中药瓜蒌薤白半夏汤对急性心肌梗死后心室重构和炎症因子的影响  

The effect of Chinese herbal formula Gualou Xiebai Banxia decoction on ventricular remodeling and inflammatory factors after acute myocardial infarction

作　　者：杨琦 林辉[1] 吕海涛[1] 吴国水[2] 郭航远[1] 池菊芳[1] YANG Qi;LIN Hui;LYU Haitao(Department of Cardiology,Shaoxing People's Hospital(Shaoxing Hospital,Zhejiang University School of Medicine),Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)心内科,312000 [2]绍兴市人民医院(浙江大学绍兴医院)中医科,312000

出　　处：《心电与循环》2020年第2期128-132,共5页Journal of Electrocardiology and Circulation

基　　金：浙江省中医药科技计划项目(2017ZA138,2018ZA123)。

摘　　要：目的观察中药瓜蒌薤白半夏汤对急性心肌梗死后心室重构和炎症因子的影响。方法2017年3月至2018年3月收治的急性ST段抬高型心肌梗死(STEMI)患者68例,随机分为对照组(34例)和观察组(34例)。对照组给予常规治疗,观察组在上述基础上给予中药瓜蒌薤白半夏汤治疗。比较两组治疗前后血浆N末端B型脑钠肽前体(NT-proBNP)、炎症因子转化生长因子β(TGF-β)、肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、基质金属蛋白酶9(MMP-9)水平,左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)。结果治疗前两组间各项指标差异均无统计学意义(均P>0.05)。治疗1周后NT-proBNP、TGF-β、TNF-α、IL-1和MMP-9观察组均显著低于对照组(均P<0.05)。治疗3个月后,TGF-β、TNF-α、IL-1和MMP-9观察组均低于对照组(均P<0.05)。治疗后LVEF、LVEDV和LVESV两组间差异均有统计学意义(均P<0.05)。结论中药瓜蒌薤白半夏汤能够降低心肌梗死后炎症反应,并能改善心功能。Objective To observe the effect of Chinese herbal formula Gualou Xiebai Banxia decoction on ventricular remodeling and inflammatory factors after acute myocardial infarction(AMI).Methods A total of 68 patients with AMI were enrolled from March 2017 to March 2018 and randomly assigned to control group(n=34)and observation group(n=34).The control group received conventional treatment.The observation group were treated with conventional treatment and Chinese herbal formula Gualou Xiebai Banxia decoction.The levels of plasma N-terminal pro-BNP(NT-proBNP),transforming growth factor-β(TGF-β),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),matrix metalloprotease 9(MMP-9),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF)before and after treatment were compared between the two groups.Results There was no significant difference of above parameters between the two groups(all P>0.05)before the treatment.After 1 week of treatment,the levels of NT-proBNP,TGF-β,TNF-α,IL-1 and MMP-9 were significantly lower in the observation group than in the control group(all P<0.05).The levels of TGF-β,TNF-α,IL-1 and MMP-9 were significantly lower in the observation group than in the control group 3 months later after treatment(all P<0.05).There was significant difference of LVEF,LVEDV and LVESV between the two groups after treatment(all P<0.05).Conclusion Chinese herbal formula Gualou Xiebai Banxia decoction can reduce inflammatory response and improve heart function.

关 键 词：瓜蒌薤白半夏汤 急性心肌梗死 心室重构 心功能 炎症因子 中药 

分 类 号：R542.22[医药卫生—心血管疾病]