糖心舒合剂改善糖尿病心肌病的临床及实验研究

发布时间：2018-07-30 08:10

【摘要】：目的:观察糖心舒合剂对糖尿病心肌病气阴两虚,瘀血内阻证患者的临床疗效及糖心舒合剂对糖尿病心肌病大鼠心功能及心肌组织结构的改善的实验研究。方法:临床研究,60例糖尿病心肌病患者随机分为治疗组和对照组,两组均进行基础治疗,包括糖尿病健康教育;饮食、运动疗法;降糖、降脂、降压等基础治疗。治疗组在基础治疗的基础上加用糖心舒合剂,每日一剂,治疗8w,两组治疗前、后给予测定血糖、糖化血红蛋白、血脂、BNP、心功能分级、超声心动图及安全性指标,并做中医症候疗效评定,判断糖心舒合剂治疗糖尿病心肌病的临床疗效。实验研究,应用STZ制备糖尿病心肌病大鼠模型,分为模型组、中药组,剩余14只大鼠为正常组。中药组给予糖心舒合剂灌胃,正常组及模型组给予同等剂量生理盐水灌胃,给药8w,观察大鼠一般状况、血糖、BNP、超声心动图改变,通过心肌组织HE染色及Masson染色观察糖尿病心肌病大鼠心肌组织的改变。结果:临床研究结果显示,治疗后两组综合疗效统计显示,治疗组总有效率83.33%,对照组总有效率46.67%,治疗组优于对照组(P0.05);治疗后两组症状积分均较前有所降低,治疗组和对照组比较有统计学意义(P0.05);糖心舒合剂在改善DCM患者的血糖、糖化血红蛋白、血脂、BNP、心功能疗效方面优于对照组(P0.05);安全性指标观察发现患者血常规、尿常规、大便常规、肝肾功能均未见明显变化,说明糖心舒合剂具有良好的安全性。动物实验结果显示,模型组与正常组大鼠相比,心脏体积增大,心肌细胞破坏,心肌间质胶原纤维增加,中药组和模型组大鼠相比,心脏体积略小,大鼠心肌细胞破坏和心肌间质胶原纤维减少;中药组与模型组比较BNP、血糖、及超声心动图均明显改善。结论:糖心舒合剂治疗DCM临床疗效显著,并改善DCM大鼠心功能及心肌超微结构,具有较好的临床研究价值。
[Abstract]:Objective: to observe the clinical effect of Tangxinshu mixture on diabetic cardiomyopathy patients with deficiency of qi and yin and internal obstruction of blood stasis, and to observe the improvement of heart function and myocardial tissue structure of diabetic cardiomyopathy rats by Tangxinshu mixture. Methods: 60 patients with diabetic cardiomyopathy were randomly divided into treatment group and control group. The two groups were treated with basic treatment, including diabetes health education, diet, exercise therapy, hypoglycemia, lipid-lowering, hypotension and so on. The treatment group was treated with Tangxinshu mixture once a day for 8 weeks. Before and after treatment, blood glucose, glycosylated hemoglobin, blood lipids and BNPs, cardiac function grading, echocardiography and safety indexes were measured in the treatment group. The clinical effect of Tangxinshu mixture on diabetic cardiomyopathy was evaluated. The experimental study showed that the diabetic cardiomyopathy rats were induced by STZ and were divided into two groups: the model group, the Chinese medicine group, and the remaining 14 rats as the normal group. The rats in the traditional Chinese medicine group were treated with Tangxinshu mixture, and the normal group and the model group were given the same dose of normal saline for 8 weeks. The general status, blood glucose and BNPs were observed, and the changes of echocardiography were observed. The changes of myocardial tissue in diabetic cardiomyopathy rats were observed by HE staining and Masson staining. Results: the results of clinical study showed that the total effective rate of the treatment group was 83.33 and the total effective rate of the control group was 46.67, which was better than that of the control group (P0.05), the symptom score of the two groups was lower than that of the previous treatment group (P0.05), the total effective rate of the treatment group was 83.33 and that of the control group was 46.67. Treatment group and control group compared with the statistical significance (P0.05); Tangxinshu mixture in improving DCM patients' blood sugar, glycosylated hemoglobin, blood lipids and BNPs, the curative effect of heart function was better than the control group (P0.05). The routine defecation, liver and kidney function did not change obviously, which indicated that Tangxinshu mixture had good safety. The results of animal experiments showed that compared with the normal group, the heart volume of the model group was larger, the myocardial cells were destroyed, the collagen fibers of the myocardial interstitial were increased, and the heart volume of the traditional Chinese medicine group was slightly smaller than that of the model group. Compared with the model group, BNP, blood glucose and echocardiography were significantly improved in the traditional Chinese medicine group. Conclusion: Tangxinshu mixture has a good clinical value in treating DCM and improving cardiac function and myocardial ultrastructure in DCM rats.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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