益气养阴活血中药对急性心肌梗死患者血运重建后心室壁运动的影响  

Effect of Chinese Herbal Medicine for Benefiting Qi and Nourishing Yin to Promote Blood Circulation on Ventricular Wall Motion of AMI Patients after Revascularization

作　　者：李永强[1] 金枚[2] 仇盛蕾[2] 朱天刚[3] 边红[4] 王承龙[1] 刘红旭[2] 姚立芳[1] 史大卓[1] 

机构地区：[1]中国中医科学院西苑医院心血管病中心,北京100091 [2]首都医科大学附属北京中医医院心内科 [3]北京大学人民医院心内科 [4]首都医科大学附属同仁医院心内科

出　　处：《中国中西医结合杂志》2009年第4期300-304,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家“十五”科技攻关计划资助项目(No.2003BA712A11)

摘　　要：目的观察益气养阴活血中药对急性心肌梗死(AMI)患者血运重建后心室壁运动和收缩功能的影响。方法80例AMI患者,随机分为西药常规治疗加心悦胶囊及复方丹参片组(简称中药组,40例)和西药常规治疗加安慰剂组(对照组,40例),疗程3个月。分别于血运重建后14天和3个月行多巴酚丁胺负荷状态的多普勒超声试验,观察AMI患者左室射血分数(LVEF)、室壁运动计分指数、正常心肌百分比、前壁和下壁AMI左室梗死相关节段收缩期纵向峰值应变力(LSPS)和应变率(LSPSR)的变化。结果试验过程中,中药组脱落3例,对照组脱落2例,共75例完成试验。血运重建后14天多巴酚丁胺负荷状态超声显示,中药组AMI患者LVEF值、正常心肌百分比,前壁AMI患者左室前壁心尖段LSPS、心尖段、中间段和基底段LSPSR负向值,下壁AMI患者左室下壁基底段LSPS、基底段和中间段LSPSR负向值皆较对照组明显增加(P<0.05,P<0.01);血运重建后3个月多巴酚丁胺负荷状态超声显示,中药组前壁AMI患者左室前壁心尖段LSPS、LSPSR负向值,下壁AMI患者左室下壁基底段LSPS和LSPSR负向值较对照组明显增加(P<0.05)。与血运重建后14天比较,中药组前壁AMI患者血运重建后3个月左室前壁心尖段和下壁AMI患者左室下壁基底段LSPS负向值明显增加(P<0.05)。结论益气养阴活血中药结合西医常规治疗可明显改善AMI患者血运重建后左室收缩功能和室壁运动。Objective To investigate the effect of Chinese herbal medicine for benefiting qi and nourishing yin to promote the blood circulation （abbr. as CHM） in promoting ventricular wall motion and myocardial contraction in acute myocardial infarction （AMI） patients after revascularization. Methods Subjects were 80 AMI patients after revascularization, of those, the 40 patients in the TCM group were treated with Xinyue Capsule and compound Tanshinon Tablet upon the basic conventional Western medical treatment and the other 40 in the control group were given conventional Western medicine alone, the course for them all was 3 months. Cardiac function indexes, including left ventricular ejection fraction （LVEF）, wall motion indices, normal myocardial percentage （NMP）, longitudinal systolic peak strain （LSPS） and rate （LSPSR）, were observed by Doppler ultrasound under dobutamine stress at the 14 days after revascularization and the end of 3-month treatment. Results Except the 5 cases （3 in the TCM group and 2 in the control group） dropped out in the observation period, the trial was completed in 75 patients totally. LVEF, NMP, minus LSPS of left ventricular anterior apex and inferior basement, minus LSPSR of anterior apex, middle, basement, and minus LSPSR of inferior middle, basement were more significantly increased in Chinese medicinal treatment group than those in the control group at 14-day after revascularization （ P 〈0.01 ）. The treatment group, minus LSPS and minus LSPSR of the left ventricular anterior apex and the inferior basement were at markedly higher levels compared with the controls at 3-month after revas-cularization （P 〈0.05）. Minus LSPSR of the left ventricular anterior apex and the inferior basement in the treat- ment group at 3-month was higher than that at 14-day after revascularization （ P 〈 0.05）. Conclusion CHM combining with conventional Western medicine treatment could improve the left ventricular contractive function and wall motion in AMI patients after

关 键 词：益气养阴活血中药 急性心肌梗死 血运重建 心室壁运动 

分 类 号：R259[医药卫生—中西医结合]