温阳益气汤防治蒽环类化疗药物所致心肌损伤对患者心功能、氧化应激与内皮功能的影响  

Wenyang Yiqi Decoction Improves Myocardial Injury Caused by Anthracycline Chemotherapy Drugs and Its Effects on Cardiac Function,Oxidative Stress,and Endothelial Function of Patients

作　　者：解晓青 李洁 XIE Xiao-qing;LI Jie(Department of Oncology,Qingdao Hospital of Traditional Chinese Medicine,Qingdao Shandong 266033)

机构地区：[1]青岛市中医医院肿瘤科,山东青岛266033

出　　处：《世界中西医结合杂志》2023年第2期346-351,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：青岛市2020年度中医药科研计划项目(2020-ZYY008)。

摘　　要：目的探讨温阳益气汤防治蒽环类化疗药物所致心肌损伤的临床价值。方法选取2020年9月—2021年9月期间青岛市中医医院收治的蒽环类化疗药物所致心肌损伤患者100例,按随机数字表法分为对照组与治疗组,每组各50例。对照组维持常规西医治疗,期间积极、有效监测心脏功能,采用β-受体阻滞剂对症干预;治疗组在对照组的基础上加服温阳益气汤。治疗4个疗程后,观察比较两组患者治疗前后心脏彩超指标[左室收缩末内径(Left ventricular end systolic diameter,LVESd)、左室舒张末内径(Left ventricular end diastolic diameter,LVEDd)、左室射血分数(Left ventricular ejection fraction,LVEF)、静脉血液流速比(E/A)]、心肌损伤标志物[心型脂肪酸结合蛋白(Heart type fatty acid binding protein,H-FABP)、肌钙蛋白(Troponin,cTnI)、肌红蛋白(Myoglobin,Myo)]、氧化应激反应指标[丙二醛(Malondialdehyde,MAD)、脂质过氧化物(Lipid peroxide,LPO)、超氧化物歧化酶(Superoxide dismutase,SOD)]、内皮功能指标[内皮素-1(Endothelin-1,ET-1)、前列环素(Prostacyclin,PGI2)、血栓素A2(Thromboxane A2,TXA2)]水平及生活质量(European Organization for Research and Treatment of Cancer quality of life questionnaire core 30,EORTC QLQ-C30)评分变化。结果(1)心脏彩超指标:治疗后两组患者LVESd、LVEDd与治疗前比较,差异无统计学意义(P>0.05),LVEF较治疗前降低,E/A较治疗前升高,差异有统计学意义(P<0.05);治疗组LVESd、LVEDd与对照组比较,差异无统计学意义(P>0.05),LVEF高于对照组,E/A低于对照组,差异有统计学意义(P<0.05);(2)心肌损伤标志物:治疗后两组患者血清H-FABP、cTnI、Myo水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清H-FABP、cTnI、Myo水平均低于对照组,差异有统计学意义(P<0.05);(3)氧化应激反应指标:治疗后两组患者血清MAD、LPO水平较治疗前升高,SOD水平较治疗前降低,差异有统计学意义(P<0.05);Objective To explore the clinical value of Wenyang Yiqi Decoction in preventing and treating myocardial injury caused by anthracycline chemotherapy drugs.Methods A total of 100 patients with myocardial injury caused by anthracycline chemotherapy drugs in Qingdao Hospital of Traditional Chinese Medicine from September 2020 to September 2021 were included and divided into a control group and a treatment group by random number table,with 50 cases in each group.The control group maintained conventional western medical treatment,during which the cardiac function was actively and effectively monitored,and symptomatic intervention was performed withβ-blockers.On this basis,the treatment group was given Wenyang Yiqi Decoction.After four treatment courses,the cardiac color ultrasound indexes[left ventricular end systolic diameter(LVESd),left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),and venous blood flow rate ratio(E/A)],myocardial injury markers[heart-shaped fatty acid binding protein(H-FABP),troponin(cTnI),and myoglobin(Myo)],oxidative stress response indexes[malondialdehyde(MAD),lipid peroxide(LPO),and superoxide dismutase(SOD)],endothelial function indexes[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)score]before and after treatment of the two groups were compared.Results(1)In terms of cardiac color ultrasound indexes,there was no significant difference in LVESd and LVEDd between the two groups after treatment and before treatment(P>0.05).As compared with before treatment,LVEF was decreased,and E/A was increased(P<0.05).There was no significant difference in LVESd and LVEDd between the two groups after treatment(P>0.05).The LVEF in the treatment group was higher than that in the control group,while the E/A was lower(P<0.05).(2)In terms of myocardial injury markers,after treatment,the levels of serum H-FABP,cTnI,and Myo in the two groups were higher(P>0.05),and the levels of the indexes in the treatment group wer

关 键 词：蒽环类化疗药物 心肌损伤 温阳益气汤 心功能 氧化应激 内皮功能 生活质量 

分 类 号：R542.2[医药卫生—心血管疾病]