發(fā)布時間：2018-10-26 13:39

【摘要】：目的:從動物實(shí)驗(yàn)和臨床研究兩方面,探討心可舒的臨床療效、安全性及其抗動脈粥樣硬化的內(nèi)在機(jī)制。(1)動物實(shí)驗(yàn)方法:36只新西蘭大白兔隨機(jī)分4組,分別為對照組、高脂AS模型組、氟伐他汀組及心可舒組,每組9只。通過HE染色評估粥樣斑塊的程度。應(yīng)用免疫組化檢測巨噬細(xì)胞、基質(zhì)金屬蛋白酶9(MMP-9)和α-平滑肌肌動蛋白(α-SMA)的表達(dá),蛋白免疫印跡法分析斑塊VCAM-1的表達(dá)水平。結(jié)果:1)HE示:心可舒組、氟伐他汀組、高脂組內(nèi)膜都存在斑塊的形成,以高脂組動脈斑塊最為明顯,而心可舒組及氟伐他汀組的斑塊增厚相對較小,對照組血管形態(tài)正常。2)心可舒組VCAM-1的表達(dá)明顯低于高脂組的水平(P0.01)。3)心可舒組巨噬細(xì)胞、基質(zhì)金屬蛋白酶9(MMP-9)及α-平滑肌肌動蛋白(α-SMA)的水平亦明顯低于高脂組(P0.01)。(2)臨床試驗(yàn)方法:從山東省立醫(yī)院心內(nèi)科及中醫(yī)科門診收集符合冠心病心絞痛氣滯血瘀證診斷標(biāo)準(zhǔn)的患者,將這60例患者,按照隨機(jī)分組的原則,分為2組。對照組30例,給予常規(guī)用藥;治療組30例,在常規(guī)用藥上加服心可舒,一次四粒,每日三次,4周后進(jìn)行臨床療效評定。分別對兩組患者心絞痛程度、中醫(yī)證候、心電圖及安全性檢測等綜合分析,繼而評價其療效和安全性。結(jié)果:1)臨床研究發(fā)現(xiàn),在中醫(yī)證候積分上,與對照組比較治療組效果更顯著(P0.01)。2)在心絞痛發(fā)作次數(shù)、持續(xù)時間,硝酸甘油用量,心電圖變化,證候療效方面,治療組優(yōu)于對照組(P0.05)。結(jié)論:臨床研究發(fā)現(xiàn),心可舒膠囊在臨床治療氣滯血瘀型穩(wěn)定型心絞痛初步取得一定療效,是一個安全有效的方劑;基礎(chǔ)研究證實(shí),心可舒可通過抗炎作用保護(hù)血管內(nèi)皮及抗動脈粥樣硬化�？傊�,心可舒可以有效治療冠心病穩(wěn)定型心絞痛。
[Abstract]:Objective: to investigate the clinical efficacy, safety and anti-atherosclerosis mechanism of Xinkesu from animal experiment and clinical study. (1) Animal experiment methods: 36 New Zealand white rabbits were randomly divided into 4 groups, respectively, as control group. High fat AS model group, fluvastatin group and Xinkesu group, 9 rats in each group. The extent of atherosclerotic plaques was evaluated by HE staining. The expressions of macrophages, matrix metalloproteinase-9 (MMP-9) and 偽 -smooth muscle actin (偽 -actin) were detected by immunohistochemistry, and the expression of VCAM-1 in plaque was analyzed by Western blot. Results: 1) HE showed that there were plaques in the intima of Xinkeshu group, fluvastatin group and hyperlipidemia group, especially in high-fat group, but the plaque thickening was relatively small in Xinkeshu group and fluvastatin group. The expression of VCAM-1 in Xinkesu group was significantly lower than that in hyperlipidemia group (P0.01). 3) the macrophage expression in Xinkesu group was significantly lower than that in high fat group (P0.01). The levels of matrix metalloproteinase 9 (MMP-9) and 偽-smooth muscle actin (偽-SMA) were also significantly lower than those of high fat group (P0. 01). (2). Patients who meet the diagnostic criteria of angina pectoris with Qi stagnation and blood stasis syndrome of coronary heart disease, The 60 patients were divided into 2 groups according to the principle of random grouping. 30 cases in the control group were treated with routine medication, and 30 cases in the treatment group were treated with Xinkesu, four pills once a day, three times a day, and the clinical efficacy was evaluated after 4 weeks. The degree of angina pectoris, TCM syndromes, electrocardiogram and safety test were analyzed, and the efficacy and safety were evaluated. Results: 1) Clinical study showed that the effect of treatment group was more significant than that of control group (P0.01) in TCM syndromes score (P0.01). 2) in angina pectoris attack times, duration, nitroglycerin dosage, electrocardiogram changes, syndromes curative effect. The treatment group was superior to the control group (P0.05). Conclusion: clinical study shows that Xinkesu capsule is a safe and effective prescription for the treatment of stable angina pectoris with Qi stagnation and blood stasis type. Basic research confirmed that Xinkeshu can protect vascular endothelium and atherosclerosis through anti-inflammatory effect. In a word, Xinkesu can effectively treat stable angina pectoris of coronary heart disease.
【學(xué)位授予單位】：山東中醫(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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