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目的:探讨加味补阳还五汤对心肌梗死后患者心室重构及miRNA-21、GDF-15表达的影响。方法:将100例心肌梗死患者作为研究对象,随机分为研究组、对照组各50例;对照组单纯采用传统的西医方法治疗,研究组在西医方法治疗的基础上给予加味补阳还五汤治疗。观察对照组、研究组中医证候积分变化、超声心动图、miRNA-21及GDF-15的表达水平、NT-Pro BN含量。结果:在进行治疗的4个月后,研究组总有效率89%,明显高于对照组总有效率78%(P<0.05);研究组中医证候积分改善也明显优于对照组(P<0.05);研究组经过加味补阳还五汤治疗后LVESV、LVEDV、NT-pro BNP、GDF-15水平下降明显,均显著低于对照组患者,研究组SV、LVEF水平升高明显,均显著高于对照组患者,差异均有统计学意义(均P<0.05);两组治疗后miRNA-21较治疗前表达水平升高,研究组升高更为明显。结论:使用加味补阳还五汤治疗心肌梗死后患者能取得显著的效果,补阳还五汤可调控miRNA-21高表达、GDF-15低表达,改善心脏功能,抑制心室重构,改善心肌梗死患者预后,值得临床进一步推广使用。
Objective: To investigate the effect of Jia Wei Bu Yang Huan Wu Tang on myocardial remodeling and the expression of miRNA-21 and GDF-15 in patients with myocardial infarction. Methods: One hundred patients with myocardial infarction were randomly divided into study group and control group with 50 cases in each group. The control group was treated with traditional western medicine only. The study group was given Jiaweixu Buyang Huanwu Decoction treatment. The changes of TCM syndrome score, echocardiography, expression of miRNA-21 and GDF-15, and NT-Pro BN contents in the control group and the study group were observed. Results: After 4 months of treatment, the total effective rate was 89% in the study group, which was significantly higher than 78% in the control group (P <0.05). The improvement of TCM syndrome scores in the study group was also significantly better than that in the control group <0.05). The levels of LVESV, LVEDV, NT-pro BNP and GDF-15 in the study group decreased significantly after treatment with Jia Wei Bu Yang Huan Wu Tang, which were significantly lower than those in the control group Significantly higher than the control group, the difference was statistically significant (both P <0.05); two groups after treatment miRNA-21 expression levels before treatment increased, the study group increased more significantly. Conclusion: Weixinghuwu Decoction can significantly improve the expression of miRNA-21, reduce the expression of GDF-15, improve cardiac function, restrain ventricular remodeling and improve myocardium after myocardial infarction The prognosis of patients with infarction, it is worth to further promote the use of clinical.