丹参饮加味辅助西药治疗高血压伴心肌梗死患者的疗效及作用机制分析

Curative Effect and Mechanism of Modified Danshen Decoction(丹参饮加味)Combined with Western Medicine in Treatment of Patients with Hypertension and Myocardial Infarction

目的探究高血压伴心肌梗死患者应用丹参饮加味辅助西药治疗并分析其作用机制。方法以本院2017年1月—2019年7月期间收治116例高血压伴心肌梗死患者为对象,根据随机分组方式将患者分为中西医联用组(n=58)和单用西医组(n=58),分别应用丹参饮加味辅助西药与单纯西医治疗。比较两组患者治疗前后血压与心脏功能,心肌情况,血流动力学指标,血脂情况,不良反应发生率。结果两组患者治疗后血压与心脏功能、心肌情况、血流动力学指标、血脂情况均明显改善(P<0.05)。治疗后中西医联用组患者舒张压、收缩压、WMSI等血压与心脏功能指标,心肌梗死面积、颈动脉内膜中层厚度等心肌指标,全血黏度比高切、红细胞压积、血浆黏度、全血黏度比低切、纤维蛋白原等血流动力学指标,TC、TG、HDL-C等血脂水平显著低于单用西医组,LVEF、CI等心脏功能指标,LDL-C水平均显著高于单用西医组(P<0.05);中西医联用组患者不良反应发生率低于单用西医组,差异没有统计学意义(6.78%VS 11.86%,P>0.05)。结论高血压伴心肌梗死采用丹参饮加味辅助西药治疗效果显著,其主要依靠缓解患者心肌损伤,降低血脂水平,改善患者血流动力学情况发挥作用。

Objective To investigate the curative effect and mechanism of Modified Danshen(丹参饮加味)Decoction combined with western medicine in the treatment of patients with hypertension and myocardial infarction.Methods A total of 116 patients with hypertension and myocardial infarction who were admitted to the hospital between January 2017 and July 2019 were selected as the subjects.They were randomly divided into the traditional Chinese and western medicine group(n=58)and the Western medicine group(n=58).The two groups were treated with Modified Danshen Decoction combined with western medicineand western medicine alone,respectively.Blood pressure,cardiac function,myocardial condition,hemodynamic parameters,blood lipids and incidence of adverse reactions were compared between the two groups before and after treatment.Results Blood pressure,cardiac function,myocardial condition,hemodynamic parameters and blood lipids in both groups were significantly improved after treatment(P<0.05).After treatment,blood pressure and cardiac function indicators such as diastolic blood pressure,systolic blood pressure and WMSI,myocardial indexes such as myocardial infarct size and carotid intima-media thickness,hemodynamic parameters such as whole blood high-shear viscosity,hematocrit,plasma viscosity and whole blood low-shear viscosity,levels of blood lipids such as TC,TG and HDL-C in the traditional Chinese and western medicine group were significantly lower than those in the western medicine group.However,cardiac function indicators like LVEF and CI and the LDL-C level were significantly higher than those of the western medicine group(P<0.05).The incidence of adverse reactions was lower in the traditional Chinese and western medicine group than that in the western medicine group(6.78%vs 11.86%,P>0.05).Conclusion Modified Danshen Decoction combined with western medicine is effective in the treatment of hypertension with myocardial infarction.It works mainly by relieving myocardial injury,lowering levels of blood lipids and improving hemodynamics.