血府逐瘀汤对缺血再灌注心肌的保护作用

目的观察不同配比的血府逐瘀汤后处理对缺血再灌注心肌的保护作用。方法纳入冠状动脉粥样硬化性心脏病并行经皮冠状动脉介入（PCI）的患者120例,随机分为对照组（n=30）和血府逐瘀汤后处理组（n=90）,后处理组又按桃仁、红花不同配比分为1：1组（n=30）、4：3组（n=30）和3：4组（n=30）,对照组患者PCI术前术后均采用常规药物治疗,后处理组在采用常规药物治疗基础上于PCI术前3d起连续应用血府逐瘀汤至PCI术后4d,每天2次。检测PCI术后各组患者心肌酶（CK、CK-MB）峰值变化及超氧化物歧化酶（SOD）和丙二醛（MDA）水平,观察术后24h内心律失常发生率,并统计术后3个月主要心血管不良事件（包括心源性死亡、再发心肌梗死、再发心绞痛、心力衰竭）发生率。结果血府逐瘀汤后处理组心肌酶峰值及MDA明显低于对照组（P〈0.05）、SOD明显高于对照组（P〈0.01）,术后24h心律失常和3个月内主要心血管不良事件发生率低于对照组（P〈0.01）,进一步对比不同配比的血府逐瘀汤后处理结果,发现桃仁/红花4：3组疗效最佳。结论血府逐瘀汤后处理对PCI术后的心肌具有保护作用,可改善患者预后,其中以桃仁与红花4：3疗效最佳。

Protective effect of Xuefu Zhuyu Tang on myocardial ischemia-reperfusion

Objective To observe the protective effect of postconditioning of Xuefu Zhuyu Tang with different compositions on myocardial ischemia-reperfusion.Methods The patients（n =120）with coronary heart disease（CHD）and intervened by percutaneous coronary intervention（PCI）were randomly divided into control group（n =30）and Xuefu Zhuyu Tang postconditioning group（postconditioning group,n =90）,and the latter was divided again into 1：1 group,4：3 group and 3：4 group（each n =30）according to different proportions of Taoren（Semen Persicae）and Honghua（Flos Carthami）.The control group was treated with routine drugs before and after PCI,and postconditioning group was continuously given Xuefu Zhuyu Tang twice a day from 3 days before PCI to 4 days after PCI besides of routine drugs.The peak value changes of myocardium enzymes（CK and CK-MB）,and levels of superoxide dismutase（SOD）and malondialdehyde（MDA）were detected in all groups after PCI.The incidence rate of arrhythmia within 24 hours after PCI was observed,and incidence rate of major adverse cardiovascular events（MACE,including cardiac death,reinfarction,recurrent angina and heart failure）were counted 3 months after PCI.Results The peak values of myocardium enzymes and MDA were significantly lower（P〈0.05）and SOD was significantly higher（P〈0.01）in postconditioning group than those in control group.The incidence rates of arrhythmia within 24 hours after PCI and MACE 3 months after PCI were lower in postconditioning group than those in control group（P〈0.01）.The curative effect was the best in 4：3 group after comparing further the sub-groups with different proportions of Xuefu Zhuyu Tang.Conclusion Xuefu Zhuyu Tang postconditioning has a protective effect on myocardium and can improve patients ＇ prognosis after PCI.The curative effect was the best when the proportion of Taoren and Honghua is 4：3.