PHARMACOLOGIC EFFECTS OF CODONOPSIS PILOSULA-ASTRAGALUS INJECrlON IN THE TREATMENT OF CHD PATIENTS

The results of the present studies suggestthat CP-A possesses a high therapeutic value inthe treatment of CHD.It's therapeutic effectsinclude strengthening of left ventricular per-fomance,increasing the volume of nutritousblood supply to myocardium,inhibiting plateletaggregation and release functions,increasing pla-telet cAMP,and inhibiting platelet cAMP-PDEactivity.     

生脉液对冠心病患者血浆cAMP含量的影响及其与左心功能改善的关系

临床研究表明生脉液能提高冠心病心绞痛、急性心肌梗塞病人心脏的射血分数,改善左室功能。生脉液对冠心病患者血浆cAMP含量的影响及其与左心功能改善的关系尚未见报道。本文对此进行了初步观察,现将结果报告如下。     

中医药治疗冠心病

冠心病在我国的发病率已呈现逐渐上升的趋势,尤其是北京地区急性心肌梗塞的发病率可能居全国之首。近十余年,我国的中医和中西医结合专家,应用中医药治疗冠心病、心绞痛及急性心肌梗塞,取得了较好的疗效。为此,本刊特邀请几位心血管病专家谈谈个人的经验和体会,供读者参考。廖家桢教授(北京中医学院):《素问·痹沦》说:“心痹者,脉不通”《素问·五病篇》也指出:“邪在心,则病心痛”这些论述反映了包括冠心病在内的某些“心痛”的病机。分析冠心病的舌、脉、症,我认为其基本病机气虚血瘀,气虚为本,血瘀为标。从气血相关的理论出发,气病可有气滞和气虚之分,但二者皆可致瘀,气滞血瘀是实证,气虚血瘀则为本虚标实。据我观察,冠心病属气虚血瘀者十之有七,属气滞血     

中西医结合研究冠心病的近况

由中华医学会心血管学会与中国中西医结合研究会联合举行的"全国冠心病学术讨论会于1986年11月在南京召开。会议共收到论文五百余篇,其中属中西医结合的论文70余篇,经审稿会议选定在大小会上交流的中西医结合的论文近30篇。从这些论文可以看出中西医结合防治冠心病的研究工作正在向纵深发展,     

CLINICAL AND EXPERIMENTAL STUDIES OF CORONARY HEART DISEASE TREATED WITH YI-QI HUO-XUE INJECTION

The purpose of the present work was to evaluatethe clinical efficacy and the mechanism of Yi-qiHuo-xue Injection(YHI 益气活血注射液)in treat-ment of coronary heart disease.YHI consists ofGinseng,Astragalus and Angelicae Sinensis.(人参黄芪,当归).The 10% dextrose serves as a pla-cebo.The results were as follows:1.the frequencyand severity of angina episodes were reduced by90.63%;2.the isehemic ST-T in ECG was improvedin 56.25% of eases;3.the tolerance to treadmillexercise was increased from 348,50 to 505.50 M.;4.the left ventricular function was strengthened,PEP/LVET ratio reduced from 0.45 to 0.36,the activityof(Na -K )ATPase in myocardial cell membraneof rats inhibited by 19.2%;5.the blood viscosity anderythrocyte electrophoretic time lowered;6.theadhesion and aggregation of platelet in patients withCHD were inhibited by 27% and 59.4% respectively;7.the plasma TXB_2 level in CHD was reduced from260.28±164.4 to 139.29±57.01 pg/ml;8.the plasma6-keto-PGF_(1α) level in CHD was increased from33.45±22.5 to 57.48±13.1 pg/ml,and in rats from185.77 to 366.33 pg/ml.The differences were allstatistically significant(P<0.05-0.01)in comparisonwith the placebo group.     

党参对血栓素A2和前列环素合成的影响

24例冠心病患者用党参口服液20ml(含生药党参20g)每日3次,治疗7天;另外10例冠心病患者每日用阿斯匹林0.5g 治疗7天作对照。经治疗,血浆 TXB_2含量在党参组从156.76±11.875pg/ml 明显减至125.01±8.855pg/ml(x±S下同),P<0.05;抑制率为15.67±5.66%,P<0.05;6-酮-PGF_(6-K)含量和抑制率均无明显变化,P>0.05。阿斯匹林组 TBX_2含量也有明显下降,P<0.05,抑制率为38.11±8.69%,P<0.001;6-K 也有较大减少,其抑制率为24.33±9.40%,P<0.05。为了揭示党参对 TXA_2和 PGI_2的作用机制,用制备的猪肺微粒体作为环氧化酶、TXA_2合成酶和 PGI_2合成酶的供酶体,用放免法分别测定了党参对由花生四烯酸或前列腺素内过氧化物合成 TXB_2及6-K 的含量。结果表明,以花生四烯酸或前列腺素内过氧化物合成的 TXB_2含量皆被党参明显抑制;在党参100mg/ml 剂量时仅明显抑制 TXB_2合成,而对6-K 生成无抑制,提示党参在此剂量时呈现 TXA_2合成酶抑制剂作用,当党参剂量为300mg/ml 时,TXA_2和PGI_2的合成酶均被抑制,P<0.001。其作用机理有待进一步研究。     

简述冠心病心绞痛的辨证论治

冠心病心绞痛可能包括在中医的“胸痹”、“胸痹心痛”、“厥心痛”、“久心痛”等病范围之内。对本病的辨证分型目前各家意见不一,使初学者不易掌握。总的看来,属本虚标实。其基本的病机是气虚血瘀,气虚为本,血瘀为标。心主血脉,气行血行。血液在脉管中保持正常的运行需赖气的推动和统摄。气影响血的正常运行有两种可能,一是气滞,一是气虛,两者皆可导致血瘀。前者为实证,后者为虚证,治法自然不一样。心绞痛是气滞血瘀为主,还是气虚血瘀为主,应“审证求因”,     

EFFECT OF SHENG MAI SAN ON LEFT VENTRICULAR PERFORMANCE IN CORONARY HEART DISEASE

The present study aims at ascertaining thenature of Xin Qi Xu (XQX,deficiency of Heart-Qi) and the effect of the drug Sheng Mai San 生脉散(SMS) on heart performance,using systolicand diastolic time intervals as criteria in CHDassociated with XQX patients.The results ascompared with normal subjects showed increa-ses in QA_2,PEP,ICT,IRP,SFP,RFP,a/H%,PEP/LVET and SFP/RFP and a reduction ofLVET,suggesting that the patients have a la-tent cardiac insufficiency possibly relating tothe nature of XQX.The changes in systolic anddiastolic time intervals after intravenous ShengMai San were prolongation of MST and LVET,shortening of PEP and PEP/LVET,and slowingof heart rate.These changes are statisticallysignificant (P<0.05-0.001).The blood pressurewas not significantly changed.These changesand their degree suggest a positive inotropic ac-tion on myocardium and a reduction of myo-cardial oxygen consumption by Sheng Mat San.Its effects compared with Cedilanid-D showedthat the action of both drugs on systolic anddiastolic time intervals was similar.We ten-tatively suggest,therefore,that the inotropicaction of SMS simulates that of digitalis glycosi-des.Further studies are needed to determinewhether SMS affects the heart in the same wayas digitalis glycosides,for current work indica-tes that SMS may have other effects on theheart.     

突出中医特色 利用现代科学发展中医

科研工作的第一步是选择研究课题,确定主攻目标。选题的正确与否,关系到研究工作的成败。因此,要“三思而行”。所谓“三思”就是要思考三个方面:1.从中医基本理论出发;2.从实际出发;3.力求“标新立异”。众所周知,科学研究工作是应用已有科学知识和技术手段,探索未知,认识规律,改造客观。所