ETHNOPHARMACOLOGICAL RELEVANCE:Yuxintong capsule, a traditional Chinese patent medicine, has been widely used in the treatment of coronary heart disease (CHD). However, whether it can improve cardiopulmonary fitness (CRF) in patients with CHD remains unclear. AIM OF THE STUDY:To evaluate the efficacy and safety of Yuxintong capsule in CRF in patients with stable CHD. MATERIALS AND METHODS:A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial was conducted in 13 hospitals in China from March 2021 to November 2021, and 404 patients with stable CHD were randomly assigned to receive either Yuxintong capsule and conventional Western medicine (Yuxintong group) or placebo and conventional Western medicine (placebo group) in a 1:1 ratio for 12 weeks (ChiCTR2000041293, December 23, 2020). The primary outcomes were peak oxygen uptake (VO2peak) and anaerobic threshold (AT). The secondary outcomes were metabolic equivalents (METs), duration and onset time of 1-mm ST-segment depression on electrocardiography (ECG), and 36-Item Short Form Health Survey (SF-36) scores. The main safety indicators included complete blood count, urinalysis, liver function, renal function, coagulation function, and 12-lead electrocardiogram. And adverse events were recorded throughout the trial. RESULTS:369 patients, 187 in the Yuxintong group and 182 in the placebo group, were finally included for analysis. Compared with placebo group, 12-week treatment with Yuxintong showed an improvement in AT (0.98 ± 2.88 vs. 0.12 ± 2.79 mL kg-1·min-1; LSMD, 0.80 [95 % CI: 0.28 to 1.32]; P < 0.025), and general health (13.61 ± 15.13 vs. 8.29 ± 14.14; LSMD 5.30, [95 % CI: 2.33 to 8.31]; P < 0.05) and vitality scores (12.46 ± 11.32 vs. 6.01 ± 11.41; LSMD 6.43, [95 % CI: 4.13 to 8.31]; P < 0.05) on SF-36 scale. The other outcomes did not significantly differ between the two groups. The adverse events were similar between the two groups. CONCLUSIONS:Yuxintong capsule, as an adjunctive therapy to conventional treatment, improved AT, and general health and vitality scores on SF-36 scale in patients with stable CHD. However, the improvements in VO2peak, METs, and the duration and onset time of 1-mm ST-segment depression on ECG were not statistically significant.

目的 探讨瓜蒌薤白半夏汤对心肌缺血再灌注损伤（MIRI）模型大鼠的心肌保护作用及机制。方法 本实验时间为2022年2月至2023年2月。采用随机数字表法将40只大鼠分为假手术组（A组）、模型组（B组）、瓜 蒌薤白半夏汤组（C组）、核因子κB（NF-κB）抑制剂组（D组），每组10只。C组、D组大鼠给予瓜蒌薤白半夏汤 预处理，A组、B组大鼠给予等量0.9%氯化钠溶液预处理，四组均连续干预7 d；A组大鼠于末次给药后1 h开胸，但不 结扎；B组、C组、D组大鼠于末次给药后1 h制备MIRI模型（采用左前降支结扎法制备），其中D组大鼠于再灌注前10 min腹腔注射吡咯烷二硫代甲酸铵。比较四组大鼠心肌梗死面积百分比、心肌组织形态学、血清炎症因子（IL-1β、 TNF-α）水平、血清氧化应激指标〔丙二醛（MDA）、超氧化物歧化酶（SOD）、乳酸脱氢酶（LDH）〕、心肌组 织超微结构及心肌组织Toll样受体4（TLR4）、NF-κB p65蛋白表达水平、mRNA相对表达量。结果 B组大鼠心肌梗 死面积百分比高于A组，C组和D组大鼠心肌梗死面积百分比低于B组，D组心肌梗死面积百分比高于C组（P＜0.05）。 HE染色结果显示，C组大鼠心肌组织纤维排列、心肌组织形态改变、横纹结构改变均优于B组；D组大鼠细胞核散落 在外侧明显。Masson染色结果显示，B组大鼠心肌细胞排列紊乱，少部分胶原纤维染色阳性；C组和D组大鼠心肌细胞 排列较规则，几乎无胶原纤维染色阳性。B组大鼠血清IL-1β、TNF-α、MDA水平及LDH活性高于A组，血清SOD活 性低于A组（P＜0.05）；C组和D组大鼠血清IL-1β、TNF-α、MDA水平及LDH活性低于B组，血清SOD活性高于B组 （P＜0.05）；D组大鼠血清IL-1β、TNF-α、MDA水平及LDH活性低于C组，血清SOD活性高于C组（P＜0.05）。透 射电镜扫描结果显示，B组大鼠细胞质中存在较多空泡，自噬体较多，C组大鼠细胞质中可见少数自噬泡，D组大鼠 细胞质部分呈空泡化。B组大鼠心肌组织TLR4、NF-κB p65蛋白表达水平、mRNA相对表达量高于A组，C组和D组大 鼠心肌组织TLR4、NF-κB p65蛋白表达水平、mRNA相对表达量低于B组，D组大鼠心肌组织TLR4、NF-κB p65蛋白 表达水平、mRNA相对表达量低于C组（P＜0.05）。结论 瓜蒌薤白半夏汤预处理可减轻炎症反应、氧化应激及抑制 心肌细胞自噬小体产生，进而缩小MIRI模型大鼠心肌梗死面积，保护心肌细胞，其机制可能与瓜蒌薤白半夏汤抑制 TLR4/NF-κB信号通路有关。

目的 观察和畅膏联合西药治疗阴虚阳亢型原发性高血压(EH)的疗效.方法 选取2021年2月—2022年1月在福建中医药大学附属人民医院心血管科门诊就诊的阴虚阳亢型原发性高血压患者78例,采用随机数字表法分为对照组和治疗组各39例,治疗期间对照组脱落2例,治疗组脱落1例.对照组予常规西药治疗,治疗组在对照组治疗基础上加服和畅膏,2组疗程均为12周.比较2组疗效、中医证候疗效及治疗前后动态血压、血管紧张素Ⅱ(AngⅡ)、血管细胞黏附分子-1(VCAM-1)、心踝血管指数(CAVI)、内皮型一氧化氮合酶(eNOS)、血流介导的血管舒张功能(FMD)变化.结果 2组疗效比较,治疗组总有效率为78.95％,优于对照组的56.76(P<0.05);2组中医证候疗效比较,治疗组总有效率为94.74％,优于对照组的56.76％(P<0.05);与治疗前比较,治疗后2组动态血压、AngⅡ、VCAM-1、CAVI均显著下降(P均<0.01),eNOS、FMD均显著升高(P均<0.01);治疗后2组比较,治疗组动态血压、AngⅡ、VCAM-1、CAVI均降低更显著(P均<0.05),eNOS、FMD均上升更显著(P均<0.05).结论 和畅膏联合西药能更好地改善阴虚阳亢型原发性高血压患者血管顺应性及内皮功能,较单用降压药具有更好疗效,可更好地稳定血压和改善临床症状.

The purpose of this study was to determine the effect of amiodarone (Ami) on hERG-T618I currents in HEK293 cells. A transient transfection method was used to transfer hERG-T618I and hERG wild-type (WT) channel plasmids into HEK293 cells. An extracellular local perfusion method was used for administration. Currents were recorded using the whole-cell patch clamp technique. Ami (10 μM) had a greater retarding effect on the hERG-T618I channel than WT (P < 0.05). The half-inhibitory concentration for the mutant was approximately 1.82 times that of WT (P < 0.05). The WT current inhibition fraction against Ami was significantly greater than T618I in the same cell (P < 0.05). The STEP current of the mutant channel was larger than the WT channel, but the characteristic of inward rectification did not appear. Ami reduced the STEP current of the mutant channel, and the steady-state activation curve indicated that channel activation decreased (P > 0.05). Ami restored partial inactivation of the mutant channel. Ami effectively reduced the current in the phase 2 plateau (P < 0.05), but the phase 3 current did not exhibit the characteristics of a WT current. Ami inhibited hERG-T618I currents on HEK293 cells, but the effect was weaker than WT.

Objective To investigate the protective effect and mechanism of pretreatment of Gualou Xiebai Banxia decoction on myocardial ischemia-reperfusion injury(MIRI)model rats.Methods This experiment was conducted from February 2022 to February 2023.A total of 40 rats were divided into sham group(A group),model group(B group),Gualou Xiebai Banxia decoction group(C group),and nuclear factor-κB(NF-κB)inhibitor group(D group)using random number table method,10 rats in each group.Rats in groups C and D were pretreated with Gualou Xiebai Banxia decoction,while rats in groups A and B were pretreated with an equal amount of 0.9%sodium chloride solution.All four groups were continuously intervened for 7 days.Rats in group A underwent thoracotomy at 1 hour after the last administration,but were not ligated;while rats in groups B,C,and D were used to prepare MIRI models using the left anterior descending branch ligation method at 1 hour after the last administration.Rats in group D were intraperitoneally injected with ammonium pyrrolidine dithioformate at 10 minutes before reperfusion.The percentage of myocardial infarction area,myocardial tissue morphology,serum inflammatory factor(IL-1β and TNF-α)levels,serum oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),lactate dehydrogenase(LDH)],myocardial tissue ultrastructure,Toll like receptor 4(TLR4),NF-κB p65 protein expression level and relative mRNA expression level in myocardial tissue were compared in the four groups of rats.Results The percentage of myocardial infarction area in group B was higher than that in group A,the percentage of myocardial infarction area in groups C and D was lower than that in group B,while the percentage of myocardial infarction area in group D was higher than that in group C(P<0.05).The HE staining results showed that the fiber arrangement,morphological changes,and transverse structural changes of myocardial tissue in group C were superior to those in group B,and the nuclei of group D were scattered and obvious on the outer side.The results of Masson staining showed that the arrangement of myocardial cells in group B was disordered,and a few collagen fibers were positively stained;the arrangement of cells in groups C and D was relatively regular,with almost no positive staining of collagen fibers.Serum levels of IL-1β,TNF-α,MDA and serum LDH activity in group B were higher than those in group A,while the serum SOD activity was lower than that in group A(P<0.05);serum levels of IL-1β,TNF-α,MDA and serum LDH activity in groups C and D were lower than those in group B,while the serum SOD activity was higher than that in group B(P<0.05);serum levels of IL-1β,TNF-α,MDA and serum LDH activity in group D were lower than those in group C,while the serum SOD activity was higher than that in group C(P<0.05).The scanning results of the projection electron microscope showed that there were many vacuoles and autophagosomes in the cytoplasm of group B,a few autophagosomes in the cytoplasm of group C,and partial cytoplasmic vacuolization of group D.The protein expression level and mRNA relative expression level of TLR4 and NF-κB p65 in myocardial tissue of group B were higher than those of group A,the protein expression level and mRNA relative expression level of TLR4 and NF-κB p65 in myocardial tissue of groups C and D were lower than those of group B,while the protein expression level and mRNA relative expression level of TLR4 and NF-κB p65 in myocardial tissue of group D were lower than those of group C(P<0.05).Conclusion Pretreatment of Gualou Xiebai Banxia decoction can reduce inflammatory response,oxidative stress,and inhibit the production of autophagosomes in myocardial cells,thereby reducing the myocardial infarction area and protecting myocardial cells in MIRI model rats.Its mechanism may be related to the inhibition of TLR4/NF-κB signal pathway by Gualou Xiebai Banxia decoction.

目的:分析冠状动脉慢血流患者血栓弹力图的特点,观察其与冠脉TIMI血流帧数的相关性.方法:回顾性分析2019年1月至2021年11月于福建中医药大学附属人民医院心血管内科因胸闷、胸痛初次就诊患者2426例临床资料.根据入选标准,最终纳入冠状动脉慢血流患者50例为观察组,经冠脉造影检查排除冠心病且无冠脉慢血流患者50例为对照组.收集两组的一般资料、血栓弹力图、血脂、纤维蛋白原、血小板数据,观察组冠脉TIMI血流帧数等资料,进行统计学分析.结果:观察组吸烟人数(18例)明显多于(6例)对照组,差异有统计学意义(P＜0.05).两组纤维蛋白原、血小板水平比较,差异无统计学意义(P＞0.05).观察组血栓弹力图R、K明显较对照组低,α角、MA较对照组升高,差异有统计学意义(P＜0.05).观察组冠脉平均TIMI血流帧数与血栓弹力图的R、K、α角、MA均无明显相关性(P＞0.05).结论:吸烟患者更容易引起冠状动脉慢血流.有冠状动脉慢血流的患者血液系统呈高凝血因子活性,纤维蛋白原及血小板功能明显增高,处于高血栓风险状态.

Background:This study aimed to explore the effects of Kangdaxin oral liquid on myocardial fibrosis in heart failure with preserved ejection fraction (HFpEF) rats.Methods:A total of 30 Sprague Dawley (SD) rats were randomly divided into 3 groups Sham operation group (Sham), HFpEF group (HFpEF), and HFpEF with drug intervention group (HFpEF + I). Rats in HFpEF + I group were given Kangdaxin oral liquid at a dose of 2.7 mL/(kg·d). After modeling or treatment, the value of E/A and E/e' in each group of rats were measured by echocardiography. The N-terminal pro b-type natriuretic peptide (NT-proBNP) level was determined by enzyme-linked immunosorbent assay (ELISA). Heart weight/body mass index (Hw/W) and left ventricular weight/body mass index (LVw/W) were calculated after the rats were sacrificed; the transforming growth factor-β1 (TGF-β1) protein expression level in cardiac tissue was detected by western blot.Results:Compared with sham group, the values of diastolic function item (E/A) and mitral annular early diastolic velocity (E/e') in HFpEF group were significantly decreased, and the level of NT-proBNP was significantly increased (P<0.05). Compared with HFpEF group, the value of E/A and E/e' in HF + I group were significantly increased, and the level of NT-proBNP was significantly decreased (P<0.05). Compared with sham group, the expression of TGF-β1 protein in heart tissue of HFpEF group were significantly increased (P<0.05). Compared with HFpEF group, the expression of TGF-β1 protein in HFpEF + I group were significantly decreased (P<0.05).Conclusions:Kangdaxin oral liquid has protective effect on heart in HFpEF rats, which can reduce the protein expression of TGF-β1 in the heart tissue of HFpEF rats. This may be a possible mechanism to inhibit myocardial fibrosis and improve cardiac diastolic function.

BACKGROUND:Hypertension is one of the most challenging public health problems worldwide. Previous studies suggested that the Songling Xuemaikang capsule (SXC)-a Chinese herbal formula-was effective for essential hypertension. However, the efficacy of SXC monotherapy for hypertension remains unclear. We aimed to compare the blood pressure (BP)-lowering efficacy and safety of SXC versus losartan in patients with essential hypertension. METHODS:In this multicenter, randomized, double-blind, noninferiority trial in China, patients 18 to 65 years of age with mild essential hypertension were randomly allocated to receive either SXC or losartan for 8 weeks. The primary outcome was the change in sitting diastolic BP from baseline to 8 weeks, with a predefined noninferiority margin of -2.5 mm Hg. RESULTS:Of the 755 patients who entered a 2-week run-in period, 628 patients (327 women and 301 men; mean [SD] age, 52.6 [9.2] years) were randomly assigned to the SXC (n=314) or losartan (n=314) group. The primary analysis based on the intention-to-treat principle showed that the change in diastolic BP from baseline to 8 weeks was similar between the SXC and losartan groups (-7.9 [8.0] versus -8.1 [7.9]). The lower boundary of 95% CI (mean difference, -0.24 [95% CI, -1.51 to 1.03]) was above the margin of -2.5 mm Hg, showing noninferiority. Results were consistent with per-protocol analysis. SXC produced greater improvements in total hypertension symptom score (-5.7 [4.2] versus -5.0 [4.0]; P=0.020) and total cholesterol (-0.1 [1.0] versus 0.1 [1.2]; P=0.025). There were no differences between groups in the other BP and patient-reported outcomes. Incidence and severity of adverse events were similar between groups. CONCLUSIONS:SXC was well tolerated and demonstrated noninferior to losartan in BP lowering in patients with mild hypertension. SXC might be an alternative for mild hypertension, particularly for patients with a preference for natural medicine. REGISTRATION:URL: www.chictr.org.cn; Unique identifier: ChiCTR-IPR-16008108.

目的:探讨康达心口服液对缺血性心肌病患者血清人可溶性生长刺激表达基因蛋白2(sST2)水平的影响.方法:收集在福建中医药大学附属人民医院就诊的阳虚水泛型缺血性心肌病患者60例,按随机数字表法分为对照组和观察组各30例,对照组参照《稳定性冠心病诊断与治疗指南2018》和《中国心力衰竭诊断和治疗指南2018》推荐的治疗方案治疗,观察组在对照组基础上加用康达心口服液治疗,两组观察期均为4周,两组治疗前、后分别进行心脏彩超、6分钟步行试验,检测sST2、N末端B型利钠肽原(NT-proBNP)等指标.结果:两组患者治疗前各观察指标无统计学差异(P均＞0.05),用药4周后观察组与对照组比较sST2、NT-proBNP下降,LVEF、6分钟步行试验评级提高,差异有统计学意义(P均＜0.05).结论:联合使用康达心口服液能在优化治疗基础上进一步降低阳虚水泛型缺血性心肌病患者sST2,起到抑制心肌纤维化作用,治疗效果好.

目的 探讨康达心口服液对心肾综合征(CRS)大鼠的影响及潜在机制.方法 将60只SD大鼠随机分为5组:假手术(sham)组、心力衰竭(HF)组、CRS组、HF干预(HF+I)组、CRS干预(CRS+I)组,通过心脏彩超测量各组大鼠左室射血分数(LVEF)、左室缩短分数(FS);通过ELISA法检测血清氨基末端脑钠肽前体(NT-proBNP)、肌酐(Cr)、尿素氮(Bun)、总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平.结果 HF组、HF+I组、CRS组、CRS+I组大鼠的FS及LVEF值低于sham组,血清NT-proBNP水平高于sham组,差异有统计学意义(P<0.05).HF+I组的FS及LVEF值高于HF组,NT-proBNP水平低于HF组,差异有统计学意义(P<0.05).CRS+I组的FS及LVEF值高于CRS组,NT-proBNP水平低于CRS组,差异有统计学意义(P<0.05).CRS组、CRS+I组大鼠的血清Cr及Bun水平高于sham组,差异有统计学意义(P<0.05).CRS+I组的血清Cr及Bun水平低于CRS组,差异有统计学意义(P<0.05).HF组、HF+I组、CRS组、CRS+I组的血清T-AOC、SOD水平低于sham组,MDA水平高于sham组,差异有统计学意义(P<0.05).HF+I组大鼠的血清T-AOC、SOD水平高于HF组、MDA水平低于HF组,差异有统计学意义(P<0.05).CRS+I组大鼠的血清TAOC、SOD水平高于CRS组,MDA水平低于CRS组,差异有统计学意义(P<0.05).结论 康达心改善CRS大鼠心功能的效应,可能是通过提高抗氧化能力、抑制氧化应激实现的.

目的 观察双清消斑饮加八段锦联合西药治疗稳定性冠心病痰瘀互结证的疗效.方法 选取2020年5—11月在福建中医药大学附属人民医院心血管科住院的稳定性冠心病痰瘀互结证患者80例,按随机数字表法分为对照组和观察组各40例,研究期间对照组剔除5例,观察组剔除4例,最终对照组35例、观察组36例纳入统计.对照组给予规范西药治疗,观察组在对照组治疗基础上加用双清消斑饮口服联合八段锦训练,2组疗程均为8周.比较治疗前后2组心肺运动试验(CPET)指标[峰值摄氧量(peak VO2)、无氧阈值(AT)、氧脉搏(VO2/HR)、峰值运动时间(peak TIME)、AT时最大代谢当量(MET)]、心绞痛严重程度分级及中医证候积分的变化情况.结果 治疗后2组peak VO2、AT、VO2/HR、peak TIME和MET均较治疗前升高(P均<0.05),治疗后观察组上述指标比对照组升高更明显(P<0.05);2组治疗后心绞痛严重程度分级分布情况均较治疗前改善(P均<0.01),观察组较对照组改善更明显(P<0.05);2组治疗后胸闷痛位置固定、痰多体胖,身体有瘀点或瘀斑、面色紫暗、脘腹痞满、头昏多寐、大便黏腻中医证候积分均较治疗前下降(P均<0.01),治疗后观察组上述指标均较对照组下降更明显(P均<0.05).结论 双清消斑饮加八段锦联合西药治疗稳定性冠心病痰瘀互结证能够改善CPET指标,降低心绞痛严重程度,改善临床症状.

目的:观察化痰活血方对痰瘀互结型冠状动脉慢血流(CSF)患者相关炎症因子、运动平板试验指标以及中医证候的影响.方法:纳入2019年8月-2020年7月在福建中医药大学附属人民医院心血管科住院符合诊断的患者88例,随机分为对照组、中药组各44例,对照组给予西药治疗,中药组在对照组基础上加用化痰活血方,治疗周期为8周,对比治疗前后两组炎症因子、运动平板试验指标以及中医证候积分的变化.结果:治疗后2组炎症因子TNF-α、IL-6均较前明显下降(P＜0.05),中药组下降优于对照组(P＜0.05);治疗后2组运动平板试验指标均较治疗前改善(P＜0.05),中药组明显优于对照组(P＜0.05);治疗后两组患者中医证候积分均较治疗前明显下降(P＜0.05),中药组明显优于对照组(P＜0.01).结论:化痰活血方联合西药治疗能够降低CSF相关炎症因子水平,提高患者运动平板实验阈值,改善中医证候.

目的 体内外观察和厚朴酚(HNK)对动脉粥样硬化(AS)模型Wnt/β-连环蛋白(β-catenin)信号通路及动脉硬化的影响;探讨和厚朴酚调控Wnt/β-catenin信号通路对AS形成过程影响的可能机制.方法 动物实验:8只SD大鼠作为正常对照组,24只高脂喂养SD大鼠随机分为AS组(高脂喂养+维生素D2注射建立AS模型),AS+HNK组[建立模型后HNK腹腔注射5 mg/(kg·d),2次/d,连续8周]和AS+HNK-PNU组[AS+HNK组的基础上加用Wnt/β-catenin拮抗剂PNU-74654 100 mg/(kg·d),连续8周],每组8只.检测各组血脂水平,HE染色图像分析测定胸主动脉中膜面积及血管壁厚度,免疫印迹法检测大鼠胸主动脉组织Wnt/β-catenin的蛋白表达.细胞实验:培养人脐静脉内皮细胞(HUVEC)及人主动脉平滑肌细胞(HA-VSMC)分为对照组、AS模型组[使用20 mg/L氧化型低密度脂蛋白(ox-LDL)干预48 h诱导建立细胞AS模型],AS+HNK组(AS+HNK 32 μmol/L干预48 h)、AS+HNK-PNU 组(AS+HNK 32 μmol/L+PNU-74654 50 μmol/L 干预48 h);分别采用实时荧光定量聚合酶链反应(RT-PCR)法和Western blot法检测细胞Wnt3a和β-catenin mRNA及蛋白质表达.采用Transwell小室实验检测HA-VSMC迁移能力.结果 动物实验:与对照组相比,AS组血清三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)水平升高(均P＜0.05),与AS组比较,AS+HNK组和AS+HNK-PNU组血脂水平降低(P＜0.05).与对照组比较,AS组大鼠胸主动脉中膜面积及血管壁厚度增加(均P＜0.01);胸主动脉组织Wnt/β-catenin蛋白表达水平增加(P＜0.05);和厚朴酚可降低AS模型大鼠胸主动脉中膜面积及血管壁厚度和Wnt/β-catenin蛋白表达水平(P＜0.05),联合使用PNU-74654此效应下降.细胞实验:两种细胞株模型组Wnt3a及β-catenin mRNA和蛋白表达水平高于对照组;AS+HNK组的Wnt3a、β-catenin蛋白表达与mRNA相对表达量低于AS+HNK-PNU组及AS组(均P＜0.05).AS组HA-VSMC迁移能力高于对照组,AS+HNK组与AS+HNK-PNU组HA-VSMC迁移能力低于AS组(P＜0.05).结论 和厚朴酚可下调AS模型Wnt、β-catenin表达,抑制平滑肌细胞迁移,降低主动脉中膜面积和血管壁厚度;和厚朴酚改善AS的作用可能与Wnt/β-catenin信号通路有关.

我国冠状动脉(冠脉)粥样硬化性心脏病(冠心病)的发病率和死亡率高且呈快速上升趋势,由此带来的社会和医疗负担日益严重.经皮冠脉介入治疗(percutaneous coronary intervention ,PCI)引导的血运重建是目前治疗冠心病的主要手段.越来越多的临床证据[1-2 ]表明,只有解除由冠脉狭窄导致血流动力学意义的心肌缺血,患者才能从PCI的血运重建中获得远期收益.鉴于使用压力导丝测量的血流储备分数(fractional flow reserve ,FFR)技术临床应用不足,计算冠脉生理学技术应运而生.其中,定量血流分数(quantitative flow ratio ,QFR)测定是一种基于冠脉造影(coronary angiography ,CAG )的计算FFR技术,可在导管室中实时评估冠脉病变导致有生理学意义的心肌缺血及其严重程度.为了更好地规范 Q FR的临床应用,让该技术尽快在各类医疗机构中普及使用,特制订福建省冠脉 Q FR临床应用专家共识.

目的 探讨高血压病患者盐摄入量与中医证型以及心、肾靶器官损害程度的相关性.方法 纳入符合诊断的高血压病患者148例,填写问卷调查,采集临床资料,进行中医辨证分型.通过24小时尿钠排泄量估算每日盐摄入量,测定尿微量白蛋白(MAU)水平,同时应用心脏彩超测定左心室重量指数(LVMI),进行相关性分析.结果 ①盐摄入量越多,血压分级越高.高血压3级组患者盐摄入量明显高于高血压1级组(P<0.05).②根据盐摄入量分组,高盐组与中盐组SBP、LVMI、MAU明显高于低盐组(P<0.05),高盐组SBP、LVMI、MAU明显高于中盐组(P<0.05).③高血压中医证型中痰湿壅盛组比例较高;高血压病各中医证型患者盐摄入量比较:肝火亢盛证

目的:研究丹参饮通过介导过氧化物酶体增殖物激活型受体γ(PPAR-γ)/肝X受体α(LXR-α)/三磷酸腺苷结合盒转运体A1(ABCA1)信号通路减轻大鼠冠状动脉粥样硬化的作用机制.方法:选取无特定病原体(SPF)级40只健康Wist-ar大鼠作为实验动物,随机分为空白组、冠状动脉粥样硬化组(对照组)、丹参饮低剂量观察组(低剂量组)和丹参饮高剂量观察组(高剂量组),比较各组大鼠的炎症介质水平、ICAM-1水平、脂代谢水平、PPAR-γ、LXR-α和ABCA1 mRNA表达和蛋白表达.结果:对照组、低剂量组和高剂量组的三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)均高于空白组(P<0.05),低剂量组和高剂量组的TG、TC和LDL-C均低于对照组(P<0.05),且高剂量组低于低剂量组(P<0.05),但4组的HDL-C表达差异无统计学意义(P>0.05);对照组、低剂量组和高剂量组的炎症介质和ICAM-1表达均高于空白组(P<0.05),低剂量组和高剂量组的炎症介质和ICAM-1表达均低于对照组(P<0.05),且高剂量组低于低剂量组(P<0.05);对照组、低剂量组和高剂量组的PPAR-γ、LXR-α和ABCA1 mRNA和蛋白表达均高于空白组(P<0.05),且低剂量组和高剂量组明显高于对照组(P<0.05),高剂量组明显高于低剂量组(P<0.05).结论:丹参饮可以通过对PPAR-γ-LXR-α-ABCA1信号通路的介导,发挥出抗冠状动脉粥样硬化的作用.

目的 分析在抗心肌缺血再灌注损伤(MIRI)治疗中天山花楸叶黄酮提取物的作用机制.方法 选取2020年1月—2021年1月实验室小鼠50只,全部样本实施K-H灌注液20 min灌注后,根据具体用药方法分组,对照组10只,另行110 min恒压灌注;模型组10只,20 min全心停灌+60 min复灌;高剂量FST组10只,K-H液20 min灌注+1.5 mg/L总黄酮10 min灌注,停灌20 min,K-H液复灌60 min;低剂量FST组10只,20 min K-H液灌注,0.5 mg/L金丝桃苷10 min灌注,停灌20 min,复灌60 minK-H液;CDZ组(抑制剂组)10只,K-H液20 min灌注,含抑制剂灌注液(1μmol/L)20 min灌注,停灌20 min,K-H液复灌60 min.借助网络药理学研究手段,研究天山花楸中对MIRI具有对抗作用的黄酮提取物,定位其作用靶点,分析作用机理.结果 有效成分方面,天山花楸在抗心肌缺血再灌注损伤中发挥药效的成分以黄酮类化合物为主,在治疗时以TSPO为主要靶点,其中心血管相关靶标占比37％.剂量影响方面,不同剂量皆可改善患者心功能,修复心肌梗死组织,缓解病理损伤,提升心肌抗氧化水平,促进mPTP维持闭合状态,对线粒体水肿起到抑制作用.其中低剂量FST组心肌梗死面积(62.71±5.29)％,抑制剂组心肌梗死面积(50.24±4.80)％,高剂量用药药效较显著,心肌梗死面积为(46.19±4.58)％,消极影响较低,差异有统计学意义(F=51.403,P=0.017).结论 天山花楸叶黄酮提取物可用于修复MIRI,改善心肌梗死和心肌舒缩功能,降低相关组织氧化应激影响,药物成分在TSPO靶点发挥作用,阻断mPTP孔开放作用,缓解线粒体水肿,降低心肌损伤.

目的 观察康达心口服液治疗慢性心力衰竭阳虚血瘀证患者临床疗效及对心功能和运动耐量的影响.方法 选取80例慢性心力衰竭阳虚血瘀证患者,按随机数字表法分成对照组和观察组,对照组按照指南使用ACEI、β受体阻滞剂、利尿剂等西药常规治疗,观察组在对照组治疗方案的基础上加用康达心口服液治疗.8周后比较两组中医证候积分、治疗前后血清N末端B型脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2).治疗前后进行心肺运动试验(CPET),比较无氧阈值(AT)、峰值摄氧量(peakVO2)的变化.结果 观察组与对照组治疗后NT-proBNP、sST2均较治疗前显著下降(P<0.01),观察组比对照组下降显著(P<0.05).对照组与观察组治疗后AT和peakVO2均较治疗前升高(P<0.05),观察组比对照组升高显著(P<0.05).在中医证候疗效方面,观察组较对照组改善显著(P<0.05).结论 康达心口服液能进一步改善慢性心力衰竭阳虚血瘀证患者的中医临床证候及其心功能和运动耐量.

目的 探讨温阳通络方对急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后患者心室重构和血管内皮功能的影响.方法 简单随机选取2019年1月-2021年1月在该院接受PCI治疗的AMI患者80例,以随机数表法分为对照组与观察组,各40例.对照组接受阿司匹林,氯吡格雷+阿托伐他汀治疗,观察组加用温阳通络方治疗,比较两组临床疗效及心室重构和血管内皮功能的变化.结果 观察组治疗总有效率高于对照组(92.50％vs 75.00％),差异有统计学意义(x2=4.501,P=0.034);观察组治疗后胸闷、气短与心悸积分低于对照组,差异有统计学意义(P＜0.05);观察组治疗后左室舒张末内径(LVEDD)小于对照组,左室射血分数(LVEF)与室间隔厚度(IVSd)大于对照组,差异有统计学意义(P＜0.05);观察组治疗后血清基质金属蛋白酶-9(MMP-9)与肿瘤坏死因子-α(TNF-α)水平低于对照组,差异有统计学意义(P＜0.05),一氧化氮(NO)水平高于对照组,差异有统计学意义(P＜0.05).结论 温阳通络方可改善AMI患者接受PCI术后心室重构与血管内皮功能.

目的 观察四君子汤合丹参饮加味联合增强型体外反搏治疗气虚血瘀型稳定性冠心病的临床疗效.方法 选取我院心血管内科2018年10月至2020年7月住院和(或)门诊的气虚血瘀型稳定性冠心病患者120例作为研究对象,按数字表法随机分为对照组和治疗组,每组60例.对照组采用西医常规治疗,治疗组在对照组基础上加用四君子汤合丹参饮加味联合增强型体外反搏治疗,两组均连续治疗35天.比较两组治疗前后中医证候积分及中医证候疗效、运动平板试验Duke评分、西雅图心绞痛量表(SAQ)积分的变化.结果 两组治疗后中医证候积分均显著下降(P<0.05),治疗组下降优于对照组(P<0.05),治疗组中医证候疗效优于对照组(P<0.05).两组治疗后运动平板试验Duke评分明显升高(P<0.05),治疗组优于对照组(P<0.05);两组治疗后SAQ量表中的躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、疾病认识程度各维度计分均显著升高,其中躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度升高幅度优于对照组(P<0.05).结论 四君子汤合丹参饮加味联合体外反搏治疗能进一步改善气虚血瘀型稳定性冠心病患者的中医证候,提高其运动耐量及生活质量.