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ABSTRACT: 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.
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).
This study was conducted from January 2005 to March 2006 using a double-blinded, randomized method. Thirty-five AMI patients (Killip I-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.
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.
After 3-month treatment, the TCM symptoms in the treatment group were improved as compared with the control group (X(2)=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.
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.
Journal of Chinese Integrative Medicine 08/2009; 7(7):616-21. DOI:10.3736/jcim20090704
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ABSTRACT: To investigate the effect of Chinese herbal medicine for benefiting qi and nourishing yin to promote the blood circulation (abbr. as CHM) in promoting ventricular wall motion and myocardial contraction in acute myocardial infarction (AMI) patients after revascularization.
Subjects were 80 AMI patients after revascularization, of those, the 40 patients in the TCM group were treated with Xinyue Capsule and compound Tanshinon Tablet upon the basic conventional Western medical treatment and the other 40 in the control group were given conventional Western medicine alone, the course for them all was 3 months. Cardiac function indexes, including left ventricular ejection fraction (LVEF), wall motion indices, normal myocardial percentage (NMP), longitudinal systolic peak strain (LSPS) and rate (LSPSR), were observed by Doppler ultrasound under dobutamine stress at the 14 days after revascularization and the end of 3-month treatment.
Except the 5 cases (3 in the TCM group and 2 in the control group) dropped out in the observation period, the trial was completed in 75 patients totally. LVEF, NMP, minus LSPS of left ventricular anterior apex and inferior basement, minus LSPSR of anterior apex, middle, basement, and minus LSPSR of inferior middle, basement were more significantly increased in Chinese medicinal treatment group than those in the control group at 14-day after revascularization (P < 0.01). The treatment group, minus LSPS and minus LSPSR of the left ventricular anterior apex and the inferior basement were at markedly higher levels compared with the controls at 3-month after revascularization (P < 0.05). Minus LSPSR of the left ventricular anterior apex and the inferior basement in the treatment group at 3-month was higher than that at 14-day after revascularization (P < 0.05).
CHM combining with conventional Western medicine treatment could improve the left ventricular contractive function and wall motion in AMI patients after revascularization.
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban 05/2009; 29(4):300-4.
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ABSTRACT: To observe the effects of Chinese drugs for supplementing qi, nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction (AMI) patients after revascularization.
Eighty patients with anterior or inferior ventricular wall AMI, who had received revascularization by intravenous thrombolysis or coronary bypass, were randomized into the treated group and the control group equally, both treated with conventional Western medical treatment, but combined, respectively, with Xinyue Capsule (, XYC) plus Composite Salvia Tablet (CST) and placebo for 3 months. Dobutamine stress echocardiography (DSE) was performed 14 days and 3 months after revascularization, respectively on every patient to observe blood perfusion extent (b value), myocardial perfusion velocity (k value) and local blood fl ow volume (k x b) in left ventricular infarction-related vascular segments under stressed state.
With 5 cases dropping out in the observation period (3 in the treated group and 2 in the control group), the trial was completed in 75 patients in total. The 14-day DSE shows that the b value and k x b value of left anterior ventricular wall mid segment and apex segment, and the k value of apex segment in patients with anterior wall AMI, as well as the b value and k x b of basal segment in patients with inferior wall AMI in the treated group were significantly higher than those in the control group (P<0.05 or P<0.01). The 3-month DSE shows that the b value of apex segment, k x b value of basal segment, mid segment and apex segment of left anterior ventricular wall in patients with anterior wall AMI as well as the b value and k x b value of basal segment of left inferior ventricular wall in patients with inferior wall AMI were all higher in the treated group than those in the control group, respectively (P<0.05). The comparison between 14-day DSE and 3-month DSE in the treated group showed that the b value of apex segment of left anterior ventricular wall in patients with anterior wall AMI and the k x b value of apex segment and mid segment of left inferior ventricular wall in patients with inferior wall AMI significantly increased along with the on-going treatment (P<0.05).
Therapy with Chinese drugs for supplementing qi, nourishing yin and activating blood circulation in combination with conventional Western medical treatment could obviously improve the blood perfusion at the myocardial tissue level in infarction-related vascular segments.
Chinese Journal of Integrative Medicine 03/2009; 15(1):19-25. DOI:10.1007/s11655-009-0019-7 · 1.22 Impact Factor