扩心方治疗急性心肌梗死后患者心室重构的临床观察  

Clinical Observation of Kuoxin Formula in Treatment of Ventricular Remodeling in Patients with Acute Myocardial Infarction

作　　者：周尹轶凡 吴琼 王佑华[1] 李睿智 王浩[1] 曹敏[1] 邓兵[1] 周端[1] ZHOU Yin-yi-fan;WU Qiong;WANG You-hua;LI Rui-zhi;WANG Hao;CAO Min;DENG Bing;ZHOU Duan(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《时珍国医国药》2024年第12期2816-2820,共5页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金资助项目(82004319);上海市卫生健康委员会卫生健康青年人才培养计划(2022YQ040);上海市科技计划项目(22Y11922000);上海申康医院发展中心临床三年行动计划重大临床研究(SHDC2020CR4054)。

摘　　要：目的观察扩心方联合西医标准治疗对急性心肌梗死后患者心室重构的临床疗效。方法纳入100例患者随机分为对照组和观察组,每组50例,对照组给予西医标准治疗,观察组在此基础上加用扩心方,疗程12周。检测治疗前后临床疗效、心超指标(LVEF,LVEDD,LVESD,IVS,LVPWT),血清NT-proBNP,ST-2,Galectin-3,MMP-9,PICP,IL-6,VEGF以及MLHFQ评分、Lee氏心衰评分、主要心血管不良事件、安全性指标变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,观察组EF、LVEDD、LVESD改善优于对照组(P<0.05),血清NT-proBNP,ST2,Galectin-3,MMP-9,PICP,IL-6下降均优于对照组(P<0.05),血清VEGF增加优于对照组(P<0.05),两组患者均未发现明显不良反应。结论扩心方联合西医标准治疗可安全有效地缓解心肌梗死后患者临床症状,改善心室重构。Objective To observe the clinical effect of Kuoxin Formula combined with standard western medicine on ventricular remodeling in patients with acute myocardial infarction.Methods A total of 100 patients were randomly divided into control group and observation group,50 cases in each.The control group was treated with standard western medicine,and the observation group was treated with Kuoxin Formula on the basis of the control group for 12 weeks.Clinical efficacy,echocardiographic indexes(LVEF,LVEDD,LVESD,IVS,LVPWT),serum NT-proBNP,ST-2,Galectin-3,MMP-9,PICP,IL-6,VEGF,MLHFQ score,Lee's heart failure score,major adverse cardiovascular events,and safety indicators were detected before and after treatment.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the improvement of EF,LVEDD and LVESD in the observation group was better than that in the control group(P<0.05).Meanwhile,the serum NT-proBNP,ST2,Galectin-3,MMP-9,PICP and IL-6 in the observation group were obviously decreased while the serum of VEGF was increased(P<0.05).No significant adverse reactions were found in both groups.Conclusion Kuoxin Formula combined with western medicine standard treatment can safely and effectively relieve the clinical symptoms of patients with myocardial infarction and improve ventricular remodeling.

关 键 词：扩心方 急性心肌梗死 心室重构 气阴两虚兼血瘀证 

分 类 号：R256.22[医药卫生—中医内科学]