Effects of Shenzhi Tongxin Capsule Combined with Conventional Western Medicine on the IL-23/IL-17 Inflammatory Axis and Myocardial Ischemia-reperfusion Injury in Elderly Patients with Acute Myocardial Infarction Undergoing Primary PCI

HUANG Qing; HUANG Guangwei; CAO Guangying; ZHAN Peng

doi:10.12102/j.issn.1672-1349.2025.23.016

Abstract：Objective: To explore the effect of Shenzhi Tongxin Capsule combined with conventional western medicine on the interleukin-23 (IL-23)/interleukin-17 (IL-17) inflammatory axis and myocardial ischemia-reperfusion injury in elderly patients with acute myocardial infarction (AMI) undergoing direct percutaneous coronary intervention (PCI). Methods: A total of 97 elderly AMI patients who underwent direct PCI at the emergency department of Anshun People's Hospital, Guizhou Province from June 2021 to February 2023 were selected. The patients were randomly divided into a control group (48 cases) and an observation group (49 cases) using a random number table method. Both groups received PCI treatment. The control group was given nicorandil on the basis of routine medication after PCI, while the observation group was given nicorandil and Shenzhi Tongxin Capsule. The treatment lasted for one week after PCI. Clinical efficacy, creatine kinase isoenzyme (CK-MB), IL-23, heart-type fatty acid-binding protein (H-FABP), troponin c (cTnI), IL-17, malondialdehyde (MDA), left ventricular end-diastolic diameter (LVEDD), superoxide dismutase (SOD), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), number of ischemic episodes, and myocardial infarction area were compared between the two groups. Follow-up for 6 months was conducted to evaluate the occurrence of major adverse cardiovascular events (MACE). Results: The clinical control and effective rate of the observation group was 81.63%, which was higher than 56.25% in the control group (P < 0.05). One and seven days after surgery, the levels of IL-23, IL-17, MDA, CK-MB, cTnI, and H-FABP in the observation group were significantly lower than those in the control group, while SOD levels were significantly higher (P < 0.05). The number of ischemic episodes and the area of myocardial infarction were also reduced in the observation group (P < 0.05). Seven days and one month after surgery, LVEDD and LVMI in the observation group were lower than those in the control group, while LVEF was higher (P < 0.05). The incidence of MACE within six months after PCI in the observation group was 10.20% (5/49), significantly lower than 27.08% (13/48) in the control group, with statistical significance (P < 0.05). Conclusion: Shenzhi Tongxin Capsule combined with conventional western medicine shows clear therapeutic effects in elderly AMI patients undergoing direct PCI. It can regulate the expression of IL-23/IL-17 inflammatory axis factors, weaken oxidative stress, alleviate myocardial injury, reduce the number of ischemic episodes and the area of myocardial infarction, thereby promoting recovery of cardiac function and reducing the risk of adverse events.