益气复脉方对气虚血瘀型阵发性房颤患者疗效及对血清CACNB2、microRNA-499水平的影响  

Effect of Yiqi Fumai Recipe on serum levels of CACNB2 and microRNA-499 in patients with paroxysmal atrial fibrillation of qi deficiency and blood stasis type

作　　者：王爱亮 李瑞[1] 高想[3] 顾宁[4] WANG Ailiang;Li Rui;GAO Xiang;GU Ning(Nanjing University of Traditional Chinese Medicine,Nanjing 210023,China;Department of Cardiology,Qidong Hospital of Traditional Chinese Medicine,Nantong 226200,China;Department of Cardiology,Nantong Hospital of Traditional Chinese Medicine,Nantong 226000,China;Department of Cardiology,Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210001,China)

机构地区：[1]南京中医药大学,江苏南京210023 [2]启东市中医院心内科,江苏南通226200 [3]南通市中医院心内科,江苏南通226000 [4]南京中医药大学附属南京中医院心内科,江苏南京210001

出　　处：《药物评价研究》2023年第2期401-407,共7页Drug Evaluation Research

基　　金：南通市科学技术局科研立项课题(JCZ2022062)。

摘　　要：目的探讨益气复脉方治疗气虚血瘀型阵发性房颤患者疗效及对患者血清L型钙通道β2(CACNB2)与微小RNA-499(miR-499)水平的影响。方法选取2020年2月—2022年2月启东市中医院收治的110例气虚血瘀型阵发性房颤患者,采用随机、非盲法将其分为对照组与试验组,每组各55例。对照组(脱落2例,纳入53例)采取常规治疗(口服达比加群酯胶囊及胺碘酮片),试验组(脱落1例,纳入54例)在对照组基础上联合益气复脉方(党参15 g、法半夏9 g、黄连10 g、鬼箭羽15 g、川芎15 g、丹参30 g、赤芍15 g、白芍15 g、炙甘草10 g、磁石30 g、远志10 g,乏力甚者加生黄芪补气治本,胸闷甚者加郁金、香附等行气开郁)治疗;4周为1个疗程,两组患者均治疗1个疗程。评估两组临床疗效及安全性。比较两组治疗前后房颤发作次数、房颤发作持续时间及主要症状改善情况。比较两组治疗前后血清CACNB2与miR-499水平。结果试验组治疗总有效率显著高于对照组(P<0.05)。治疗后,两组患者房颤发作次数及持续时间均显著低于本组治疗前(P<0.05),试验组患者房颤发作次数及持续时间均显著低于对照组(P<0.01)。治疗后,两组患者心悸、气短、胸闷、头晕和乏力等症状积分均显著低于本组治疗前(P<0.05),试验组患者心悸、气短、胸闷、头晕和乏力等症状积分均显著低于对照组(P<0.01)。治疗后,两组患者血清CACNB2高于本组治疗前(P<0.05),试验组患者血清CACNB2水平显著高于对照组(P<0.01)。治疗后,两组患者血清miR-499水平明显低于本组治疗前(P<0.05),试验组患者血清miR-499低于对照组(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论益气复脉方可有效上调阵发性房颤患者血清miR-499表达及降低CACNB2表达,改善患者临床症状,减少房颤发作次数,缩短单次发作持续时间,提高气虚血瘀型阵发性房颤临床疗效。Objective To explore the therapeutic effect of Yiqi Fumai Recipe on paroxysmal atrial fibrillation of qi deficiency and blood stasis type and its effect on serum L-type calcium channelβ2(CACNB2)and microRNA-499(miR-499)levels.Methods A total of 110 patients with paroxysmal atrial fibrillation of qi deficiency and blood stasis type treated in Qidong Hospital of Traditional Chinese Medicine from February 2020 to February 2022 were randomly divided into control group and experimental group,with 55 cases in each group.Patients in control group(two cases of abscission,the remaining 53 cases)were treated with routine treatment(orally administration with Dabigatran Ester Capsules and Amiodarone Tablets),and patients in experimental group(one case of abscission,the remaining 54 cases)were treated with Yiqi Fumai Formula based on control group.Four weeks was a course of treatment,and both groups received one course of treatment.The clinical efficacy and safety of the two groups were evaluated.The frequency of atrial fibrillation attack,duration of atrial fibrillation attack and improvement of main symptoms were compared between the two groups before and after treatment.The levels of serum CACNB2 and microRNA-499 were compared between the two groups before and after treatment.Results The clinical overall effective rate of the experimental group was significantly higher than that of the control group(P<0.05).After treatment,the frequency and duration of atrial fibrillation in two groups were significantly lower than before treatment,and the frequency and duration of atrial fibrillation in experimental group were significantly lower than control group(P<0.01).After treatment,the symptom scores of palpitation,shortness of breath,chest tightness,dizziness and fatigue in the two groups were significantly lower than those before treatment(P<0.01),and the symptom scores of palpitation,shortness of breath,chest tightness,dizziness and fatigue in the experimental group were significantly lower than those in the control group(P<0.0

关 键 词：益气复脉方 气虚血瘀 阵发性房颤 L型钙通道β2 微小RNA-499 

分 类 号：R973[医药卫生—药品]