参附汤煎剂治疗急性心肌梗死合并休克疗效及对心肌保护作用影响研究
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摘要
目的探讨参附汤煎剂治疗急性心肌梗死(AMI)合并休克的疗效及对心肌保护作用的影响。方法选取辽宁中医药大学附属医院2017年3—12月收治的100例AMI合并休克的患者为研究对象。根据随机数字表法将患者分为A组(n=50)和B组(n=50)。A组患者给予常规西医治疗,B组患者在进行常规西医治疗的基础上使用参附汤。两组患者均治疗1个月。治疗结束后,比较两组患者临床有效率,观察患者血清中肌酸激酶(CK)、乳酸盐脱氢酶(LDH)、一氧化氮(NO)的变化及中医症状评分结果。结果 B组有效率为84.0%(42/50),显著高于A组的60.0%(30/50),两组比较,差异有统计学意义(P<0.05)。治疗后B组患者的CK、LDH水平低于A组,NO水平高于A组,两组比较,差异有统计学意义(P<0.05)。两组患者心胸彻痛、胸闷气短及汗出肢冷等中医症状明较治疗前明显改善,B组中医症状积分低于A组,两组比较,差异有统计学意义(P<0.05)。结论参附汤煎剂具有益气回阳救脱的作用,可以明显改善AMI合并休克患者临床症状,增强对心肌的保护作用。
Objective To investigate the effect of Shenfu Decoction on acute myocardial infarction( AMI) combined with shock and myocardial protection. Methods A retrospective study was performed on 100 cases of AMI patients combined with shock who were admitted from March to December 2017. Patients were divided into the Group A( n = 50) and Group B( n = 50). Patients in Group A were treated with conventional western medicine,the others in Group B were given additional Shenfu Decoction on the basis of conventional western medicine. The patients in the two groups were treated for 1 months. After the treatment,the effective rate was calculated,and the changes of creatine kinase( CK),lactate dehydrogenase( LDH) and nitric oxide( NO) in the serum and the result of TCM symptom score were observed. Results The effective rate was 84. 0%( 42/50) in the Group B,which was significantly higher than60. 0%(30/50) in the Group A,and the difference was statistically significant between the two groups( P < 0. 05). After the treatment,levels of CK and LDH in Group B were lower than those in Group A,the level of NO in Group B was higher than that in Group A( P <0. 05). After the treatment,both groups of patients were improved in the TCM symptoms such as heart and chest pain,chest tightness and shortness of breath,sweat out and cold limbs;the TCM symptom score in Group B was lower than that in Group A( P < 0. 05).Conclusion Shenfu Decoction has the effect of restoring yang-qi and rescuing patients from collapse,which can obviously improve the clinical symptoms of AMI patients combined with shock and enhance the protective effect on myocardium.
Objective To investigate the effect of Shenfu Decoction on acute myocardial infarction( AMI) combined with shock and myocardial protection. Methods A retrospective study was performed on 100 cases of AMI patients combined with shock who were admitted from March to December 2017. Patients were divided into the Group A( n = 50) and Group B( n = 50). Patients in Group A were treated with conventional western medicine,the others in Group B were given additional Shenfu Decoction on the basis of conventional western medicine. The patients in the two groups were treated for 1 months. After the treatment,the effective rate was calculated,and the changes of creatine kinase( CK),lactate dehydrogenase( LDH) and nitric oxide( NO) in the serum and the result of TCM symptom score were observed. Results The effective rate was 84. 0%( 42/50) in the Group B,which was significantly higher than60. 0%(30/50) in the Group A,and the difference was statistically significant between the two groups( P < 0. 05). After the treatment,levels of CK and LDH in Group B were lower than those in Group A,the level of NO in Group B was higher than that in Group A( P <0. 05). After the treatment,both groups of patients were improved in the TCM symptoms such as heart and chest pain,chest tightness and shortness of breath,sweat out and cold limbs;the TCM symptom score in Group B was lower than that in Group A( P < 0. 05).Conclusion Shenfu Decoction has the effect of restoring yang-qi and rescuing patients from collapse,which can obviously improve the clinical symptoms of AMI patients combined with shock and enhance the protective effect on myocardium.
引文
[1]赵兰巧,田文友,田青.中西医结合治疗急性心肌梗死合并心源性休克的临床观察[J].山东医药,2010,50(28):99-100.
[2]文治勇,胡东芳,刘晓东.AMI并发心源性休克患者在IABP支持下行急诊PCI对术后炎性因子水平的影响[J].疑难病杂志,2014,13(4):358-360.
[3]柏冬,刘丽梅,岳广欣,等.参附注射液临床应用的文献梳理[J].环球中医药,2014,7(1):68-72.
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[6]郑筱萸.中药新药临床研究指南原则:试行[M].北京:中国医药科技出版社,2002:43-44.
[7]郑文达,甄玉成,邝开安.参附汤加味治疗慢性心力衰竭40例临床观察[J].中国医药指南,2016,14(10):191-192.
[8]余金明.中西医结合治疗急性心肌梗死合并心源性休克临床分析[J].中国民族民间医药,2013,22(11):89-89.
[9]周如生.心肌梗死合并高脂血症患者运用丹参川芎嗪注射液治疗的疗效观察[J].中国医疗器械信息,2015,21(2Z):106.
[10]张丰刚.丹红注射液联合步长稳心颗粒治疗急性心肌梗死合并心律失常疗效观察[J].亚太传统医药,2014,10(13):108-109.
[11]徐菲飞,彭成,王茁伉,等.参附注射液对新生大鼠心肌细胞ATP酶及相关离子的影响[J].中药药理与临床,2013,29(3):19-21.
[12]康素娴,张瑜,赵芳,等.参附注射液对老年气虚血瘀型舒张性心力衰竭患者生存质量的影响[J].现代中西医结合杂志,2014,23(10):1060-1061.
[13]刘智,孙大中,鲁雨博,等.参附药对对心肌缺血大鼠血液流变学及认知能力的影响[J].上海中医药杂志,2015,49(1):82-86.
[14]尹贤洙.参附汤治疗慢性心力衰竭的临床效果观察[J].中国医药指南,2014,12(29):280-281.
[2]文治勇,胡东芳,刘晓东.AMI并发心源性休克患者在IABP支持下行急诊PCI对术后炎性因子水平的影响[J].疑难病杂志,2014,13(4):358-360.
[3]柏冬,刘丽梅,岳广欣,等.参附注射液临床应用的文献梳理[J].环球中医药,2014,7(1):68-72.
[4]陈灏珠.实用心脏病学[M].第5版.上海:上海科学技术出版社,2016.
[5]叶任高,陆再英.内科学[M].第6版.北京:人民卫生出版社,2005.
[6]郑筱萸.中药新药临床研究指南原则:试行[M].北京:中国医药科技出版社,2002:43-44.
[7]郑文达,甄玉成,邝开安.参附汤加味治疗慢性心力衰竭40例临床观察[J].中国医药指南,2016,14(10):191-192.
[8]余金明.中西医结合治疗急性心肌梗死合并心源性休克临床分析[J].中国民族民间医药,2013,22(11):89-89.
[9]周如生.心肌梗死合并高脂血症患者运用丹参川芎嗪注射液治疗的疗效观察[J].中国医疗器械信息,2015,21(2Z):106.
[10]张丰刚.丹红注射液联合步长稳心颗粒治疗急性心肌梗死合并心律失常疗效观察[J].亚太传统医药,2014,10(13):108-109.
[11]徐菲飞,彭成,王茁伉,等.参附注射液对新生大鼠心肌细胞ATP酶及相关离子的影响[J].中药药理与临床,2013,29(3):19-21.
[12]康素娴,张瑜,赵芳,等.参附注射液对老年气虚血瘀型舒张性心力衰竭患者生存质量的影响[J].现代中西医结合杂志,2014,23(10):1060-1061.
[13]刘智,孙大中,鲁雨博,等.参附药对对心肌缺血大鼠血液流变学及认知能力的影响[J].上海中医药杂志,2015,49(1):82-86.
[14]尹贤洙.参附汤治疗慢性心力衰竭的临床效果观察[J].中国医药指南,2014,12(29):280-281.
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