益气逐瘀法干预择期PCI围手术期对EPCs动员与归巢影响研究  

The Effect of Qi-enhancing and Stagnation-removing Therapy on EPCs Mobilization and homing in PCI Perioperative Period

作　　者：张玉灵[1,2] 邢文龙[1] 尚菊菊[1] 周琦[1] 李享[1] 刘红旭[1] 

机构地区：[1]首都医科大学附属北京中医医院心血管科,北京100010 [2]北京中医药大学,北京100029

出　　处：《世界中医药》2017年第2期254-257,265,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(编号:81273741);北京市自然科学基金项目(编号:7142077);首都卫生发展科研专项-重点攻关项目(编号:首发2014-1-2231);北京市中医药管理局重点学科项目

摘　　要：目的:探讨益气逐瘀法对择期PCI围手术期EPCs动员与归巢影响。方法:采用随机、双盲、安慰剂、对照试验方法,研究对象为首都医科大学附属北京中医医院心血管科2016年7月至2016年11月成功接受PCI治疗的证属气虚血瘀证非ST段抬高急性冠脉综合征(NSTE-ACS)患者。64名符合纳入标准的患者被随机分为试验组(n=33)和对照组(n=31),对照组予常规西药治疗+安慰剂,试验组在常规西药治疗基础上加服参元丹胶囊,分别采用流式细胞仪、ELISA法进行检测2组择期PCI前后3个时点(术前、术后24 h、术后1周)外周血EPCs计数及促血管内皮生成因子VEGF水平,探索益气逐瘀法对NSTE-ACS患者择期PCI围手术期EPCs动员与归巢的影响。结果:2组受试者PCI术前外周血EPCs计数、VEGF水平比较差异无统计学意义(P=0.35、P=0.48),2组PCI术后外周血中EPCs计数及VEGF水平较术前均升高(P<0.05),但接受参元丹治疗的患者外周血中VEGF水平高于对照组。2组PCI术后7 d和术后24 h比较,外周血EPCs计数及VEGF水平均变化不大(P>0.05)。结论:参元益气活血胶囊(参元丹)干预NSTE-ACS患者PCI围手术期可促进骨髓EPCs动员与归巢,其机制可能与SYD增加循环中VEGF水平有关。Objective：To observe the effect of Qi-enhancing and Stagnation-removing therapy on EPCs mobilization and homing in PCI perioperative period.Methods：A randomized,double blind,placebo controlled trial was conducted.A total of 64 NSTE-ACS patients who received PCI and belongs to Qi-deficiency and blood-stasis syndrome were concluded in this study.Patients were randomized into Shen Yuan Dan（SYD） group （n=33） and the control group （n=31）.The control group was given conventional western medicine treatment＋placebo,on that basis,the treatment group was given SYD.Using flow cytometry instrument and ELISA method to detect EPCs count and VEGF levels of the two groups before and after elective PCI 3 points（preoperative and postoperative 24 hours,after 1 week）.Results：Before treatment,the EPCs count and VEGF level were of no statistically significant difference between the two group （P=0.35,P=0.48）.After treatment,the EPCs count in the peripheral blood and VEGF levels increased in both groups （P〈0.05）.While SYD group had higher VEGF than the control group.After treatment 7 d and 24 h,EPCs count and the level of VEGF in the peripheral blood of the two groups had no significant difference（P〉0.05）.Conclusion：Shen Yuan Dan in patients can promote bone marrow EPCs mobilization and homing in patients with NSTE-ACS PCI in perioperative period,it may be related to boosting VEGF levels.

关 键 词：冠心病 参元丹 围手术期心肌损伤 内皮祖细胞 

分 类 号：R285.6[医药卫生—中药学] R242[医药卫生—中医学]