【摘要】：目的觀察益腎活血解毒湯對(duì)動(dòng)脈粥樣硬化的影響,探討其可能作用機(jī)制,為中醫(yī)治療動(dòng)脈粥樣硬化提供新的依據(jù)。方法實(shí)驗(yàn)部分:1、動(dòng)物分組:將60只大鼠隨機(jī)分為正常對(duì)照組10只及造模組50只。2、動(dòng)物造模:對(duì)照組予以普通飼料喂養(yǎng),造模組予以高脂飼料及維生素D3聯(lián)合應(yīng)用,1個(gè)月后隨機(jī)抽取造模組10只,取大鼠空腹血,檢測(cè)血清TC、TG、LDL-C、HDL-C水平,結(jié)果顯示造模組血脂水平均顯著升高;檢測(cè)大鼠主動(dòng)脈,以發(fā)現(xiàn)動(dòng)脈粥樣硬化斑塊為造模成功指標(biāo)。隨后隨機(jī)將造模組分為模型組、西藥組(阿托伐他汀組),中藥組(益腎活血解毒湯組),及中西結(jié)合組(阿托伐他汀加益腎活血解毒湯組),每組10只。每天1次,連續(xù)給藥1個(gè)月。3、指標(biāo)檢測(cè):實(shí)驗(yàn)結(jié)束后第2天,腹腔注射麻醉大鼠,腹主動(dòng)脈取血檢測(cè)血脂、黏附分子、IL-8水平,取腹主動(dòng)脈制作標(biāo)本觀察病理形態(tài)。臨床部分:1、分組:采用隨機(jī)分組法,納入冠心病心絞痛(腎虛血瘀型)患者40例,分為研究組20例,對(duì)照組20例。對(duì)照組予以常規(guī)西藥治療,研究組在常規(guī)治療基礎(chǔ)上加用益腎活血解毒湯。2、指標(biāo)及療效:治療周期為1個(gè)月,治療前后分別監(jiān)測(cè)患者血脂、黏附分子、IL-8、D-二聚體水平,評(píng)估治療前后積分及心電圖改善情況。全部計(jì)量資料以“_x±s”表示,組間比較采用配對(duì)資料t檢驗(yàn),兩組比較采用獨(dú)立樣本t檢驗(yàn),多組獨(dú)立樣本用方差分析,計(jì)數(shù)資料用x2檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。所有資料用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果實(shí)驗(yàn)研究:與模型組相比中藥組、西藥組、中西醫(yī)結(jié)合組各炎性因子的表達(dá)明顯降低,血脂水平明顯下降(P0.05),中西醫(yī)結(jié)合組優(yōu)于中藥組和西藥組(P0.05)。鏡下觀察各治療組與模型組相比脂質(zhì)沉積較少,平滑肌增生較輕,內(nèi)膜較規(guī)整。臨床研究:治療后患者血脂、血清ICAM-1、VCAM-1、D-二聚體、IL-8水平較治療前均有明顯降低(P0.05)。研究組各項(xiàng)療效優(yōu)于對(duì)照組(P0.05)。結(jié)論1.益腎活血解毒湯具有抑制動(dòng)脈粥樣硬化大鼠血清中黏附分子的表達(dá),調(diào)節(jié)脂質(zhì)代謝,減輕血管內(nèi)皮損傷,減少脂質(zhì)的吸收和在血管局部的沉積、抑制平滑肌細(xì)胞遷移增殖,從而預(yù)防或延緩動(dòng)脈粥樣硬化的進(jìn)程而達(dá)到抗動(dòng)脈粥樣硬化作用。2.益腎活血解毒湯能夠改善AS患者臨床癥狀,調(diào)節(jié)脂質(zhì)代謝,抑制血清黏附分子的表達(dá),改善高凝狀態(tài)。
[Abstract]:Objective to observe the effect of Yishen Huoxue jiedu decoction on atherosclerosis and explore its possible mechanism so as to provide a new basis for TCM treatment of atherosclerosis. Methods: 1. Animal groups: 60 rats were randomly divided into normal control group (n = 10) and model group (n = 50). The model group was treated with high fat diet and vitamin D3. 10 rats in the model group were randomly selected after one month. Fasting blood samples were taken and serum TC,TG,LDL-C,HDL-C levels were measured. The results showed that the blood lipid levels in the model group were significantly higher than those in the model group, and the aorta of the rats were detected. To find atherosclerotic plaques as a model success index. Then the model group was randomly divided into three groups: model group, western medicine group (Atto vastatin group), traditional Chinese medicine group (Yishen Huoxue jiedu decoction group) and western combination group (Atto vastatin plus Yishen Huoxue jiedu decoction group) with 10 rats in each group. Once a day for one month, the indexes were measured: on the second day after the experiment, anesthetized rats were injected intraperitoneally, blood lipid, adhesion molecule, IL-8 level were measured by abdominal aorta, and the pathological morphology of abdominal aorta was observed. Clinical part: 1. Group: 40 patients with coronary heart disease angina pectoris (kidney deficiency and blood stasis type) were randomly divided into study group (20 cases) and control group (20 cases). The control group was treated with routine western medicine, and the study group was treated with Yishen Huoxue jiedu decoction on the basis of routine treatment. 2. Index and curative effect: the treatment period was 1 month. Blood lipid, adhesion molecule and IL-8,D- dimer were monitored before and after treatment. To evaluate the improvement of integral and electrocardiogram before and after treatment. All the measurement data were expressed as "_ x 鹵s", the paired data t test was used in the comparison between groups, the independent sample t test was used in the two groups, the analysis of variance was used in many independent samples, and the counting data was x2 test. The difference was statistically significant (P0.05). All the data were analyzed by SPSS17.0 statistical software. Results: compared with the model group, the expression of inflammatory factors in TCM group, western medicine group and integrated Chinese and western medicine group were significantly decreased, the level of blood lipid was significantly decreased (P0.05), and the combination of traditional Chinese and western medicine group was superior to the traditional Chinese medicine group and western medicine group (P0.05). Compared with the model group, the lipid deposition, smooth muscle hyperplasia and intima of each treatment group were observed under microscope. Clinical study: after treatment, blood lipid, serum ICAM-1,VCAM-1,D- dimer, IL-8 levels were significantly lower than before treatment (P0.05). The efficacy of the study group was better than that of the control group (P0.05). Conclusion 1. Yishen Huoxue jiedu decoction can inhibit the expression of adhesion molecules in serum of atherosclerosis rats, regulate lipid metabolism, reduce vascular endothelial injury, reduce lipid absorption and deposition in blood vessels, inhibit smooth muscle cell migration and proliferation. In order to prevent or delay the progression of atherosclerosis and achieve anti-atherosclerosis effect. 2. Yishen Huoxue jiedu decoction can improve the clinical symptoms of AS patients, regulate lipid metabolism, inhibit the expression of serum adhesion molecules and improve hypercoagulability.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R285

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