Effect of Guanxin-V Mixture Combined with Sacubitril Valsartan on Cardiac Function after PCI in STEMI Patients

[Objectives]To observe the effect of Guanxin-V Mixture combined with Sacubitril Valsartan on cardiac function in patients after PCI for acute ST-segment elevation myocardial infarction(STE-MI).[Methods]41 cases of STEMI patients(qi and yin deficiency and blood stasis and obstruction)hospitalized in Nanjing Hospital of Chinese Medicine affiliated to Nanjing University of Chinese Medicine from January 2020 to June 2021 were randomly divided into 21 cases in the treatment group and 20 cases in the control group,and the two groups were given standardized Western medicine treatment as soon as possible after PCI.The control group was treated with Sacubitril Valsartan,and the treatment group was treated with Guanxin-V Mixture on the basis of treatment in the control group.The patients in the two groups were treated for 3 months,and the TCM syndrome score,left ventricular ejection fraction(LVEF),and N-Terminal Pro-Brain Natriuretic Peptide(NT-proBNP),interleukin-6(IL-6),and high-sensitivity C-reactive protein(hs-CRP)levels,and the incidence of heart failure and adverse reactions in the two groups after treatment were recorded.[Results]After the treatment,the TCM syndrome score and serum NT-proBNP,IL-6 and hs-CRP levels of the two groups significantly decreased(P<0.05),and the levels of the treatment group were significantly lower than those of the control group(P<0.05);the LVEF of the two groups significantly increased(P<0.05),and the level of the treatment group was significantly higher than that of the control group(P<0.05).Comparison of the incidence of heart failure and adverse reactions in the two groups showed no statistically significant differences(P>0.05).[Conclusions]Guanxin-V Mixture combined with Sacubitril Valsartan could significantly improve cardiac function in STEMI patients undergoing PCI,and its effect may be related to the suppression of inflammatory response.

冠心V号合剂联合西医常规疗法对冠心病慢性收缩性心功能不全患者心功能的影响

目的观察冠心V号合剂联合西医常规疗法对冠心病慢性收缩性心功能不全患者心功能的影响。方法将60例冠心病慢性收缩性心功能不全患者随机分为两组,治疗组31例,对照组29例。对照组给予西医常规治疗,治疗组在西医常规治疗的基础上加用中药冠心Ⅴ号合剂。两组疗程均为28天。观察治疗前后血流动力学指标、6分钟步行试验的变化情况。结果两组治疗后EF、CO、SV、6分钟步行距离均较治疗前提高(P<0.05),且治疗组治疗后各项指标均高于对照组(P<0.05)。结论冠心V号合剂联合西医常规疗法可提高冠心病心功能不全患者运动耐量,调节血流动力学,改善心功能。

冠心Ⅴ号合剂干预急性心肌梗死模型大鼠心室重构及心肌TLR4信号通路研究

目的:观察冠心Ⅴ号合剂对急性心肌梗死(AMI)模型大鼠心室重构及心肌TLR4信号通路的影响。方法:雄性SD大鼠56只,采用冠状动脉左前降支结扎法建立急性心肌梗死模型,分别给予冠心Ⅴ号合剂小剂量(0.5 g/ml)、中剂量(1 g/ml)、大剂量(2 g/ml)及血脂康胶囊连续干预4周,以心脏彩超观察心脏结构及心功能,荧光定量PCR法检测TLR4mRNA、Myd88mRNA、NF-κBmRNA表达。结果:模型组实验大鼠心功能明显下降,梗死区心肌组织TLR4mRNA、Myd88mRNA、NF-κBmRNA表达上调,与空白组、假手术组比较差异有统计学意义;药物干预组各组上述指标均低于模型组;冠心Ⅴ号合剂大剂量组上述指标低于余治疗组,差异有统计学意义。结论:冠心Ⅴ号合剂能够抑制急性心肌梗死大鼠TLR4信号通路并改善心室重构。

HPLC法测定冠心Ⅴ号合剂中丹参酮ⅡA含量

目的：建立测定冠心Ⅴ号合剂中丹参酮ⅡA含量的HPLC方法。方法：采用高效液相色谱法,以甲醇-水（80∶20）为流动相,色谱柱为Kromasil C18柱（4.6mm×250mm,5μm）,柱温为30℃,流速为1.0mL·min-1,检测波长为270nm。结果：丹参酮ⅡA在0.012 5~0.360 0μg范围内呈良好的线性关系,平均回收率为98.06%。结论：本方法简便可行、重复性好,可用于测定冠心Ⅴ号合剂中丹参酮ⅡA的含量。

HPLC法同时测定冠心Ⅴ号颗粒中丹参素和丹参酮ⅡA的含量

目的建立同时测定冠心V号颗粒中丹参素和丹参酮ⅡA含量的HPLC方法。方法采用高效液相色谱法，以甲醇一0．5％醋酸水溶液梯度洗脱，色谱柱为KromasilC18柱（4．6×250mm，5μm），流速为1．0mL·min－1，检测波长为281nm，柱温为35℃。结果丹参素和丹参酮ⅡA分别在0．1～0．8μg和0．02-0．16μg范围内呈良好的线性关系；平均回收率分别为100．17％和99．35％。结论本方法简便可行、重复性好，可用于同时测定冠心V号颗粒中丹参素和丹参酮ⅡA的含量。

冠心Ⅴ号合剂对大鼠急性心肌梗死后心室重构的作用及机制

目的:观察冠心Ⅴ号合剂对急性心肌梗死(AMI)后心室重构的作用,探讨冠心Ⅴ号合剂改善心室重构的机制。方法:雄性SD大鼠56只,随机分为空白组、假手术组、模型组、冠心Ⅴ号合剂临床等剂量组,2,4倍剂量组(0.5,1,2 g·kg-1),血脂康组(12.5 g·kg-1)。采用冠状动脉左前降支结扎法建立急性心肌梗死模型,各组模型鼠造模成功24 h后开始灌胃给药1次/d,连续4周,以心脏彩超测量射血分数(EF),缩短分数(FS),计算体表面积及左室心肌质量指数(LVMI),用Western blot技术检测Toll样受体4(TLR4),髓样分化因子(My D88),核因子-κB/P65(NF-κB/p65)蛋白表达。结果:与空白组、假手术组比较,模型组大鼠EF,FS降低,LVMI升高,梗死区心肌组织TLR4,My D88,NF-κB/p65蛋白表达上调,差异有统计学意义(P<0.05);与模型组比较,冠心Ⅴ号合剂干预组各组大鼠EF,FS升高,LVMI降低,梗死区心肌组织TLR4,My D88,NF-κB/p65蛋白表达降低,差异有统计学意义(P<0.05)。结论:冠心Ⅴ号合剂能够抑制TLR4/My D88/NF-κBp65信号通路,改善心室结构及心功能,从而干预心肌梗死后心室重构。

冠心Ⅴ号合剂HPLC指纹图谱研究

目的建立冠心Ⅴ号合剂的HPLC指纹图谱分析方法。方法采用Diamonsil C_(18)柱(4.6 mm×250 mm,5μm),检测波长:270 nm;以甲醇(A)-0.1%甲酸水溶液(B)为流动相,梯度洗脱;柱温:30℃;流速:1.0mL·min^(-1)。采用中药色谱指纹图谱相似度评价系统软件(2004A版),确定共有峰,计算相似度,并对其色谱峰进行了指认和归属。结果通过10批样品的测定,建立冠心Ⅴ号合剂HPLC指纹图谱,得到16个共有峰,相似度均在0.98以上。所建立的指纹图谱可用于冠心Ⅴ号合剂的定性鉴别。结论所建立方法专属性强、准确可靠、重复性好,为冠心Ⅴ号合剂的质量控制提供了有效方法。