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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (7): 616-621.doi: 10.3736/jcim20090704

• Original Clinical Research • Previous Articles     Next Articles

Therapy for replenishing qi, nourishing yin and promoting blood circulation in patients with acute myocardial infarction undergoing percutaneous coronary intervention: A randomized controlled trial

Sheng-lei Qiu a, Mei Jina, Jing-hong Yia, Tian-gang Zhub, Xin Quanb, Yan Lianga   

  1. a Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital University of Medical Sciences, Beijing 100010, China
    b Department of Cardiology, Peopled Hospital, Peking University, Beijing 100044, China
  • Received:2009-02-03 Accepted:2009-04-24 Online:2009-07-20 Published:2009-07-15
  • Contact: Mei Jin E-mail:jinmei622@yahoo.com.cn

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Background

No-reflow phenomenon after reperfusion treatment of acute myocardial infarction (AMI) is becoming more recognized today. The effective treatment for no-reflow has not been reported.
Objective

To observe the effects of traditional Chinese medicine (TCM) therapy for replenishing qi, nourishing yin, and promoting blood circulation on AMI patients undergoing percutaneous coronary intervention (PCI).Design, setting, participants and interventions: This study was conducted from January 2005 to March 2006 using a double-blinded, randomized method. Thirty-five AMI patients (KillipⅠ-Ⅱ) were first diagnosed as ST segment elevation AMI and obtained primary PCI. They were recruited from People’s Hospital, Peking University. All patients’ symptoms accorded with qi-yin deficiency syndrome and blood stasis syndrome. They were randomly and double blindly divided into control group (18 cases) and treatment group (17 cases). The patients in the control group received Western medicine treatment, and the patients in the treatment group were treated with Western medicine plus American ginseng and Salviae miltiorrhizae preparations. They were all treated for 3 months.Main outcome measures: Before and after 3-month treatment, the TCM symptoms were observed and scored. At the state of baseline and dobutamine stress, left ventricular ejection fraction (LVEF), wall motion score (WMS), WMS index and normal cardiac muscle percentage (NCMP), and the myocardial contrast echocardiography index k, which reflects myocardium microcirculation perfusion, were detected.
Results

After 3-month treatment, the TCM symptoms in the treatment group were improved as compared with the control group ( χ2=4.118, P=0.042). At the state of dobutamine stress, LVEF in the treatment group after treatment was higher than those in the control group (t=2.130, P=0.041) and before treatment (t=2.345, P=0.032). Although the number of the segments with increased k value was more than that in the control group, there was no significant difference.
Conclusion

TCM therapy for replenishing qi, nourishing yin and promoting blood circulation can improve the clinical symptoms and quality of life of the AMI patients undergoing PCI, and is beneficial to myocardium microcirculation. Thus, it may be an alternative cardioprotective treatment strategy for successful myocardial microcirculation in AMI patients after reperfusion.

Key words: Myocardial infarction, Reinforcing qi, Nourishing yin, Activating blood and removing stasis, Reperfusion, Randomized controlled trial

Figure 1

Flow diagram of this randomized trial"

Table 1

Echocardiogram outcome in two groups before and after treatment （$\bar{x}$±s）"

Group n LVEF （%） WMSI NCMP （%）
Baseline Dobutamine stress Baseline Dobutamine stress Baseline Dobutamine stress
Control
Before treatment 18 53.92±7.70 60.66±12.00 1.15±0.16 1.11±0.14 85.88±15.71 90.00±14.10
Three-month treatment 18 60.00±9.33 65.15±10.53 1.15±0.22 1.14±0.17 88.94±20.16 88.94±14.49
Treatment
Before treatment 17 54.99±7.58 63.27±12.05 1.14±0.16 1.05±0.06 89.00±12.41 95.64±6.09
Three-month treatment 17 59.81±9.57 72.11±8.65*△ 1.15±0.30 1.12±0.24 90.24±13.25 92.59±16.59
[1] Society of Cardiology of Chinese Medical Association, Editor Committee of Chinese Journal of Cardiology, Editor Committee of Chinese Circulation Journal. Guidelines for diagnosis and treatment of acute myocardial infarction[J]. Zhongguo Xun Huan Za Zhi, 2001,16(6):407-422
doi: 10.14164/j.cnki.cn11-5581/r.2015.23.211
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, 中国循环杂志编辑委员会. 急性心肌梗死诊断和治疗指南[J]. 中国循环杂志, 2001,16(6):407-422
doi: 10.14164/j.cnki.cn11-5581/r.2015.23.211
[2] North-east Subgroup of the Collaboration Group of Thoracic Obstruction Emergency, Bureau of Medical Administration of State Administration of Traditional Chinese Medicine. Standards of diagnosis and treatment of thoracic obstruction(myocardial infarction)[J]. Zhongguo Zhong Yi Ji Zheng, 1995,4(4):183-185
国家中医药管理局医政司胸痹急症协作组东北分组. 胸痹心厥(冠心病心肌梗塞)急症诊疗规范[J]. 中国中医急症, 1995,4(4):183-185
[3] Yan HB, Zhu XL. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction(revised edition)[M]. Beijing: China Environment Science Publishing House, 2004: 9-186
颜红兵, 朱小玲 . 美国ST段抬高心肌梗死治疗指南(修订版)[M]. 北京: 中国环境科学出版社, 2004: 9-186
[4] Zheng XY. Guidelines of clinical research on Chinese new herbal medicines[M]. Beijing: Medical Science and Technology Publishing House of China, 2002: 72-78
郑筱萸 . 中药新药临床研究指导原则[M]. 北京: 中国医药科技出版社, 2002: 72-78
[5] Shi YS, Zhang HX, Huang TG. Practice of coronary cardiology(4th ed)[M]. Tianjin: Tianjin Science & Technology Translation & Publishing Corporation, 2005,( 4th ed):974-975
石毓澍, 张鸿修, 黄体钢 . 实用冠心病学(第4版)[M]. 天津: 天津科技翻译出版公司, 2005,( 第4版):974-975
[6] Wang CL, Shi DZ, Yin HJ, Chen KJ . Effect of Panax quinquefolius saponin on angiogenesis and expressions of VEGF and bFGF in myocardium of rats with acute myocardial infarction[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2007,27(4):331-334
doi: 10.3321/j.issn:1003-5370.2007.04.013
王承龙, 史大卓, 殷惠军, 陈可冀 . 西洋参茎叶总皂苷对急性心肌梗死大鼠心肌VEGF、bFGF表达及血管新生的影响[J]. 中国中西医结合杂志, 2007,27(4):331-334
doi: 10.3321/j.issn:1003-5370.2007.04.013
[7] Ji HG, Si L, Si XC, Zhang Q . Research advances of protective effect of Danshen against myocardial ischemia and reperfusion injury[J]. Guang Ming Zhong Yi, 2006,21(3):52-53
季海刚, 司亮, 司晓晨, 张琪 . 丹参对心肌缺血再灌注损伤保护作用的研究进展[J]. 光明中医, 2006,21(3):52-53
[8] Hou XL, Li BL, Zhao L, Huang SD, Xu ZY, Zhang GX . Effects of Xuefu Zhuyu Capsule on endothelin-1 release in myocardium and vascular endothelium and nitric oxide/nitric oxide synthase system of swines after acute myocardial infarction and reperfusion[J]. J Chin Integr Med, 2008,6(4):381-386
侯霄雷, 李白翎, 赵雷, 黄盛东, 徐志云, 张冠鑫 . 血府逐瘀胶囊对急性心肌梗死再灌注后心肌及内皮素-1、一氧化氮/一氧化氮合酶体系影响的实验研究[J]. 中西医结合学报, 2008,6(4):381-386
[9] Tang H, Xie JM . Clinical trend on myocardial contrast echocardiography[J]. Zhongguo Yi Liao Qi Xie Xin Xi, 2006,12(2):10-12
唐红, 解俊敏 . 心肌声学造影的临床应用进展[J]. 中国医疗器械信息, 2006,12(2):10-12
[10] Senior R, Janardhanan R, Jeetley P, Burden L . Myocardial contrast echocardiography for distinguishing ischemic from nonischemic first-onset acute heart failure: insights into the mechanism of acute heart failure[J]. Circulation, 2005,112(11):1587-1593
doi: 10.1161/CIRCULATIONAHA.104.530089
[11] Guo SZ, Shu XH, Pan CZ, Li YL, Ge JB, Chen HZ . Value of low dose dobutamine real-time myocardial contrast echocardiography in the assessment of coronary artery disease[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2005,33(5):419-424
郭士遵, 舒先红, 潘翠珍, 李延林, 葛均波, 陈灏珠 . 定量实时心肌声学造影结合小剂量多巴酚丁胺负荷试验在冠心病诊断中的应用价值[J]. 中华心血管病杂, 2005,33(5):419-424
[12] Yan H, Zhang J, Yang XC . Tissue Doppler imaging in acute myocardial infarction[J]. Xin Xue Guan Bing Jin Zhan, 2005,26(4):402-404
闫慧, 张涓, 杨新春 . 多普勒组织成像技术在急性心肌梗死中的应用[J]. 心血管病学进展, 2005,26(4):402-404
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