中药分期论治主动脉夹层的疗效观察
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摘要
目的观察镇肝息风汤和血府逐瘀汤治疗主动脉夹层的疗效。方法将确诊为主动脉夹层需保守治疗的患者86例,随机分为对照组和中药组。对照组给予西医常规治疗主动脉夹层的方法,中药组在对照组基础上,在急性期和亚急性期加服中汤药镇肝息风汤,慢性期加服血府逐瘀汤,疗程为6个月。治疗前后分别用酶联免疫吸附法检测病人血浆基质金属蛋白酶-2(MMP-2)含量,用主动脉多层螺旋CT血管成像(CTA)检测病人主动脉最大内径和假腔的最大内径。结果治疗后,中药组血浆MMP-2含量低于对照组,中药组主动脉最大内径和假腔最大内径均小于对照组,差异具有统计学意义(P<0.05)。结论在西医常规治疗的基础上,中汤药治疗主动脉夹层,能够增加疗效,改善预后。
Objectives To study the effect of traditional Chinese med icine prescription of Zhengan Xifeng decoction and Xuefu Zhuyu decoction on aortic dissection(AD). Methods 86 patients of AD were randomly divided into control group and traditional Chinese medicine group. The patients in control group were given conservative treatment to cure AD. The patients in traditional Chinese medicine group were treated with additional traditional Chinese medicine prescription of Zhengan Xifeng decoction in acute period and subacute stage, and Xuefu Zhuyu decoction in chronic period respectively. Enzyme linked immunosorbent assay(ELISa)method was used to test the levels of plasma metalloproteinases-2(MMP-2) before and after treatment. The maximum diameter of aorta and maximum fake cavity were detected by multi-slice spiral CT angiography(CTA). Results After treatment, the levels of MMP-2 of traditional Chinese medicine group were lower than that of control group. The aorta maximum diameter and maximum fake cavity of traditional Chinese medicine group were smaller than that of the control group( P <0.05). There were evident differences between the two groups. Conclusion Traditional Chinese medicine of Zhengan Xifeng decoction and Xuefu Zhuyu decoction can effectively inhibit AD.
Objectives To study the effect of traditional Chinese med icine prescription of Zhengan Xifeng decoction and Xuefu Zhuyu decoction on aortic dissection(AD). Methods 86 patients of AD were randomly divided into control group and traditional Chinese medicine group. The patients in control group were given conservative treatment to cure AD. The patients in traditional Chinese medicine group were treated with additional traditional Chinese medicine prescription of Zhengan Xifeng decoction in acute period and subacute stage, and Xuefu Zhuyu decoction in chronic period respectively. Enzyme linked immunosorbent assay(ELISa)method was used to test the levels of plasma metalloproteinases-2(MMP-2) before and after treatment. The maximum diameter of aorta and maximum fake cavity were detected by multi-slice spiral CT angiography(CTA). Results After treatment, the levels of MMP-2 of traditional Chinese medicine group were lower than that of control group. The aorta maximum diameter and maximum fake cavity of traditional Chinese medicine group were smaller than that of the control group( P <0.05). There were evident differences between the two groups. Conclusion Traditional Chinese medicine of Zhengan Xifeng decoction and Xuefu Zhuyu decoction can effectively inhibit AD.
引文
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[11]朱海燕.血府逐瘀汤治疗慢性盆腔炎疗效观察[J].实用中医学杂志,2010,26(4):223.
[12]王冬梅,叶品良,李贞翠.血府逐瘀汤的临床应用进展[J].中国保健营养,2013,3(3):126-128.
[2] Flanagan L,Bancroft R,Rittoo D. The value of d-dimer in the diagnosis of acute aortic dissection. Int J Cardiol,2007,11(8):e70-71.
[3] Miyahara S,Mukohara N,Fukuzumi M,et al. Long-term follow-up of acute type B aortic dissection:ulcer-like projections in thrombosed false lumen play a role in late aortic events[J]. J Thorac Cardiovasc Surg,2011,142(2):e25-e31.
[4]王燕妮,卿希亮,许锁春.主动脉夹层140例临床分析[J].临床急诊杂志,2010,11(2):78-80.
[5] Shiga T,Wajima Z,Apfel C C,et al. Diagnostic accuracy of transesophageal echocardiography,helical computed tomography,and magnetic resonance imaging for suspected thoracic aortic dissection:systematic review and meta-anal-ysis[J]. Arch Intern Med,2006,166(13):1350-1356.
[6] WANG L,ZHANG J,FU W,et al. Association of smooth musclecell phenotypes with extracellular matrix disorders in thoracic aortic dissection[J].J Vasc Surg,2012,56(6):1698-1709.
[7] ZHANG X,SHEN YH,LEMAIRE S A.Thoracic aortic dissection:are matrix metal loproteinsaes involved?[J].Vascular,2009,17(3):147-157.
[8] LUCIANO F,BORGES P,ZIAD T P,et al. Tissue diffusion and retention of metalloproteinases in ascending aortic aneurysms and dissections[J].Hum Pathol,2009,40(3):306-313.
[9] DARRELL W,Ying HS,Ludivine R,et al. Molecular mechanic dissection[J]. J Surg Res,2013,184(2):907-924.
[10]赵兴梅,徐光忠,李建利,等.川牛膝和怀牛膝的现代药理研究概况[J].华西药学杂志,2004,19(3):205-207.
[11]朱海燕.血府逐瘀汤治疗慢性盆腔炎疗效观察[J].实用中医学杂志,2010,26(4):223.
[12]王冬梅,叶品良,李贞翠.血府逐瘀汤的临床应用进展[J].中国保健营养,2013,3(3):126-128.