血府逐瘀汤联合瑞舒伐他汀治疗急性心肌梗死的疗效及对血管内皮功能和炎症因子的影响

Efficacy of Xuefu Zhuyu Decoction combined with rosuvastatin in treatment of acute myocardial infarction and its impacts on vascular endothelial functions and inflammatory factors

目的分析血府逐瘀汤联合瑞舒伐他汀治疗急性心肌梗死的疗效及对血管内皮功能和炎症因子的影响。方法选择2020年6月~2022年7月期间于北京中医医院顺义医院收治的急性心肌梗死患者(n=272)为研究对象,按照简单随机数字表法将其分为对照组(136例,口服瑞舒伐他汀治疗)和观察组(136例,在对照组的基础上给予血府逐瘀汤治疗)。记录两组临床疗效及随访期间不良心血管事件的发生情况,并对比两组患者治疗前后血管内皮功能指标及炎症因子水平。结果观察组总有效率(94.8%)高于对照组(84.6%),差异有统计学意义(P<0.01)。治疗前两组患者血清hs-CRP、TNF-α、IL-8及IL-6水平比较差异无显著差异。治疗前、治疗后7 d和治疗后14 d各组数值依序下降,相邻组间及跨组间均有统计学差异(均P<0.05)。而治疗后观察组均低于同期对照组相应数据(均P<0.01)。治疗前两组患者FMD、ITM、NO及ET-1水平差异无统计学意义;与治疗前比较,治疗后两组FMD与NO均依序明显升高(均P<0.01),ITM与ET-1均依序明显降低(均P<0.01);治疗7 d后,观察组FMD(P<0.05)与NO(P<0.01)高于对照组,ITM(P<0.01)与ET-1(P<0.05)低于对照组;治疗14 d后,两组FMD、ITM、NO与ET-1比较均无显著差异。随访6个月,观察组治疗后综合心率失常、心力衰竭、再发心肌梗死和再发心绞痛等指标,不良心血管事件总发生率低于对照组(P<0.01)。结论血府逐瘀汤联合瑞舒伐他汀可降低急性心肌梗死患者不良心血管事件的发生率,抑制炎症反应,保护血管内皮功能,提高疾病治疗效果。

AIM To analyze the efficacy of Xuefu Zhuyu Decoction combined with rosuvastatin in treatment of acute myocardial infarction and its impacts on vascular endothelial functions and inflammatory factors.METHODS A total of 272 patients with acute myocardial infarction admitted to our hospital from June 2020 to July 2022 served as the research subjects and according to the simple random number table,they were grouped into the control group(136 cases,treated with rosuvastatin)and the observation group(136 cases,treated with Xuefu Zhuyu Decoction on the basis of the control group).The clinical efficacy and incidence of adverse cardiovascular events during follow-up were recorded in both groups and vascular endothelial function indicators and inflammatory factor levels were compared before and after treatment in both groups.RESULTS The total effective rate of the observation group(94.8%)was higher than that of the control group(84.6%),with a statistically significant difference(P<0.01).Serum hs CRP and TNF in the two groups of patients before treatment-α、There was no significant difference in the levels of IL-8 and IL-6.The values of each group decreased sequentially before treatment,7 days after treatment,and 14 days after treatment,with statistical differences between adjacent groups and across groups(all P<0.05).After treatment,the observation group was lower than the corresponding data of the control group during the same period(all P<0.01).There was no statistically significant difference in the levels of FMD,ITM,NO,and ET-1 between the two groups of patients before treatment;Compared with before treatment,FMD and NO in both groups increased significantly in sequence after treatment(all P<0.01),while ITM and ET-1 decreased significantly in sequence(all P<0.01);After 7 days of treatment,FMD(P<0.05)and NO(P<0.01)in the observation group were higher than those in the control group,while ITM(P<0.01)and ET-1(P<0.05)were lower than those in the control group;After 14 days of treatment,there was no significant difference in FMD,ITM,NO,and ET-1 between the two groups.After a follow-up of 6 months,the observation group showed a lower overall incidence of adverse cardiovascular events compared to the control group(P<0.01)in terms of comprehensive indicators such as arrhythmia,heart failure,recurrent myocardial infarction,and recurrent angina pectoris after treatment.CONCLUSION Xuefu Zhuyu Decoction combined with rosuvastatin reduces the incidence of adverse cardiovascular events in patients with acute myocardial infarction,inhibits inflammatory reaction,protects vascular endothelial function and improves the therapeutic effect of disease.