补肾通脉方对急性心肌梗死经皮冠状动脉介入治疗术后患者血清TLR4/NF-κB炎性信号通路的影响  

Effect of Bushen Tongmai Decoction(补肾通脉方) on Serum TLR4/NF-κB Inflammatory Signaling Pathway in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention

作　　者：张庆 梁田 卢磊 刘敏 刘晓丹 张培影[3] 

机构地区：[1]南京中医药大学第一临床医学院 [2]徐州市中医院 [3]徐州市中心医院

出　　处：《中医杂志》2017年第24期2115-2118,共4页Journal of Traditional Chinese Medicine

摘　　要：目的观察补肾通脉方干预急性心肌梗死经皮冠状动脉介入治疗(PCI)术后患者的疗效及可能作用机制。方法将96例急性心肌梗死且急诊行PCI术后患者随机分为治疗组和对照组各48例,对照组给予常规治疗,治疗组在常规治疗的基础上,于术后第2天开始加用补肾通脉方口服4周。于治疗前后测定两组患者血清TLR4/NF-κB炎性信号通路相关因子表达,包括白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平及Toll样受体4(TLR4)蛋白、核转录因子κB(NF-κB)蛋白;并于治疗后评价心功能疗效。结果治疗后治疗组心功能疗效总有效率为95.8%,高于对照组的85.4%(P<0.05);治疗组与对照组治疗前IL-6、TNF-α水平及TLR4蛋白、NF-κB蛋白水平比较差异无统计学意义(P>0.05),治疗后两组IL-6、TNF-α水平及TLR4蛋白、NF-κB蛋白均低于本组治疗前(P<0.05),且治疗组低于对照组(P<0.05)。结论补肾通脉方对急性心肌梗死PCI术后患者具有心肌保护作用,其机制可能与抑制TLR4/NF-κB炎性信号通路的激活,减少其下游炎症因子TNF-α、IL-6的表达有关。Objective To observe the efficacy and its possible mechanism of Bustten l Ongmat uecoctton in [nc treatment of acute myocardial infarction after percutaneous coronary intervention （PCI）. Methods Ninety six pa- tients with acute myocardial infarction after emergency PCI were randomly divided into a treatment group and a control group, with 48 cases in each group. The control group was given the conventional therapy. In addition to the conven- tional therapy, the treatment group was given Bushen Tongmai Decoction orally for 4 weeks from the second day after PCI. Serum levels of TLR4/NF-KB inflammatory signaling pathway-related factors were measured before and after treatment. The related factors included interleukin-6 （IL-6）, tumor necrosis factor-o~ （TNF-oL）, Toll-like receptor4 （TLR4） protein and nuclear factor-KB （NF-KB） protein. Cardiac function efficacy was evaluated after treatment. Results After treatment, the total effective rate of cardiac function efficacy in the treatment group was 95.8% , which was higher than that in the control group （ 85.4%, P 〈 0.05 ）. There was no statistical significant difference in levels of IL-6, TNF-c~, TLR4 protein and NF-KB protein between the treatment group and control group before treat- ment （P 〉 0.05）. The levels of IL-6, TNF-ct, TLR4 protein and NF-KB protein in each group after treatment were both lower than those before treatment （P 〈 0.05 ）, and the levels of those indicators in the treatment group were low- er than those in the control group （P 〈 0. 05）. Conclusion Bushen Tongmai Decoction seems to have myocardial protective effect on patients with acute myocardial infarction after PCI. The possible mechanism may be related to the inhibition of the activation of TLR4/NF-KB inflammatory signaling pathway and the decrease of the expression of the downstream inflammatory factors TNF-c~ and IL-6.

关 键 词：急性心肌梗死 补肾通脉方 经皮冠状动脉介入治疗 炎性信号通路 

分 类 号：R259[医药卫生—中西医结合]