ABSTRACT
Objective:To evaluate the clinical efficacy of Wenyang Huoxue Jiedu Decoction combined with trimetazidine tablets in the treatment of patients with acute myocardial infarction (AMI) after interventional therapy.Methods:A total of 90 patients with AMI of syndrome of cold coagulation of heart vein after interventional surgery in the angshan Hongci Hospital , who met the inclusion criteria were enrolled between February 2020 and April 2021, and they were divided into two groups by the random number table method, with 45 in each group. The control group was given conventional western medicine treatments such as anti-coagulation, lipid regulation and oral administration of trimetazidine tablets, while the observation group adopted Wenyang Huoxue Jiedu Decoction on the basis of the control groups. Both groups were treated for 2 weeks. Before and after treatment, TCM symptoms were scored, and serum creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT) and myoglobin (MYO) were detected by ELISA. Left ventricular ejection fraction (LVEF), stroke volume (SV) and left ventricular end-systolic diameter (LVESD) were detected by color ultrasonic instrument, and the clinical efficacy was evaluated. Results:The effective rate was 95.6% (43/45) in the observation group and that in the control group was 88.9% (40/45) ( χ2=1.39, P=0.238). The scores of excruciating pain in the chest, wheezing and incapability of supination, chest tightness and shortness of breath and palpitation in the observation group were significantly lower than those in the control group ( t=5.07, 3.43, 4.98, 5.15, P<0.01). After treatment, the levels of CK-MB [(47.62±8.31) U/L vs. (53.49±8.27) U/L, t=3.36], cTnT [(0.48±0.16) μg/L vs. (0.63±0.25) μg/L, t=3.39] and MYO [(125.47±25.63) μg/L vs. (163.28±30.17) μg/L, t=6.41] were significantly lower in the observation group compared to the control group ( P<0.01). The LVESD [(42.15±7.04) mm vs. (46.03±7.26) mm, t=2.57] in the observation group after treatment was significantly lower than that of the control group ( P<0.05), while the LVEF [(56.73±8.34)% vs. (52.49±8.26)%, t=2.42] and SV [(71.58±4.31) ml vs. (65.47±4.23) ml, t=6.79] were significantly higher than those in the control group ( P<0.05 or P<0.01). Conclusion:Wenyang Huoxue Jiedu Decoction combined with trimetazidine tablets can improve the cardiac function, alleviate the myocardial injury, relieve symptoms of patients with AMI of syndrome of cold coagulation of heart vein after interventional surgery.
ABSTRACT
Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.