| Objective: To observe the Tiaopihuxin Decoction on acute ST segment elevation myocardial infarction(STEMI) clinical curative effect, myocardial enzymes of troponin I(c Tn I), creatine kinase isoenzyme(CK-MB), myoglobin(MYO) changes in the degree and the adverse drug reaction, and the experimental observation on acute myocardial infarction in the rat troponin I(c Tn I), brain natriuretic peptide(BNP), LDH and CK-MB, Ca2+-Mg2+ atpase,Na1+-K1+ atpase of compare and then myocardial cell pathology observation, Tiaopihuxin Decoction on STEMI the clinical curative effect and improve myocardial energy metabolism link and mechanism, in the treatment of the spleen mindarmor party provide theoretical and experimental basis for clinical coronary heart disease.Methods: 1.Clinical observation: choose 40 patients selected, syndrome differentiation of traditional Chinese medicine meets the criteria for the coronary heart disease patients with STEMI, using random grouping method, the above, 40 patients divided into treatment group and control group.In the two groups were given in accordance with clinical coronary heart disease(CHD) STEMI treatment method of treatment.Treatment group on the basis of the original western medicine treatment, at the same time add Tiaopihuxin Decoction.Two groups of a course of 2 weeks.Observed 2 weeks after treatment of TCM syndrome integral value, and detect the serum c Tn I, CK- MB, MYO,BNP, LVEF(left ventricular ejection fraction, %) level change and the situation of adverse drug reactions.2. The animal experiment: after number 64 experimental rats were randomly divided into four groups, namely the spleen mindarmor high and low dose treatment group, trimetazidine hydrochloride surgery group, control group, model in each group were 16, at the same time choose 16 of the same type as the normal control group rats.(1). After the experiment to take HE dyeing production between groups of rats myocardial specimens, then observed the pathological changes of AMI myocardial cells;(2).Enhanced chemiluminescence method between groups of rats afterexperimental c Tn T, serum CK-MB, LDH, BNP levels;(3). The immune histochemical method, the test between groups in the myocardial tissue of rats after experimental drug intervention Ca2+-Mg2+ atpase;Na1+-K1+ atpase content;(4). All the result of the experiment data are in accordance with the input data, SPSS 18.0 software for statistical processing.Results: 1. Clinical observation:(1) through the SPSS software to analysis the treatment group and control group of TCM syndrome integral, integral syndromes was found between the two groups have no significant difference(p>0.05), the two groups were given test set treatment after treatment, integral has the following syndromes was found in the two groups, treatment group of TCM syndrome integral down significantly compared with control group(p<0.01).(2) the two groups before treatment c Tn I,CK-MB, MYO, BNP, LVEF level there was no significant difference(p>0.05), and found that after treatment, the treatment group of c Tn I, CK- MB, MYO level significantly lower than the control group(p<0.01).(3) statistical analysis it is concluded that the treatment group and control group before treatment the BNP, LVEF index there was no significant difference(p>0.05).After treatment, the treatment group than the control group of BNP decreased more significantly(p<0.01), and LVEF treatment group were significantly higher than the control group(p<0.01).(4) during the period of clinical observation found no Tiaopihuxin Decoction significantly adverse drug reactions.2. The animal experiment:(1) after the end of the experiment observation to the change of each rat myocardial enzyme, found the model control group, the trimetazidine group, Tiaopihuxin Decoction high and low dose group were significantly increased compared with normal control group(P<0.01);But the trimetazidine group, Tiaopihuxin Decoction high dose of Chinese traditional medicine group, the Tiaopihuxin Decoction low dose group compared with model control group, the myocardial enzyme in three group were significantly lower(P< 0.01);And Tiaopihuxin Decoction high dose group,the Tiaopihuxin Decoction low dose group compared with trimetazidine group found that Tiaopihuxin Decoction high dose group of myocardial enzymes and thetrimetazidine group were similar(P>0.05), while Tiaopihuxin Decoction compared with trimetazidine group, low dose group differ from that of myocardial enzyme(P <0.05).(2)found in this experiment between groups of rats after the BNP levels were significantly increased compared with normal control group(P< 0.01), the model control group the BNP's highest levels.And Tiaopihuxin Decoction high dose group, the Tiaopihuxin Decoction of low dose group, the trimetazidine group BNP levels compared with model control group had obvious difference(P<0.01), including Tiaopihuxin Decoction high dose group and the trimetazidine group BNP were similar(P > 0.05), Tiaopihuxin Decoction low dose group of the BNP level and Tiaopihuxin Decoction low-dose group,the trimetazidine group to compare the difference(P < 0.05).(3) after the experiment found that the model control group rats myocardial cell cavity change, necrotic myocardial cell nucleus is not obvious, microscopically a large number of myocardial fibrosis, edges are scattered in the survival myocardium, irregular arrangement.Tiaopihuxin Decoction high dose group and the trimetazidine group in necrosis of myocardial cell to some extent, but the overall situation model is obviously better than the control group and lower than that of normal control group.Tiaopihuxin Decoction is visible in the lower dosage treatment groups darker view area, number of myocardial cells survive, myocardial arranged closely, nucleus complete degrees than Tiaopihuxin Decoction high dose group, the trimetazidine group is low.(4) of each group rats after experimental Ca2+-Mg2+ atpase,Na1+-K1+ atpase is found, the rest of the four groups of Ca2+-Mg2+ atpase,Na1+-K1+ atpase activity is higher than the model control group(P< 0.01).Trimetazidine group, Tiaopihuxin Decoction high dose of Chinese traditional medicine group, the Tiaopihuxin low doses of traditional Chinese medicine Decoction group and model control group Ca2+-Mg2+ atpase,Na1+-K1+ atpase comparison, found that there are differences(P< 0.01), can be obtained after drug intervention in the trimetazidine group, Tiaopihuxin Decoction high dose of Chinese traditional medicine group, the Tiaopihuxin low doses of traditional Chinese medicine Decoction group of Ca2+-Mg2+ atpase,Na1+-K1+ atpase is higher than the model control group.Tiaopihuxin Decoction high dose of Chinese traditional medicine group, theTiaopihuxin low doses of traditional Chinese medicine Decoction group between Ca2+-Mg2+ atpase,Na1+-K1+ atpase comparative have statistical difference(P<0.05).Trimetazidine group and Tiaopihuxin Decoction high dose of Chinese traditional medicine group Ca2+-Mg2+ atpase,Na1+-K1+ atpase is no significant difference(P > 0.05).Conclusion: 1. Tiaopihuxin Decoctio can reduce myocardial injury markers in patients with STEMI c Tn I, CK-MB, MYO levels, can improve myocardial ischemia, reduce the patients' clinical symptoms.2. Tiaopihuxin Decoctio to raising the level of LVEF in patients with STEMI, decrease BNP level, improve cardiac function after myocardial infarction patients.3. Tiaopihuxin Decoctio may adjust the myocardial intracellular Ca2+-Mg2+ atpase,Na1+-K1+ atpase activity, which can improve the energy metabolism of myocardial infarction(mi) cells, achieve the goal of AMI.4. Tiaopihuxin Decoctio animal experiments found that the spleen protect heart are reduce rat myocardial enzymes and the effect of the BNP.5. Tiaopihuxin Decoction treatment of AMI may exist, the relationship between drug dose concentration within a certain range to increase the spleen mindarmor dose, can achieve the best effect for the treatment of AMI.6. Clinical trials and animal studies have not found Tiaopihuxin Decoctio have obvious adverse drug effect. |
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