本文選題：氣虛血瘀　切入點：冠脈寧口服液　出處：《新鄉(xiāng)醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的1.通過動物實驗探討冠脈寧口服液對ApoE基因敲除小鼠(ApoE-/-小鼠)動脈粥樣硬化模型的影響及機制,進(jìn)一步明確冠脈寧口服液的治療作用。2.觀察冠脈寧口服液輔助治療氣虛血瘀型冠心病穩(wěn)定型心絞痛患者的臨床療效及對血清白介素-6(IL-6)、超敏C反應(yīng)蛋白(hs-CRP)、內(nèi)臟脂肪素(Visfatin)的影響。方法1.動物實驗研究利用高脂飼料喂養(yǎng)ApoE-/-小鼠造動脈粥樣硬化模型,以冠脈寧口服液進(jìn)行干預(yù),并設(shè)立對照組,12周后比較各組小鼠血脂及血清IL-6、hs-CRP、Visfatin水平的變化,HE染色觀察小鼠主動脈組織病理形態(tài)學(xué)變化。2.臨床研究選取我院心內(nèi)科就診的120例符合入選條件的冠心病穩(wěn)定型心絞痛患者,隨機分為觀察組(60例)和對照組(60例),對照組采用西醫(yī)常規(guī)藥物治療,觀察組在此基礎(chǔ)上給予冠脈寧口服液口服,療程均3個月。觀察并比較治療后兩組的臨床療效及兩組患者治療前后心電圖、冠狀動脈CT和冠狀動脈造影陽性率、血脂、血流變學(xué)指標(biāo)、血清IL-6、hs-CRP、Visfatin水平的變化。結(jié)果1.動物實驗:(1)模型組、冠脈寧組、復(fù)方丹參組血清TC、TG、LDL-C水平及血清hs-CRP、Visfatin、IL-6水平高于空白對照組(P0.01或0.05),HDL-C含量低于空白對照組(P0.05)。(2)與模型組比較,冠脈寧組、復(fù)方丹參組血清TC、TG、LDL-C水平及血清hs-CRP、Visfatin、IL-6水平降低(P均0.05),而HDL-C水平升高(P0.05)。(3)冠脈寧組與復(fù)方丹參組比較,上述指標(biāo)的差異無統(tǒng)計學(xué)意義(P0.05)。(4)空白對照組主動脈未見動脈粥樣硬化改變,模型組、冠脈寧組和復(fù)方丹參組都有主動脈組織內(nèi)膜增厚及粥樣斑塊的形成。與模型組比較,冠脈寧組和復(fù)方丹參組組織病理損傷程度較輕,斑塊面積較小。2.臨床研究:(1)觀察組和對照組臨床療效的總有效率分別是96.7%和95.0%,比較二者差異無統(tǒng)計學(xué)意義(P0.05)。(2)兩組心電圖療效及分布無明顯差異(P0.05)。(3)兩組均能降低冠狀動脈CTA和冠狀動脈造影總陽性率(P0.05),二者效果差異無統(tǒng)計學(xué)意義(P0.05)。(4)兩組均能明顯降低血清TC、TG和LDL-C水平(P均0.05),觀察組降低血清TC、TG和LDL-C的效果優(yōu)于對照組(P0.05)。(5)兩組均能明顯降低高切還原黏度(Hηre)、低切還原黏度(Lηre)、全血黏度(BV)、紅細(xì)胞聚集指數(shù)(RAI)、紅細(xì)胞剛性指數(shù)(RRI)、纖維蛋白原(Fb)、紅細(xì)胞壓積(HCT)、血沉(ESR)等血液流變學(xué)指標(biāo)(P均0.05),且觀察組的作用更明顯(P0.05)。(6)觀察組和對照組治療后血清IL-6、hs-CRP、Visfatin水平較本組治療前降低(P均0.05)。觀察組降低血清IL-6、hs-CRP、Visfatin水平的作用優(yōu)于對照組(P均0.05)。(7)兩組治療前后血、尿、大便常規(guī)及肝、腎功能等化驗指標(biāo)比較,差異無統(tǒng)計學(xué)意義P0.05)。兩組患者治療期間均無明顯不良反應(yīng)。結(jié)論1.冠脈寧口服液可提高ApoE-/-動脈粥樣硬化小鼠的活躍度,降低血脂及血清hs-CRP、Visfatin及IL-6水平,減少動脈粥樣硬化斑塊面積,作用優(yōu)于復(fù)方丹參片,具有一定的抗動脈粥樣硬化作用。2.西醫(yī)常規(guī)治療加用冠脈寧口服液可有效緩解冠心病患者心絞痛癥狀,改善心肌供血和冠狀動脈管腔狹窄,改善血液黏度,降低血脂和hs-CRP、IL-6及Visfatin等炎癥因子水平,作用優(yōu)于單純西藥治療,且無明顯不良反應(yīng)。
[Abstract]:Objective to investigate 1. animal experiments of Guanmaining oral liquid on ApoE knockout mice (ApoE-/- mice) influence atherosclerosis model and mechanism, further observation of therapeutic effect of.2. Guanmaining oral liquid adjuvant treatment of coronary heart disease clearly Guanmaining oral liquid stable clinical efficacy in patients with angina pectoris and on serum interleukin -6 (IL-6), high sensitive C reactive protein (hs-CRP), visfatin (Visfatin) method. The influence of 1. animal experiments using high-fat diet ApoE-/- mice model of atherosclerosis, in Guanmaining oral liquid to intervene, and set up the control group after 12 weeks, compared blood lipid and serum IL-6, mouse hs-CRP, change the level of Visfatin, to observe the pathological changes of mouse aorta.2. clinical research in our hospital department of Cardiology for treatment of 120 cases of eligible stable coronary heart disease and angina HE staining The pain of patients, were randomly divided into observation group (60 cases) and control group (60 cases), the control group were treated with routine drug treatment, the observation group was given oral Guanmaining oral liquid, the course of treatment was 3 months. To observe and compare the clinical efficacy of the two groups after treatment of ECG and two groups of patients before and after treatment, the positive rate of coronary CT and blood lipids, blood rheology indexes, serum IL-6, hs-CRP, Visfatin levels in 1.. Results: (1) experimental animal model group, Guanmaining group, Salvia miltiorrhiza group, serum TC, TG, LDL-C and serum levels of hs-CRP, Visfatin, IL-6 levels higher than the control group (P0.01 or 0.05), the HDL-C content is lower than the blank control group (P0.05). (2) compared with the model group, Guanmaining group, Salvia miltiorrhiza group, serum TC, TG, LDL-C and serum levels of hs-CRP, Visfatin, IL-6 decreased (P 0.05), and increased the level of HDL-C (P0.05) (3. Guanmaining) group and Salvia miltiorrhiza group Comparison, no statistically significant difference between the index (P0.05). (4) blank control group no aortic atherosclerosis model group, Guanmaining group and Salvia miltiorrhiza group have formed aorta intimal thickening and plaque. Compared with the model group, Guanmaining group and Danshen group the pathological damage to a lesser extent.2., small patch clinical research: (1) observation group and the control group clinical total effective rate were 96.7% and 95%, there was no significant difference between the two (P0.05) (2). No significant difference between the two groups of ECG and distribution (P0.05). (3) the two groups can reduce the total the positive rate of coronary artery CTA and coronary artery angiography (P0.05), no statistically significant difference between the two effects (P0.05). (4) the two groups could significantly reduce serum TC, TG and LDL-C levels (P 0.05), the observation group decreased the serum levels of TC, TG and LDL-C, the effect is better than that of control group (P0.05) (. 5)涓ょ粍鍧囪兘鏄庢樉闄嶄綆楂樺垏榪樺師榛忓害(H畏re),浣庡垏榪樺師榛忓害(L畏re),鍏ㄨ榛忓害(BV),綰㈢粏鑳?yōu)鑱氶泦鎸囨暎?

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