益母草和复方丹参注射液对兔心肌缺血-再灌注损伤及冠心病患者的疗效比较

Comparison the Therapeutical Effects of Leonuru Heterophyllus Injection and Composite Salvia Miltiorrhiza Injection on Myocardial Ischemia-Reperfusion Injury in Rabcits and on the Patients with Coronary Heart Disease

目的 :探讨益母草与复方丹参注射液对兔心肌缺血 再灌注损伤及冠心病患者的疗效。方法 :①动物实验 :新西兰白兔 4 0只 (造成心肌缺血 再灌注损伤模型 )等分为益母草组 (Ⅰ组 ) ;复方丹参组 (Ⅱ组 ) ;维拉帕尔组 (Ⅲ组 )和缺血 再灌注组(对照组 )。实验过程中观测心电图 ,左室内压峰值 (LVSP)、左室内压最大上升和下降速率 (±dp dtmax)。②临床观察 :心肌缺血患者 72例分为益母草组 (治疗组 4 2例 )和复方丹参组 (对照组 30例 )。观察两组治疗前后心电图、心功能、血液流变学、甲襞微循环、症状、体征等的变化。结果 :①动物实验 :各治疗组和对照组比较 ,缺血 4 0min及再灌注 4 0min的LVSP、±dp dtmax均明显高于对照组 ,而∑ST段则明显低于对照组 (P <0 0 1)。再灌注 4 0min ,Ⅰ组优于其他治疗组 (P <0 0 1)。②临床观察 :两组经 30天治疗后心电图、症状、体征、心功能、血液流变学等指标均明显改善 (P <0 0 1) ,治疗组优于对照组 (P <0 0 1)。两组治疗后微循环瘀滞均有明显改善 (P <0 0 1) ,但治疗组优于对照组 (P <0 0 1)。结论 :益母草注射液、维拉帕尔注射液、复方丹参注射液对心肌缺血 再灌注损伤有明显疗效 ,可改善ECG、心功能、微循环、血液流变学 。

Objective: To compare the therapeutical effects of Leonuru Heterophyllus injection(LHI)and composite salvia miltiorrhiza injection(CSMI)on myocardial ischemia reperfusion injury in rabbits and on the patients with coronary heart disease(CHD). Methods: Forty rabbits were randomly divided into LHI group, CSMI group, Verapamil injection group(VI)and ischemia reperfusion control group(I RC). Seventy two patients with myocardial ischemia were divided into the groups of LHI and CSMI. Results: The values of LVSP, ±dp/dt max at the 40th minute after ischemia and the 40th minute after reperfusion in the LHI group, CSMI group and VI group were obviously higher than those of I RC group respectively( P <0 01), whereas the values of ∑ST segment voltage in lead ECG were obviously lower than those of I RC group respectively( P <0 01). The therapeutical effects of LHI group on the reperfusion injury were remarkably better than those of CSMI group and VI group respectively( P <0 01). After 30 days of LHI or CSMI therapy, the ECG, cardial function, microcirculation, hemorheology in the patients with CHD had obviously got better( P <0 01), but the therapeutical effect of the LHI group was better than that of CSMI group. Conclusion: LHI, VI and CSMI can improve the cardial function and alleviate the myocardial ischemia and reperfusion injury. The therapeutical effect of the LHI is better than that of CSMI and VI.