五参汤加减治疗对心梗患者PCI术后血液流变学、心功能的影响  

Effect of Modified Wushen Decoction on Hemorheology and Cardiac Function in Patients with Myocardial Infarction after PCI

作　　者：王晶 郭晋源 杨海龙 李刚 张云锋 WANG Jing;GUO Jinyuan;YANG Hailong;LI Gang;ZHANG Yunfeng(Baoji High tech Hospital,Shaanxi Baoji 721000,China;Yijun County People s Hospital,Shaanxi Yijun 727299,China)

机构地区：[1]宝鸡高新医院,陕西宝鸡721000 [2]宜君县人民医院,陕西宜君727299

出　　处：《现代中医药》2024年第1期56-61,共6页Modern Chinese Medicine

基　　金：陕西省重点研发计划项目(S2017-ZDYF-YBXM-SF-0221)。

摘　　要：目的观察急性心肌梗死患者经皮冠状动脉介入术(PCI)后给予五参汤加减治疗对患者心功能、血液流变学的影响。方法选取2020年4月—2022年5月我院收治的进行PCI治疗的急性心肌梗死患者88例,随机分为对照组(44例,术后常规西药治疗)、五参汤组(44例,术后常规西药+五参汤加减治疗),测量比较两组患者治疗前后血液流变学、心功能、血清炎性因子、氧化应激指标,记录心血管不良事件及不良反应发生情况。结果治疗后五参汤组3项血液流变学指标均显著低于对照组(P<0.05);治疗后五参汤组C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P<0.05);治疗后五参汤组血清MDA水平低于对照组,SOD水平高于对照组(P<0.05);治疗后五参汤组左心室射血分数(LVEF)显著高于对照组,左心室收缩末期内径(LVESD)显著低于对照组(P<0.05);五参汤组心血管不良事件发生率显著低于对照组(P<0.05);不良反应发生率对比,五参汤组与对照组无显著差异(P>0.05)。结论五参汤加减用于急性心肌梗死PCI术后治疗可显著改善患者血液流变学及心功能,降低PCI术后MACE发生率,给药安全性高,其生效机制可能与下调炎性因子,减轻氧化应激反应有关。Objective To observe the effects of modified Wushen decoction on cardiac function and hemorheology in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods 88 patients with acute myocardial infarction treated with PCI in our hospital from April 2020 to May 2022 were selected and randomly divided into a control group(44 cases,treated with conventional Western medicine after surgery)and a Wushen decoction group(44 cases,treated with conventional Western medicine and modified Wushen decoction after surgery).Blood rheology,heart function,serum inflammatory factors,oxidative stress indicators were measured and compared between the two groups before and after treatment,and cardiovascular adverse events and adverse reactions were recorded.Results After treatment,the three hemorheological indicators in the Wushen decoction group were significantly lower than those in the control group(P<0.05);After treatment,the levels of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the Wushen decoction group were significantly lower than those in the control group(P<0.05);After treatment,the serum MDA level in the Wushen decoction group was lower than that in the control group,while the SOD level was higher than that in the control group(P<0.05);After treatment,the left ventricular ejection fraction(LVEF)in the Wushen decoction group was significantly higher than that in the control group,and the left ventricular end systolic diameter(LVESD)was significantly lower than that in the control group(P<0.05);The incidence of cardiovascular adverse events in the Wushen decoction group was significantly lower than that in the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the Wushen decoction group and the control group(P>0.05).Conclusion Modified Wushen decoction can significantly improve hemorheology and cardiac function in patients with acute myocardial infarction after PCI,reduce the incidence of MACE after PCI,and has high sa

关 键 词：急性心肌梗死 经皮冠状动脉介入术 心功能 血液流变学 炎性因子 

分 类 号：R256.22[医药卫生—中医内科学]