黄芪注射液配伍川芎嗪抗心肌缺血再灌注损伤的临床研究

目的：探讨黄区茫射液配伍川莼嗪防治体外循环心内直视手术中心肌因再灌损伤（ＭＩＲＩ）的作用机理，并探讨ＭＩＲＩ的中医病机、治则。方法；风湿性心脏病瓣膜置换术和先一 心脏病室间隔修补术患者２４例，随机分为对照组、黄茶注射液组（益气组）、川芎嗪组（活血组）、黄芪注射液配伍且（益气活血组）各６例，术中动态监测心电；分别在麻醉前（Ｔ１）、主动脉阻断１０ｍｉｎ（Ｔ２）、主动脉开放１０ｍｉｎ（Ｔ３）、３０ｍｉｎ

Clinical Study of Astragalus Injection Plus Ligustrazine in Protecting Myocardial Ischemia Reperfusion Injury

OBJECTIVE: To investigate the mechanism of Astragalus injection plus ligustrazine in preventing the occurrence of myocardial ischemia reperfusion injury (MIRI) during open heart surgery of cardiopulmonary bypass, and the treating principle of MIRI in TCM. METHODS: Twenty-four patients suffering from either valvular heart diseases or congenital ventricular septal defect were randomly divided into three treated groups (Astragalus, ligustrazine, Astragalus plus ligustrazine) and the control group, 6 in each group. Blood samples were taken via subclavian central vein at the time before anesthesia (T1), 10 minutes of occlusion of aorta (T2), 10 minutes (T3) and 30 minutes (T4) after the release, and the end of operation (about 180 minutes after release, T5) respectively; EKG was observed, and the levels of asparate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), MB isoenzyme of CK (CK-MB), malondialdehyde (MDA) and the activity of superoxide dismutase (SOD), nitric oxide (NO), nitric oxide synthetase (NOS) were determined. RESULTS: The treated groups could reduce the levels of AST, LDH, CK, CK-MB, MDA, SOD compared with the control group, particularly Astragalus plus ligustrazine, there had significant difference (P < 0.05, P < 0.01). In NO activity improvement, Astragalus plus ligustrazine won the best effect, Astragalus group the next. CONCLUSIONS: The mechanism of MIRI is Qi deficiency and blood stasis in TCM, its treating principles should be promoting Qi and removing the blood stasis. According to the authors' study, Astragalus plus ligustrazine could effectively protect against MIRI, which is better than using the 2 medicines separately.