| 引用本文:迟红玉1，柴苗苗1，崔丽2，郭兆增2，妥少勇2，曹月娟2.曲美他嗪联合养心氏片防治放疗相关心脏损伤的临床疗效观察及作用机制研究[J].世界中医药,2020,(02):. |
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| 曲美他嗪联合养心氏片防治放疗相关心脏损伤的临床疗效观察及作用机制研究 |
| Clinical Efficacy Observation and Mechanism Study on Trimetazidine Combined with Yangxinshi Tablets in Prevention and Treatment for Cardiac Injury Associated with Radiotherapy |
| 投稿时间：2019-04-29 |
| DOI：10.3969/j.issn.1673-7202.2020.02.027 |
| 中文关键词: 放疗 心脏损伤 曲美他嗪 养心氏片 作用机制 心肌标志物 氧化应激 炎性反应 |
| English Keywords:Radiotherapy Cardiac injury Trimetazidine Yangxinshi Tablets Mechanism Myocardial markers Oxidative stress Inflammatory reaction |
| 基金项目:天津市人民医院科研项目（2016YJ027） |
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| 中文摘要: |
| 目的:观察曲美他嗪联合养心氏片防治放疗相关心脏损伤的临床疗效，并探讨其可能的作用机制。方法:选取2017年8月至2018年11月天津市人民医院收治的接受胸部放疗患者72例作为研究对象，按随机数字表法随机分为对照组、单药组和双药组，每组24例。对照组采用常规放射治疗，单药组于放疗首日开始服用曲美他嗪20 mg/次，3次/d，服用至放疗结束；双药组于放疗首日开始服用曲美他嗪20 mg/次，3次/d，联合养心氏片3片/次，3次/d，服用至放疗结束，分别于放疗前、放疗剂量达到30 Gy、40 Gy及放疗结束时观察是否出现心脏损伤相关的临床表现，检测心电图、心肌标志物（cTnT、BNP、心肌酶谱）、丙二醛（MDA）、超氧化物歧化酶（SOD）及白细胞介素-6(IL-6)等指标，观察其变化。结果:与对照组相比，用药组在临床症状改善、心电图、超声心动图、心肌标志物等临床指标变化差异有统计学意义，在SOD、MDA、IL-6等分子机制上看变化差异有统计学意义。结论：曲美他嗪联合养心氏片能在一定程度上有效防治放疗期间发生的心脏损伤，安全性好，值得在临床上推广应用，养心氏片联合曲美他嗪对于放射性心脏损伤的保护作用机制可能是减轻辐射导致的氧化应激及炎性反应。 |
| English Summary: |
| To observe clinical efficacy of trimetazidine combined with Yangxinshi Tablets in prevention and treatment of radiotherapy-related cardiac injury, and to explore its possible mechanism.Methods:A total of 72 patients receiving chest radiotherapy admitted in Tianjin People's Hospital from August 2017 to November 2018 were selected as study objects and randomly divided into control group, single-drug group and double-drug group, with 24 cases in each group.The control group was given routine radiotherapy.The single-drug group was given trimetazidine 20 mg each time since the beginning of radiotherapy, 3 times a day, until the end of radiotherapy.The double-drug group was given trimetazidine 20 mg each time since the beginning of radiotherapy, 3 times a day, combined with Yangxinshi Tablets 3 tablets each time, 3 times a day, until the end of radiotherapy.Before the radiotherapy, when the radiotherapy dose reached 30 Gy and 40 Gy, and at the end of radiotherapy, cardiac injury-related clinical manifestations were observed.Electrocardiogram, myocardial markers(cTnT, BNP and myocardial zymogram), malondialdehyde(MDA), superoxide dismutase(SOD)and interleukin-6(IL-6)were detected and their changes were observed.Results:Compared with the control group, there were significant differences in the drug groups in the improvement of clinical symptoms, electrocardiogram, echocardiography, myocardial markers and other clinical indicators, and in the changes of molecular mechanisms like SOD, MDA and IL-6.Conclusion:Trimetazidine combined with Yangxinshi Tablets can effectively prevent and treat heart injury during radiotherapy to a certain extent.It is safe and worthy of clinical application.The protective mechanism of Yangxinshi Tablets combined with trimetazidine for radiotherapy-induced cardiac injury may be related to alleviating oxidative stress and inflammatory reaction caused by radiation. |
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