Shexiang Tongxin Dropping Pill combined with thrombus aspiration improves myocardial perfusion after PCI in patients with STEMI: the clinical research

Objective:To study the effect of Shexiang Tongxin Dropping Pill combined with thrombus aspiration on improving myocardial perfusion after PCI in patients with STEMI.Methods:A total of 104 patients with STEMI who received emergency PCI combined with thrombus aspiration in our hospital between May 2013 and October 2015 were selected as the research subjects and randomly divided into two groups: observation group received perioperative antiplatelet combined with Shexiang Tongxin Dropping Pill therapy, and the control group received perioperative antiplatelet therapy alone. Before treatment and 3 days after treatment, serum myocardial injury indexes, endothelial injury indexes and RAS system indexes were determined;4 weeks after treatment, serum ventricular remodeling indexes were determined. Results:3 d after treatment, serum CK, CK-MB, cTnI, cTnT, ET-1, vWF, PRA, AngII and ALD levels of both groups were significantly lower than those before treatment while NO level was significantly higher than that before treatment;serum CK, CK-MB, cTnI, cTnT, ET-1, vWF, PRA, AngII and ALD levels of observation group 3 d after treatment were significantly lower than those of control group while NO level was significantly higher than that of control group;4 weeks after treatment, serum PICP, ICTP, PIIINP, HSP47 and GDF-15 levels of observation group were significantly lower than those of control group.Conclusion: Shexiang Tongxin Dropping Pill application during perioperative period of PCI combined with thrombus aspiration can reduce myocardial cell damage and endothelial function injury as well as inhibit RAS system activation and ventricular remodeling.

Shexiang Tongxin Dropping Pill Promotes Angiogenesis through VEGF/eNOS Signaling Pathway on Diabetic Coronary Microcirculation Dysfunction

Objective:To study the effect of Shexiang Tongxin Dropping Pill(STDP)on angiogenesis in diabetic cardiomyopathy mice with coronary microcirculation dysfunction(CMD).Methods:According to a random number table,6 of 36 SPF male C57BL/6 mice were randomly selected as the control group,and the remaining 30 mice were injected with streptozotocin intraperitoneally to replicate the type 1 diabetes model.Mice successfully copied the diabetes model were randomly divided into the model group,STDP low-dose group[15 mg/(kg·d)],medium-dose group[30 mg/(kg·d)],high-dose group[60 mg/(kg·d)],and nicorandil group[15 mg/(kg·d)],6 in each group.The drug was given by continuous gavage for 12 weeks.The cardiac function of mice in each group was detected at the end of the experiment,and coronary flow reserve(CFR)was detected by chest Doppler technique.Pathological changes of myocardium were observed by hematoxylin-eosin staining,collagen fiber deposition was detected by masson staining,the number of myocardial capillaries was detected by platelet endothelial cell adhesion molecule-1 staining,and the degree of myocardial hypertrophy was detected by wheat germ agglutinin staining.The expression of the vascular endothlial growth factor(VEGF)/endothelial nitric oxide synthase(eNOS)signaling pathway-related proteins in myocardial tissue was detected by Western blot.Results:Compared with the model group,medium-and high-dose STDP significantly increased the left ventricular ejection fraction and left ventricular fraction shortening(P<0.01),obviously repaired the disordered cardiac muscle structure,reduced myocardial fibrosis,reduced myocardial cell area,increased capillary density,and increased CFR level(all P<0.01).Western blot showed that high-dose STDP could significantly increase the expression of VEGF and promote the phosphorylation of vascular endothelial growth factor receptor 2,phosphoinositide 3-kinase,protein kinase B,and eNOS(P<0.05 or P<0.01).Conclusion:STDP has a definite therapeutic effect on diabetic CMD,and its mechanism may be related to promoting angiogenesis through the VEGF/eNOS signaling pathway.

Shexiang Tongxin Dropping Pill Allieviates Heart Failure via Extracellula Matrix-Receptor Interaction Pathways Based on RNA-Seq Transcriptomics and Experimental Studies

Objective:To investigate the protective mechanisms of Chinese medicine Shexiang Tongxin Dropping Pills(STDP) on heart failure(HF).Methods:Isoproterenol(ISO)-induced HF rat model and angiotensin Ⅱ(Ang Ⅱ)-induced neonatal rat cardiac fibroblast(CFs) model were used in the present study.HF rats were treated with and without STDP(3 g/kg).RNA-seq was performed to identify differentially expressed genes(DEGs).Cardiac function was evaluated by echocardiography.Hematoxylin and eosin and Masson’s stainings were taken to assess cardiac fibrosis.The levels of collagen Ⅰ(Col Ⅰ) and collagen Ⅲ(Col Ⅲ) were detected by immunohistochemical staining.CCK8 kit and transwell assay were implemented to test the CFs’ proliferative and migratory activity,respectively.The protein expressions of α-smooth muscle actin(α-SMA),matrix metalloproteinase-2(MMP-2),MMP-9,Col I,and Col Ⅲ were detected by Western blotting.Results:The results of RNA-seq analysis showed that STDP exerted its pharmacological effects on HF via multiple signaling pathways,such as the extracellular matrix(ECM)-receptor interaction,cell cycle,and B cell receptor interaction.Results from in vivo experiments demonstrated that STDP treatment reversed declines in cardiac function,inhibiting myocardial fibrosis,and reversing increases in Col Ⅰ and Col Ⅱ expression levels in the hearts of HF rats.Moreover,STDP(6,9 mg/mL) inhibited the proliferation and migration of CFs exposed to Ang Ⅱin vitro(P<0.05).The activation of collagen synthesis and myofibroblast generation were markedly suppressed by STDP,also the synthesis of MMP-2 and MMR-9,as well as ECM components Col Ⅰ,Col Ⅲ,and α-SMA were decreased in Ang Ⅱ-induced neonatal rats’ CFs.Conclusions:STDP had anti-fibrotic effects in HF,which might be caused by the modulation of ECM-receptor interaction pathways.Through the management of cardiac fibrosis,STOP may be a compelling candidate for improving prognosis of HF.

据出土文献说“痛心疾首”及相关字词

成语{痛心疾首}由{痛心}和{疾首}两个词组合而成。卜辞中“疾首”与“首疾”并见。“疾”字在商代甲骨文中就已出现,“病”字则是到了战国时代才出现。在战国出土文献中,“疾”表示的病情比“病”更严重,与《说文解字》的记载相反。{疾}{病}都是非宾格动词,故在“N1+V+N2”这种句式中,可移位为“N1+N2+V”,且N1和N2有领属关系。{痛}{疼}则是典型的不及物动词,不能带宾语,因此{痛心}{疼心}不符合语法规则。“痛心”“疼心”原本作“疾心”。{疾首}和{疾心}本指生理上的疼痛不适感,在春秋末期引申指精神上的痛苦或痛恨,为了强调一种极度的痛苦痛恨而组合成一个四字成语,为了避复,将{疾心}改成{痛心},从而组成{痛心疾首}这个成语。{痛心}一词在汉代以后才开始流行,当是从成语{痛心疾首}中分割出来的。

脂肪因子代谢对冠状动脉微血管功能障碍的影响及麝香通心滴丸的临床应用价值

目的 探讨脂肪因子代谢对冠状动脉微血管功能障碍(MVD)的影响及麝香通心滴丸(STDP)的临床应用价值。方法 纳入2018年9月至2019年12月上海交通大学医学院附属新华医院心内科收治的41例冠心病患者,分为非MVD组(20例)和MVD组(21例);29例MVD患者随机分为基础治疗组(14例)和STDP组(15例),分别进行为期3个月的基础治疗和基础治疗加STDP治疗;分析各组患者主诉、血生物化学指标、血浆炎症因子及脂肪因子水平的变化。采用12~14周龄雄性C57BL/6小鼠制备心肌缺血再灌注(IR)模型,分为假手术组、IR组(生理盐水灌胃)和IR+STDP组(STDP灌胃),每组5只,采用ELISA测定血浆炎症因子水平,通过硫黄素-S荧光密度法测定心脏组织微血管阻塞情况,采用蛋白质组学分析探寻IR组与IR+STDP组间差异表达蛋白质并通过蛋白质印迹法进行验证。结果 与非MVD组比较,MVD组血浆瘦素水平增高[(9.89±2.42)μg/L vs (4.76±1.02)μg/L,P<0.01],脂联素水平下降[(5.02±1.30)pg/mL vs (7.19±1.76)pg/mL,P<0.05],抵抗素水平升高[(9.20±2.03)μg/L vs (5.70±1.32)μg/L,P<0.05]。Pearson相关分析显示血浆瘦素水平与微循环阻力呈正相关(r=0.82,P<0.01)。ROC曲线分析结果显示,根据血浆瘦素水平判断MVD的AUC值为0.855,最佳临界值为>9.395 μg/L,灵敏度为0.714,特异度为0.867。MVD患者治疗3个月后,相较于基础治疗组,STDP组主诉胸闷、胸痛症状改善率较高[73.3%(11/15) vs 21.4% (3/14)],血浆瘦素、IL-6、TNF-α水平均降低[(11.36±0.54)μg/L vs (12.12±0.85)μg/L、(3.96±1.76)pg/mL vs (8.65±1.29)pg/mL、(24.82±3.07)ng/mL vs (32.45±3.32)ng/mL,均P<0.05]。在动物实验中,与IR组相比,IR+STDP组小鼠IR术后无回流面积减少45%(P<0.01)、低回流及无回流面积减少23%(P<0.05),血浆IL-6、TNF-α水平均下降[(378.25±19.66)pg/mL vs (457.32±32.01)pg/mL、(289.71±47.62)pg/mL vs (371.28±41.05)pg/mL,均P<0.05]。蛋白质组学分析结果显示,IR+STDP组小鼠心脏组织中血管性血友病因子(vWF)、细胞间黏附分子-1(ICAM-1)蛋白质表达水平低于IR组,蛋白质印迹法验证结果亦提示IR+STDP组vWF及ICAM-1蛋白质表达较IR组下调(均P<0.01)。结论 MVD患者存在脂肪因子代谢异常,血浆瘦素水平较高。STDP治疗可改善MVD患者的临床症状,降低血浆瘦素水平和炎症指标,机制可能与其抗血小板、抗炎作用有关。

麝香通心滴丸预处理对大鼠心肌缺血再灌注损伤的保护作用机制

目的:观察麝香通心滴丸预处理对大鼠心肌缺血再灌注(I/R)损伤后心肌细胞和血管的保护作用及潜在机制。方法:将60只雄性SD大鼠随机分为假手术组(Sham组)、I/R组、麝香通心滴丸组(SXTX组)和阳性组,每组15只。SXTX组以18.90 mg/(kg·d)的浓度灌胃;阳性组以尼可地尔1.35 mg/(kg·d)的浓度灌胃;Sham组和I/R组给予等体积去离子水灌胃。各组均灌胃1周后,行冠状动脉前降支结扎-松解手术,除Sham组外其余各组大鼠结扎左冠状动脉前降支30 min后,再灌注120 min,构建心肌I/R模型。通过心肌苏木精-伊红(HE)染色、心肌Masson染色观察大鼠心肌组织及血管改变;电镜观察心肌细胞和血管的超微结构改变;免疫组织化学法观察血管相关蛋白低氧诱导因子-1α(HIF-1α)和血管内皮生长因子(VEGF)表达情况。结果:与Sham组比较,I/R组大鼠心肌细胞坏死和血管损伤明显,心肌组织中HIF-1α表达增加;与I/R组相比,SXTX组心肌细胞和血管病理结构损伤减轻,缺血区心肌组织VEGF含量明显增加。结论:麝香通心滴丸预处理可保护大鼠心肌细胞和血管I/R损伤,可能与上调VEGF蛋白表达、促进缺血区微血管新生有关。

Effect of Shexiang Tongxin Dropping Pills(麝香通心滴丸) on the Immediate Blood Flow of Patients with Coronary Slow Flow

Objective: To observe the immediate effect and safety of Shexiang Tongxin dropping pills(麝香通心滴丸, STDP) on patients with coronary slow flow(CSF), and furthermore, to explore new evidence for the use of Chinese medicine in treating ischemic chest pain. Methods: Coronary angiography(CAG) with corrected thrombolysis in myocardial infarction(TIMI) frame count(CTFC) was applied(collected at 30 frames/s). The treatment group included 22 CSF patients, while the control group included 22 individuals with normal coronary?ow. CSF patients were given 4 STDP through sublingual administration, and CAG was performed 5 min after the medication. The immediate blood ?ow frame count, blood pressure, and heart rate of patients before and after the use of STDP were compared. The liver and kidney functions of patients were examined before and after treatments. Results: There was a signi?cant difference in CTFC between groups(P<0.05). The average CTFC values of the vessels with slow blood ?ow in CSF patients were, respectively, 49.98±10.01 and 40.42±11.33 before and after the treatment with STDP, a 19.13% improvement. The CTFC values(frame/s) measured before and after treatment at the left anterior descending coronary artery, left circumflex artery, and right coronary artery were, respectively, 48.00±13.32 and 41.80±15.38, 59.00±4.69 and 50.00±9.04, and 51.90±8.40 and40.09±10.46, giving 12.92%, 15.25%, and 22.76% improvements, respectively. The CTFC values of vessels with slow ?ow before treatment were signi?cantly decreased after treatment(P<0.05). There were no apparent changes in the heart rate, blood pressure, or liver or kidney function of CSF patients after treatment with STDP(all P>0.05). Conclusions: The immediate effect of STDP in treating CSF patients was apparent. This medication could signi?cantly improve coronary ?ow without affecting blood pressure or heart rate. Our ?ndings support the potential of Chinese medicine to treat ischemic chest pain.

Shexiang Tongxin Dropping Pill（麝香通心滴丸）Protects against Na2S2O4-Induced Hypoxia-Reoxygenation Injury in H9c2 Cells

Objectives: To investigate the protective effects of Shexiang Tongxin Dropping Pill(麝香通心滴丸,STP) on Na2S2O4-induced hypoxia-reoxygenation injury in cardiomyoblast H9c2 cells. Methods: The cell viability and levels of mRNA and protein expression in H9c2 cells were determined following Na2S2O4-induced hypoxia using Hoechst staining, annexin V/propidium iodide(PI) flow cytometry, real-time polymerase chain reaction and Western blot analysis. Results: STP pretreatment signi?cantly increased the viability and inhibited aberrant morphological changes in H9c2 cardiomyoblast cells induced by Na2S2O4 treatment(P<0.05). In addition, STP pretreatment attenuated Na2S2O4-induced hypoxic damage, down-regulated the expression of pro-apoptotic Bax,and up-regulated the expression of anti-apoptotic Bcl-2 in H9c2 cells(P<0.05). Conclusions: STP was strongly cardioprotective in hypoxia-reoxygenation injury by preventing hypoxic damage and inhibiting cellular apoptosis.These results further support the use of STP as an effective drug for the treatment of ischemic heart disease.

Shexiang Tongxin dropping pill(麝香通心滴丸)protects against sodium laurate-induced coronary microcirculatory dysfunction in rats

OBJECTIVE:To investigate the protective effects of Shexiang Tongxin dropping pill(麝香通心滴丸,STDP)in a rat model of coronary microcirculatory dysfunction(CMD).METHODS:Sprague-Dawley rats were allocated randomly into four groups:sham,CMD model,STDP,and nicorandil.After 4 weeks of treatment,CMD was induced by injection of sodium laurate(0.2 m L,2 g/L)into the left ventricle while obstructing the ascending aorta.Rats in the sham group underwent an identical surgical procedure but were administered physiological(0.9%)saline(0.2 m L).Twenty-four hours after surgery,blood samples were collected for biochemical analyses and enzyme-linked immunosorbent assays.Heart tissues were removed for histopathology staining;apoptosis and inflammatory cytokines were examined by Western blotting.RESULTS:The STDP group had a lower level of creatine kinase-myocardial band,lactate dehydrogenase,and cardiac troponin-I than that in the CMD model group.Infiltration of inflammatory cells,myocardial ischaemia,and microthrombosis were relieved in the STDP group compared with CMD model group.Levels of endothelin-1,nuclear factor-kappa B,tumour necrosis factor-α,interleukin-6,interleukin-1β,malondialdehyde,B-cell lymphoma(Bcl)-2-associated X protein,and caspase-3 were lower,and levels of nitric oxide,Bcl-2,and superoxide dismutase were higher,in the STDP group in comparison with the CMD model group.CONCLUSION:STDP pretreatment improved the CMD induced by sodium laurate via anti-inflammatory,anti-apoptosis,and anti-oxidant mechanisms.

Shexiang Tongxin Dropping Pill(麝香通心滴丸)Reduces Coronary Microembolization in Rats via Regulation of Mitochondrial Permeability Transition Pore Opening and AKT-GSK3βPhosphorylation

Objective To investigate the protective effects of Shexiang Tongxin Dropping Pill(麝香通心滴丸,STDP)following sodium laurate-induced coronary microembolization(CME)in rats.Methods Forty rats were divided into 4 groups:the control(sham)group,CME group,low-dose STDP pretreatment group(20 mg·kg^(−1)·d^(−1)),and high-dose STDP pretreatment group(40 mg·kg^(−1)·d^(−1)).The rats were intragastric administrated with STDP 2 weeks before operation.Moreover,the histopathological alterations were observed using optical microscopy and transmission electron microscopy.Antioxidant biomarkers were analyzed by enzyme-linked immunosorbent assay.Mitochondrial functions including the mitochondrial permeability transition pore(mPTP)mtDNA copy number were determined and proteins of AKT/GSK3βwere analyzed by Western blot.Results The rats in the CME group showed a significant increase in the fibrinogen-like protein 2 expression level and mitochondrial dysfunction and a decrease in the expression level of antioxidant biomarkers(superoxide dismutase and catalase,P<0.01 for all).In contrast,the rats in the low-and high-dose STDP pretreatment groups showed a significant decrease in coronary microthrombi(P<0.05);moreover,STDP restored the antioxidant-related protein activities and mitochondrial function,inhibited mPTP opening,decreased AKT-Ser473 phosphorylation,and increased GSK3β-Ser9 phosphorylation(P<0.05 or P<0.01).Conclusion STDP may be useful for treatment of CME,possibly via regulation of mPTP opening and AKT/GSK3βphosphorylation.

麝香通心滴丸治疗慢性心力衰竭作用机制研究进展

慢性心力衰竭作为各种心脏疾病的晚期阶段,具有住院率高、病死率高的特点,严重影响患者预后。气虚血瘀证是心力衰竭的常见证型,具有益气活血作用的麝香通心滴丸在治疗慢性心力衰竭方面具有积极作用。从临床和基础研究资料来看,麝香通心滴丸可通过抗炎、抑制心肌纤维化和减轻心肌缺血再灌注损伤等多种机制改善心力衰竭,是潜在的心力衰竭治疗药物。未来需要更多大规模随机对照试验,提供更坚实的证据支持。

基于网络药理学探讨参蛭通心胶囊核心药对人参-水蛭治疗扩张型心肌病的作用机制

目的:基于网络药理学方法探究参蛭通心胶囊核心药对人参-水蛭治疗扩张型心肌病(dilated cardiomyopathy,DCM)的作用机制。方法:通过中药系统药理学数据库与分析平台(traditional Chinese medicine systems pharmacology database and analysis platform,TCMSP)、BATMAN-TCM数据库获取人参-水蛭药对的活性成分及潜在靶点并导入UniProt数据库对所得基因进行标准化处理;运用人类基因数据库(the human gene database,GeneCards)获取DCM已知靶点;通过绘制韦恩图得到药物与疾病的交集靶点,将药物活性成分及药物-疾病共同靶点等数据导入Cytoscape 3.7.2软件,构建药物-成分-疾病-靶点网络;运用STRING数据库构建蛋白-蛋白互作网络(protein-protein interactions,PPI)并筛选出核心靶点;将核心靶基因导入基因功能注释数据库(the database for annotation visualization and integrated discovery,DAVID)平台对所得交集靶点进行基因本体(gene ontology,GO)和京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes,KEGG)通路富集分析,同时利用OmicShare进行数据的可视化分析。结果:经筛选共获得人参-水蛭药对有效成分35个,药物-疾病交集靶点184个,涉及的核心靶点主要有胰岛素、白蛋白、肿瘤坏死因子、内皮一氧化氮合成酶、过氧化物酶体增殖物激活受体、白细胞介素1β等。人参-水蛭的有效成分通过对细胞膜、细胞外间隙、电压门控钙通道复合体等部位的作用、一氧化氮生物合成过程的正调控、细胞间信号传递、对凋亡过程的负调控等过程和CAMP信号通路等在内的多个信号通路协同作用治疗DCM。结论:参蛭通心胶囊的核心药对人参-水蛭可以通过参与调控多成分、多靶点、多通路治疗DCM。

Antiplatelet and myocardial protective effect of Shexiang Tongxin Dropping Pill in patients undergoing percutaneous coronary intervention:A randomized controlled trial

Background:High on-clopidogrel platelet reactivity could be partially explained by loss-of-function alleles of CYP2 C19,the enzyme that converts clopidogrel into its active form.Shexiang Tongxin Dropping Pill(STDP)is a traditional Chinese medicine to treat angina pectoris.STDP has been shown to improve blood flow in patients with slow coronary flow and attenuate atherosclerosis in apolipoprotein E-deficient mice.However,whether STDP can affect platelet function remains unknown.Objective:The purpose of this study is to examine the potential effects of STDP on platelet function in patients undergoing percutaneous coronary intervention(PCI)for unstable angina.The interaction between the effects of STDP with polymorphisms of CYP2 C19 was also investigated.Design,participants and intervention:This was a single-center,randomized controlled trial in patients undergoing elective PCI for unstable angina.Eligible subjects were randomized to receive STDP(210 mg per day)plus dual antiplatelet therapy(DAPT)with clopidogrel and aspirin or DAPT alone.Main outcome measures:The primary outcome was platelet function,reflected by adenosine diphosphate(ADP)-induced platelet aggregation and platelet microparticles(PMPs).The secondary outcomes were major adverse cardiovascular events(MACEs)including recurrent ischemia or myocardial infarction,repeat PCI and cardiac death;blood biomarkers for myocardial injury including creatine kinase-MB isoenzyme(CK-MB)and high-sensitive troponin I(hs Tn I);and biomarkers for inflammation including intercellular cell adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),monocyte chemoattractant protein-1(MCP-1)and galectin-3.Results:A total of 118 subjects(mean age:[66.8±8.9]years;male:59.8%)were included into analysis:58 in the control group and 60 in the STDP group.CYP2 C19 genotype distribution was comparable between the 2 groups.In comparison to the control group,the STDP group had significantly lower CKMB(P<0.05)but similar hs Tn I(P>0.05)at 24 h after PCI,lower ICAM-1,VCAM-1,MCP-1 and galectin-3 at 3 months(all P<0.05)but not at 7 days after PCI(P>0.05).At 3 months,the STDP group had lower PMP number([42.9±37.3]vs.[67.8±53.1]counts/μL in the control group,P=0.05).Subgroup analysis showed that STDP increased percentage inhibition of ADP-induced platelet aggregation only in slow metabolizers(66.0%±20.8%in STDP group vs.36.0%±28.1%in the control group,P<0.05),but not in intermediate or fast metabolizers.The rate of MACEs during the 3-month follow-up did not differ between the two groups.Conclusion:STDP produced antiplatelet,anti-inflammatory and cardioprotective effects.Subgroup analysis indicated that STDP inhibited residual platelet reactivity in slow metabolizers only.

麝香通心滴丸联合瑞舒伐他汀治疗冠心病合并高胆固醇血症的效果和对肝功能的影响

目的:研究麝香通心滴丸联合瑞舒伐他汀治疗冠心病(CHD)合并高胆固醇血症的效果和对肝功能的影响。方法:选取2020年6月—2022年6月在上海市嘉定区中心医院住院治疗的60例CHD合并高胆固醇血症患者,按照随机数字表法将其分为两组,每组30例,单一组给予瑞舒伐他汀治疗,联合组在单一组基础上加以麝香通心滴丸治疗,对比两组临床疗效、血脂水平、内皮功能及肝功能。结果:治疗6个月后,联合组总有效率高于单一组,差异有统计学意义(P<0.05);联合组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均低于单一组,高密度脂蛋白胆固醇(HDL-C)高于单一组,差异均有统计学意义(P<0.05);联合组一氧化氮(NO)高于单一组,内皮素-1(ET-1)低于单一组,差异均有统计学意义(P<0.05);两组谷丙转氨酶(ALT)、谷草转氨酶(AST)均升高,但联合组均低于单一组,差异均有统计学意义(P<0.05)。结论:使用麝香通心滴丸联合瑞舒伐他汀治疗CHD合并高胆固醇血症具有良好效果,能够有效降低患者血脂水平,改善内皮功能,且对肝功能影响较小。

麝香通心滴丸治疗糖尿病合并急性心肌梗死患者的效果

目的:探究麝香通心滴丸治疗糖尿病合并急性心肌梗死患者的效果。方法:选取2022年4月—2023年4月常德德星医院收治的112例糖尿病合并急性心肌梗死患者。随机将其分为对照组和观察组,各56例。对照组给予常规治疗,观察组在对照组基础上给予麝香通心滴丸。比较两组临床疗效,治疗前后促血管生成因子、心功能、糖脂代谢及安全性。结果:观察组总有效率为92.86%,高于对照组的78.57%,差异有统计学意义(P<0.05)。治疗后,两组血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)均升高,血小板衍生生长因子(PDGF)降低,且观察组VEGF、bFGF均高于对照组,其PEDF水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组左心室射血分数(LVEF)均升高,左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)均降低,观察组LVEF高于对照组,LVEDD及LVESD均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)均降低,观察组FPG、HbA1c、TG及TC均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:麝香通心滴丸治疗糖尿病合并急性心肌梗死效果显著,可调节患者血管生成因子表达与糖脂代谢,促进其心功能恢复,较为安全。

麝香通心滴丸与美托洛尔联合治疗老年冠心病心绞痛的效果研究

目的 分析麝香通心滴丸与美托洛尔联合治疗老年冠心病(CHD)心绞痛的效果。方法 选取老年CHD心绞痛患者82例,使用随机数字表分为对照组及研究组,每组41例。对照组患者采用美托洛尔治疗,研究组患者在对照组基础上联合麝香通心滴丸治疗。比较两组患者的临床疗效,心绞痛发作持续时间与发作频次,不良反应发生情况。结果 研究组总有效率95.12%较对照组的78.05%高(P<0.05)。治疗8周后,研究组心绞痛发作持续时间(3.00±0.50)min/次短于对照组的(4.12±0.49)min/次、心绞痛发作频次(2.10±0.52)次/周少于对照组的(3.03±0.47)次/周(P<0.05)。两组患者用药不良反应发生率对比,结果未见差异性(P>0.05)。结论 麝香通心滴丸与美托洛尔联合治疗老年CHD心绞痛效果可靠,能够有效抑制心绞痛发作时间与频次,安全性较为理想。

煤矿水文孔井下启封技术

为了解决钻孔突水事故,对水文孔进行注浆封堵,保证煤矿安全,以同忻煤矿8102工作面作为研究对象,优化井下启封技术,应用高压注浆法对水文孔进行封堵,在8102工作面皮带顺槽采用钻探、巷探的方式明确1602钻孔位置,并对其实施启封技术,成功完成井下封堵操作。现场实践证明,确定施工方案,实施高压注浆、钻探和巷探能够有效落实井下启封技术,确保煤矿生产的安全性,以免出现突水事故,而且还能有效降低成本投入,对同类型的钻孔启封具有一定的参考价值。

麝香通心滴丸联合西药治疗缺血性心肌病并发慢性心力衰竭气虚血瘀证临床研究

目的:观察麝香通心滴丸联合西药治疗缺血性心肌病(ICM)并发慢性心力衰竭(CHF)气虚血瘀证的临床疗效。方法:选取100例ICM并发CHF气虚血瘀证患者,按随机数字表法分为治疗组与对照组各50例。对照组给予西药治疗,治疗组在对照组基础上给予麝香通心滴丸治疗,2组均治疗4周。比较2组临床疗效,治疗前后中医证候积分、心功能指标[平均室壁应力(MWS)、左室心肌质量指数(LVMI)、血清N末端B型利钠肽原(NT-proBNP)]与血清晚期糖基化终末产物受体(RAGE)、核转录因子(NF)-κB及S100钙结合蛋白A8/A9复合物(S100A8/A9)水平。结果:治疗后,治疗组临床疗效总有效率98.00%,高于对照组86.00%(P<0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。治疗后,2组MWS、LVMI及血清NT-proBNP水平均较治疗前降低(P<0.05),治疗组MWS、 LVMI及血清NT-proBNP水平均低于对照组(P<0.05)。治疗后,2组血清RAGE、 NF-κB、S100A8/A9水平均较治疗前降低(P<0.05),治疗组血清RAGE、NF-κB、S100A8/A9水平均低于对照组(P<0.05)。结论:麝香通心滴丸联合西药治疗ICM并发CHF气虚血瘀证疗效确切,可减轻患者的临床症状,改善其心功能,作用机制可能与下调血清NT-proBNP、RAGE、NF-κB、S100A8/A9水平有关。

盐酸洛哌丁胺联合痛泻宁颗粒对腹泻型肠易激综合征的临床疗效

目的观察盐酸洛哌丁胺联合痛泻宁颗粒对腹泻型肠易激综合征(IBS)的临床疗效。方法收集60例腹泻型IBS患者的临床资料,按照治疗方案的不同将患者分为观察组(盐酸洛哌丁胺与痛泻宁颗粒联用)和对照组(盐酸洛哌丁胺单用),每组30例。治疗4周后,评估并比较2组患者治疗前后腹痛评分、腹泻评分、症状总评分。结果治疗前,2组患者腹痛评分、腹泻评分、症状总评分比较,差异无统计学意义(P>0.05);对照组治疗后的腹痛评分、腹泻评分、症状总评分与治疗前比较,差异无统计学意义(P>0.05);治疗后,观察组腹痛评分、腹泻评分、症状总评分均低于治疗前,且均低于对照组,差异有统计学意义(P<0.05)。用药期间,2组患者均未观察到明显不良反应。结论盐酸洛哌丁胺与痛泻宁颗粒联用对腹泻型IBS患者疗效显著,且用药安全性良好。

麝香通心滴丸联合沙库巴曲缬沙坦对慢性心力衰竭患者的临床疗效观察

目的 观察麝香通心滴丸联合沙库巴曲缬沙坦对慢性心力衰竭(CHF)患者的疗效。方法 选择2020年1月至2021年12月金华市人民医院收治的CHF患者100例,采用随机数字表法分为两组,各50例。对照组口服沙库巴曲缬沙坦钠片,观察组采用麝香通心滴丸联合沙库巴曲缬沙坦钠片治疗。两组治疗周期12周。观察并比较两组患者的临床疗效、心功能指标[左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)和左心室收缩末期内径(LVESd)],比较两组患者明尼苏达心力衰竭生活质量问卷(MLHFQ)评分、6 min步行试验(6MWT)距离及血清N末端脑钠肽前体(NT-proBNP)水平。结果治疗12周,观察组患者治疗总有效率高于对照组;两组患者LVEDd、LVESd、MLHFQ评分、NT-proBNP水平低于治疗前,而LVEF、6MWT距离高于治疗前;观察组LVEDd、LVESd、MLHFQ评分、NT-proBNP水平低于对照组,而LVEF、6MWT距离高于对照组,差异均有统计学意义(均P<0.05)。结论 麝香通心滴丸联合沙库巴曲缬沙坦对CHF患者疗效显著,患者心功能改善,血清NT-proBNP水平降低。