活血化瘀中成药增强左卡尼丁在冠心病患者中的心肌保护作用研究

Study on the Myocardial Protective Effect of Left Carnitine on Patients with Coronary Heart Disease

目的探讨活血化瘀中成药在增强左卡尼丁在冠心病患者心肌保护中的作用。方法随机选取我院2016年1月至2018年1月符合诊断标准的冠心病患者80例。采用随机数字表法进行分组,对照组40例在常规抗凝、降脂等基础治疗上给予左卡尼丁2.0g+生理盐水250mL静脉滴注,观察组40例在对照组基础上加用活血化瘀中成药(大珠红景天10mL+红花黄色素150mg+丹红注射液20mL+血栓通注射液450mg+丹参多酚酸盐150mg+长春西丁30mg)静滴,记录两组患者治疗前、治疗后6、12、24和36h心肌酶谱(CK-MB、cTnI、CK)含量的变化以及心功能指标心指数(CI)以及左心射血分数(LVEF)的变化。结果两组患者心肌酶谱均较降低,差异具有统计学意义(P<0.05);治疗后cTnI呈先高后降低的趋势,在治疗后12h开始明显降低,CK-MB在治疗后12h降低最明显,但在随后的24h和36h与对照组比较差异无统计学意义(P>0.05),CK在治疗后均呈明显下降趋势(P<0.05);两组在治疗后CI和LVEF在第3天开始升高,其中第5天开始与对照组比较差异具有统计学意义(P<0.05)。结论应用活血化瘀中成药可在早期即增强左卡尼丁在冠心病患者中的心肌保护作用,其联合应用的心肌保护作用优势更为明显。

Objective to explore the role of traditional Chinese medicine for promoting blood circulation and removing blood stasis in enhancing myocardial protection in patients with coronary heart disease.Methods A total of 80 cases of CHD patients who met the diagnostic criteria were randomly selected from January 2016 to January 2018 in our hospital.Using the random number table method to group,control group 40 cases in the conventional anticoagulant,lipid-lowering treatment based on l carnitine for a 2.0 g+saline 250 mL intravenous drip,observation group 40 cases in the control group with promoting blood circulation to remove blood stasis based on proprietary Chinese medicine safflower yellow pigment(big bead rhodiola 10 mL+150 mg+20 mL+Dan red injection blood clots injection 450 mg+salvia miltiorrhiza polyphenols acid salt 150 mg+changchun cefoxitin 30 mg)static drops,The changes of myocardial enzyme spectra(ck-mb,cTnI,CK)at 6 h,12 h,24 h,and 36 h before and after treatment,as well as the changes of cardiac function index(CI)and left ejection fraction(LVEF)were recorded.Results the myocardial enzyme spectra of the two groups were decreased,and the difference was statistically significant(P<0.05).After the treatment,cTnI showed a trend of the first height and then decreased,which began to decrease significantly 12 hours after the treatment.Ck-mb decreased most significantly 12 hours after the treatment,but the difference was not statistically significant at 24 h and 36 hours after the treatment(P>0.05).After treatment,CI and LVEF in the two groups began to increase on the third day after surgery,and the difference was statistically significant on the fifth day compared with the control group(P<0.05).Conclusion the myocardial protective effect of l-carnitine on patients with coronary heart disease can be enhanced at an early stage by using traditional Chinese medicine for promoting blood circulation and removing stasis.