加味丹参饮对老年轻、中度高血压伴心肌梗死患者心肌功能的保护作用观察
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摘要
目的观察加味丹参饮对老年轻、中度高血压伴心肌梗死患者心肌功能的保护作用。方法选取80例高血压伴心肌梗死的老年患者,按随机数字表法分为观察组与对照组各40例。对照组患者予以酒石酸美托洛尔片、贝那普利氢氯噻嗪片、缬沙坦片、辛伐他汀胶囊、阿司匹林肠溶片进行治疗;观察组在对照组基础上联合加味丹参饮进行治疗,两组均治疗6个月。比较两组治疗前后的左心室射血分数(LVEF)、左室壁运动指数(WMSI)、血浆脑钠钛(BNP)水平,治疗前、治疗3个月、治疗6个月的心肌梗死面积,治疗期间心肌不良事件发生情况与不良反应总发生率。结果两组治疗后的LVEF较治疗前均显著升高、WMSI与血清BNP水平较治疗前均显著降低(P<0.05)。观察组治疗后的LVEF显著高于对照组、WMSI与血清BNP水平显著低于对照组(P<0.05)。两组治疗3个月及6个月的心肌梗死面积较治疗前均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。观察组心肌不良事件发生率为2.5%,显著低于对照组20.0%(P<0.05)。观察组与对照组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论加味丹参饮治疗老年轻、中度高血压伴心肌梗死患者可有效缩小心肌梗死范围,保护心肌功能,减少心肌不良事件的发生,且安全可靠,值得推广。
Objective To observe the protective effect of Modified Danshen decoction on myocardial function in elderly patients with mild to moderate hypertensive myocardial infarction. Methods A total of 80 cases of elderly hypertensive patients with myocardial infarction were selected and randomly divided into observation group and control group with 40 cases in each group. Patients in the control group were treated with metoprolol tartrate tablets, benazepril hydrochlorothiazide tablets,valsartan tablets, simvastatin capsules and aspirin enteric-coated tablets. The observation group was administrated with modified Danshen decoction on the basis of control group. The treatment course was for 6 months. The left ventricular ejection fraction(LVEF), left ventricular wall motion index(WMSI) and plasma brain natriuretic peptide(BNP) levels before and after treatment, the infarct size at before treatment, after treatment for 3 months and 6 months, the adverse cardiac events and the incidence of adverse events during the treatment were compared between the two groups. Results The LVEF of both groups increased significantly after treatment than before treatment, and WMSI and serum BNP levels were significantly lower than before treatment(P<0.05). The LVEF in the observation group was significantly higher than that in the control group, and the levels of WMSI and serum BNP were significantly lower than those in the control group(P<0.05). The infarct size at treatment for 3 months and 6 months in bot h groups was significantly lower than that before treatment(P <0.05). The infarct size in observation group at 3 months and 6 months which were significantly lower than the control group. The incidence of myocardial adverse events in the observation group was 2.5%, which was significantly lower than 20.0% in the control group(P <0.05).The total incidence of adverse reactions in observation group and control group were statistically significant(P >0.05).Conclusion The modified Danshen decoction shows a safe and reliable effect in treatment of elderly patients with mild to moderate hypertensive myocardial infarction, which could effectively reduce myocardial infarction, myocardial function,reduce myocardial adverse events, worthy of promoting.
Objective To observe the protective effect of Modified Danshen decoction on myocardial function in elderly patients with mild to moderate hypertensive myocardial infarction. Methods A total of 80 cases of elderly hypertensive patients with myocardial infarction were selected and randomly divided into observation group and control group with 40 cases in each group. Patients in the control group were treated with metoprolol tartrate tablets, benazepril hydrochlorothiazide tablets,valsartan tablets, simvastatin capsules and aspirin enteric-coated tablets. The observation group was administrated with modified Danshen decoction on the basis of control group. The treatment course was for 6 months. The left ventricular ejection fraction(LVEF), left ventricular wall motion index(WMSI) and plasma brain natriuretic peptide(BNP) levels before and after treatment, the infarct size at before treatment, after treatment for 3 months and 6 months, the adverse cardiac events and the incidence of adverse events during the treatment were compared between the two groups. Results The LVEF of both groups increased significantly after treatment than before treatment, and WMSI and serum BNP levels were significantly lower than before treatment(P<0.05). The LVEF in the observation group was significantly higher than that in the control group, and the levels of WMSI and serum BNP were significantly lower than those in the control group(P<0.05). The infarct size at treatment for 3 months and 6 months in bot h groups was significantly lower than that before treatment(P <0.05). The infarct size in observation group at 3 months and 6 months which were significantly lower than the control group. The incidence of myocardial adverse events in the observation group was 2.5%, which was significantly lower than 20.0% in the control group(P <0.05).The total incidence of adverse reactions in observation group and control group were statistically significant(P >0.05).Conclusion The modified Danshen decoction shows a safe and reliable effect in treatment of elderly patients with mild to moderate hypertensive myocardial infarction, which could effectively reduce myocardial infarction, myocardial function,reduce myocardial adverse events, worthy of promoting.
引文
[1]黄丽娜.急性心肌梗死合并高血压患者的临床特征分析[J].实用心脑肺血管病杂志,2016,24(4):135-136.
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[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
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[8]高学东.血浆BNP,hs-CRP,hs-c Tn T水平与老年急性心肌梗死患者预后相关性分析[J].中国老年保健医学,2017,15(2):21-22.
[9]陈聪,任婷,胡华,等.加味丹参饮预处理对大鼠心肌缺血再灌注损伤的保护作用[J].湖南中医药大学学报,2016,36(6):11-15.
[10]葛俊芳,韩甫.加味丹参饮治疗老年麻醉患者急性心肌缺血35例[J].河南中医,2016,36(9):1531-1533.
[11]李鑫辉,黄政德,葛金文,等.加味丹参饮对血瘀证兔心肌缺血再灌注损伤的影响[J].中国中医药信息杂志,2011,18(6):37-39.
[12]韩析言.加味丹参饮体外诱导骨髓间充质干细胞向心肌样细胞分化的实验研究[J].中国比较医学杂志,2016,26(11):43-48,5.
[13]任婷,杨胜辉,饶春梅,等.加味丹参饮预处理调节ODC活性抗大鼠心肌缺血再灌注损伤研究[J].湖南中医药大学学报,2017,37(1):13-17.
[14]田玉,王欣,祁登叶,等.自拟中药益心饮方联合溶栓治疗急性心肌梗死临床观察[J].中国中医急症,2016,25(6):1182-1184.
[15]金香兰.加昧丹参饮联合西药治疗冠心病心绞痛心血瘀阻证35例疗效分析[J].中国实用医药,2016,11(25):181-183.
[16]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[2]李海明,段淼,陈念,等.高血压家族史对隐形高血压发病及心脏损害的影响[J].中国循环杂志,2016,31(7):654-658.
[3]乔松彦.益气化瘀汤对急性心肌梗死再灌注后心肌微血管保护作用观察[J].实用医药杂志,2017,33(10):1126-1127.
[4]蒋磊,范金茹,陈彤,等.心痛方治疗急性心肌梗死痰瘀互结气郁证的临床疗效及对MPO的影响[J].湖南中医大学学报,2015,35(7):34-37.
[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
[6]潘柏申.心肌梗死诊断标准的修订和心肌生化标志物[J].中华医学杂志,2001,87(7):444-446.
[7]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:39-40.
[8]高学东.血浆BNP,hs-CRP,hs-c Tn T水平与老年急性心肌梗死患者预后相关性分析[J].中国老年保健医学,2017,15(2):21-22.
[9]陈聪,任婷,胡华,等.加味丹参饮预处理对大鼠心肌缺血再灌注损伤的保护作用[J].湖南中医药大学学报,2016,36(6):11-15.
[10]葛俊芳,韩甫.加味丹参饮治疗老年麻醉患者急性心肌缺血35例[J].河南中医,2016,36(9):1531-1533.
[11]李鑫辉,黄政德,葛金文,等.加味丹参饮对血瘀证兔心肌缺血再灌注损伤的影响[J].中国中医药信息杂志,2011,18(6):37-39.
[12]韩析言.加味丹参饮体外诱导骨髓间充质干细胞向心肌样细胞分化的实验研究[J].中国比较医学杂志,2016,26(11):43-48,5.
[13]任婷,杨胜辉,饶春梅,等.加味丹参饮预处理调节ODC活性抗大鼠心肌缺血再灌注损伤研究[J].湖南中医药大学学报,2017,37(1):13-17.
[14]田玉,王欣,祁登叶,等.自拟中药益心饮方联合溶栓治疗急性心肌梗死临床观察[J].中国中医急症,2016,25(6):1182-1184.
[15]金香兰.加昧丹参饮联合西药治疗冠心病心绞痛心血瘀阻证35例疗效分析[J].中国实用医药,2016,11(25):181-183.
[16]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.