体外反搏联合麝香保心丸对AMI患者PCI术后GDF-15、IL-6的影响

发布时间：2018-05-16 19:50

本文选题：增强型体外反搏 + 麝香保心丸　；参考：《广州中医药大学》2015年硕士论文

【摘要】：目的：通过观察生长分化因子(Growth Differentiation-Factor-15, GDF-15)、白细胞介素6 (Interleukin 6,IL-6)、超敏C反应蛋白(High Sensitivity C-Reactive Protein, hs-CRP)三个炎症因子的变化,结合中医疗效判定,初步评估增强型体外反搏(Enhanced External Counterpulsation, EECP)联合麝香保心丸(Shexiang Baoxin Pill, SXBX)治疗对气虚血瘀型急性心肌梗死(Acute Myocardial Infarction, AMI)患者经皮冠脉介入治疗(Percutaneous Coronary Intervention, PCI)术后效果的意义。方法：本研究采用病例-对照及自身对照研究的设计方法,选取行PCI术的气虚血瘀型AMI患者60例,随机分为两组：对照组和EECP+SXBX组,每组各30例。对照组常规西药治疗,EECP+SXBX组在常规西药基础上加用EECP和麝香保心丸,7天为一个疗程。分别检测术前15分钟、术后第3天、术后第7天不同时间点的GDF-15、IL-6、hs-CRP的浓度,记录术前和术后第7天的临床症候。结果：EECP+SXBX组和对照组治疗前血清hs-CRP、IL-6、GDF-15浓度差异无统计学意义(P0.05)；治疗后,两组病例术后第3天血清hs-CRP、IL-6、GDF-15浓度均比术前升高,差异具有统计学意义(均P0.05)；EECP+SXBX组术后第3天血清hs-CRP、 IL-6、GDF-15浓度升高幅度比对照组低,两组术后第3天与术前差值比较,差异有统计学意义(P0.05); EECP+SXBX组术后第7天血清hs-CRP、IL-6、GDF-15浓度下降幅度比对照组高,两组术后第7天与术前差值比较,差异有统计学意义(P0.05)；EECP+SXBX组显效7例,有效19例,无效3例,加重1例；对照组显效2例,有效12例,无效13例,加重3例两组比较,差异有统计学意义(P0.05)。结论：PCI术可引起血管内皮损伤和炎症反应；EECP联合麝香保心丸治疗可以减轻PCI术后血管内皮损伤和炎症反应；EECP联合麝香保心丸治疗可改善心肌微循环,促进心肌修复和心脏康复。
[Abstract]:Objective: to observe the changes of growth differentiation factor (Growth differentiation) Factor-15 (GDF-15), interleukin 6 (IL-6) and high Sensitivity C-Reactive protein (hs-CRP) in order to determine the efficacy of traditional Chinese medicine (TCM). To evaluate the effect of enhanced External Counterpulsation, EECP) combined with Shexiang Baoxin Pill, SXBX) in the treatment of acute myocardial infarction with Qi deficiency and blood stasis after percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI) with Qi deficiency and blood stasis. Methods: in this study, 60 cases of AMI with Qi deficiency and blood stasis were randomly divided into two groups: control group and EECP SXBX group, 30 cases in each group. The control group treated EECP SXBX with routine western medicine plus EECP and Shexiang Baoxin Pill for 7 days as a course of treatment. The levels of GDF-15 IL-6hs-CRP were measured 15 minutes before operation, 3 days after operation and 7 days after operation. The clinical symptoms were recorded before and 7 days after operation. Results there was no significant difference in serum hs-CRPnIL-6GDF-15 concentration between the two groups before treatment, and the serum hs-CRPG-6GDF-15 level was higher in the two groups on the 3rd day after treatment than that before operation, and there was no significant difference between the two groups in serum hs-CRP- IL-6GDF-15 concentration before and after treatment, and there was no significant difference between the two groups before and after treatment. The serum hs-CRP and IL-6 GDF-15 concentrations in the EECP SXBX group were significantly lower than those in the control group on the 3rd day after operation, and the difference between the two groups on the 3rd day after operation was compared with that before operation. There was a significant difference between the two groups on the 7th day after operation, and the decrease of serum hs-CRP- IL-6 GDF-15 concentration in the EECP SXBX group was higher than that in the control group, and the difference between the two groups on the 7th day after operation was statistically significant compared with the preoperative difference. The difference was significant in 7 cases, 19 cases and 3 cases in the EECP SXBX group, and the difference was significant in 7 cases, 19 cases and 3 cases, respectively. In the control group, there were 2 cases with marked effect, 12 cases with effective effect, 13 cases with no effect and 3 cases with aggravation, the difference was statistically significant (P 0.05). ConclusionEECP combined with Shexiang Baoxin Pill can reduce vascular endothelial injury and inflammatory response after PCI, can improve myocardial microcirculation, promote myocardial repair and cardiac rehabilitation.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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