参术益心汤对急性心肌梗死患者血管内皮功能和细胞因子影响

Effect of Shenzhu Yixin Decoction on Vascular Endothelial Function and Cytokines in Patients with Acute Myocardial Infarction

目的观察参术益心汤对急性心肌梗死患者血管内皮功能和细胞因子影响。方法94例患者依据随机数字表法分为观察组与对照组各47例。对照组患者采取常规治疗,观察组在对照组基础上服用参术益心汤。两组疗程均为14 d。比较两组治疗疗效,治疗前后主要症状积分、心功能[左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)]、血管内皮功能[内皮素-1(ET-1)和一氧化氮(NO)]和细胞因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平及不良反应。结果观察组急性心肌梗死患者总有效率为91.49%,高于对照组的72.34%(P<0.05)。观察组治疗后急性心肌梗死患者胸闷胸痛、倦怠乏力和气短懒言积分低于对照组(P<0.05)。观察组治疗后急性心肌梗死患者LVEDV和LVESV低于对照组,而LVEF高于对照组(P<0.05)。观察组治疗后急性心肌梗死患者ET-1水平低于对照组,而NO水平高于对照组(P<0.05)。观察组治疗后急性心肌梗死患者IL-1β、IL-6和TNF-α水平低于对照组(P<0.05)。两组治疗期间均未发生明显不良反应。结论参术益心汤对急性心肌梗死患者疗效良好,可显著减轻患者临床症状,改善血管内皮功能,且抑制炎症状态,保护心功能。

Objective:To investigate the effect of Shenzhu Yixin Decoction on vascular endothelial function and cytokines in patients with acute myocardial infarction.Methods:A total of 94 patients with acute myocardial infarction were divided into an observation group of 47 cases and a control group of 47 cases according to the random number table method.Patients in the control group took conventional treatment,and the observation group took Shenzhu Yixin Decoction on the basis of the control group.The course of treatment for both groups was 14days.The therapeutic effects of the two groups,the main symptom scores before and after treatment,cardiac function[left ventricular end diastolic volume(LVEDV),left ventricular end systole volume(LVESV)and left ventricular ejection fraction(LVEF)],vascular endothelial function[endothelin-1(ET-1)and nitric oxide(NO)]and cytokines[interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]changes,and adverse reactions were compared.Results:The total effective rate of patients with acute myocardial infarction(91.49%)was higher control group(72.34%)(P<0.05).After treatment,the observation group scores of chest tightness,chest pain,fatigue and shortness of breath in patients with acute myocardial infarction in the observation group were lower than those in the control group(P<0.05).After treatment,the LVEDV and LVESV of patients with acute myocardial infarction in the observation group were lower than those in the control group,while LVEF was higher than it in the control group(P<0.05).After treatment,the ET-1 level of patients with acute myocardial infarction in the observation group was lower than the control group,while the NO level was higher than the control group(P<0.05).After treatment,the levels of IL-1β,IL-6 and TNF-αin patients with acute myocardial infarction in the observation group were lower than the control group(P<0.05).No obvious adverse reactions occurred in the two groups during treatment.Conclusion:Shenzhu Yixin Decoction has a good effect on patients with acute myocardial infarction.It can significantly reduce the clinical symptoms of patients,improve vascular endothelial function,inhibit inflammation,and protect heart function.