中医综合疗法对经皮冠状动脉介入术后冠心病患者心功能及心肌缺血再灌注的影响  

The Influence of TCM Comprehensive Therapy on Cardiac Function and Myocardial Ischemia-Reperfusion in Patients with Coronary Heart Disease After Percutaneous Coronary Intervention

作　　者：刘磊[1] LIU Lei(The Third Hospital Attached to Henan University of TCM,Zhengzhou,Henan,China,45000)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《河南中医》2018年第10期1511-1514,共4页Henan Traditional Chinese Medicine

基　　金：河南省科技攻关计划项目(编号:201304062)

摘　　要：目的:观察中医综合疗法对经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后冠状动脉粥样硬化性心脏病(简称冠心病)患者心功能及心肌缺血再灌注的影响。方法:将110例患者随机分为观察组和对照组,每组各55例。对照组患者给予常规西医治疗,观察组在对照组的基础上给予中医综合疗法。比较两组患者的临床疗效,检测两组患者治疗前后心肌酶学指标[血清超氧化物歧化酶(serum superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(CK-MB)]及生化指标[内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)]水平。彩超评估两组患者治疗前后左心室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、每搏输出量(stroke volume,SV)。采用NYHA分级标准评价心肌梗死溶栓治疗(thrombolysis in myocardial infarction,TIMI)后TIMI心肌灌注分级(TIMAI myocardial perfusion grade,TMP)。结果:观察组有效率为94. 55%,对照组有效率为76. 36%,两组患者临床疗效比较,差异具有统计学意义(P <0. 05)。观察组TMP 1~2级13例,3级42例;对照组TMP 1~2级25例,3级30例,两组患者TMP分级情况比较,差异具有统计学意义(P <0. 05)。两组患者治疗后LVEDD、LVESD、心功能评分、CK、CK-MB、MDA、ET低于治疗前,且观察组低于对照组,两组患者治疗后SV、LVEF、SOD、NO高于治疗前,且观察组高于对照组,差异均有统计学意义(P <0. 05)。结论:中医综合治疗能够显著改善PCI术后冠心病患者的心肌缺血再灌注及心功能指标,且临床疗效显著。Objective： To observe the influence of TCM comprehensive therapy on cardiac function and myocardial ischemia-reperfusion in patients with coronary heart disease after percutaneous coronary intervention（PCI）. Methods： One hundred and ten patients were randomly divided into the observation group and the control group,with 55 cases in each group. The patients in the control group were given conventional western medicine treatment and the ones in the observation group were given comprehensive TCM therapy on this basis of the control group. The clinical effects of two groups were compared. The myocardial enzymatic indexes including serum superoxide dismutase（SOD）,malondialdehyde（MDA）,creatine kinase（CK） and creatine kinase isoenzyme（CK-MB）,and biochemical indexes including endothelin（ET）,nitric oxide（NO） before and after the treatment in the two groups were detected. The left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter（LVEDD）,left ventricular end systolic diameter（LVESD）,stroke volume（SV） before and after treatment in the two groups were evaluated by color Doppler ultrasound. The myocardial perfusion grade（TMP） of patients with myocardial infarction after thrombolysis in myocardial infarction（TIMI） was evaluated by NYHA grading standard. Results： The effective rate of the observation group was 94. 55%,and that of the control group was 76. 36%. The difference was statistically significant（P〈0. 05）. There were 13 cases of TMP grade 1-2 and 42 cases of TMP grade 3 in the observation group and 25 cases of TMP grade 1-2 and 30 cases of TMP grade 3 in the control group. There was significant difference in TMP grading between the two groups（P〈0. 05）. The LVEDD,LVESD,cardiac function score,CK,CK-MB,MDA,ET were lower in the two groups after the treatment than those before the treatment,and the observation group was lower than the control group. The SV,LVEF,SOD,NO in the two groups after the treatment were higher than those bef

关 键 词：冠状动脉粥样硬化性心脏病 经皮冠状动脉介入术 中医综合治疗 桃红四物汤 针灸疗法 心肌缺血再灌注 心功能 

分 类 号：R259.414[医药卫生—中西医结合]