益气活血通络法治疗急性心肌梗死介入术后患者43例
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摘要
目的:观察益气活血通络法对急性心肌梗死介入术后患者中医证候积分、炎症因子和内皮功能的影响。方法:将86例患者随机分为观察组、对照组各43例,对照组采用参麦注射液和替罗非班注射液治疗,观察组在对照组的基础上给予益气活血通络方口服治疗,术后14天观察临床疗效和症状积分,测定血清白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)炎性因子水平,彩色多普勒超声测检测肱动脉内径。结果:总有效率观察组为86.05%,对照组为65.12%,2组比较差异有统计学意义(P<0.05)。腹痛、恶心呕吐、腹胀、嗳气等症状积分,血清IL-6、IL-8、TNF-α等炎症因子,以及肱动脉内皮依赖性舒张功能(FMD)治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后组间比较,差异也有统计学意义(P<0.05)。结论:在参麦注射液、替罗非班注射液治疗的基础上采用益气活血通络法治疗急性心肌梗死介入术后患者,可提高临床疗效,降低证候积分,减轻炎症反应,增强内皮功能。
Objective: To observe the effects of YiQi HuoXue TongLuo method on TCM syndrome integral, inflammatory factor and endothelial function of the patients with acute myocardial infarction after the intervention.Methods: Eighty-six patients were randomized into the observation group and the control group, 43 cases each group, the control group adopted Shen Mai injection and trofiban injection, the observation group orally took YiQi HuoXue TongLuo recipe, clinical effects and TCM syndrome integral were observed in 14 days after the operation,the levels of IL-6, IL-8 and TNF-α were detected, internal diameter of brachial artery was detected by color Doppler ultrasound. Results: Total effective rate of the observation group was 86.05%, higher than 65.12% of the control group, and the difference had statistical meaning(P <0.05). The difference showed statistical meaning in the comparisons of the integrals of the syndromes such as abdominal pain, nausea and vomiting, abdominal distension,belching and others, inflammatory factors including IL-6, IL-8 and TNF-α, and FMD between before and after treating within two groups(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05). Conclusion: On the foundation of Shen Mai injection and trofiban injection, YiQi HuoXue TongLuo method applied to the patients with acute myocardial infarction after the intervention could raise clinical effects, decrease syndrome integrals, alleviate the inflammation and enhance endothelial function.
Objective: To observe the effects of YiQi HuoXue TongLuo method on TCM syndrome integral, inflammatory factor and endothelial function of the patients with acute myocardial infarction after the intervention.Methods: Eighty-six patients were randomized into the observation group and the control group, 43 cases each group, the control group adopted Shen Mai injection and trofiban injection, the observation group orally took YiQi HuoXue TongLuo recipe, clinical effects and TCM syndrome integral were observed in 14 days after the operation,the levels of IL-6, IL-8 and TNF-α were detected, internal diameter of brachial artery was detected by color Doppler ultrasound. Results: Total effective rate of the observation group was 86.05%, higher than 65.12% of the control group, and the difference had statistical meaning(P <0.05). The difference showed statistical meaning in the comparisons of the integrals of the syndromes such as abdominal pain, nausea and vomiting, abdominal distension,belching and others, inflammatory factors including IL-6, IL-8 and TNF-α, and FMD between before and after treating within two groups(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05). Conclusion: On the foundation of Shen Mai injection and trofiban injection, YiQi HuoXue TongLuo method applied to the patients with acute myocardial infarction after the intervention could raise clinical effects, decrease syndrome integrals, alleviate the inflammation and enhance endothelial function.
引文
[1]杨晓正,郑轶,郭三强,等.冠状动脉内注射参麦注射液联合西药治疗急性心肌梗死介入术后冠状动脉无复流30例临床观察[J].中医杂志,2014,55(10):854-857.
[2]Sanjuan R,Blasco ML,Martincz-Maicas H,et al.Acute myocardial infarction:high risk ventricular tachyarrhythmias and admission glucose level in patients with and without diabetes mellitus[J].Curr Diabetes Rev,2011,7(2):126-134.
[3]张晓华,董巍,王丽娅,等.心脉隆注射液对急性心肌梗死介入术后心力衰竭患者的疗效观[J].中国全科医学,2013,16(2):205-207.
[4]王玲玲,唐银辉,罗伶俐.急性心肌梗死介入术后无复流患者血清ADAMTS-13和hs-CRP水平的变化[J].中国老年学杂志,2015,35(3):610-612.
[5]中华医学会心血管病学分会,中华心血管病杂志编辑委员会,《中国循环杂志》编辑委员会,等.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:72.
[7]蒋翎.急性心肌梗死介入术后发生心肌缺血/再灌注损伤的危险因素分析[J].医学综述,2012,18(18):3134-3136.
[8]黄斌.通心络胶囊对急性心肌梗死介入术后炎性反应和血管内皮功能的影响[C].北京:2011中国医师协会中西医结合医师大会论文集,2011:1-6.
[9]马先林,乔瑞省.冠脉注射负荷量盐酸替罗非班对急性心肌梗死患者心肌血液灌注和心功能的影响[J].山东医药,2015,59(29):64-66.
[10]卢健棋,何贵新,潘朝锌,等.安心颗粒联合替罗非班对急性心肌梗死介入术后心肌微循环的影响[J].广州中医药大学学报,2013,30(6):792-795.
[11]邹治国,刘和俊,周碧蓉,等.急性心梗患者介入前后血清炎性细胞因子水平变化与早期预后关系[J].安徽医科大学学报,2015,50(11):1665-1669.
[12]路妍.瑞舒伐他汀对急性心肌梗死患者行择期PCI术后血脂、血液流变学指标及血管内皮功能的影响[J].河北医药,2015,44(24):3710-3712.
[13]孙秀玲.黄芪药理作用机制的研究进展[J].中国处方药,2015,14(6):29-30.
[14]刘海波,徐峻,彭勇,等.丹参活血化瘀活性成分的靶标[J].物理化学学报,2010,26(1):199-205.
[15]刘斌峰.丹参川芎嗪注射液联合高压氧治疗肝硬化合并急性心肌梗死的效果[J].中国当代医药,2015,22(20):150-152.
[16]陈少兰.中西医结合护理对急性心肌梗死患者康复效果的影响[J].西部中医药,2014,27(4):129-131.
[17]张艳.自拟益气通脉汤辅助预防心肌梗死后心室重构效果观察[J].西部中医药,2014,27(9):106-108.
[18]陈翔,陈少华,苏大理,等.尿激酶溶栓治疗急性心肌梗死[J].中国当代医药,2012,19(15):22-23.
[19]郝朝艳.基层医院急性心肌梗死的非手术治疗体会[J].中国当代医药,2011,18(4):140-141.
[2]Sanjuan R,Blasco ML,Martincz-Maicas H,et al.Acute myocardial infarction:high risk ventricular tachyarrhythmias and admission glucose level in patients with and without diabetes mellitus[J].Curr Diabetes Rev,2011,7(2):126-134.
[3]张晓华,董巍,王丽娅,等.心脉隆注射液对急性心肌梗死介入术后心力衰竭患者的疗效观[J].中国全科医学,2013,16(2):205-207.
[4]王玲玲,唐银辉,罗伶俐.急性心肌梗死介入术后无复流患者血清ADAMTS-13和hs-CRP水平的变化[J].中国老年学杂志,2015,35(3):610-612.
[5]中华医学会心血管病学分会,中华心血管病杂志编辑委员会,《中国循环杂志》编辑委员会,等.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:72.
[7]蒋翎.急性心肌梗死介入术后发生心肌缺血/再灌注损伤的危险因素分析[J].医学综述,2012,18(18):3134-3136.
[8]黄斌.通心络胶囊对急性心肌梗死介入术后炎性反应和血管内皮功能的影响[C].北京:2011中国医师协会中西医结合医师大会论文集,2011:1-6.
[9]马先林,乔瑞省.冠脉注射负荷量盐酸替罗非班对急性心肌梗死患者心肌血液灌注和心功能的影响[J].山东医药,2015,59(29):64-66.
[10]卢健棋,何贵新,潘朝锌,等.安心颗粒联合替罗非班对急性心肌梗死介入术后心肌微循环的影响[J].广州中医药大学学报,2013,30(6):792-795.
[11]邹治国,刘和俊,周碧蓉,等.急性心梗患者介入前后血清炎性细胞因子水平变化与早期预后关系[J].安徽医科大学学报,2015,50(11):1665-1669.
[12]路妍.瑞舒伐他汀对急性心肌梗死患者行择期PCI术后血脂、血液流变学指标及血管内皮功能的影响[J].河北医药,2015,44(24):3710-3712.
[13]孙秀玲.黄芪药理作用机制的研究进展[J].中国处方药,2015,14(6):29-30.
[14]刘海波,徐峻,彭勇,等.丹参活血化瘀活性成分的靶标[J].物理化学学报,2010,26(1):199-205.
[15]刘斌峰.丹参川芎嗪注射液联合高压氧治疗肝硬化合并急性心肌梗死的效果[J].中国当代医药,2015,22(20):150-152.
[16]陈少兰.中西医结合护理对急性心肌梗死患者康复效果的影响[J].西部中医药,2014,27(4):129-131.
[17]张艳.自拟益气通脉汤辅助预防心肌梗死后心室重构效果观察[J].西部中医药,2014,27(9):106-108.
[18]陈翔,陈少华,苏大理,等.尿激酶溶栓治疗急性心肌梗死[J].中国当代医药,2012,19(15):22-23.
[19]郝朝艳.基层医院急性心肌梗死的非手术治疗体会[J].中国当代医药,2011,18(4):140-141.