心痛方治疗急性心肌梗死痰瘀互结气郁证的临床疗效及对MPO的影响  

Clinical Efficacy of Xintong Prescription on Treatment of AMI with phlegm and blood stasis and qi depression syndrome and its Effect on MPO Level

作　　者：蒋磊[1] 范金茹[2] 陈彤[2] 罗琼[2] 熊杜 廖建萍[2] 王建湘[2] 

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《湖南中医药大学学报》2015年第7期34-37,共4页Journal of Hunan University of Chinese Medicine

基　　金：湖南省科技厅项目(2013sk3094)

摘　　要：目的观察心痛方治疗急性心肌梗死(AMI)的临床疗效及对髓过氧化物酶(MPO)的影响。方法将AMI痰瘀互结气郁证患者40例随机分为对照组和观察组各20例。对照组予以西医常规治疗(绝对卧床休息、心电监护、上氧、抗凝、抗血小板聚集、抗心肌缺血、调脂稳定斑块等),观察组在西医常规治疗基础上加服中药心痛方。疗程均为28 d。观察两组中医证候积分、中医证候疗效、心电图ST段回落50%以上患者例数、心肌酶峰值、MPO变化。结果两组患者治疗后证候积分均显著下降(P<0.01),且观察组下降幅度大于对照组(P<0.05);对照组总有效率为75%,观察组为85%,观察组疗效优于对照组(P<0.05);心电图ST段回落例数观察组与对照组比较,差异无统计学意义(P>0.05)。两组心肌酶峰值比较,观察组肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)峰值均明显低于对照组(P<0.05)。治疗后两组患者血清MPO水平均显著下降(P<0.01),且观察组下降幅度大于对照组(P<0.01)。结论心痛方治疗急性心肌梗死痰瘀互结气郁证疗效确切。心痛方能显著降低血清MPO水平,推测其可能是通过抑制MPO而减轻炎症反应,减少心肌损伤。Objective To observe the clinical efficacy of Xintong prescription on treatment of acute myocardial infarction （AMI） and its effect on MPO level. Methods The 40 cases of AMI patients with phlegm and blood stasis and qi depression syndrome were randomly divided into the control group and observation group, 20 cases in each group. The control group was given conventional Western medicine treatment （absolute bed rest, electrocardiograph monitoring, oxygen, anti-freezing, antiplatelet aggregation, anti-myocardial ischemia, lipid regulation to stabilize plaque）, and the observation group was additionally given Xintong prescription on base of conventional western medicine treatment group, the course of treatment was for 28 d. The TCM symptom integral, efficacy, the cases of patients whose ECG ST segment fell more than 50%, myocardial enzyme peak, and the level of MPO in the two groups were observed. Results The patients＂ symptom integral of the two groups was declined significantly after treatment （P〈0.01）, the decrease range of the treatment group was larger than that of control group （P〈0.05）. The total effective rate of the control group was 75%, the observation group was 85%; The therapeutic effect of observation group was better than control group （P〈0.05）; The number of ECG ST recovery segment in the observation group was compared with the control group, there is no remarkable statistical significance （P〉0.05）. To compare the myocardial enzyme peak, CK and CK-MB in observation group were significantly lower than the control group （P〈0.05）. The patients＂ serum level of MPO was decreased obviously after treatment （P 〈0.01）, and the decrease range of observation group was bigger than the control group （P〈0.01）. Conclusion Xintong prescription showed obvious curative effect in treatment of AMI with phlegm and blood stasis and qi depression syndrome. The prescription could reduce the level of serum MPO. Its mechanism was probably by inhibiting MPO to reduce inflamm

关 键 词：急性心肌梗死 心痛方 痰瘀互结气郁证 髓过氧化物酶 瓜蒌 柴胡 

分 类 号：R256.22[医药卫生—中医内科学] R542.22[医药卫生—中医学]