复方延胡索汤剂治疗急性心肌梗死合并恶性室性心律失常

Study on Compound Rhizoma Corydalis Decoction in the Treatment of Acute Myocardial Infarction Complicated with Malignant Ventricular Arrhythmia

目的:观察复方延胡索汤剂治疗早期急性心肌梗死合并恶性心律失常的临床疗效。方法:将106例早期急性心肌梗死合并恶性室性心律失常患者按照随机数字表法分为对照组和观察组,每组各53例。对照组予以盐酸胺碘酮片治疗,观察组在对照组治疗的基础上给予复方延胡索汤剂治疗。比较两组患者的临床疗效、不良反应发生率及治疗前后中医证候积分、心肌酶谱指标[肌酸激酶同工酶-MB(creatine kinase isoenzymes,CK-MB)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)]、血管内皮功能指标[一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)、血管性假血友病因子(Von willebrand factor,vWF)]、心电图检查以及炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、超敏C反应蛋白(hs-C reactive protein,hs-CRP)]变化情况。结果:观察组有效率为90.57%,对照组有效率为75.47%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分、CK-MB、NT-proBNP、cTnⅠ、QT、Tp-Te、Tp-Te/QT、TNF-α、IL-6及hs-CRP水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后NO高于本组治疗前,ET-1、vWF低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:复方延胡索汤剂治疗早期急性心肌梗死合并恶性心律失常,可缓解患者的临床症状,有效减轻患者心肌缺血程度,改善其血管内皮功能,降低炎性因子水平。

Objective:To observe the clinical efficacy of Compound Rhizoma Corydalis Decoction on acute myocardial infarction compli-cated with malignant ventricular arrhythmia.Methods:A total of 106 patients with early acute myocardial infarction complicated with ma-lignant ventricular arrhythmias were randomly divided into the control group and the observation group,with 53 cases in each group.The control group was treated with Amiodarone Hydrochloride Tablets,while the observation group was treated with Compound Rhizoma Co-rydalis Decoction on the basis of the control group.Then the clinical efficacy,adverse reaction rate,the changes in TCM syndrome score,myocardial zymogram indexes[including creatine kinase isozyme MB(CK-MB),N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI)],vascular endothelial function indexes[including nitric oxide(NO),endothelin-1(ET-1),von willebrand factor(vWF)],electrocardiogram and inflammatory factors[including tumor necrosis factor-α(TNF-α),interleukin 6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)]of the two groups before and after treatment were compared.Results:The effective rate of the observation group was 90.57%,while that of the control group was 75.47%.The difference between the two groups of pa-tients was statistically significant(P<0.05).After treatment,the TCM syndrome scores,the levels of CK-MB,NT-proBNP,cTnⅠ,QT,Tp-Te,Tp Te/QT,TNF-α,IL-6 and hs-CRP of the two groups were all lower than those of the same group before treatment,and the above indexes in the observation group were lower than those in the control group before treatment,and all the differences were statisti-cally significant(P<0.05);The NO level in the two groups was higher than that of the same group before treatment,while the ET-1 and vWF levels were lower than those before treatment,and all the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Com-pound Rhizoma Corydalis Decoction can alleviate the clinical symptoms of patients with early acute myocardial infarction complicated with malignant arrhythmia,effectively reduce myocardial ischemia injury,improve vascular endothelial function,and reduce the levels of inflammatory factors.