本文選題：創(chuàng)傷修復(fù) + 冠心病��； 參考：《北京中醫(yī)藥大學(xué)》2015年博士論文

【摘要】：本文包括文獻綜述及課題研究兩部分；綜述分為中醫(yī)綜述和西醫(yī)綜述,課題研究分為臨床觀察和基礎(chǔ)實驗研究。一、文獻綜述文獻綜述從中醫(yī)和西醫(yī)兩方面詳細的論述了對冠心病介入治療遠期預(yù)后的現(xiàn)有研究和認識,為更科學(xué)的防治冠心病的進展及各種并發(fā)癥提供理論支持。二、臨床研究目的：觀察益氣涼血生肌方對冠心病介入術(shù)后患者遠期心血管事件及生存質(zhì)量的影響。方法：采用臨床隨訪的方法,將國家中醫(yī)藥管理局中醫(yī)藥科研專項課題(2005)97例冠心病介入治療后7.5～9.1年的患者,分為51例中藥治療組和46例對照組,觀察7.5-9.1年后遠期心血管事件發(fā)生情況、二級預(yù)防情況、遠期心血管事件干預(yù)因素、生存曲線情況,對兩組間數(shù)據(jù)進行統(tǒng)計比較分析。結(jié)果：①與對照組相比中藥治療組的遠期復(fù)發(fā)心絞痛、心肌梗死、心衰和心源性死亡的單獨心血管事件發(fā)病率無明顯統(tǒng)計學(xué)差異(P0.05),但是所有心血管事件發(fā)病率與對照組比較具有統(tǒng)計學(xué)差異(P0.05)；②兩組在規(guī)律治療及良好生活習(xí)慣等冠心病二級預(yù)防方面無統(tǒng)計學(xué)差異；③中藥干預(yù)(服用益氣涼血生肌方)和定期門診復(fù)查進入了Logistic回歸(P0.05),兩者對心血管事件有保護作用；與對照組相比中藥治療組遠期生存曲線有更好趨勢,但沒有統(tǒng)計學(xué)上的差異(P0.05)結(jié)論：①早期服用益氣涼血生肌方可降低冠心病介入治療后遠期心血管事件的發(fā)生率。②益氣涼血生肌方改善冠心病介入治療的遠期預(yù)后。三、基礎(chǔ)實驗研究目的：基于中醫(yī)創(chuàng)傷修復(fù)理論,觀察益氣涼血生肌方對血管內(nèi)皮細胞增殖遷移及損傷修復(fù)的作用,探討益氣涼血生肌方改善冠心病介入術(shù)后遠期預(yù)后的作用機制。方法：采用體外實驗的方法,對人臍靜脈內(nèi)皮細胞(HUVECs)損傷造模,分為益氣涼血生肌中藥組、ARB西藥組、中西醫(yī)結(jié)合組、模型組、對照組；采用CCK-8法檢測細胞增殖率、透射電鏡觀察細胞超微結(jié)構(gòu)變化、活細胞工作站檢測細胞遷移率、硝酸還原法檢測一氧化氮(NO)濃度、熒光探針法檢測活性氧自由基(ROS)含量、酶聯(lián)免疫吸附法檢測內(nèi)皮素(ET-1)濃度、RT-PCR檢測ET-1蛋白基因表達水平等；并對組間數(shù)據(jù)進行統(tǒng)計分析比較。結(jié)果：①與模型組相比,益氣涼血生肌方組和ARB西藥組均對損傷后的內(nèi)皮細胞具有增殖作用且細胞增殖率50%,兩者增殖率相比無統(tǒng)計學(xué)差異(P0.05),中西醫(yī)結(jié)合治療組與中藥組和西藥組兩者相比均有統(tǒng)計學(xué)差異(P0.05)；②與模型組比較,中藥組、ARB西藥組和中西醫(yī)結(jié)合組透射電鏡下?lián)p傷內(nèi)皮細胞的細胞核邊界清楚、內(nèi)質(zhì)網(wǎng)增多增密、線粒體數(shù)目增加,中藥組和中西醫(yī)結(jié)合組的內(nèi)質(zhì)網(wǎng)折疊更明顯,線粒體飽滿、數(shù)目較西藥組增多;③與模型組相比ARB西藥組和中西醫(yī)結(jié)合組細胞遷移顯著加快(P0.05),中西醫(yī)結(jié)合組優(yōu)于ARB西藥組,中藥組整體遷移曲線優(yōu)于模型組,但未表現(xiàn)出明顯的差異(P0.05)；④與模型組相比,進行藥物干預(yù)后N0含量上升(P0.05),ROS無明顯差異、ET-1含量下降(P0.05),中西醫(yī)結(jié)合組的促NO釋放、抑制ET-1釋放作用與中藥組和ARB西藥組相比有統(tǒng)計學(xué)差異(P0.05)；⑤ RT-PCR示模型組的Ct均值高于對照組,藥物干預(yù)后Ct均值下降,中藥組和中西醫(yī)結(jié)合組均值低于西藥組,治療后血管內(nèi)皮細胞的ET-1基因表達含量降低,但沒有統(tǒng)計學(xué)顯著性差異(P0.05)結(jié)論：①益氣涼血生肌方對損傷性血管內(nèi)皮細胞有促進增殖的作用；②益氣涼血生肌方減輕血管內(nèi)皮細胞的超微結(jié)構(gòu)的損傷；③益氣涼血生肌方對血管內(nèi)皮細胞損傷劃痕模型有促遷移的作用；④益氣涼血生肌方增加血管活性物質(zhì)N0的釋放、減輕細胞損傷因子ET-1的濃度,并影響ET-1蛋白基因表達水平。⑤中西醫(yī)結(jié)合治療對血管內(nèi)皮細胞的增殖、遷移、細胞超微結(jié)構(gòu)、細胞因子濃度及基因表達的損傷修復(fù)作用優(yōu)于單純中藥治療或西藥治療。
[Abstract]:This paper includes two parts : literature review and subject research .
This review is divided into a review of TCM and a review of western medicine . The study is divided into clinical observation and basic experiment research . The clinical research aim : To observe the effect of Yiqi Liangxue Shengji on the long - term cardiovascular events and the quality of life of coronary heart disease after interventional therapy .
( 2 ) There was no statistical difference between the two groups in the secondary prevention of coronary heart disease , such as regular treatment and good living habits ;
( 3 ) Logistic regression ( P0.05 ) was entered into the traditional Chinese medicine intervention ( taking Yiqi Liangxue Shengji Fang ) and regular clinic examination , both had protective effect on cardiovascular events ;
Objective : To observe the effect of Yiqi Liangxue Shengji on the long - term prognosis of coronary heart disease after percutaneous coronary intervention .
CCK - 8 method was used to detect the cell proliferation rate , the ultrastructural changes of the cells were observed by transmission electron microscope , the concentration of nitric oxide ( NO ) was detected by the living cell workstation , the concentration of nitric oxide ( NO ) was detected by nitrate reduction method , the concentration of reactive oxygen free radical ( ROS ) was detected by fluorescence probe method , the concentration of ET - 1 was detected by enzyme linked immunosorbent assay , and the expression level of ET - 1 protein gene was detected by RT - PCR .
Results : 鈶，

本文編號：1918823