本文關(guān)鍵詞： 高血壓 左心室肥厚 腎性高血壓大鼠 益氣活血化痰法 原癌基因　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:通過(guò)益氣活血化痰法治療高血壓LVH的臨床療效觀察和動(dòng)物實(shí)驗(yàn)探討其作用機(jī)理,評(píng)價(jià)本方法治療高血壓LVH的臨床療效及安全性,以期進(jìn)一步為中醫(yī)藥治療高血壓LVH提供新的方法和理論,且為其臨床廣泛應(yīng)用提供客觀依據(jù)。方法:一、臨床研究:對(duì)60例符合高血壓LVH的患者,按照就醫(yī)的先后順序進(jìn)行編號(hào),隨機(jī)分成對(duì)照組30例和治療組30例。治療組予益氣活血化痰中藥復(fù)方,對(duì)照組予替米沙坦口服,以3個(gè)月療程觀察其療效。觀察指標(biāo)為血壓變化值、超聲心動(dòng)圖結(jié)果,依據(jù)結(jié)果進(jìn)行評(píng)定。二、通過(guò)建立動(dòng)物實(shí)驗(yàn)探究其作用機(jī)理。實(shí)驗(yàn)中用Wistar大鼠建立左室肥厚模型,觀察其血壓、左室重量指數(shù)、心肌組織的病理改變、心肌細(xì)胞形態(tài)參數(shù)、原癌基因c-fos、c-mmyc的表達(dá),探討益氣活血化痰法自制中藥復(fù)方的療效。臨床研究結(jié)果:1.兩組患者經(jīng)治療后血壓值均有所改善,改善情況顯著。治療后兩組組內(nèi)對(duì)比,經(jīng)t檢驗(yàn)分析,差別擁有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后兩個(gè)組分之間進(jìn)行比較,經(jīng)t檢驗(yàn)分析,無(wú)差異比較性(P0.05)。2.兩組患者經(jīng)治療后超聲心動(dòng)圖指標(biāo)均有所改善,改善情況顯著。治療后兩組組內(nèi)對(duì)比,經(jīng)t檢驗(yàn)分析,差別擁有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后兩個(gè)組分之間進(jìn)行比較,經(jīng)t檢驗(yàn)分析,無(wú)差異比較性(P0.05)。實(shí)驗(yàn)研究結(jié)果:1.中藥復(fù)方降壓作用顯著。2.中藥復(fù)方可降低左室重量指數(shù),改善心室重構(gòu)。3.光鏡、電鏡及免疫組化結(jié)果示:中藥復(fù)方可改善心肌重構(gòu),抑制心肌間質(zhì)纖維化,抑制原癌基因c-fos、c-myc異常高表達(dá)。結(jié)論:1.益氣活血化痰復(fù)方有良好的降壓作用,可改善高血壓左室肥厚患者的心肌厚度以及收縮功能。2.采取縮窄腎動(dòng)脈的手術(shù)方法,復(fù)制高血壓大鼠模型,其病理變化與人類(lèi)高血壓LVH相類(lèi)似,該模型可用于高血壓的研究。3.益氣活血化痰復(fù)方明顯減輕左心室重量指數(shù),降低心肌細(xì)胞體積。4.通過(guò)光鏡、電鏡的觀察及免疫組化證實(shí)益氣活血化痰復(fù)方能夠抑制心肌細(xì)胞纖維化,改善心肌實(shí)質(zhì)與間質(zhì)重構(gòu),抑制心肌細(xì)胞中c-fos、c-myc原癌基因的高表達(dá),從而達(dá)到減輕和逆轉(zhuǎn)高血壓LVH的目的。
[Abstract]:Objective: To explore the mechanism through clinical observation and animal experimental method of Yiqi Huoxue Huatan to treat hypertension LVH, clinical efficacy and safety evaluation of the LVH method for treatment of hypertension, in order to provide new methods and theories of traditional Chinese medicine in the treatment of hypertension LVH and its clinical application methods: to provide an objective basis., clinical study: 60 patients with hypertension LVH patients, according to medical order number, 30 cases were randomly divided into control group and treatment group. 30 cases in treatment group were treated with Yiqi Huoxue Huatan prescription of traditional Chinese medicine, the control group was given telmisartan orally, observe its curative effect to 3 months of treatment. Observed the change of blood pressure values. Echocardiography results were assessed on the basis of the results. Two, through the establishment of animal experiments to explore the mechanism of Wistar. The rat model of left ventricular hypertrophy in the experiment, to observe the blood pressure, left ventricular weight index The number of pathological changes of myocardial tissue, myocardial cell morphological parameters, proto oncogene c-fos, c-mmyc expression, to investigate the effect of Yiqi Huoxue Huatan method Chinese medicine compound. The result of clinical study: 1. patients of the two groups after treatment, blood pressure values were improved significantly. Compared in the two groups after treatment were analyzed t test, the difference has statistical significance (P0.05). After treatment between the two groups were compared and analyzed by t test, the difference of.2. (P0.05) two patients with echocardiographic indexes were improved, improved significantly. Compared in the two groups after treatment, analysis by t test, difference has statistical significance (P0.05). After treatment between the two groups were compared and analyzed by t test, the difference of (P0.05). The experimental results: 1. Chinese herbal compound hypotensive effect of Chinese herbal compound.2. significantly reduced left ventricular weight index, left ventricular The reconstruction of.3. light microscope, electron microscope and immunohistochemical results showed that: the Chinese medicine can improve myocardial remodeling, inhibit myocardial fibrosis, inhibition of oncogene c-fos, abnormal expression of c-myc. Conclusion: 1. Guanxinping compound has good antihypertensive effect, can improve the myocardial thickness and systolic function in.2. patients with hypertension and left ventricular hypertrophy the surgical approach of coarctation of renal artery, copy the rat model of hypertension, the pathological changes and human hypertension is similar to the LVH, the model can be used for the study of hypertension.3. Guanxinping compound significantly reduced left ventricular weight index, reduce myocardial cell volume.4. by light microscope, electron microscope observation and immunohistochemistry confirmed Qi Bushenhuoxuehuatan compound can inhibit myocardial fibrosis and improve myocardial parenchyma and interstitium remodeling, inhibit myocardial cell c-fos, high expression of c-myc, thus alleviating and reversing the high The purpose of the blood pressure LVH.

【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

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