目的:研究宣痹通脉汤联合美托洛尔对急性心肌梗死(AMI)后早期心室重构和心脏功能的影响。方法:纳入本院96例AMI患者随机分组,48例给予美托洛尔治疗者归为对照组,48例给予宣痹通脉汤+美托洛尔治疗者归为治疗组,治疗4周。比较两组疗效,治疗前后中医证候积分、左心室参数、心功能、心肌钙蛋白(c TnⅠ)和氨基前端脑钠肽(Nt-pro BNP)变化。结果:治疗组治疗总有效率91.67%,对照组75%,差异具有统计学意义(P<0.05);治疗后,两组胸痛、胸闷、心悸、眩晕、乏力、气短积分均显著降低,左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)显著上升,左心室舒张末内径(LVEDD)显著下降,每搏输出量(SV)、心脏指数(CI)显著提升,心功能显著提升,且治疗组提升或降低幅度大于对照组,差异具有统计学意义(P<0.05);治疗后,两组c TnⅠ和Nt-pro BNP水平显著下降,且治疗组下降幅度大于对照组,差异具有统计学意义(P<0.05)。结论:宣痹通脉汤联合美托洛尔可显著改善AMI患者临床证候表现,改善早期心室重构和提升心功能,减小心肌梗死面积,疗效显著,值得临床推广。 Objective: To study the effect of Xuanbi Tongmai Decoction combined with metoprolol on early ventricular remodeling and cardiac function after acute myocardial infarction (AMI). Methods: A total of 96 patients with AMI admitted to our hospital were randomly divided into two groups: 48 patients were treated with Metoprolol, and 48 patients treated with Xuanbi Tongmai + Metoprolol were assigned to treatment group for 4 weeks. The curative effect, TCM syndrome score, left ventricular parameter, cardiac function, cardiac troponin (cTnⅠ) and Nt-pro BNP before and after treatment were compared. Results: The total effective rate was 91.67% in the treatment group and 75% in the control group, the difference was statistically significant (P <0.05); after treatment, the chest pain, chest tightness, palpitations, dizziness, (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular end diastolic diameter (LVEDD), stroke volume (SV), cardiac index (P <0.05). After treatment, the levels of cTnI and Nt-pro BNP in both groups decreased significantly, and the levels of cTnI and Nt-pro BNP in both groups were significantly decreased The decrease was greater than the control group, the difference was statistically significant (P <0.05). Conclusion: Xuanbi Tongmai Decoction combined with metoprolol can significantly improve the clinical manifestations of patients with AMI, improve early ventricular remodeling and improve cardiac function, reduce myocardial infarction area, significant effect, worthy of clinical promotion.