参附汤对急性心肌梗死患者PCI术后心肌损伤及血清IL-10、BNP的影响  

Effects of Shenfu Decoction on Serum IL-10 and BNP in Patients with AMI after PCI

作　　者：张宁 安良 连蕊 王林清 燕飞 郭宁 周文全 金爱莲[3] ZHANG Ning;AN Liang;LIAN Rui;WANG Linqing;YAN Fei;GUO Ning;ZHOU Wenquan;JIN Ailian(Zhengzhou Yihe Hospital,Zhengzhou 450000,China;The First Affiliated Hospital of Henan University of Technology,Jiaozuo 454150,China;Shangqiu First People's Hospital,Shangqiu 476100,China)

机构地区：[1]郑州颐和医院,河南郑州450000 [2]河南理工大学第一附属医院,河南焦作454150 [3]商丘市第一人民医院,河南商丘476100

出　　处：《中医药信息》2022年第7期59-64,共6页Information on Traditional Chinese Medicine

基　　金：2020年度河南省医学科技攻关计划联合共建基金项目(LHGJ20200931)。

摘　　要：目的:探讨参附汤对急性心肌梗死患者经皮冠状动脉介入(PCI)术后心肌损伤及血清IL-10、BNP的影响。方法:选取符合纳入标准的102例急性心肌梗死患者作为研究对象,依据随机数字表将患者随机分为观察组51例(参附汤+常规药物治疗)和对照组51例(常规药物治疗),连续治疗3个月。观察比较两组患者治疗前后心肌损伤情况、心功能、微循环指标、不良反应及血清白介素-10(IL-10)、脑钠肽(BNP)的水平,并比较临床疗效。结果:观察组的总有效率92.16%(47/51)高于对照组76.47%(39/51),两组比较有统计学意义(P<0.05)。治疗后,两组患者心肌损伤情况、心功能、微循环指标及血清IL-10、BNP的水平均较治疗前改善(P<0.05);且观察组血清心肌肌钙蛋白I(cTnI)、磷酸激酶同工酶(CK-MB)、肌红蛋白(Mb)、左心室收缩末期容积(LVESV)和左室舒张末期容积(LVEDV)、BNP、微循环抵抗指数(IMR)低于对照组(P<0.01),左室射血分数(LVEF)、血清IL-10和冠状动脉血流储备指数(CFR)高于对照组(P<0.01)。结论:参附汤治疗PCI术后急性心肌梗死患者疗效较好,可通过降低冠状动脉血流阻力、改善心肌血供、降低炎症反应,进而改善患者心肌损伤情况和心功能,且安全性较好。Objective:To explore the effects of Shenfu Decoction on serum levels of IL-10 and BNP in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:A total of 102 patients with AMI undergoing PCI were randomly divided into the observation group(n=51)and the control group(n=51).The control group was treated with routine medication;on which basis,the observation group was also treated with Shenfu Decoction.Both groups were treated for continuous three months.Myocardial injury,cardiac function,micro-circulation indexes,and serum levels of IL-10 and BNP were compared between before and after the treatment in the two groups.Adverse reactions and clinical efficacy were compared between the two groups after the treatment.Results:The total effective rate of the observation group was 92.16%(47/51),which was significantly higher than 76.47%(39/51)of the control group(P<0.05).Myocardial injury,cardiac function,micro-circulation indexes,as well as serum levels of IL-10 and BNP were all improved after the treatment compared with those before the treatment in the two groups(P<0.05).The levels of cTnI,CK-MB,Mb,LVESV,LVEDV,BNP and IMR were lower in the observation group than those in the control group after the treatment(P<0.05);whereas the levels of LVEF,IL-10 and CRF were higher in the observation group than those in the control group(P<0.05).Conclusion:The curative effect of Shenfu Decoction is significant in treating AMI after PCI,which can improve myocardial injury and cardiac function by reducing coronary blood flow resistance,improving myocardial blood supply and reducing inflammation response,thus to improve myocardial injury and cardiac function with its good safety.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 参附汤 心肌损伤 

分 类 号：R259[医药卫生—中西医结合]