心肌梗死后心室重构过程中医治则治法的运用及其机制(英文)

Application and mechanism of therapeutic principles in Chinese medicine in ventricular reconstruction after myocardial infarction

目的:心肌梗死后心室重构是远期发生心脏功能障碍的重要危险因素之一,中医药对心肌梗死后心室重构的主要治疗原则及治疗方法有其独特的优势。资料来源:应用网络www.google.com,Medline检索1987-01/2003-12中国医学核心期刊关于心肌梗死后心室重构研究方面的相关文献,逐一校对,检索词:心室复建(reconstruction,ventricular),心肌梗塞(myocardialinfarction),清热化痰removingblood-stasisandresolvingspu-(tum,清心养阴(clearingheatandnourishingyin)。)资料选择:选择心肌梗死后心室重构的相关文献56篇,排除非随机研究原著性文献,未排除非盲法研究原著的文献。资料提炼:在56篇文献中,内容呈不同程度重复的有14篇,给予删除;对42篇文献进行分类整理,用于综述,其中12篇选用为参考文献。资料综合:心肌梗死为本虚标实之证,以益气活血、祛瘀化痰、调气理脾、清热养阴等为主要治疗法则,其中益气为治本中之本,养阴为治本中之标;祛瘀化痰为治标中之本,理气清热为治标中之标。益气活血可通过减轻心室压力和体循环血管阻力,改善血流动力学而可能对防治心室重构有益。结论:心肌梗死后心肌适应不良性肥厚和心肌外基质堆积和纤维化,长期使用祛瘀化痰、清热养阴等方法可抗心肌梗死后心室重构,改善心脏功能。

OBJECTIVE:Ventricular reconstruction after myocardial infarction is one of the important dangerous factors to the remote occurrence of cardiac functional disturbance.Chinese medicine is of unique advantages in the main therapeutic principles and methods for the post infarct ventricular reconstruction.DATA SOURCES:To search for and proofread the relevant literatures on the researches on post infarct ventricular reconstruction in Nuclear Journals of Chinese Medicine from January 1987 to December 2003 by www.google.com, Medline.Referring word:ventricular reconstruction,myocardial infarction,removing blood stasis and resolving phlegm,clearing heat and nourishing yin.STUDY SELECTION:Fifty six papers on post infarct ventricular reconstruction were selected,excluded the original literatures on non random researches and included the original literatures on non blind researches.DATA EXTRACTION:Of 56 papers,14 papers were deleted for they were repeated in the contents in different degrees.The rest 42 papers were classified and 12 papers of which were selected as the references.DATA SYNTHESIS:Myocardial infarction is the syndrome in which the root cause is deficiency and the symptoms are excess.The main therapeutic principles are to benefit qi,eliminate stasis,resolve phlegm, activate blood circulation, regulate qi,strengthen spleen, clear away heat and nourish yin.Of which,benefiting qi is the primary of the treatment for the root cause and nourishing yin is the secondary of the treatment for the root cause.Eliminating stasis and resolving phlegm is the primary of the treatment for symptoms,regulating qi and clearing away heat is the secondary of the treatment for symptoms.To benefit qi and activate blood circulation can improve blood dynamics to probably benefit the protection of ventricular reconstruction by reducing ventricular pressure and vascular resistance of systematic circulation.CONCLUSION:After myocardial infarction,it happens inadaptable myocardial hypertrophy and external stromal accumulation and fibrosis of cardiac muscles.Long term application of the principles for eliminating stasis,resolving phlegm,clearing away heat and nourishing yin can resist ventricular reconstruction and improve post infarct cardiac function.