Abstract: Background　Current therapeutic options for ischemic cardiovascular diseases mainly include revascularization and pharmaceutical treatments，which are associated with marked short-term effects yet unsatisfactory long-term effects.It has been suggested that transient ischemic attack would induce post-ischemic adaptive changes that are protective for the organism，the mechanism is associated with the activation of protein kinase C （PKC） and phosphoinositide 3-kinase （PI3K），and increased release of endogenous adenosine，etc.Objective　To explore the effects of cupping therapy on serum PKC and PI3K in hospitalized patients with cardiovascular diseases.Methods　In accordance with the inclusion criteria，315 inpatients with cardiovascular disease were selected from Department of Cardiovascular and General，Nanhai District People's Hospital from April 2017 to May 2018.By use of a random number table，they were divided into the control group and experimental group，receiving regular treatment（including lipid-regulating，antiplatelet and blood pressure stabilization therapies），regular treatment with cupping therapy，respectively.Baseline characteristics such as sex ratio，mean age，percents of having smoking history，drinking history，hypertension history，diabetes history and coronary heart disease history，and mean serum PKC and PI3K levels were compared between two groups.The efficacy of treatment was evaluated by changes in mean serum PKC and PI3K levels from baseline to the end of the treatment.If the post-treatment serum PKC and PI3K levels increased by at least 30% of baseline levels，then the treatment is defined as effective.Results　Except for 8 dropouts（3 were discharged prematurely for personal reasons，5 withdrew from cupping therapy early），other 307 cases（158 in the experimental group，149 in the control group） who finished one-week treatment were included in the final analysis.There were no significant differences between the two groups in sex ratio，mean age，percents of having smoking history，history of alcohol intake，history of hypertension，history of diabetes，or history of coronary heart disease （P>0.05）．In terms of serum PKC，there were 28 responders and 121 non-responders in the control group，and 117 responders and 41 non-responders in the treatment group，indicating the experimental group obtained a higher response rate （χ2=97.07，P<0.01）．In terms of serum PI3K，there were 25 responders and 124 non-responders in the control group，and 126 responders and 32 non-responders in the treatment group，indicating higher response rate was achieved in the experimental group （χ2=121.65，P<0.01）．Post-treatment serum PKC and PI3K levels increased significantly in the experimental group compared with baseline（P<0.05）．Conclusion　For hospitalized patients with cardiovascular diseases，cupping therapy in combination with regular treatment could up-regulate serum PKC and PI3K.As a TCM treatment，cupping therapy is easily accepted and shows a significant superiority in clinical application.

Key words: Cardiovascular diseases, Cupping therapy, Ischemic preconditioning, Ischemic preconditioning, Protein kinase C, Phosphatidylinositol 3-kinase

摘要： 背景　目前治疗缺血性心血管病以血运重建及药物治疗为主，其近期效果明显，但远期效果欠佳。目前认为机体短暂缺血后会有缺血后适应性变化，并对机体产生保护作用，其机制与人蛋白激酶C（PKC）、磷酸肌醇3-激酶（PI3K）的激活及内源性腺苷释放增多等有关。目的　探讨火罐法对住院心血管病患者血清PKC、PI3K的影响。方法　选取2017年4月—2018年5月于佛山市南海区人民医院心血管内科及综合科住院的符合纳入标准的患者315例。依据随机数字表法将其分为对照组和试验组。对照组入院后按相关指南行调脂、抗血小板、平稳血压等常规治疗，试验组在常规治疗的基础上行火罐法治疗。比较两组患者基线资料，包括性别、年龄、吸烟史、饮酒史、高血压病史、糖尿病病史、冠心病病史。分别以血清PKC、PI3K水平较基线升高30%定义为有效，比较两组患者血清PKC水平治疗有效情况、血清PI3K水平治疗有效情况，及其入院时和出院时血清PKC、PI3K水平。结果　315例患者中，因个人原因提前出院3例，中途未完成火罐法治疗5例，最后住院满1周并完成火罐法治疗307例，其中试验组158例，对照组149例。试验组与对照组患者性别、年龄、吸烟史、饮酒史、高血压病史、糖尿病病史、冠心病病史比较，差异无统计学意义（P>0.05）。对照组患者血清PKC水平治疗有效28例，无效121例；试验组患者血清PKC水平治疗有效117例，无效41例；试验组患者血清PKC水平治疗有效率高于对照组（χ2=97.07，P<0.01）。对照组患者血清PI3K水平治疗有效25例，无效124例；试验组患者血清PI3K水平治疗有效126例，无效32例；试验组患者血清PI3K水平治疗有效率高于对照组（χ2=121.65，P<0.01）。试验组患者出院时血清PKC、PI3K水平高于入院时（P<0.05）。结论　火罐法治疗可上调住院心血管病患者血清PKC、PI3K水平，且其本身为一种传统中医治疗方法，患者容易接受，临床开展优势明显。

关键词: 心血管疾病, 火罐法, 缺血预适应, 缺血预处理, 蛋白激酶C, 磷酸肌醇3-激酶