益气活血法联合心脏康复对急性冠脉综合征患者介入术后炎症因子、CAVI、ABI及心功能的影响  

Effects of YiqiHuoxue Prescription Combined with Cardiac Rehabilitation on Inflammatory Factors,CAVI,ABI,and Cardiac Function in Patients with ACS after Intervention

作　　者：高占义[1] 魏月娟[1] 侯春霞[1] 吴林林[1] 白杰 GAO Zhan-yi;WEI Yue-juan;HOU Chun-xia;WU Lin-lin;BAI Jie(Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Cangzhou Hebei 061000)

机构地区：[1]河北省沧州中西医结合医院心内科,河北沧州061000

出　　处：《世界中西医结合杂志》2022年第9期1802-1806,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划课题(2019269)。

摘　　要：目的探讨中药益气活血法联合心脏康复对急性冠脉综合征(Acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后炎症因子、踝臂指数(Ankle brachial index,ABI)和心踝血管指数(Cardio ankle vascular index,CAVI)及心功能的影响。方法选取2017年1月—2019年4月期间河北省沧州中西医结合医院心内科收治的ACS患者108例,按照随机数字表法分为治疗组和对照组,每组各54例。对照组接受PCI术后基础治疗和中药益气活血方治疗;治疗组在对照组治疗基础上接受心脏康复训练。治疗8周后,观察比较两组患者治疗前后主要中医证候评分、左室舒张末期内径(Left ventricular end diastolic diameter,LVEDD)、左室舒张末期容积(Left ventricular end diastolic volume,LVEDV)、左室射血分数(Left ventricular ejection fraction,LVEF)、ABI、CAVI;并比较两组患者血清高敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor–α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)水平。治疗结束后对两组患者继续随访6个月,比较两组患者脑卒中、急性心肌梗死、心源性死亡等心脑血管不良事件发生率。结果治疗后两组患者胸痛、胸闷、心悸、气短乏力积分均较治疗前显著降低,差异有统计学意义(P<0.05);且治疗组胸闷、心悸、气短乏力积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者LVEDV较治疗前降低,LVEDD、LVEF较治疗前升高,差异有统计学意义(P<0.05);且治疗组LVEDV低于对照组,LVEDD、LVEF高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清hs-CRP、TNF-α、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05),且治疗组血清hs-CRP、TNF-α、IL-6水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者两侧CAVI较治疗前降低,两侧ABI较治疗前升高,差异有统计学意义(P<0.01)Objective To investigate the effects of YiqiHuoxue Prescription combined with cardiac rehabilitation on inflammatory factors,ankle brachial index(ABI),cardio ankle vascular index(CAVI),and cardiac function in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 108 patients with ACS admitted to the Department of Cardiology of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2017 to April 2019 were randomly divided into a treatment group and a control group by random number table method,with 54 patients in each group.The control group received basic treatment after PCI and YiqiHuoxuePrescription,andthe treatment group was additionally treated with cardiac rehabilitation training based on the treatment of the control group.The both groups were treated for 8 weeks.The main traditional Chinese medicine(TCM)syndrome scores,left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),ABI,and CAVI of the two groups were compared before and after treatment.The serum high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)levels of the two groups were compared.After treatment,the patients in the two groups were followed up for 6 months to compare the incidence of cardiovascular and cerebrovascular adverse events such as stroke,acute myocardial infarction,and cardiogenic death.Results The scores of chest pain,chest tightness,palpitation,shortness of breath,and fatigue in patients of the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,the LVEDV in patients of the two groups was decreased,whereas the LVEDD and LVEF were increased(P<0.05).The LVEDV of the treatment group was lower than that of the control group,whereas the LVEDD and LVEF were higher than those of the control group(P<0.05).After treatment,the levels

关 键 词：急性冠脉综合征 皮冠状动脉介入 心脏康复 中药 益气活血 

分 类 号：R541.4[医药卫生—心血管疾病]