| Background: Drug eluting stents(DES)in the development of reperfusion therapy for acute myocardial infarction can effectively reduce the short-term stent restenosis,but DES will delay the regeneration of vascular endothelium after PCI and increase the incidence of late thrombosis,this trend is thought to be related to the mechanical damage of vascular endothelial cells in the process of stent implantation and the inhibition of endothelial cell regeneration under the drug coating.Endothelial repair,however,is similar to a process of wound healing.TCM believes that wound healing has a great relationship with Qixue vigor or wane,and supplementing qi and activating blood circulation method is core of the treatment of acute myocardial infarction(AMI).As Buyang Huan Wu Decoction is the classic side of Invigorating Qi and promoting blood circulation,so presumably Buyang Huan Wu Decoction can protect the DES caused endothelial dysfunction.Objective: Through the observation of VEGF Levels,plasma adiponectin levels and change rate of brachial artery bore induced to insight into the effection of Buyanghuanwu Decoction on acute myocardial infarction patients after stent implantation.And provide evidence to substantiate that applying the method of invigorating qi and promoting blood circulation can protect the vascular endothelial function and prevent restenosis after stent implantation.To pave the way of further study the deep mechanism of the endothelial function by the method,but also in order to find out effective drugs which protect endothelial function and prevent in-stent restenosis to make a useful exploration.Methods: According to the inclusion and exclusion criterion,selected40 cases with AMI after drug-eluting stent(DES)implantation from these patients that to the Department of Cardiology,the First Affiliated Hospital of Guangxi College of traditional Chinese medicine hospital for treatment from September 2014 to January 2016.Male 27 cases,female 13 cases,Randomly divided into treatment group and control group,The control group were treated only with Western medicine(WM),the treatment group were treated with combined WM and Buyang Huanwu Decoction.Two groups of patients were treated for 14 days.EILSA method was used to detect the level of plasma adiponectin in the two groups before and after treatment,and the level of VEGF in the mononuclear cells after treatment,Evaluation of TCM syndrome score and Flow-mediated dilation(FMD)and nitroglycerin-mediated dilation(NMD)of brachial artery by color ultrasonic doppler of these patients before and after the treatment.Results:(1)the improvement of angina symptoms: the treatment group was treated with routine western medicine,and the total effective rate was 73.52%. Treatment group in Buyang Huanwu Decoction treatment on the basis of with the conventional western medicine,and even served for 14 days,such as,the total efficiency rate of angina pectoris symptoms improved was 73.52%.The treatment group was significantly better than the control group(P < 0.05).(2)the improvement of traditional Chinese medicine syndromes: the total effective rate of treatment group was 87%,the control group was73.52%,the treatment group was significantly better than the control group(P<0.05).(3)Plasma adiponectin and VEGF: treatment group,the levels of plasma adiponectin were significantly higher indicating more effective than the control group(P < 0.05);mononuclear cells to secrete VEGF level: in treating group mononuclear cells secreted VEGF obviously increased,the effect was better than that in the control group(P < 0.01).(4)FMD was significantly improved in treatment group,and better than the control group(P<0.01),while the results showed that there was no significant difference in contents of NMD between the treatment group and the control group(P>0.05).Conclusion: Buyang Huan Wu Decoction Combined with conventional western medicine treatment can effectively relieve the clinical symptoms of patients with AMI after stent implantation,also improve the TCM syndrome,increase patients plasma adiponectin level and VEGF level of mononuclear cells secreted,improvement in patients with FMD,while NMD had no significant difference. |
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