文献类型：期刊文献

中文题名：补阳还五汤集束化治疗家兔心脏骤停后综合征的疗效观察及其机制

英文题名：Clinical Observation on Buyang Huanwu Decoction Clustering in the Treatment for Rabbits with PCAS and Study on Its Mechanism

作者：张卫强[1];张志明[1];雍文兴[1];王功臣[1];宋忠阳[2];黄达[1];邵向阳[2];颉志英[2]

第一作者：张卫强

机构：[1]甘肃中医药大学附属医院,甘肃兰州730000;[2]甘肃中医药大学.

第一机构：甘肃中医药大学第二附属医院

年份：2020

卷号：33

期号：10

起止页码：1

中文期刊名：西部中医药

外文期刊名：Western Journal of Traditional Chinese Medicine

收录：CSTPCD

基金：兰州市科技局项目(1304FKCA116);甘肃省中医药管理局科研课题(GZK-2014-57)。

语种：中文

中文关键词：心脏骤停后综合征;补阳还五汤;家兔;集束化治疗;动物实验

外文关键词：PCAS;Buyang Huanwu decoction;rabbit;cluster therapy;animal experiment

摘要：目的:观察补阳还五汤集束化治疗家兔心脏骤停后综合征(post-cardiac arrest syndrome,PCAS)的疗效并探讨其可能机制。方法:将40只清洁级家兔,随机分为亚低温复苏组(A组)、补阳还五汤+亚低温组(B组)、米伐西醇+κ-阿片受体激动剂(U50488H)+亚低温组(C组)、补阳还五汤+米伐西醇+U50488H+亚低温组(D组)。各组于制颤前15 min、自主循环恢复后给予相应干预后于30、60、120、180 min检测血流动力学情况、氧化应激指标、炎症因子、心脑损伤标志物情况。结果:与A组相比,血流动力学监测显示B组、C组、D组各组左室舒张末压(left ventricular end diastolic pressure,LVEDP)均有不同程度下降、左室内压上升和下降最大速率(peakdp/dt)不同程度上升,其中以D组改善最为明显;血清学检测显示B组、C组、D组各组血清心脑损害标志物心肌肌钙蛋白I(cardiac troponin I,cTnI)、神经元特异性烯醇化酶(neuron specific enolase,NSE)浓度、炎症因子白细胞介素8(interleukin-8,IL-8)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)活性及氧化应激指标丙二醛(malonaldehyde,MDA)含量均有不同程度降低,而超氧化物歧化酶(superoxide dismutase,SOD)活性则升高明显。结论:补阳还五汤集束化治疗能够明显减少家兔PCAS后心脑损害标志物的生成,减轻心脑细胞损伤,其机制可能是该治疗方案能够明显改善血流动力学状况,提高自由基活性,抑制炎症反应,其疗效优于单纯使用西药(米伐西醇+U50488H)或复方补阳还五汤。
Objective: To observe clinical effects of Buyang Huanwu decoction in the treatment for rabbits with post-cardiac arrest syndrome(PCAS) and discuss its potential mechanism. Methods: Forty rabbits were randomized into subhypothermia resuscitation group(A group), Buyang Huanwu decoction+subhypothermia group(B group),mivazerol+ κ-opioid receptor agonist(U50488 H) + subhypothermia group(C group) and Buyang Huanwu decoction+mivazerol+U50488 H+subhypothermia group(D group), hemodynamic condition, oxidative stress index,inflammatory factors and heart-brain injury markers were detected around 15 minutes before inducing ventricular fibrillation, 30 minutes, 60 minutes, 120 minutes and 180 minutes after autonomous cyclic recovery was restored and the corresponding intervention was given. Results: Compared with A group, hemodynamic monitoring showed that left ventricular end diastolic pressure(LVEDP) of B group, C group and D group reduced partly, maximum rate of left ventricular pressure ascending and descending velocity(peadp/dt) rose in various degrees, among them, the improvements of D group the most obvious;serological detection indicated that the contents of MDA, TNF-α, IL-8,the concentrations of NSE and cTnI in B group, C group and D group lowered in different degrees, while the activity of SOD rose notably. Conclusion: Clustering therapy of Buyang Huanwu decoction could obviously reduce the generation of heart-brain injury markers after PCAS, relieve heart-brain cellular injury, and its mechanism might be that therapeutic regimen could notably improve hemodynamic conditions, raise the activity of free radical and inhibit inflammatory reactions, and its effects are superior to these of only use of Western medicine(mivazerol+U50488 H)or Buyang Huanwu decoction.