the incidence of left ventricular remodeling and the incidence of rehospitalization due to acute heart failure in STEMI patients with
qi
deficiency and blood stasis syndrome after PCI, with good safety profile.
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