温阳活血法抑制心房颤动患者心房重构及血栓前状态的机制研究

Mechanisms on Atrial Remodeling and Prethrombotic State Inhibited with Wenyang Huoxue Therapy in the Patients of Atrial Fibrillation

目的探讨温阳活血法抑制心房颤动患者心房重构及血栓前状态的机制。方法将明确诊断为持续性房颤患者79例,随机单盲分为治疗组与对照组。两组患者均接受西药常规治疗(抗血小板聚集药物及控制心室律药物β受体阻滞剂),治疗组在此基础上加温阳活血法组方的中药治疗,疗程为28 d。评价两组患者治疗后临床疗效,并计算中医症候积分,观察两组患者治疗前后血浆金属蛋白酶-9(MMP-9)、血小板(PLT)、纤维蛋白原(FIB)变化情况。结果两组患者治疗后临床疗效比较,治疗组优于对照组(P<0.05)。两组患者治疗后中医症候积分、血浆MMP-9、PLT、FIB变化比较,治疗组明显低于对照组,两组比较差异有统计学意义(P<0.05,P<0.01)。结论温阳活血药物治疗心房颤动能够明显改善患者心悸、气短等症状,具有抑制心房重构的趋势及抑制血栓前状态的作用。

Objective To explore the mechanisms on atrial remodeling and prethrombotic state in- hibited with Wenyang Huoxue therapy（ the therapy for warming up yang and activating blood circulation）in the patients of atrial fibrillation （AF）. Methods Seventy - nine patients diagnosed as persistent AF were di- vided into a treatment group and a control group with random single blind method. The conventional western medication（ aspirin for anti -platelet aggregation and 13 blockers for controlling ventricular rhythm）was ac- cepted in the two groups. In the treatment group, on the basic treatment, the herbal medication was added for warming up yang and activating blood circulation. The duration of treatment was 28 days. The clinical efficacy was evaluated before and after treatment in the two groups. TCM symptom score was calculated. The changes in MMP -9, PLT and FIB were observed before and after treatment in the two groups. Results In compari- son of clinical efficacy after treatment, the result in the treatment group was better than that in the control group （ P 〈 0.05 ）. The changes in TCM symptom score, plasma MMP - 9, PLT and FIB in the treatment group were less than those in the control group after treatment, indicating the significant difference （ P 〈 0.05, P 〈 0.01 ）. Conclusion The herbal medicine for warming up yang and activating blood circulation relieves pal- pitation and shortness of breath in the treatment of AF and inhibits atrial remodeling and prethrombotic state.