Volume 39 Issue 2
Feb.  2023
Turn off MathJax
Article Contents
ZHANG Cheng-bo, ZHANG Su-jie, YANG Yue-dong, SHEN Jian-ping. Effect of Yiqi Huoxue Formula on Myocardial Fibrosis in Patients with Heart Failure after Acute ST-Segment Elevation Myocardial Infarction[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(2): 111-117. doi: 10.14148/j.issn.1672-0482.2023.0111
Citation: ZHANG Cheng-bo, ZHANG Su-jie, YANG Yue-dong, SHEN Jian-ping. Effect of Yiqi Huoxue Formula on Myocardial Fibrosis in Patients with Heart Failure after Acute ST-Segment Elevation Myocardial Infarction[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(2): 111-117. doi: 10.14148/j.issn.1672-0482.2023.0111

Effect of Yiqi Huoxue Formula on Myocardial Fibrosis in Patients with Heart Failure after Acute ST-Segment Elevation Myocardial Infarction

doi: 10.14148/j.issn.1672-0482.2023.0111
  • Received Date: 2022-10-28
    Available Online: 2023-02-17
  •   OBJECTIVE  To evaluate the effect of Yiqi Huoxue formula on myocardial fibrosis in patients with heart failure after acute ST-segment elevation myocardial infarction.  METHODS  A total of 41 patients with acute ST-segment elevation myocardial infarction with qi deficiency and blood stasis who attended the Jiangsu Integrated Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese from February 2019 to January 2021 were selected and divided into 20 cases in the control group and 21 cases in the study group according to the random number table. The control group was given standard treatment for myocardial infarction, while the study group was treated with Yiqi Huoxue formula based on the standard treatment. The course of treatment was 12 weeks. Before and after treatment, we observed the changes of both groups in the traditional Chinese medicine (TCM) syndrome score, clinical efficacy, human plasma lipoprotein-related phospholipase A2 (Lp-PLA2), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), N-terminal pro-brain natriuretic peptide (NT-proBNP), 6 minutes walk test (6MWT), echocardiographic parameters [left ventricular ejection fraction (LVEF), left atrium dimension (LAD), left ventricular end-diastolic dimension (LVEDD)], extracellular volume (ECV) and longitudinal relaxation time (T1) by cardiac magnetic resonance imaging.  RESULTS  After treatment, the TCM syndrome scores were reduced in both groups (P < 0.05, P < 0.01), but study group presented better curative effects in chest tingling, shortness of breath, faint low voice, lusterless complexion, post-activity fatigue, spontaneous sweating, scaly skin, as well as total score (P < 0.05, P < 0.01). In addition, the clinical efficacy of TCM in the study group was better than that in the control group (P < 0.05). The levels of Lp-PLA2, hs-CRP, IL-6, NT-proBNP, ECV and T1 were reduced in both groups (P < 0.05), but the results of the study group were better than those of the control group (P < 0.05). Besides, the results of 6MWT and LVEF were increased in both groups (P < 0.05), but the results of the study group were better than those of the control group (P < 0.05). There was no statistically significant difference in the comparison of major cardiovascular adverse events between the two groups (P>0.05).  CONCLUSION  Yiqi Huoxue formula can mitigate the clinical symptoms of patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention (PCI), improve the clinical efficacy of traditional Chinese medicine, and inhibit myocardial fibrosis. The mechanism may be related to the reduction of the inflammatory response.

     

  • loading
  • [1]
    中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2015, 43(5): 380-393. doi: 10.3760/cma.j.issn.0253-3758.2015.05.003

    Society of Vascular Diseases of Chinese Medical Association, Editorial Committee of chinese journal of cardiology. Guidelines for diagnosis and treatment of acute ST-segment elevation myocardial infarction[J]. Chin J Cardiol, 2015, 43(5): 380-393. doi: 10.3760/cma.j.issn.0253-3758.2015.05.003
    [2]
    JENNINGS RB, MURRY CE, STEENBERGEN C, et al. Development of cell injury in sustained acute ischemia[J]. Circulation, 1990, 82(S3): Ⅱ2-Ⅱ12.
    [3]
    中国医师协会心血管内科医师分会, 中国心衰中心联盟, 《慢性心力衰竭"新四联"药物治疗临床决策路径专家共识》工作组, 等. 慢性心力衰竭"新四联"药物治疗临床决策路径专家共识[J]. 中国循环杂志, 2022, 37(8): 769-781. doi: 10.3969/j.issn.1000-3614.2022.08.003

    Chinese College Of Cardiovascular Physicians Chinese Heart Failure Center Alliance The Task Force For Expert Consensus Decision Pathway For Quadruple Pharmacotherapy Management Of Chronic Heart Failure, et al. Expert consensus on decision-making pathway for quadruple pharmacotherapy management of chronic heart failure[J]. Chin Circ J, 2022, 37(8): 769-781. doi: 10.3969/j.issn.1000-3614.2022.08.003
    [4]
    JENCA D, MELENOVSKY V, STEHLIK J, et al. Heart failure after myocardial infarction: Incidence and predictors[J]. ESC Heart Fail, 2021, 8(1): 222-237. doi: 10.1002/ehf2.13144
    [5]
    GONZALEZ A, SCHELBERT EB, DIEZ J, et al. Myocardial interstitial fibrosis in heart failure: Biological and translational perspectives[J]. J Am Coll Cardiol, 2018, 71(15): 1696-1706. doi: 10.1016/j.jacc.2018.02.021
    [6]
    ZHANG SJ, ZHANG YY, WANG XD, et al. Effects of Shenfu Qiangxin Drink on H2O2-induced oxidative stress, inflammation and apoptosis in neonatal rat cardiomyocytes and possible underlying mechanisms[J]. Exp Ther Med, 2021, 21(6): 553. doi: 10.3892/etm.2021.9985
    [7]
    中华医学会心血管病学分会心力衰竭学组. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004

    Heart Failure Group of Cardiovascular Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of heart failure in China 2018[J]. Chin J Cardiol, 2018, 46(10): 760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004
    [8]
    陈可冀, 吴宗贵, 朱明军, 等. 慢性心力衰竭中西医结合诊疗专家共识[J]. 中国中西医结合杂志, 2016, 36(2): 133-141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201602001.htm

    CHEN KJ, WU ZG, ZHU MJ, et al. Expert consensus on diagnosis and treatment of chronic heart failure with integrated traditional Chinese and western medicine[J]. Chin J Integr Tradit West Med, 2016, 36(2): 133-141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201602001.htm
    [9]
    郑筱萸. 中药新药临床研究指导原则: 试行[M]. 北京: 中国医药科技出版社, 2002: 54-58.

    ZHENG XY. Guiding Principles for Clinical Research of New Chinese Medicines: Trial Implementation[M]. Beijing: China medical science press, 2002: 54-58.
    [10]
    HWANG IC, KIM HK, PARK JB, et al. Aortic valve replacement-induced changes in native T1 are related to prognosis in severe aortic stenosis: T1 mapping cardiac magnetic resonance imaging study[J]. Eur Heart J Cardiovasc Imaging, 2020, 21(6): 653-663. doi: 10.1093/ehjci/jez201
    [11]
    王清任. 医林改错[M]. 上海: 上海科学技术出版社, 1966: 45.

    WANG QR. Correction of Errors in Medical Works[M]. Shanghai: Shanghai scientific and technical publishers, 1966: 45.
    [12]
    覃华, 张琰, 杜小燕, 等. 黄芪皂苷Ⅳ对LPS诱导大鼠心肌损伤的保护作用及机制[J]. 现代生物医学进展, 2013, 13(8): 1452-1455. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201308015.htm

    QIN H, ZHANG Y, DU XY, et al. Protective effect and mechanism of astragaloside Ⅳ on LPS-induced cardiomyocyte injury[J]. Prog Mod Biomed, 2013, 13(8): 1452-1455. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201308015.htm
    [13]
    韩晓娟, 陈礴, 侯海文. SIRT1/TLR4/NF-κB在丹参素治疗大鼠心肌梗死的保护作用[J]. 中国循证心血管医学杂志, 2020, 12(4): 443-445. doi: 10.3969/j.issn.1674-4055.2020.04.16

    HAN XJ, CHEN B, HOU HW. Protective effect of SIRT1/TLR4/NF-κB in rats with myocardial infarction treated with Danshensu[J]. Chin J Evid Based Cardiovasc Med, 2020, 12(4): 443-445. doi: 10.3969/j.issn.1674-4055.2020.04.16
    [14]
    张继红, 覃慧林, 贺海波, 等. 丹参对心衰大鼠心肌保护作用及SIRT1和SDF-1、CXCR4关系研究[J]. 中药药理与临床, 2014, 30(6): 96-101. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYL201406030.htm

    ZHANG JH, QIN HL, HE HB, et al. Cardioprotective effects of Salvia miltiorrhiza on heart failure rats and SIRT1 and SDF-1, CXCR4 relationship[J]. Pharmacol Clin Chin Mater Med, 2014, 30(6): 96-101. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYL201406030.htm
    [15]
    刘晓丹, 潘涛. 红景天苷对心肌缺血-再灌注大鼠心肌梗死面积及细胞凋亡的影响[J]. 中西医结合心脑血管病杂志, 2016, 14(23): 2751-2754. doi: 10.3969/j.issn.1672-1349.2016.23.010

    LIU XD, PAN T. Influence of salidroside on myocardial infarctional size and apoptosis index in rats with myocardial ischemia reperfusion injury[J]. Chin J Integr Med Cardio/Cerebrovascular Dis, 2016, 14(23): 2751-2754. doi: 10.3969/j.issn.1672-1349.2016.23.010
    [16]
    高群, 李思耐, 林谦. 黄芪、党参对心力衰竭小鼠心肌细胞钙瞬变的影响[J]. 中医杂志, 2017, 58(16): 1408-1411. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201716015.htm

    GAO Q, LI SN, LIN Q. Effects of Huangqi and Dangshen on calcium transients in myocardial cells of heart failure model mice[J]. J Tradit Chin Med, 2017, 58(16): 1408-1411. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201716015.htm
    [17]
    辛玲, 贾云云, 杨艳. 益气活血法治疗气虚血瘀型急性心肌梗死患者的疗效及对心功能、左心室重构、血清可溶性人基质裂解素2、脑钠肽水平的影响[J]. 世界中西医结合杂志, 2022, 17(4): 787-791. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202204026.htm

    XIN L, JIA YY, YANG Y. Clinical efficacy of replenishing qi and activating blood method on patients with acute myocardial infarction with qi deficiency and blood stasis syndrome and effects on cardiac function, left ventricular remodeling, and serum sST2 and BNP levels[J]. World J Integr Tradit West Med, 2022, 17(4): 787-791. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202204026.htm
    [18]
    FRANGOGIANNIS NG. Regulation of the inflammatory response in cardiac repair[J]. Circ Res, 2012, 110(1): 159-173.
    [19]
    余航, 陈慧, 曹丽菲, 等. 急性心肌梗死患者血清脂蛋白相关磷脂酶A2的表达及其与冠状动脉病变程度和预后的相关性[J]. 临床心血管病杂志, 2020, 36(5): 433-437. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202005009.htm

    YU H, CHEN H, CAO LF, et al. Expression of lipoprotein-associated phospholipase A2 and its correlation with the severity of coronary lesions and clinical prognosis in patients with acute myocardial infarction[J]. J Clin Cardiol, 2020, 36(5): 433-437. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202005009.htm
    [20]
    刘旭武. 瑞舒伐他汀对冠心病急性心肌梗死患者血清炎症因子、免疫功能及心功能的影响[J]. 检验医学与临床, 2020, 17(9): 1281-1283. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202009043.htm

    LIU XW. Effects of rosuvastatin on serum inflammatory factors, immune function and cardiac function in patients with acute myocardial infarction of coronary heart disease[J]. Lab Med Clin, 2020, 17(9): 1281-1283. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL202009043.htm
    [21]
    胡芳, 沈金峰, 邓鹏, 等. 益气活血通脉颗粒治疗冠心病经皮冠状动脉介入术后气虚血瘀证患者的疗效观察[J]. 广州中医药大学学报, 2021, 38(11): 2323-2329. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202111005.htm

    HU F, SHEN JF, DENG P, et al. Clinical observation of Yiqi Huoxue Tongmai Granules in the treatment of patients with coronary heart disease after percutaneous coronary intervention and differentiated as blood stasis due to qi deficiency syndrome[J]. J Guangzhou Univ Tradit Chin Med, 2021, 38(11): 2323-2329. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202111005.htm
    [22]
    李燕, 黄凌波, 付兵, 等. 心脏磁共振T1 Mapping技术和ECV评估扩张型心肌病心肌纤维化应用分析[J]. 中国循证心血管医学杂志, 2018, 10(2): 185-189. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX201802016.htm

    LI Y, HUANG LB, FU B, et al. Analysis on application of cardiac magnetic resonance T1 Mapping and ECV techniques of dilated cardiomyopathy myocardial fibrosis evaluation[J]. Chin J Evid Based Cardiovasc Med, 2018, 10(2): 185-189. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX201802016.htm
    [23]
    褚福永, 刘巍, 尚菊菊, 等. 参元益气活血汤治疗冠心病心力衰竭患者临床疗效及对凝血酶、TGF-β1、Col-Ⅰ、Col-Ⅲ水平的影响[J]. 安徽中医药大学学报, 2020, 39(3): 18-22. https://www.cnki.com.cn/Article/CJFDTOTAL-AHZY202003007.htm

    CHU FY, LIU W, SHANG JJ, et al. Clinical effect of Shenyuan Yiqi Huoxue Decoction in treatment of heart failure caused by coronary heart disease and its influence on the levels of thrombin, transforming growth factor-β1, type Ⅰ collagen, and type Ⅲ collagen[J]. J Anhui Univ Chin Med, 2020, 39(3): 18-22. https://www.cnki.com.cn/Article/CJFDTOTAL-AHZY202003007.htm
    [24]
    王新东, 孙雪梅, 方祝元. 稳律平悸颗粒对心房颤动心肌纤维化干预效应的CMR T1 mapping定量评估[J]. 南京中医药大学学报, 2020, 36(3): 307-312. https://www.cnki.com.cn/Article/CJFDTOTAL-NJZY202003008.htm

    WANG XD, SUN XM, FANG ZY. Quantitative assessment of CMR T1 mapping on the interventional effects of wenlü pingji granule on myocardial fibrosis and atrial fibrillation[J]. J Nanjing Univ Tradit Chin Med, 2020, 36(3): 307-312. https://www.cnki.com.cn/Article/CJFDTOTAL-NJZY202003008.htm
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(6)

    Article Metrics

    Article views (187) PDF downloads(29) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return