早期应用自拟益气活血方防治急性心肌梗死后抑郁状态的临床效果研究  

Clinical Effect of Early Application of Self-prescribed Yiqihuoxue Decoction on Prevention and Treatment of Depressive Symptoms after Acute Myocardial Infarction

作　　者：王梦玺 刘倩 沈乐[1] 陈晓虎 WANG Mengxi;LIU Qian;SHEN Le;CHEN Xiaohu(Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院,江苏省南京市210029 [2]南京中医药大学,江苏省南京市210023

出　　处：《中国全科医学》2022年第11期1357-1362,共6页Chinese General Practice

基　　金：国家自然科学基金面上项目(81973824);国家自然科学基金青年科学基金项目(82004308);国家中医药管理局中医药循证能力建设项目(2019XZZX-XXG004);江苏省研究生实践创新计划项目(SJCX20_0585)。

摘　　要：背景急性心肌梗死后容易产生抑郁等负性情绪,目前针对此类患者的治疗措施主要是在急性心肌梗死治疗的基础上加用精神类药物,但精神类药物只能在抑郁发生后使用,无法早期应用于大部分急性心肌梗死患者。目的评价早期应用自拟益气活血方对急性心肌梗死后抑郁状态的防治作用。方法选取2020年5月至2021年3月在江苏省中医院住院治疗的急性心肌梗死患者44例为研究对象,随机分为对照组和试验组,各22例。对照组给予标准西医治疗,试验组给予标准西医治疗+自拟益气活血方,两组均治疗3周。治疗1周后检测两组患者白介素6(IL-6)和白介素8(IL-8)水平,治疗3周后评估汉密尔顿抑郁量表-17(HAMD-17)评分、抑郁状态发生率、心绞痛积分、中医证候积分和中医证候改善率。结果试验组治疗后HAMD-17评分较治疗前降低(P<0.05)。治疗后对照组、试验组IL-6水平均较治疗前降低(P<0.05),治疗后试验组IL-6水平低于对照组(P<0.05)。对照组治疗后IL-8水平较治疗前降低(P<0.05)。治疗后试验组心绞痛积分低于对照组(P<0.05)。对照组、试验组治疗后中医证候积分均较治疗前降低(P<0.05),治疗后试验组中医证候积分低于对照组(P<0.05)。治疗后试验组中医证候改善率高于对照组(P<0.05)。结论早期应用自拟益气活血方能有效降低急性心肌梗死患者IL-6水平、缓解心绞痛症状并改善中医证候,同时对抑郁状态有轻度减轻作用。Background Post-acute myocardial infarction(AMI)patients are prone to depression and other negative emotions.Current treatment for post-AMI patients with depression is anti-myocardial infarction treatment plus antidepression treatment,in the circumstances that the patients have depression.In view of this,the therapeutic program could not be used early in most post-AMI patients.Objective To assess the effect of early application of self-prescribed Yiqihuoxue Decoction on the prevention and treatment of post-AMI depression.Methods Participants were eligible AMI inpatients(n=44)who were selected from Jiangsu Province Hospital of Chinese Medicine from May 2020 to March 2021 and equally randomized into a control group and an experimental group,receiving three-week standard Western treatment,and three-week standard Western treatment with self-prescribed Yiqihuoxue Decoction,respectively.The interleukin-6(IL-6)and interleukin-8(IL-8)were measured at the end of one-week treatment.At the end of three-week treatment,depression prevalence was estimated using HAMD-17 score,angina pectoris was graded using angina score,and TCM syndrome score and improvement rate of TCM syndrome were measured.Results The HAMD-17 score in the experimental group decreased significantly after treatment(P<0.05).The IL-6 in both groups demonstrated a significant decrease after treatment(P<0.05),and the decrease was much more obvious in the experimental group(P<0.05).The IL-8 in the control group was lower after treatment than at baseline(P<0.05).The post-treatment angina score in the experimental group was lower than that in control group(P<0.05).The TCM syndrome score decreased significantly in both groups after treatment(P<0.05).And it showed a much more obvious decrease in the experimental group(P<0.05).The TCM syndrome improvement rate in the experimental group was higher than that in control group(P<0.05).Conclusion For AMI patients,early use of self-prescribed Yiqihuoxue Decoction significantly reduced the serum IL-6 level,relieved angina pec

关 键 词：心肌梗死 抑郁 益气活血方 病症防治 治疗结果 

分 类 号：R542.22[医药卫生—心血管疾病] R794.42[医药卫生—内科学]