益气活血化痰法治疗高血压左室肥厚的临床与实验研究

发布时间：2018-02-16 06:43

本文关键词： 高血压左心室肥厚肾性高血压大鼠益气活血化痰法原癌基因　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:通过益气活血化痰法治疗高血压LVH的临床疗效观察和动物实验探讨其作用机理,评价本方法治疗高血压LVH的临床疗效及安全性,以期进一步为中医药治疗高血压LVH提供新的方法和理论,且为其临床广泛应用提供客观依据。方法:一、临床研究:对60例符合高血压LVH的患者,按照就医的先后顺序进行编号,随机分成对照组30例和治疗组30例。治疗组予益气活血化痰中药复方,对照组予替米沙坦口服,以3个月疗程观察其疗效。观察指标为血压变化值、超声心动图结果,依据结果进行评定。二、通过建立动物实验探究其作用机理。实验中用Wistar大鼠建立左室肥厚模型,观察其血压、左室重量指数、心肌组织的病理改变、心肌细胞形态参数、原癌基因c-fos、c-mmyc的表达,探讨益气活血化痰法自制中药复方的疗效。临床研究结果:1.两组患者经治疗后血压值均有所改善,改善情况显著。治疗后两组组内对比,经t检验分析,差别拥有统计学意义(P0.05)。治疗后两个组分之间进行比较,经t检验分析,无差异比较性(P0.05)。2.两组患者经治疗后超声心动图指标均有所改善,改善情况显著。治疗后两组组内对比,经t检验分析,差别拥有统计学意义(P0.05)。治疗后两个组分之间进行比较,经t检验分析,无差异比较性(P0.05)。实验研究结果:1.中药复方降压作用显著。2.中药复方可降低左室重量指数,改善心室重构。3.光镜、电镜及免疫组化结果示:中药复方可改善心肌重构,抑制心肌间质纤维化,抑制原癌基因c-fos、c-myc异常高表达。结论:1.益气活血化痰复方有良好的降压作用,可改善高血压左室肥厚患者的心肌厚度以及收缩功能。2.采取缩窄肾动脉的手术方法,复制高血压大鼠模型,其病理变化与人类高血压LVH相类似,该模型可用于高血压的研究。3.益气活血化痰复方明显减轻左心室重量指数,降低心肌细胞体积。4.通过光镜、电镜的观察及免疫组化证实益气活血化痰复方能够抑制心肌细胞纤维化,改善心肌实质与间质重构,抑制心肌细胞中c-fos、c-myc原癌基因的高表达,从而达到减轻和逆转高血压LVH的目的。
[Abstract]:Objective: To explore the mechanism through clinical observation and animal experimental method of Yiqi Huoxue Huatan to treat hypertension LVH, clinical efficacy and safety evaluation of the LVH method for treatment of hypertension, in order to provide new methods and theories of traditional Chinese medicine in the treatment of hypertension LVH and its clinical application methods: to provide an objective basis., clinical study: 60 patients with hypertension LVH patients, according to medical order number, 30 cases were randomly divided into control group and treatment group. 30 cases in treatment group were treated with Yiqi Huoxue Huatan prescription of traditional Chinese medicine, the control group was given telmisartan orally, observe its curative effect to 3 months of treatment. Observed the change of blood pressure values. Echocardiography results were assessed on the basis of the results. Two, through the establishment of animal experiments to explore the mechanism of Wistar. The rat model of left ventricular hypertrophy in the experiment, to observe the blood pressure, left ventricular weight index The number of pathological changes of myocardial tissue, myocardial cell morphological parameters, proto oncogene c-fos, c-mmyc expression, to investigate the effect of Yiqi Huoxue Huatan method Chinese medicine compound. The result of clinical study: 1. patients of the two groups after treatment, blood pressure values were improved significantly. Compared in the two groups after treatment were analyzed t test, the difference has statistical significance (P0.05). After treatment between the two groups were compared and analyzed by t test, the difference of.2. (P0.05) two patients with echocardiographic indexes were improved, improved significantly. Compared in the two groups after treatment, analysis by t test, difference has statistical significance (P0.05). After treatment between the two groups were compared and analyzed by t test, the difference of (P0.05). The experimental results: 1. Chinese herbal compound hypotensive effect of Chinese herbal compound.2. significantly reduced left ventricular weight index, left ventricular The reconstruction of.3. light microscope, electron microscope and immunohistochemical results showed that: the Chinese medicine can improve myocardial remodeling, inhibit myocardial fibrosis, inhibition of oncogene c-fos, abnormal expression of c-myc. Conclusion: 1. Guanxinping compound has good antihypertensive effect, can improve the myocardial thickness and systolic function in.2. patients with hypertension and left ventricular hypertrophy the surgical approach of coarctation of renal artery, copy the rat model of hypertension, the pathological changes and human hypertension is similar to the LVH, the model can be used for the study of hypertension.3. Guanxinping compound significantly reduced left ventricular weight index, reduce myocardial cell volume.4. by light microscope, electron microscope observation and immunohistochemistry confirmed Qi Bushenhuoxuehuatan compound can inhibit myocardial fibrosis and improve myocardial parenchyma and interstitium remodeling, inhibit myocardial cell c-fos, high expression of c-myc, thus alleviating and reversing the high The purpose of the blood pressure LVH.

【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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