破格救心汤对心跳骤停家兔复苏后血流动力学的影响
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摘要
目的:探讨破格救心汤对心跳骤停家兔复苏后血流动力学的影响。方法:将30只清洁级家兔随机分为对照组、肾上腺素组和破格救心汤组。对照组给予相关手术,不进行致颤;肾上腺素组致颤后给予肾上腺素30μg/kg;破格救心汤组致颤后给予肾上腺素30μg/kg+破格救心汤10 m L/kg。3组动物分别于致颤前、复苏后1、12小时记录中心静脉压(CVP)、平均动脉压(MAP)、心输出量(CO)。结果:3组家兔在自主循环恢复后12小时MAP比较,对照组最高、破格救心汤组次之、肾上腺组最低,其差异均具有统计学意义(P<0.05);3组间CO比较,肾上腺素组均低于其余2组,差异均具有统计学意义(P<0.05);3组间CVP比较,对照组最低,破格救心汤组次之,肾上腺素组最高,其差异均具有统计学意义(P<0.05)。结论:肾上腺素联合破格救心汤可以改善心跳骤停家兔复苏后的血流动力学状态,作用优于单纯肾上腺素及破格救心汤治疗。
To discuss the effects of PoGe JiuXin decoction on hemodynamics of the rabbits with sudden cardiac arrest after resuscitation. Methods: Thirty rabbits were randomized into the control group, adrenaline group and PoGe JiuXin decoction group. The control group accepted the related surgery, but didn′ t perform fibrillation;adrenaline group were given adrenaline, 30 μg/kg after performing fibrillation; PoGe JiuXin decoction group were treated by adrenaline, 30 μg/kg and PoGe JiuXin decoction, 10 m L/kg after performing fibrillation. CO, MAP and CVP of the animals in three groups were recorded before fibrillation, in 1, 12 and 24 hours after resuscitation.Results: The difference had statistical meaning in the comparisons of MAP among theree groups over 12 hours after the recovery of autonomous cycle, the control group the highest, PoGe JiuXin decoction group the next and adrenaline group the lowest(P <0.05); adrenaline group was lower than the other two groups in CO, and the difference showed statistical meaning(P<0.05); the comparisons of CVP among three groups, the control group the lowest, PoGe JiuXin decoction group the next and adrenaline group the highest(P<0.05). Conclusion: Adrenaline combined with PoGe JiuXin decoction could improve hemodynamic indexes of the rabbits with sudden cardiac arrest after resuscitation, and its effects are superior to these of only adrenaline or PoGe JiuXin decoction.
To discuss the effects of PoGe JiuXin decoction on hemodynamics of the rabbits with sudden cardiac arrest after resuscitation. Methods: Thirty rabbits were randomized into the control group, adrenaline group and PoGe JiuXin decoction group. The control group accepted the related surgery, but didn′ t perform fibrillation;adrenaline group were given adrenaline, 30 μg/kg after performing fibrillation; PoGe JiuXin decoction group were treated by adrenaline, 30 μg/kg and PoGe JiuXin decoction, 10 m L/kg after performing fibrillation. CO, MAP and CVP of the animals in three groups were recorded before fibrillation, in 1, 12 and 24 hours after resuscitation.Results: The difference had statistical meaning in the comparisons of MAP among theree groups over 12 hours after the recovery of autonomous cycle, the control group the highest, PoGe JiuXin decoction group the next and adrenaline group the lowest(P <0.05); adrenaline group was lower than the other two groups in CO, and the difference showed statistical meaning(P<0.05); the comparisons of CVP among three groups, the control group the lowest, PoGe JiuXin decoction group the next and adrenaline group the highest(P<0.05). Conclusion: Adrenaline combined with PoGe JiuXin decoction could improve hemodynamic indexes of the rabbits with sudden cardiac arrest after resuscitation, and its effects are superior to these of only adrenaline or PoGe JiuXin decoction.
引文
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[3]王昱,张志明.破格救心汤对心脏骤停家兔心肌肌钙蛋白T水平的影响[J].中国医学创新,2013,10(19):12-13.
[4]魏林.乙醇对家兔心脏骤停后综合征脑保护的实验研究[D].兰州:兰州大学,2013.
[5]王洁萍,张孟瑜,心肺复苏中血管加压素与肾上腺素的联合应用[J].四川医学,2011,32(9):1346-1348.
[6]李俊,商波,陆芹芹,等.心脏骤停后综合征集束化治疗的研究[J].中国急救复苏与灾害医学杂志,2014,9(4):345-347.
[7] Sunde K,Pytte M,Jacobsen D,et a1.Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest[J].Resuscitation,2007,73(1):29-39.
[8]曹雯,张立平,秦静,等.米伐西醇对家兔心肺复苏后心功能影响的实验研究[J].中国急救复苏与灾害医学杂志,2011,6(6):514-517.
[9]李娟,张志明,雍文兴,等.补阳还五汤治疗心脏骤停后综合征40例[J].西部中医药,2015,28(2):85-87.
[10]罗林云.李可中医药学术流派附子半夏配伍临床应用特点[J].西部中医药,2017,30(4):70-72.
[11]蒲旭辉,康白,韩慧蓉,等.丝瓜络对慢性心力衰竭大鼠心功能的作用[J].时珍国医国药,2011,22(4):1020-1022.
[12]熊海霞,杨颖,孙文燕.附子多糖的药理作用研究进展[J].世界科学技术-中医药现代化,2013,15(9):1948-1951.
[13]张梅,张艺,陈海红,等.附子抗心律失常有效组分研究[J].时珍国医国药,2000,11(3):193-197.
[14]曾代文,彭成,余成浩,等.附子与干姜组分配伍对急性心衰心阳虚证大鼠血浆肾素-血管紧张素-醛固酮系统的影响[J].中药药理与临床,2011,27(4):5-7.
[15]张茜.第六届首都急危重症医学高峰论坛论文集[C].北京:2013.
[16]赫媛媛,钱旭.基于文献的附子药理作用再评价[J].西部中医药,2016,29(9):84-88.
[17]梅超南,曾瑾,赵军宁.不同产地附子炮制品抗休克、抗缓慢型心律失常作用的品质评价研究[J].中药药理与临床,2014,30(1):67-70.