《中国康复理论与实践》

《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (06): 475-477.

• 专题 • 上一篇    下一篇

益气活血方对急性心肌梗死后左室重构的干预

冯其茂1; 董耀荣1; 杨祖福2   

  1. 1.上海市中医医院心内科 上海市 200071;2.北京博爱医院内科 北京市 100068
  • 收稿日期:2005-08-15 出版日期:2006-06-25 发布日期:2006-06-25

Effect of Yiqihuoxue Recipe on Left Ventricular Remodeling after Acute Myocardial Infarction

FENG Qi-mao, DONG Yao-rong,YANG Zu-fu   

  1. The Department of Cardiac Internal Medicine, Shanghai Traditional Chinese Medicine Hospital, Shanghai 200071, China
  • Received:2005-08-15 Published:2006-06-25 Online:2006-06-25

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摘要： 目的观察益气活血方对急性心肌梗死(AMI)后左室重构的临床疗效。方法选择AMI患者40例,随机分为治疗组和对照组各20例,分别给予益气活血方和蒙诺治疗,疗程6个月。于出院前、AMI后3个月和6个月,采用二维超声心动图观察左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)、射血分数(EF)、左室重量指数(LvmassI)、E峰/A峰比值(E/A)、室壁运动指数(WMI)和室壁厚度(WT)的变化;同时观察血浆血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)、内皮素(ET)水平以及临床症状的变化。结果治疗组患者的临床症状积分明显改善(P<0.01);两组患者的EF、E/A均有提高(P<0.05或P<0.01),LvmassI、WT减小(P<0.05),但LVEDVI、LVESVI、LvmassI、EF、E/A、WMI、WT等指标两组间比较无显著性差异(P>0.05);治疗组患者的血浆ET水平降低(P<0.05),对照组患者的血浆ATⅡ、ALD水平低于治疗组(P<0.05)。结论益气活血方能明显改善AMI患者的临床症状、左室收缩和舒张功能,减轻左室重构,获得较好的临床疗效。

关键词: 急性心肌梗死, 左室重构, 益气活血方, 血管紧张素Ⅱ, 醛固酮, 内皮素

Abstract: ObjectiveTo observe the effect of Yiqihuoxue recipe on left ventricular remodeling after acute myocardial infarction (AMI).Methods40 patients with AMI were randomly divided into treatment group and control group with 20 cases in each group and received Yiqihuoxue recipe or fasinopril respectively for 6 months. Changes of clinical symptoms, the level of plasma angiotensin Ⅱ(ATⅡ), aldosterone (ALD), endothelin (ET) and echocardiographical indexes: left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), ejection fraction (EF), left ventricular mass index (LvmassI), wall motion index (WMI), wall thick (WT), E/A were assessed before discharge, and in the end of 3rd and 6th month after AMI.ResultsClinical symptoms of patients of treatment group improved significantly (P<0.01). EF and E/A of all patients in two groups increased (P<0.01 or P<0.05), LvmassI and WT reduced (P<0.05), but there were no significantly differences between two groups in LVEDVI, LVESVI, EF, LvmassI, WMI, E/A and WT(P>0.05). The level of plasma ET decreased in treatment group (P<0.05), the level of plasma ATⅡ and ALD of control group decreased more than that of treatment group (P<0.05).ConclusionYiqihuoxue recipe can significantly improve clinical symptoms, cardic function, and left ventricular remodeling, showing a better clinical efficacy.

Key words: acute myocardial infarction (AMI), left ventricular remodeling, Yiqihuoxue recipe, angiotensin Ⅱ (ATⅡ), aldosterone (ALD), endothelin (ET)