Objective To evaluate the clinical efficacy and safety of Compound Danshen Dripping Pills combined with Tirofiban in alleviating myocardial ischemia-reperfusion injury(MIRI)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Ninety-two patients with acute STEMI of qi stagnation and blood stasis syndrome who were admitted to the Chest Pain Center of Shunde Hospital,Guangzhou University of Chinese Medicine between March 2023 and October 2023 were equally randomized into a control group and a treatment group using a random number table,with 46 cases in each group.The control group received intracoronary loading dose of Tirofiban during PCI combined with postoperative intravenous micro-pump injection of Tirofiban,while the trial group additionally received Compound Danshen Dripping Pills orally,the treatment course lasted for 4 weeks.Before treatment or immediately after surgery and after 4 weeks of treatment,the two groups were observed in the changes in traditional Chinese medicine(TCM)syndrome scores,cardiac function parameters[including left ventricular ejection fraction(LVEF),cardiac output(CO),and left ventricular end-diastolic diameter(LVEDD)],and levels of inflammatory markers of C-reactive protein(CRP)and brain natriuretic peptide(BNP),as well as safety indicators such as liver and kidney function and coagulation parameters in both groups.The peak values of myocardial necrosis markers of creatine kinase-MB(CK-MB)and troponin I(cTnI)and other myocardial enzyme profiles between the two groups were compared.After treatment,the TCM syndrome efficacy of improvement,the therapeutic effect on improving ST-segment resolution(STR)of electrocardiogram,and the incidence of adverse cardiovascular events in both groups were assessed.Results(1)There were 3 patients dropping out during the trial,with a final total of 89 cases included in the efficacy analysis(44 cases in the control group and 45 cases in the trial group).(2)After 4 weeks of treatment,the total effective rate in the trial group was 95.56%(43/45)and that in the control group was 79.55%(35/44).Intergroup comparison by chi-square test showed that TCM syndrome efficacy in the trial group was significantly superior to that in the control group(P＜0.05).(3)After 4 weeks of treatment,the total effective rate for improving STR in the trial group was 93.33%(42/45)and that in the control group was 75.00%(33/44).Intergroup comparison(tested by chi-square test)demonstrated that the trial group had significantly stronger STR improvement efficacy than the control group(P＜0.05).(4)After 4 weeks of treatment,the serum levels of CRP and BNP in both groups were lower than those immediately after surgery(P＜0.05),and the trial group exhibited significantly greater reductions in both CRP and BNP levels than the control group(P＜0.01).(5)The peak values of myocardial necrosis markers of CK-MB and cTnI in the trial group were significantly lower than those in the control group,with statistically significant differences(P＜0.05).(6)After 4 weeks of treatment,the trial group showed significant improvements in LVEF and CO compared to immediate postoperative values(P＜0.05),while LVEDD demonstrated an improving trend without statistical significance(P＞0.05).The control group showed no significant improvements in LVEF,CO,or LVEDD(P＞0.05).The intergroup comparison revealed that the trial group had significantly better improvements in LVEF and CO than the control group(P＜0.05 or P＜0.01).(7)After 4 weeks of treatment,both groups showed reductions in the scores of chest pain,chest tightness,palpitations,emotional depression,hypochondriac distension,and dull complexion,as well as the total syndrome scores when compared to pretreatment values(P＜0.05),and the trial group presented significantly greater reductions than the control group(P＜0.05).(8)No statistically significant differences were shown in the parameters of liver/kidney function or coagulation between the two groups before and after treatment(P＞0.05).(9)The incidence of postoperative adverse cardiovascular events in the control group was 13.64%(6/44)and that in the trial group was 6.67%(3/45),and the intergroup comparison(tested by Fisher's exact test)showed no statistically significant difference(P＞0.05).Conclusion The combination therapy of Compound Danshen Dripping Pills and Tirofiban demonstrates significant efficacy in improving TCM syndromes,ST-segment elevation,myocardial necrosis markers,and cardiac function in STEMI patients after PCI,with good safety.