摘要
目的观察麝香通心滴丸联合尼可地尔片治疗PCI术后心肌缺血再灌注损伤的临床效果。方法选择2020年4月—2022年4月山东中医药大学附属医院心血管病二科诊治PCI术后心肌缺血再灌注损伤患者86例,根据随机数字表法分为对照组与观察组各43例。对照组患者在常规治疗基础上给予尼可地尔片治疗,观察组在对照组基础上给予麝香通心滴丸治疗,观察2组的临床疗效,治疗前后中医证候评分(胸痛胸闷、心悸汗出、气短乏力、食欲下降),血管内皮功能[血清活性氧簇(ROS)、内皮素⁃1(ET⁃1)、一氧化氮(NO)],心脏超声指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)],心肌缺血再灌注指标[TIMI分级3级、TIMI帧数计数(CTFC)、心肌显影密度分级(MBG)3级情况],记录主要心血管不良事件(MACE)。结果治疗1个月后观察组总有效率显著高于对照组(93.02%vs.74.42%,χ^(2)/P=7.196/0.027);2组中医证候评分均较治疗前降低,且观察组低于对照组(t/P=2.612/0.011、2.906/0.005、2.522/0.014、7.425/<0.001);2组ROS、ET⁃1水平均较治疗前降低,NO水平较治疗前升高,且观察组降低/升高幅度大于对照组(t/P=3.811/0.002、2.936/0.004、2.356/0.021);2组LVEF值均较治疗前升高,LVESD、LVEDD值均较治疗前降低,且观察组升高/降低幅度大于对照组(t/P=5.023/<0.001、2.738/0.008、5.879/<0.001)。治疗1月后,TIMI分级3级及MBG3级数量均较PCI治疗前升高,且观察组高于对照组(χ^(2)/P=3.957/0.047、4.497/0.034);2组CTFC帧数均较PCI治疗前降低,且观察组低于对照组(t/P=3.386/<0.001);观察组MACE不良事件发生率(全因死亡、急性致死性心肌梗死、急性心力衰竭发生率)均低于对照组(χ^(2)/P=4.074/0.044、4.195/0.041、4.914/0.027)。结论麝香通心滴丸联合尼可地尔片治疗PCI术后心肌缺血再灌注损伤临床疗效显著,可改善血管内皮功能,提高心功能,改善心肌缺
Objective To observe the clinical effect of Shexiangtongxin Dropping Pill combined with nicorandil Tab⁃lets on myocardial ischemia reperfusion injury after PCI.Methods Eighty⁃six patients with myocardial ischemia⁃reperfusion injury after PCI were selected from the Cardiovascular Disease Department of Shandong University of Traditional Chinese Medicine Affiliated Hospital from April 2020 to April 2022.They were randomly divided into a control group and an obser⁃vation group,with 43 patients in each group.The patients in the control group were treated with nicorandil Tablets on the ba⁃sis of conventional treatment,and the patients in the observation group were treated with Shexiangtongxin Dropping Pill on the basis of the control group.The clinical efficacy of the two groups was observed,and the TCM syndrome scores(chest pain,chest distress,palpitations and sweating,shortness of breath and fatigue,loss of appetite),vascular endothelial function(serum reactive oxygen species(ROS),endothelin 1(ET⁃1),nitric oxide(NO)),Cardiac ultrasound indicators[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)],myocardial ischemia⁃reperfusion indicators[TIMI grade 3,TIMI frame count(CTFC),myocardial contrast density grade(MBG)grade 3],and major cardiovascular adverse events(MACE).Results After one month of treatment,the total effec⁃tive rate of the observation group was significantly higher than that of the control group(93.02%vs.74.42%,χ^(2)/P=7.196/0.027);The TCM syndrome scores of both groups decreased compared to before treatment,and the observation group was lower than the control group(t/P=2.612/0.011,2.906/0.005,2.522/0.014,7.425/<0.001).The levels of ROS and ET⁃1 in both groups decreased compared to before treatment,while the levels of NO increased compared to before treatment.The de⁃crease/increase amplitude in the observation group was greater than that in the control group(t/P=3.811/0.002,2.936/0.004,2.356/0.021).The
作者
刘杨
张静文
张鑫
姬翔
Liu Yang;Zhang Jingwen;Zhang Xin;Ji Xiang(Affiliated Hospital of Shandong Uni-versity of Traditional Chinese Medicine,Shandong Province,Jinan 250014,China)
出处
《疑难病杂志》
CAS
2023年第6期572-577,共6页
Chinese Journal of Difficult and Complicated Cases
基金
山东省自然科学基金联合基金(ZR2021LZY011)
山东中医药科技发展计划项目(2015⁃088)。
关键词
心肌缺血再灌注损伤
冠状动脉支架植入术
麝香通心滴丸
尼可地尔片
血管内皮功能
Myocardial ischemia⁃reperfusion injury
Coronary artery stent implantation
Shexiangtongxin Dropping Pill
Nicodil tablets
Vascular endothelium function
