芪丹保心汤联合沙库巴曲缬沙坦治疗心肌梗死临床研究

Clinical Study on Qidan Baoxin Tang Combined with Sacubitril Valsartan for Myocardial Infarction

目的:观察芪丹保心汤联合沙库巴曲缬沙坦治疗心肌梗死的临床疗效及其对黏附分子、内皮功能的影响。方法:选择2018年3月—2019年3月收治的80例急性心肌梗死患者为研究对象,随机分为2组各40例。对照组予常规西药加沙库巴曲缬沙坦钠片治疗,观察组在对照组治疗方案的基础上加用芪丹保心汤口服治疗,观察2组临床疗效、黏附分子及血管内皮功能。结果:治疗后,观察组中N末端B型利钠肽原(NT-proBNP)及SF-36评分均显著优于对照组,差异均有统计学意义(P<0.05);治疗后,观察组血管内皮细胞黏附分子-1 (VCAM-1)及可溶性细胞间黏附分子-1 (ICAM-1)均优于对照组,差异均有统计学意义(P<0.05);总有效率观察组92.50%,高于对照组75.00%,差异有统计学意义(P<0.05);治疗后,观察组一氧化氮(NO)、内皮素(ET-1)优于对照组,差异均有统计学意义(P<0.05)。结论:芪丹保心汤联合沙库巴曲缬沙坦治疗心肌梗死有良好效果,可有效改善患者心功能及生活质量,其机制可能与芪丹保心汤具有调节心肌梗死患者黏附分子表达,提高血清一氧化氮水平,抑制内皮素表达及保护血管内皮有关。

Objective:To observe the clinical effect of Qidan Baoxin tang combined with sacubitril valsartan on myocardial infarction and its influence on adhesion molecules and endothelial function. Methods: A total of 80 patients with acute myocardial infarction admitted from March 2018 to March 2019 were selected as the research objects and randomly divided into two groups,40 cases in each group. The control group was treated with conventional western medicine and sacubitril valsartan,while the observation group was additionally treated with Qidan Baoxin tang based on the treatment of the control group. The clinical effect,adhesion molecules and vascular endothelial function in the two groups were observed. Results:After treatment,the scores of N-terminal B-type natriuretic peptide(NT-proBNP) and SF-36 in the observation group were significantly better than those in the control group,differences being significant(P<0.05). After treatment,levels of vascular endothelial cell adhesion molecule-1(VCAM-1) and soluble intercellular adhesion molecule-1(ICAM-1) in the observation group were better than those in the control group,differences being significant(P<0.05). The total effective rate was 92.50%in the observation group, higher than that of 75.00% in the control group, the difference being significant(P<0.05). After treatment, levels of nitric oxide(NO) and endothelin(ET-1) in the observation group were superior to those in the control group, differences being significant(P<0.05). Conclusion: The therapy of Qidan Baoxin tang combined with sacubitril valsartan has a good effect on the treatment of myocardial infarction,which can effectively improve the heart function and quality of life of patients,whose mechanism may be related to the ability of Qidan Baoxin tang to regulate the expression of adhesion molecules, increase the NO level in serum, inhibit the expression of endothelin and protect the vascular endothelium.