本文選題：冠心病 + 從脾論治　； 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:本試驗用益氣健脾和血祛痰法治療冠心病穩(wěn)定型心絞痛脾虛痰濁證患者后,檢測其血清mi R-126和炎癥因子水平,揭示“從脾論治”冠心病穩(wěn)定型心絞痛炎癥機制發(fā)生的規(guī)律及其相關(guān)關(guān)系。材料與方法:1.試驗對象:本試驗采用多中心、盲法、區(qū)組隨機、平行對照進行臨床試驗設(shè)計。對冠心病穩(wěn)定型心絞痛脾虛痰濁證患者采用益氣健脾、和血祛痰法聯(lián)合西醫(yī)基礎(chǔ)治療;2.分組方法:首先招募符合篩選標(biāo)準(zhǔn)的受試者,然后采用SPSS16.0統(tǒng)計軟件,將受試者按1:1比例隨機分配到試驗組和對照組,兩組各80例,同時招募正常受試者20例。3.干預(yù)措施:試驗組給予具益氣健脾、和血祛痰作用的中藥顆粒劑(含黨參、黃芪、白術(shù)、清半夏等中藥)聯(lián)合西醫(yī)基礎(chǔ)治療,對照組予安慰劑作用的中藥顆粒劑(含試驗組中藥顆粒劑成分的10%)聯(lián)合西醫(yī)基礎(chǔ)治療,療程12周;4.觀察方法:一般資料、mi R-126、炎性指標(biāo)。除一般資料,均以入組后第0周、4周、12周為信息采集時間點;5.統(tǒng)計學(xué)方法:數(shù)據(jù)應(yīng)用spss for windows 16.0整理、分析。計量資料以(-x±s)形式表示,p0.05差異具有統(tǒng)計學(xué)意義。結(jié)果:選取PPS數(shù)據(jù)集,最終完成的病例試驗組75例,對照組70例。1.藥物干預(yù)前,試驗組和對照組mi R-126含量明顯低于正常人組,差異均有統(tǒng)計學(xué)意義(P0.05),同時試驗組和對照組沒有差異(P0.05);藥物干預(yù)后,試驗組和對照組mi R-126的含量雖然有所增加,但是也沒有達到正常人組的含量高度,與正常人組比差異均有統(tǒng)計學(xué)意義(P0.05),同時試驗組比對照組的含量稍高,差異沒有統(tǒng)計學(xué)意義(P0.05)。2.試驗組中hs-CRP、MCP-1、VCAM-1這三個炎癥指標(biāo)給藥后下降明顯,與對照組比較有顯著差異(P0.05),SR-A有下降趨勢、SR-B有升高趨勢。對照組中給藥后炎癥因子變化均無統(tǒng)計學(xué)意義(P0.05)。3.給藥前,冠心病患者外周血mi R-126和粘附因子VCAM-1呈負(fù)相關(guān)(r=-0.694,P=0.000),mi R-126與其他炎癥因子無直線相關(guān)關(guān)系;給藥后mi R-126與炎癥因子無直線相關(guān)關(guān)系。結(jié)論:1.冠心病穩(wěn)定型心絞痛患者外周血中miR-126的含量低于正常人,給予試驗藥品后患者血清中SR-B之外的炎癥因子含量降低。2.冠心病穩(wěn)定型心絞痛患者外周血中mi R-126與粘附分子VCAM-1呈負(fù)相關(guān),mi R-126可以作為反應(yīng)冠心病嚴(yán)重程度的生物學(xué)標(biāo)志。3.益氣健脾和血祛痰法治療冠心病穩(wěn)定型心絞痛脾虛痰濁證患者有效,可升高外周血中mi R-126的水平,同時降低血清中SR-B之外的炎癥因子的含量。
[Abstract]:Objective: after treating patients with spleen deficiency and phlegm turbid syndrome of stable angina pectoris with coronary heart disease, serum mi R-126 and inflammatory factor levels were detected after treating patients with syndrome of spleen deficiency and phlegm by supplementing qi and invigorating spleen and expelling phlegm. To reveal the regularity of inflammatory mechanism of stable angina pectoris of coronary heart disease from spleen treatment and its correlation. Materials and methods: 1. Subjects: a multicenter, blind, randomized, parallel controlled clinical trial design was conducted. Patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbid syndrome were treated with Yiqi Jianpi combined with blood expelling phlegm combined with western medicine basic treatment 2. Group method: first, the subjects who met the screening criteria were recruited, then the subjects were randomly assigned to the test group and the control group according to the 1:1 scale by using SPSS16.0 software, 80 cases in each group, and 20 cases. 3 cases in the normal subjects at the same time. Intervention measures: the experimental group was treated with traditional Chinese medicine granules (including Radix Codonopsis, Radix Astragali, Atractylodes macrocephala, Radix Pinellia ternata and so on), which had the effect of invigorating qi and invigorating spleen and removing phlegm. The control group was treated with placebo-acting traditional Chinese medicine granules (10% of the experimental group) combined with western medicine. The course of treatment was 12 weeks and 4. 5%. Observation method: general data: mi R-126, inflammatory index. Except for general data, the time of information collection was 5. 5% at the end of 4 weeks and 12 weeks after entering the group. Statistical methods: the data were collected and analyzed by spss for windows 16.0. There was statistical significance in measuring data in the form of-x 鹵s. Results: 75 cases in the final trial group and 70 cases in the control group were selected from the PPS data set. Before drug intervention, the content of miR-126 in the experimental group and the control group was significantly lower than that in the normal control group (P 0.05), but there was no difference between the experimental group and the control group. But also did not reach the level of the normal group, the difference was statistically significant compared with the normal group, at the same time, the content of the experimental group was slightly higher than the control group, the difference was not statistically significant. In the experimental group, the hs-CRPU MCP-1 and VCAM-1 were significantly decreased after administration, and there was a significant difference compared with the control group. Compared with the control group, there was a decreasing trend of SR-B in the experimental group. The changes of inflammatory factors in the control group were not statistically significant (P 0.05. 3). Before administration, there was a negative correlation between mi R-126 and adhesion factor VCAM-1 in peripheral blood of patients with coronary heart disease. There was no linear correlation between mi R-126 and other inflammatory factors, but there was no linear correlation between mi R-126 and inflammatory factors after administration. Conclusion 1. The level of miR-126 in peripheral blood of patients with stable angina pectoris of coronary heart disease was lower than that of normal people, and the content of inflammatory factors other than SR-B in serum of patients with coronary heart disease stable angina pectoris was decreased by 0.2. 2. There is a negative correlation between mi R-126 and adhesion molecule VCAM-1 in peripheral blood of patients with stable angina pectoris of coronary heart disease. Mi R-126 can be used as a biological marker to reflect the severity of coronary heart disease. Invigorating qi and invigorating spleen and expelling phlegm were effective in treating patients with stable angina pectoris of coronary heart disease with deficiency of spleen and phlegm turbidity. It could increase the level of miR-126 in peripheral blood and decrease the content of inflammatory factors besides SR-B in serum.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
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本文編號：1910445