Myocardial Protection Effect of Qishen Yiqi Dropping Pills on Patients After PCI and Control Effect and Mechanism on Cardiac Adverse Events

Ling CHENG; Gen-tuoya MENG; Jun-guo LIANG

doi:10.13422/j.cnki.syfjx.20191532

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Myocardial Protection Effect of Qishen Yiqi Dropping Pills on Patients After PCI and Control Effect and Mechanism on Cardiac Adverse Events

Clinic | 更新时间：2021-02-09

- Myocardial Protection Effect of Qishen Yiqi Dropping Pills on Patients After PCI and Control Effect and Mechanism on Cardiac Adverse Events
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 16, Pages: 78-84(2019)
- 作者机构：
  
  内蒙古医科大学　附属医院，呼和浩特　 010050
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191532
  CLC： R25; R256; R256.2; R256.22
- Received：04 March 2019，
  
  Published Online：10 April 2019，
  
  Published：20 August 2019
- 稿件说明：
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Ling CHENG, Gen-tuoya MENG, Jun-guo LIANG. Myocardial Protection Effect of Qishen Yiqi Dropping Pills on Patients After PCI and Control Effect and Mechanism on Cardiac Adverse Events[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(16): 78-84.
DOI：

Ling CHENG, Gen-tuoya MENG, Jun-guo LIANG. Myocardial Protection Effect of Qishen Yiqi Dropping Pills on Patients After PCI and Control Effect and Mechanism on Cardiac Adverse Events[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(16): 78-84. DOI： 10.13422/j.cnki.syfjx.20191532.

摘要

目的：

探讨芪参益气滴丸对PCI术后气虚血瘀证患者心肌保护和对心脏不良事件的防治效果，及抗炎、抗氧化损伤机制。

方法：

将125例PCI术后患者随机分为对照组61例和观察组64例。对照组口服替格瑞洛片，90 mg/次，2次/d；和阿司匹林肠溶片，100 mg/次，1次/d；和富马酸比索洛尔片，5 mg/次，1次/d。观察组西医使用同对照组，并给予芪参益气滴丸，0.5 g/次，3次/d，于术前3 d开始口服。两组疗程均为连续治疗6个月，并进行6个月随访。于用药前、术后24，72 h检测心肌肌钙蛋白I(cTnI)，肌酸激酶同工酶(CK-MB)；于术后1周内和术后6个月记录左室射血分数(LVEF)，每搏输出量(SV)，室壁运动积分指数(WMSI)，正常心肌百分比和心肌灌注评分指数(PS)；记录术后12个月内心绞痛复发、严重心律失常、心力衰竭、再次血运重建、非致死性心肌梗死、心源性死亡、支架内再狭窄(ISR)的发生情况；于术后1周和6个月评价6 min步行试验(6 MWT)，西雅图心绞痛量表(SAQ)和气虚血瘀证评分；检测术前、术后48 h和术后6个月肿瘤坏死因子(TNF-

)，白细胞介素-6 (IL-6)，血浆可溶性细胞间黏附分子-1(s ICAM-1)，超敏C反应蛋白(hs-CRP)，超氧化物歧化酶(SOD)，丙二醛(MDA)和内皮素-1(ET-1)水平。

结果：

观察组在术后24 h和72 h，血清cTnI和CK-MB水平均低于对照组(

0.05)；观察组在术后48 h和术后6个月血清TNF-

，IL-6，s ICAM-1，hs-CRP，MDA和ET-1水平均低于对照组，SOD水平高于对照组(

0.01)；观察组在术后6个月LVEF，SV和正常心肌百分比均高于对照组(

0.05)，WMSI和PS均低于对照组(

0.05)；术后12个月内，观察组心绞痛复发率12.5%，低于对照组的29.51%；再次血运重建率4.69%，低于对照组的16.39%；MACE累积发生率37.5%，低于对照组的81.97%(

0.05，

0.01)；术后6个月，观察组患者6 min步行距离多于对照组(

0.01)，气虚血瘀证评分低于对照组和SAQ评分高于对照组(

0.01)。

结论：

对冠心病心绞痛气虚血瘀证患者，于PCI围手术期给予芪参益气滴丸干预，具有持续抗炎、抗氧化损伤和改善皮内功能作用，可以起到防治心肌损伤，减少术后MACE发生率，减轻症状，提高患者活动能力和生活质量的作用。

Abstract

Objective:

To discuss the myocardial protection effect of Qishen Yiqi dropping pills on patients with Qi deficiency and blood stasis syndrome after PCI and the control effect and mechanism on cardiac adverse events.

Method:

One hundred and twenty-five patients were randomly divided into control group (61 cases) and observation group (64 cases) by random number table after PCI. Patients in control group got Tigrillo tablets

90 mg/time

2 times/days

aspirin enteric-coated tablets

100 mg/time

1 time/day

and bisoprolol fumarate tablets

5 mg/time

1 time/day. In addition to the therapy of control group

patients in observation group were also given Qishen Yiqi dropping pills

0.5 g/time

3 times/days

3 days before operation. A course of treatment was 6 months

and follow-up were carried out for 6 months. Before treatment

and at the 24

hour after treatment

cardiac troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) were detected. During the first week after operation

and at the 6

month after operation

left ventricular ejection fraction (LVEF)

settling velocity (SV)

wall motion score index (WMSI)

percentage of normal myocardium and myocardial perfusion score index (PS) were recorded. After 12 months of the operation

recurrence of angina pectoris

severe arrhythmia

heart failure

revascularization

non-fatal myocardial infarction

cardiogenic death and in-stent restenosis (ISR) were all recorded. During the first week after the operation

and at the 6

month after operation

six-minute walking test (6 MWT)

Seattle angina scale (SAQ) and Qi deficiency and blood stasis syndrome were all scored. Before the operation

and at 48 hours and 6 months after operation

levels of tumor necrosis factor (TNF-

)

interleukin-6 (IL-6)

plasma soluble intercellular adhesion molecule-1 (sICAM-1)

high-sensitivity C-reactive protein (hs-CRP)

superoxide dismutase (SOD)

malondialdehyde (MDA) and endothelin-1 (ET-1) were all detected.

Result:

At the 24

hour after treatment

levels of cTnI and CK-MB in control group were lower than those in observation group (

0.05). At the 48

hour after operation and the 6

month after operation

levels of TNF-

IL-6

s ICAM-1 hs-CRP

MDA and ET-1 were lower than those in control group (

0.01). And level of SOD was higher than those in control group (

0.01). At the 6

months after operation

LVEF

SV and percentage of normal myocardium were higher than those in control group (

0.05)

while levels of WMSI and PS were lower than those in control group (

0.05). During 12 months after the operation

recurrence rate of angina pectoris was 12.5%

which was lower than 29.15%in control group

and revascularization rate was 4.69%

which was lower than 16.39%in control group. Cumulative incidence of MACE was 37.5%

which was lower than 81.97%in control group (

0.05 or

0.01). At the 6

month after operation

score of six-minute walking test was higher than that in control group (

0.01). And score of Qi deficiency and blood stasis syndrome was lower than that in control group (

0.01)

while score of SAQ was higher than that in control group (

0.01).

Conclusion:

Qishen Yiqi dropping pills has anti-inflammatory and antioxidant effects

and can ameliorate intradermal function

prevent and treat myocardial injury

reduce rate of MACE

relieve symptoms

and improve activity ability and quality of life of patients.

关键词

Keywords

references

裴芳，黄骥，黄婕，等．他汀类药物对 UAP 患者 PCI 术后心肌损伤与炎性因子的影响比较 [J]．重庆医学， 2015 ， 44 ( 6 )： 749 - 751 ．

苏荏，何延忠．益心通脉颗粒对冠心病介入术后气虚血瘀证的影响 [J]．中国实验方剂学杂志， 2017 ， 23 ( 20 )： 209 - 214 ．

中国医师协会心血管内科医师分会预防与康复专业委员会．经皮冠状动脉介入治疗术后运动康复专家共识 [J]．中国介入心脏病学杂志， 2016 ， 24 ( 7 )： 361 - 369 ．

史利锋，林平．经皮冠状动脉介入治疗患者术后心脏不良事件的发生情况及影响因素 [J]．中华护理杂志， 2015 ， 50 ( 12 )： 1449 - 1453 ．

中华中医药学会介入心脏病学专家委员会．经皮冠状动脉介入治疗(PCI)术后胸痛中医诊疗专家共识 [J]．中医杂志， 2014 ， 55 ( 13 )： 1167 - 1170 ．

彭勋潜，莫枢，李艳利，等．中医药干预急性冠脉综合征PCI围术期研究进展 [J]．亚太传统医药， 2018 ， 14 ( 12 )： 97 - 100 ．

陈景瑞，魏静，朱利洁，等．芪参益气滴丸对心血管系统疾病的药理作用研究进展 [J]．时珍国医国药， 2015 ， 26 ( 2 )： 434 - 437 ．

刘敏，张培影，王忠良，等．芪参益气滴丸联合心脉通贴散对PCI术后患者临床疗效及炎症因子的影响 [J]．中国中西医结合杂志， 2018 ， 38 ( 9 )： 1049 - 1053 ．

傅广，马丽霞，石顺华，等．芪参益气滴丸对经皮冠状动脉介入治疗围手术期心肌损伤的影响 [J]．中国循证心血管医学杂志， 2014 ， 6 ( 1 )： 71 - 73 ．

张晓云，魏万林，田国祥，等．芪参益气滴丸对冠状动脉介入术后炎症因子及心脏不良事件的影响 [J]．中国循证心血管医学杂志， 2013 ， 5 ( 2 )： 167-169，185 ．

颜红兵．临床冠心病诊断与治疗指南 [M]．北京：人民卫生出版社， 2010 ： 17 - 55 ．

中华医学会心血管病学分会介入心脏病学组．中国经皮冠状动脉介入治疗指南(2016) [J]．中华心血管病杂志， 2016 ， 44 ( 5 )： 382 - 400 ．

Abdelmoneim S S , Martinez M W , Mankad S V , et al . Resting qualitative and quantitative myocardial contrast echocardiography to predict cardiac events in patients with acute myocardial infarction and percutaneous revascularization [J]. Heart Vessels , 2015 , 30 ( 1 ): 45 - 55 .

刘红旭．经皮冠状动脉介入治疗(PCI)围手术期心肌损伤中医诊疗专家共识解读 [J]．世界中医药， 2016 ， 11 ( 3 )： 377 - 380 ．

世界中医药学会联合会介入心脏病专业委员会．经皮冠状动脉介入治疗围手术期心肌损伤中医诊疗专家共识 [J]．中国中西医结合杂志， 2017 ， 37 ( 4 )： 389 - 393 ．

苏强，李浪．经皮冠状动脉介入治疗围手术期心肌损伤的防治进展 [J]．中国循环杂志， 2015 ， 30 ( 12 )： 1231 - 1234 ．

张涛，陈晖，黄家树，等．丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响 [J]．中国实验方剂学杂志， 2018 ， 24 ( 2 )： 186 - 191 ．

周艳丽，王平东，赵旭，等．通络护心方联合抗凝药物用于急性心肌梗死PCI术后患者疗效及对血浆Sicam-1，心功能指标的影响 [J]．中国中医急症， 2018 ， 27 ( 7 )： 1245 - 1248 ．

林飞，王阶，郭丽，等．中医药对冠心病经皮冠状动脉介入术后治疗现状研究 [J]．中华中医药杂志， 30 ( 4 )： 1181 - 1183 ．

张强，刘珂，牛红梅，等．养心氏片对冠心病心肌PCI术后缺血再灌注损伤的治疗效果 [J]．云南中医学院学报， 2018 ， 41 ( 2 )： 15 - 18 ．

张盈颖，郭浩，王阶，等．参蒌双心丸对大鼠缺血再灌注损伤的保护作用 [J]．中国实验方剂学杂志， 2016 ， 22 ( 6 )： 94 - 97 ．

Kidonakahara M , Buddenkotte J , Kempkes C , et al . Neural peptidase endothelin-converting enzyme 1 regulates endothelin 1-induced pruritus [J]. J Clin Invest , 2014 , 124 ( 6 ): 2683 - 2689 .

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