首部急性心梗中西医结合诊疗指南发布

2018-04-10 朱蕗鋆 中国中医

4月7日,2018中国医师协会心血管内科医师年会和中国南方国际心血管病学术会议中西医结合论坛(下称中西医结合论坛)在广州举行。论坛上,全国首部《急性心肌梗死中西医结合诊疗指南》正式发布,该指南由中国科学院院士陈可冀、葛均波和广东省中医院胸痛中心医疗总监张敏州教授牵头,联合国内众多中医、西医、中西医结合、标准化及方法学领域专家共同制订。

4月7日,2018中国医师协会心血管内科医师年会和中国南方国际心血管病学术会议中西医结合论坛(下称中西医结合论坛)在广州举行。论坛上,全国首部《急性心肌梗死中西医结合诊疗指南》正式发布,该指南由中国科学院院士陈可冀、葛均波和广东省中医院胸痛中心医疗总监张敏州教授牵头,联合国内众多中医、西医、中西医结合、标准化及方法学领域专家共同制订。

我国城乡居民总死亡原因中,因心血管疾病导致的死亡高居首位,其中,心肌梗死心血管疾病死亡的首要原因。张敏州表示,如何提高心梗患者救治的标准化和规范化问题一直是研究热点。此次指南制定的主要目的是基于循证医学原则推荐有临床循证证据支持或经专家共识形成的急性心肌梗死中西医结合治疗方法,主要针对急性心肌梗死及其并发症提供的预防诊断和治疗方面建议,供从事中医、西医及中西医结合工作的医师在临床实践中参考使用。

记者查阅指南了解到,急性心肌梗死治疗的关键是早期快速开通梗死相关冠状动脉,进行再灌注治疗,该指南将急性心肌梗死归属于中医学"胸痹"、“心痛”、“厥心痛”、“真心痛”等范畴,推荐以临床常见的复合症型分为气虚血瘀、痰瘀互结、气滞血瘀、寒凝心脉、气阴两虚及正虚阳脱症型进行辨证论治。

张敏州表示,急性心梗中西医结合诊疗其实已经有了成功范本。2011年,广东省中医院就牵头制定了急性心梗中西医结合临床路径,并开展了疗效评价研究,结果证明,中西医结合临床路径能规范中医诊疗行为,缩短住院时间、降低住院费用和主要心血管事件发生率,一定程度上体现了规范的中医药治疗有利于改善的预后。如今,广东省中医院通过了2018年第一批中国胸痛中心(标准版)的认证,标志着广东省中医急性心肌梗死等胸痛疾病综合诊疗水平已经与国家标准胸痛诊疗技术接轨。

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