摘要
目的:观察麝香保心丸辅助治疗对冠心病(CHD)急性心肌梗死(AMI)患者心功能的影响及其黏附分子层面作用机制。方法:将88例患者随机分为观察组、对照组各44例。对照组予以AMI常规西医治疗,观察组在对照组基础上加用麝香保心丸治疗,疗程4周。比较2组治疗前后中医临床证候评分、心功能相关指标、血清细胞间黏附分子1(ICAM-1)、血管细胞黏附分子1(VCAM-1)水平及不良事件(MACE)发生率。结果:总有效率观察组为88.64%,对照组为72.73%,2组比较差异有统计学意义(P<0.05)。中医证候积分治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较,差异也有统计学意义(P<0.05)。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)治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较,差异也有统计学意义(P<0.05)。肌酸激酶同工酶(CK-MB)、脑钠肽(c TnⅠ)及肌红蛋白I(BNP)水平治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较,差异也有统计学意义(P<0.05)。血清ICAM-1、VCAM-1水平治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较,差异也有统计学意义(P<0.05)。随访3个月,MACE发生率观察组为4.55%,对照组为15.91%,2组比较差异有统计学意义(P<0.05)。结论:麝香保心丸辅助治疗CHD后AMI疗效确切,其作用机制可能是下调血清ICAM-1、VCAM-1而抑制炎性反应所致心肌损伤,改善心功能。
Objective: To survey the effects of She Xiang Bao Xin pills as adjunctive therapy(AT) on heart function of the patients with acute myocardial infarction(AMI) of coronary heart disease(CHD) and the mechanism in adhesion molecule layer. Methods: All 88 patients were randomized into the observation group and the control group equally. The control group accepted AMI conventional therapy of western medicine, and the observation group took She Xiang Bao Xin pills on the foundation of the treatment the control group received, the course was four weeks. The incidence of major adverse cardiac events(MACE), the levels of serum intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1), the related indexes of heart function, and TCM clinical syndrome scales of both groups were compared before and after treating. Results: Total effective rate of the observation group was 88.64%, higher than 72.73% of the control group, and the difference had statistical meaning(P<0.05). The difference was statistically significant in the comparisons of TCM syndrome scales before and after treating within two groups(P<0.05), there was a significant difference in the comparison between both groups after treating(P<0.05). The difference was statistically significant in the comparisons of LVEF, LVEDV and LVESV within two groups before and after treating(P<0.05), there was a significant difference in the comparison between both groups after treating(P<0.05). The difference wasstatistically significant in the comparisons of the levels of CK-MB, c Tn Ⅰ and BNP before and after treating within two groups(P<0.05), there was significant difference in the comparisons between both groups after treating(P<0.05). The difference was a statistically significant in the comparisons of the levels of ICAM-1 and VCAM-1 before and after treating within two groups(P<0.05), there was a significant difference in the comparisons between both groups after treating(P<0.05). After following up for three months, the incidence of MACE in the observation group was 4.55%, lower than 15.91% of the control group, and there was significant difference between both groups(P<0.05).Conclusion: She Xiang Bao Xin pills as AT for AMI of CHD could obtain definite effects, and its mechanism might be related to myocardial damage induced by inhibiting inflammatory reaction through down regulation the levels of ICAM-1 and VCAM-1, as well as to improve heart function.
出处
《西部中医药》
2017年第12期61-64,共4页
Western Journal of Traditional Chinese Medicine
关键词
心肌梗死
急性
冠心病
麝香保心丸
心功能
黏附分子
myocardial infarction
acute
coronary heart disease
SheXiang BaoXin pills
heart function
adhesion molecule
