本文關鍵詞：麝香通心滴丸治療冠心病心絞痛的療效及對動脈粥樣硬化大鼠Visfatin的影響　出處：《黑龍江中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 冠心病心絞痛 動脈粥樣硬化 痰熱瘀阻 血脂 血清內(nèi)脂素

【摘要】：目的:1、通過對20例冠心病穩(wěn)定型心絞痛痰熱瘀阻證患者的臨床觀察,探討麝香通心滴丸對冠心病穩(wěn)定型心絞痛患者心絞痛癥狀改善情況、血脂及血清內(nèi)脂素方面影響的作用機制。2、通過高脂喂養(yǎng)和垂體后葉素注射復制動脈粥樣硬化模型,觀察麝香通心滴丸對動脈粥樣硬化大鼠血脂及血清內(nèi)脂素、腹主及頸總動脈內(nèi)膜病理變化的影響,探討麝香通心滴丸對動脈粥樣硬化的作用機制。方法:1、臨床研究方法:將來自黑龍江中醫(yī)藥大學附屬第一醫(yī)院門診的20例冠心病心絞痛痰熱瘀阻證患者隨機分為試驗組(常規(guī)西藥調(diào)脂、抗血小板、擴冠治療加麝香通心滴丸)10例,對照組(常規(guī)西藥調(diào)脂、抗血小板、擴冠治療加麝香通心滴丸安慰劑)10例。每日3次,每次2�？诜�。療程56天。觀察患者用藥前后心絞痛癥狀改善情況、血脂及血清內(nèi)脂素的變化情況。2、動物實驗方法:雄性SD大鼠60只,取15只做空白對照組,其余45只以腹腔注射垂體后葉素加高脂飼料喂養(yǎng)復制動脈粥樣硬化模型,8周后空白對照組隨機取3只、造模組取9只大鼠采靜脈血檢測血脂變化情況,取腹主和頸總動脈做HE染色觀察動脈內(nèi)膜情況證實模型復制成功。將造模成功的大鼠隨機分為模型對照組、中藥治療組、西藥對照組,每組12只。從第9周開始灌胃,中藥治療組灌以麝香通心滴丸溶液(含麝香通心滴丸濃度為10.94mg/kg·d)。西藥對照組灌以瑞旨溶液(含瑞旨濃度為0.52mg/kg·d)。其余兩組均灌以同體積蒸餾水。灌胃8周后取靜脈血,用ELISA法檢測血脂及血清內(nèi)脂素,取腹主和頸總動脈采用HE染色觀察血管病理形態(tài)變化。結(jié)果:1、通過臨床觀察發(fā)現(xiàn):(1)心絞痛癥狀積分:試驗組服藥后心絞痛總分明顯低于服藥前,差異有統(tǒng)計學意義(P0.01);與對照組相比,試驗組服藥后心絞痛總分明顯降低,差異有統(tǒng)計學意義(P0.05)。(2)血脂:試驗組服藥后TC、TG、LDL-C水平明顯低于服藥前,HDL-C水平明顯高于服藥前,差異有統(tǒng)計學意義(P0.01);與對照組相比,試驗組服藥后TC、TG、LDL-C水平均降低,HDL-C水平升高,差異有統(tǒng)計學意義(P0.05)。(3)血清內(nèi)脂素:試驗組服藥后血清內(nèi)脂素水平明顯低于服藥前,差異有統(tǒng)計學意義(P0.01);與對照組相比,試驗組服藥后血清內(nèi)脂素水平明顯降低,差異有統(tǒng)計學意義(P0.05)。2、通過動物實驗發(fā)現(xiàn):(1)血脂:空白對照組、中藥治療組、西藥對照組血脂與模型對照組比較,TC、TG、LDL-C水平均降低,HDL-C水平均升高,差異有統(tǒng)計學意義(P0.05);中藥治療組與西藥對照組比較療效相當,差異無統(tǒng)計學意義(P0.05)。(2)血清內(nèi)脂素:空白對照組、中藥治療組、西藥對照組的血清內(nèi)脂素水平明顯低于模型對照組,差異有統(tǒng)計學意義(P0.05);中藥治療組與西藥對照組比較療效相當,差異無統(tǒng)計學意義(P0.05)。(3)病理結(jié)果顯示:模型對照組出現(xiàn)動脈管腔內(nèi)膜不規(guī)則增厚,平滑肌排列紊亂,彈力膜斷裂,管周可見大量泡沫細胞及脂質(zhì)沉積,炎細胞浸潤。中藥治療組及西藥對照組的血管管壁及管周脂質(zhì)沉積減少,平滑肌細胞腫脹減輕。中藥治療組顯示炎細胞浸潤減少。結(jié)論:1、臨床觀察發(fā)現(xiàn):麝香通心滴丸可明顯改善冠心病穩(wěn)定型心絞痛痰熱瘀阻證患者的心絞痛癥狀,減少心絞痛發(fā)作次數(shù)、程度及持續(xù)時間;降低患者的血清內(nèi)脂素、TC、TG、LDL-C水平,升高患者的HDL-C水平。2、動物實驗發(fā)現(xiàn):麝香通心滴丸可降低動脈粥樣硬化模型大鼠的TC、TG、LDL-C、血清內(nèi)脂素水平,升高大鼠的HDL-C水平;改善大鼠動脈內(nèi)膜損傷情況。
[Abstract]:Objective: 1. Through clinical observation of 20 cases of patients with stable angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome, explore the musk macaroni dripping pill on stable angina pectoris of coronary heart disease in patients with angina symptoms to improve the situation, the.2 mechanism of blood lipid and serum visfatin influence, through high fat feeding and pituitrin injection of the atherosclerosis model, observe the musk macaroni dripping pills on serum lipids and atherosclerosis rat visfatin, effects of abdominal artery and carotid intima main pathological changes, to explore the mechanism of heart through musk pill on atherosclerosis. Methods: 1. Clinical research methods: from the outpatient department of the First Affiliated Hospital of Heilongjiang University Of Chinese Medicine in 20 patients angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome were randomly divided into experimental group (routine antiplatelet, lipid-lowering, CHD therapy plus musk macaroni pills) in 10 cases, the control group (conventional western medicine anti blood lipid. Small, CHD therapy plus musk macaroni dripping pills of placebo) in 10 cases. 3 times daily, 2 capsules each time. Oral treatment for 56 days. Patients were observed before and after treatment of angina symptoms, blood lipid and serum visfatin.2 changes, animal experiment: 60 male SD rats, 15 rats do the blank control group, the remaining 45 rats by intraperitoneal injection of pituitrin plus high fat diet atherosclerosis model after 8 weeks, 3 rats were randomly selected in the blank control group, model group 9 rats blood serum lipid changes from abdominal aorta and carotid artery intima were observed with HE confirmed model successful. The successful model of the rats were randomly divided into model control group, Chinese medicine group, western medicine group, 12 rats in each group. From the ninth week gavage, traditional Chinese medicine treatment group treated with musk macaroni dripping pills solution (containing musk macaroni dripping pills was 10.94mg /kg - D) of Western medicine. According to Rui group was aimed solution (including Rui aims concentration was 0.52mg/kg - D). Other two groups were given the same volume of distilled water by gavage. After 8 weeks of venous blood were detected by ELISA blood lipid and serum visfatin, take the abdominal aorta and carotid artery HE staining was used to observe the pathological changes of blood vessel results: 1. Through clinical observation, found that: (1) angina symptom scores: the test group was significantly lower than the score after medication of angina pectoris before treatment, the difference was statistically significant (P0.01); compared with the control group, the experimental group after the treatment of angina pectoris score decreased significantly, the difference was statistically significant (P0.05) (2). Blood lipids: the experimental group TC after treatment, TG, LDL-C levels were significantly lower than before treatment, HDL-C was significantly higher than that before treatment, the difference was statistically significant (P0.01); compared with the control group, the experimental group after the treatment of TC, TG, LDL-C levels decreased, HDL-C level increased, the difference was statistically significant (P0.05 (3). Serum visfatin: Test) Serum visfatin levels were significantly lower than the group after treatment before treatment, the difference was statistically significant (P0.01); compared with the control group, serum visfatin levels were significantly decreased in experimental group after treatment, the difference was statistically significant (.2, P0.05) through animal experiments found that: (1) blood lipid: blank control group, Chinese medicine treatment group the western medicine group, blood lipids compared with model group, TC, TG, LDL-C levels were decreased and the level of HDL-C increased, the difference was statistically significant (P0.05); Chinese medicine treatment group and Western medicine control group efficacy, the difference was not statistically significant (P0.05). (2) serum visfatin: blank control group Chinese medicine treatment group, western medicine group, serum visfatin levels were significantly lower than the model control group, the difference was statistically significant (P0.05); Chinese medicine treatment group and Western medicine control group efficacy, the difference was not statistically significant (P0.05). (3) the pathological results showed that the model group appeared to move The vascular lumen is irregular thickening, smooth muscle disorder, elastic membrane rupture, around the pipe shows a large number of foam cells and lipid deposition, inflammatory cell infiltration. The Chinese medicine group and Western medicine control group, the vascular wall and reduce lipid deposition in peritubular smooth muscle cells, reduce swelling. Chinese medicine treatment group showed a decrease in inflammatory cell infiltration. Conclusion: 1. Clinical observation: musk macaroni dripping pills can significantly improve patients with stable angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome of angina symptoms, reduce the frequency of angina pectoris, duration and extent; reduce the serum visfatin, TC, TG, LDL-C, HDL-C of patients with elevated levels of.2, animal experiment found: musk macaroni dripping pills can reduce atherosclerosis in rat model of TC, TG, LDL-C, serum visfatin levels, elevated levels of HDL-C in rat; improve rat arterial intimal injury.

【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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