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目的：探讨黄芪注射液配伍川芎嗪防治体外循环心内直视手术中心肌缺血再灌注损伤（ＭＩＲＩ）的作用机理，并探讨ＭＩＲＩ的中医病机、治则。方法：风湿性心脏病瓣膜置换术和先天性心脏病室间隔修补术患者２４例，随机分为对照组、黄芪注射液组（益气组）川芎嗪组（活血组）、黄芪注射液配伍川芎嗪组（益气活血组）各６例。术中动态监测心电；分别在麻醉前（Ｔ１）、主动脉阻断１０ｍｉｎ（Ｔ２）、主动脉开放１０ｍｉｎ（Ｔ３）、３０ｍｉｎ（Ｔ４）、手术结束（约主动脉开放１８０ｍｉｎ，Ｔ５）经锁骨下中心静脉取血。测定血清谷草转氨酶（ＡＳＴ）、肌酸磷酸激酶（ＣＫ）、肌酸磷酸激酶同工酶（ＣＫ－ＭＢ）、乳酸脱氢酶（ＬＤＨ）、丙二醛（ＭＤＡ）含量、超氧化物歧化酶（ＳＯＤ）活力、一氧化氮（ＮＯ）和一氧化氮合成酶（ＮＯＳ）活性。结果：治疗各组与对照组比较，可减轻心肌酶、ＭＤＡ和ＳＯＤ变化，益气活血组最明显，与对照组比较多数有显著性差异（Ｐ＜０．０５，Ｐ＜０．０１）。益气组（Ｔ５）和益气活血组（Ｔ４、Ｔ５）ＮＯ活力高于对照组（Ｐ＜０．０５）。结论：ＭＩＲＩ中医辨证，病位在心，证属气虚血瘀，其治则是益气活血。黄芪注射液配伍川芎嗪注射液对其有良好的保护作用，优?
Objective: To investigate the mechanism of Astragalus injection combined with ligustrazine in prevention and treatment of myocardial ischemia-reperfusion injury (MIRI) in open-heart surgery under cardiopulmonary bypass and explore the pathogenesis and treatment of MIRI. Methods: Twenty-four patients with valve replacement of rheumatic heart disease and congenital heart disease with interventricular septum repair were randomly divided into control group, Astragalus injection group (Yiqi group), ligustrazine group (Huoxue group), Huangqi injection with ligustrazine Group (Yiqihuoxue group) each 6 cases. During the operation, ECG was monitored dynamically before anesthesia (T1), aortic occlusion 10 min (T2), aortic opening 10 min (T3), 30 min (T4) Lower central venous blood. The levels of AST, CK, CK-MB, LDH, MDA, (SOD) activity, nitric oxide (NO) and nitric oxide synthase (NOS) activity. Results: Compared with the control group, the changes of myocardial enzymes, MDA and SOD in the treatment groups were significantly reduced, the most obvious was in the Yiqi Huoxue group, most of which were significantly different from the control group (P <0.05, P <0.01). The NO level in T5 and T4, T5 groups was higher than that in control group (P <0.05). Conclusion: MIRI TCM syndrome differentiation, the disease in the heart, evidence is Qi deficiency and blood stasis, the rule is Yiqihuoxue. Astragalus injection with tetramethylpyrazine injection has a good protective effect, excellent?