麝香通心滴丸治疗冠心病心绞痛的疗效及对动脉粥样硬化大鼠Visfatin的影响

发布时间：2018-01-16 14:42

本文关键词：麝香通心滴丸治疗冠心病心绞痛的疗效及对动脉粥样硬化大鼠Visfatin的影响　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1、通过对20例冠心病稳定型心绞痛痰热瘀阻证患者的临床观察,探讨麝香通心滴丸对冠心病稳定型心绞痛患者心绞痛症状改善情况、血脂及血清内脂素方面影响的作用机制。2、通过高脂喂养和垂体后叶素注射复制动脉粥样硬化模型,观察麝香通心滴丸对动脉粥样硬化大鼠血脂及血清内脂素、腹主及颈总动脉内膜病理变化的影响,探讨麝香通心滴丸对动脉粥样硬化的作用机制。方法:1、临床研究方法:将来自黑龙江中医药大学附属第一医院门诊的20例冠心病心绞痛痰热瘀阻证患者随机分为试验组(常规西药调脂、抗血小板、扩冠治疗加麝香通心滴丸)10例,对照组(常规西药调脂、抗血小板、扩冠治疗加麝香通心滴丸安慰剂)10例。每日3次,每次2粒口服。疗程56天。观察患者用药前后心绞痛症状改善情况、血脂及血清内脂素的变化情况。2、动物实验方法:雄性SD大鼠60只,取15只做空白对照组,其余45只以腹腔注射垂体后叶素加高脂饲料喂养复制动脉粥样硬化模型,8周后空白对照组随机取3只、造模组取9只大鼠采静脉血检测血脂变化情况,取腹主和颈总动脉做HE染色观察动脉内膜情况证实模型复制成功。将造模成功的大鼠随机分为模型对照组、中药治疗组、西药对照组,每组12只。从第9周开始灌胃,中药治疗组灌以麝香通心滴丸溶液(含麝香通心滴丸浓度为10.94mg/kg·d)。西药对照组灌以瑞旨溶液(含瑞旨浓度为0.52mg/kg·d)。其余两组均灌以同体积蒸馏水。灌胃8周后取静脉血,用ELISA法检测血脂及血清内脂素,取腹主和颈总动脉采用HE染色观察血管病理形态变化。结果:1、通过临床观察发现:(1)心绞痛症状积分:试验组服药后心绞痛总分明显低于服药前,差异有统计学意义(P0.01);与对照组相比,试验组服药后心绞痛总分明显降低,差异有统计学意义(P0.05)。(2)血脂:试验组服药后TC、TG、LDL-C水平明显低于服药前,HDL-C水平明显高于服药前,差异有统计学意义(P0.01);与对照组相比,试验组服药后TC、TG、LDL-C水平均降低,HDL-C水平升高,差异有统计学意义(P0.05)。(3)血清内脂素:试验组服药后血清内脂素水平明显低于服药前,差异有统计学意义(P0.01);与对照组相比,试验组服药后血清内脂素水平明显降低,差异有统计学意义(P0.05)。2、通过动物实验发现:(1)血脂:空白对照组、中药治疗组、西药对照组血脂与模型对照组比较,TC、TG、LDL-C水平均降低,HDL-C水平均升高,差异有统计学意义(P0.05);中药治疗组与西药对照组比较疗效相当,差异无统计学意义(P0.05)。(2)血清内脂素:空白对照组、中药治疗组、西药对照组的血清内脂素水平明显低于模型对照组,差异有统计学意义(P0.05);中药治疗组与西药对照组比较疗效相当,差异无统计学意义(P0.05)。(3)病理结果显示:模型对照组出现动脉管腔内膜不规则增厚,平滑肌排列紊乱,弹力膜断裂,管周可见大量泡沫细胞及脂质沉积,炎细胞浸润。中药治疗组及西药对照组的血管管壁及管周脂质沉积减少,平滑肌细胞肿胀减轻。中药治疗组显示炎细胞浸润减少。结论:1、临床观察发现:麝香通心滴丸可明显改善冠心病稳定型心绞痛痰热瘀阻证患者的心绞痛症状,减少心绞痛发作次数、程度及持续时间;降低患者的血清内脂素、TC、TG、LDL-C水平,升高患者的HDL-C水平。2、动物实验发现:麝香通心滴丸可降低动脉粥样硬化模型大鼠的TC、TG、LDL-C、血清内脂素水平,升高大鼠的HDL-C水平;改善大鼠动脉内膜损伤情况。
[Abstract]:Objective: 1. Through clinical observation of 20 cases of patients with stable angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome, explore the musk macaroni dripping pill on stable angina pectoris of coronary heart disease in patients with angina symptoms to improve the situation, the.2 mechanism of blood lipid and serum visfatin influence, through high fat feeding and pituitrin injection of the atherosclerosis model, observe the musk macaroni dripping pills on serum lipids and atherosclerosis rat visfatin, effects of abdominal artery and carotid intima main pathological changes, to explore the mechanism of heart through musk pill on atherosclerosis. Methods: 1. Clinical research methods: from the outpatient department of the First Affiliated Hospital of Heilongjiang University Of Chinese Medicine in 20 patients angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome were randomly divided into experimental group (routine antiplatelet, lipid-lowering, CHD therapy plus musk macaroni pills) in 10 cases, the control group (conventional western medicine anti blood lipid. Small, CHD therapy plus musk macaroni dripping pills of placebo) in 10 cases. 3 times daily, 2 capsules each time. Oral treatment for 56 days. Patients were observed before and after treatment of angina symptoms, blood lipid and serum visfatin.2 changes, animal experiment: 60 male SD rats, 15 rats do the blank control group, the remaining 45 rats by intraperitoneal injection of pituitrin plus high fat diet atherosclerosis model after 8 weeks, 3 rats were randomly selected in the blank control group, model group 9 rats blood serum lipid changes from abdominal aorta and carotid artery intima were observed with HE confirmed model successful. The successful model of the rats were randomly divided into model control group, Chinese medicine group, western medicine group, 12 rats in each group. From the ninth week gavage, traditional Chinese medicine treatment group treated with musk macaroni dripping pills solution (containing musk macaroni dripping pills was 10.94mg /kg - D) of Western medicine. According to Rui group was aimed solution (including Rui aims concentration was 0.52mg/kg - D). Other two groups were given the same volume of distilled water by gavage. After 8 weeks of venous blood were detected by ELISA blood lipid and serum visfatin, take the abdominal aorta and carotid artery HE staining was used to observe the pathological changes of blood vessel results: 1. Through clinical observation, found that: (1) angina symptom scores: the test group was significantly lower than the score after medication of angina pectoris before treatment, the difference was statistically significant (P0.01); compared with the control group, the experimental group after the treatment of angina pectoris score decreased significantly, the difference was statistically significant (P0.05) (2). Blood lipids: the experimental group TC after treatment, TG, LDL-C levels were significantly lower than before treatment, HDL-C was significantly higher than that before treatment, the difference was statistically significant (P0.01); compared with the control group, the experimental group after the treatment of TC, TG, LDL-C levels decreased, HDL-C level increased, the difference was statistically significant (P0.05 (3). Serum visfatin: Test) Serum visfatin levels were significantly lower than the group after treatment before treatment, the difference was statistically significant (P0.01); compared with the control group, serum visfatin levels were significantly decreased in experimental group after treatment, the difference was statistically significant (.2, P0.05) through animal experiments found that: (1) blood lipid: blank control group, Chinese medicine treatment group the western medicine group, blood lipids compared with model group, TC, TG, LDL-C levels were decreased and the level of HDL-C increased, the difference was statistically significant (P0.05); Chinese medicine treatment group and Western medicine control group efficacy, the difference was not statistically significant (P0.05). (2) serum visfatin: blank control group Chinese medicine treatment group, western medicine group, serum visfatin levels were significantly lower than the model control group, the difference was statistically significant (P0.05); Chinese medicine treatment group and Western medicine control group efficacy, the difference was not statistically significant (P0.05). (3) the pathological results showed that the model group appeared to move The vascular lumen is irregular thickening, smooth muscle disorder, elastic membrane rupture, around the pipe shows a large number of foam cells and lipid deposition, inflammatory cell infiltration. The Chinese medicine group and Western medicine control group, the vascular wall and reduce lipid deposition in peritubular smooth muscle cells, reduce swelling. Chinese medicine treatment group showed a decrease in inflammatory cell infiltration. Conclusion: 1. Clinical observation: musk macaroni dripping pills can significantly improve patients with stable angina pectoris of coronary heart disease of phlegm heat and blood stasis syndrome of angina symptoms, reduce the frequency of angina pectoris, duration and extent; reduce the serum visfatin, TC, TG, LDL-C, HDL-C of patients with elevated levels of.2, animal experiment found: musk macaroni dripping pills can reduce atherosclerosis in rat model of TC, TG, LDL-C, serum visfatin levels, elevated levels of HDL-C in rat; improve rat arterial intimal injury.

【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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