益肾活血解毒汤对动脉粥样硬化及其相关炎性因子的实验和临床研究
发布时间：2018-10-18 11:02
【摘要】：目的观察益肾活血解毒汤对动脉粥样硬化的影响,探讨其可能作用机制,为中医治疗动脉粥样硬化提供新的依据。方法实验部分:1、动物分组:将60只大鼠随机分为正常对照组10只及造模组50只。2、动物造模:对照组予以普通饲料喂养,造模组予以高脂饲料及维生素D3联合应用,1个月后随机抽取造模组10只,取大鼠空腹血,检测血清TC、TG、LDL-C、HDL-C水平,结果显示造模组血脂水平均显著升高;检测大鼠主动脉,以发现动脉粥样硬化斑块为造模成功指标。随后随机将造模组分为模型组、西药组(阿托伐他汀组),中药组(益肾活血解毒汤组),及中西结合组(阿托伐他汀加益肾活血解毒汤组),每组10只。每天1次,连续给药1个月。3、指标检测:实验结束后第2天,腹腔注射麻醉大鼠,腹主动脉取血检测血脂、黏附分子、IL-8水平,取腹主动脉制作标本观察病理形态。临床部分:1、分组:采用随机分组法,纳入冠心病心绞痛(肾虚血瘀型)患者40例,分为研究组20例,对照组20例。对照组予以常规西药治疗,研究组在常规治疗基础上加用益肾活血解毒汤。2、指标及疗效:治疗周期为1个月,治疗前后分别监测患者血脂、黏附分子、IL-8、D-二聚体水平,评估治疗前后积分及心电图改善情况。全部计量资料以“_x±s”表示,组间比较采用配对资料t检验,两组比较采用独立样本t检验,多组独立样本用方差分析,计数资料用x2检验,P0.05为差异有统计学意义。所有资料用SPSS17.0统计软件进行统计学分析。结果实验研究:与模型组相比中药组、西药组、中西医结合组各炎性因子的表达明显降低,血脂水平明显下降(P0.05),中西医结合组优于中药组和西药组(P0.05)。镜下观察各治疗组与模型组相比脂质沉积较少,平滑肌增生较轻,内膜较规整。临床研究:治疗后患者血脂、血清ICAM-1、VCAM-1、D-二聚体、IL-8水平较治疗前均有明显降低(P0.05)。研究组各项疗效优于对照组(P0.05)。结论1.益肾活血解毒汤具有抑制动脉粥样硬化大鼠血清中黏附分子的表达,调节脂质代谢,减轻血管内皮损伤,减少脂质的吸收和在血管局部的沉积、抑制平滑肌细胞迁移增殖,从而预防或延缓动脉粥样硬化的进程而达到抗动脉粥样硬化作用。2.益肾活血解毒汤能够改善AS患者临床症状,调节脂质代谢,抑制血清黏附分子的表达,改善高凝状态。
[Abstract]:Objective to observe the effect of Yishen Huoxue jiedu decoction on atherosclerosis and explore its possible mechanism so as to provide a new basis for TCM treatment of atherosclerosis. Methods: 1. Animal groups: 60 rats were randomly divided into normal control group (n = 10) and model group (n = 50). The model group was treated with high fat diet and vitamin D3. 10 rats in the model group were randomly selected after one month. Fasting blood samples were taken and serum TC,TG,LDL-C,HDL-C levels were measured. The results showed that the blood lipid levels in the model group were significantly higher than those in the model group, and the aorta of the rats were detected. To find atherosclerotic plaques as a model success index. Then the model group was randomly divided into three groups: model group, western medicine group (Atto vastatin group), traditional Chinese medicine group (Yishen Huoxue jiedu decoction group) and western combination group (Atto vastatin plus Yishen Huoxue jiedu decoction group) with 10 rats in each group. Once a day for one month, the indexes were measured: on the second day after the experiment, anesthetized rats were injected intraperitoneally, blood lipid, adhesion molecule, IL-8 level were measured by abdominal aorta, and the pathological morphology of abdominal aorta was observed. Clinical part: 1. Group: 40 patients with coronary heart disease angina pectoris (kidney deficiency and blood stasis type) were randomly divided into study group (20 cases) and control group (20 cases). The control group was treated with routine western medicine, and the study group was treated with Yishen Huoxue jiedu decoction on the basis of routine treatment. 2. Index and curative effect: the treatment period was 1 month. Blood lipid, adhesion molecule and IL-8,D- dimer were monitored before and after treatment. To evaluate the improvement of integral and electrocardiogram before and after treatment. All the measurement data were expressed as "_ x 卤s", the paired data t test was used in the comparison between groups, the independent sample t test was used in the two groups, the analysis of variance was used in many independent samples, and the counting data was x2 test. The difference was statistically significant (P0.05). All the data were analyzed by SPSS17.0 statistical software. Results: compared with the model group, the expression of inflammatory factors in TCM group, western medicine group and integrated Chinese and western medicine group were significantly decreased, the level of blood lipid was significantly decreased (P0.05), and the combination of traditional Chinese and western medicine group was superior to the traditional Chinese medicine group and western medicine group (P0.05). Compared with the model group, the lipid deposition, smooth muscle hyperplasia and intima of each treatment group were observed under microscope. Clinical study: after treatment, blood lipid, serum ICAM-1,VCAM-1,D- dimer, IL-8 levels were significantly lower than before treatment (P0.05). The efficacy of the study group was better than that of the control group (P0.05). Conclusion 1. Yishen Huoxue jiedu decoction can inhibit the expression of adhesion molecules in serum of atherosclerosis rats, regulate lipid metabolism, reduce vascular endothelial injury, reduce lipid absorption and deposition in blood vessels, inhibit smooth muscle cell migration and proliferation. In order to prevent or delay the progression of atherosclerosis and achieve anti-atherosclerosis effect. 2. Yishen Huoxue jiedu decoction can improve the clinical symptoms of AS patients, regulate lipid metabolism, inhibit the expression of serum adhesion molecules and improve hypercoagulability.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R285
本文编号：2278924
[Abstract]:Objective to observe the effect of Yishen Huoxue jiedu decoction on atherosclerosis and explore its possible mechanism so as to provide a new basis for TCM treatment of atherosclerosis. Methods: 1. Animal groups: 60 rats were randomly divided into normal control group (n = 10) and model group (n = 50). The model group was treated with high fat diet and vitamin D3. 10 rats in the model group were randomly selected after one month. Fasting blood samples were taken and serum TC,TG,LDL-C,HDL-C levels were measured. The results showed that the blood lipid levels in the model group were significantly higher than those in the model group, and the aorta of the rats were detected. To find atherosclerotic plaques as a model success index. Then the model group was randomly divided into three groups: model group, western medicine group (Atto vastatin group), traditional Chinese medicine group (Yishen Huoxue jiedu decoction group) and western combination group (Atto vastatin plus Yishen Huoxue jiedu decoction group) with 10 rats in each group. Once a day for one month, the indexes were measured: on the second day after the experiment, anesthetized rats were injected intraperitoneally, blood lipid, adhesion molecule, IL-8 level were measured by abdominal aorta, and the pathological morphology of abdominal aorta was observed. Clinical part: 1. Group: 40 patients with coronary heart disease angina pectoris (kidney deficiency and blood stasis type) were randomly divided into study group (20 cases) and control group (20 cases). The control group was treated with routine western medicine, and the study group was treated with Yishen Huoxue jiedu decoction on the basis of routine treatment. 2. Index and curative effect: the treatment period was 1 month. Blood lipid, adhesion molecule and IL-8,D- dimer were monitored before and after treatment. To evaluate the improvement of integral and electrocardiogram before and after treatment. All the measurement data were expressed as "_ x 卤s", the paired data t test was used in the comparison between groups, the independent sample t test was used in the two groups, the analysis of variance was used in many independent samples, and the counting data was x2 test. The difference was statistically significant (P0.05). All the data were analyzed by SPSS17.0 statistical software. Results: compared with the model group, the expression of inflammatory factors in TCM group, western medicine group and integrated Chinese and western medicine group were significantly decreased, the level of blood lipid was significantly decreased (P0.05), and the combination of traditional Chinese and western medicine group was superior to the traditional Chinese medicine group and western medicine group (P0.05). Compared with the model group, the lipid deposition, smooth muscle hyperplasia and intima of each treatment group were observed under microscope. Clinical study: after treatment, blood lipid, serum ICAM-1,VCAM-1,D- dimer, IL-8 levels were significantly lower than before treatment (P0.05). The efficacy of the study group was better than that of the control group (P0.05). Conclusion 1. Yishen Huoxue jiedu decoction can inhibit the expression of adhesion molecules in serum of atherosclerosis rats, regulate lipid metabolism, reduce vascular endothelial injury, reduce lipid absorption and deposition in blood vessels, inhibit smooth muscle cell migration and proliferation. In order to prevent or delay the progression of atherosclerosis and achieve anti-atherosclerosis effect. 2. Yishen Huoxue jiedu decoction can improve the clinical symptoms of AS patients, regulate lipid metabolism, inhibit the expression of serum adhesion molecules and improve hypercoagulability.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R285
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