冠脉宁口服液治疗气虚血瘀型冠心病稳定型心绞痛的临床及实验研究

发布时间：2018-03-22 09:26

  本文选题：气虚血瘀　切入点：冠脉宁口服液　出处：《新乡医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的1.通过动物实验探讨冠脉宁口服液对ApoE基因敲除小鼠(ApoE-/-小鼠)动脉粥样硬化模型的影响及机制,进一步明确冠脉宁口服液的治疗作用。2.观察冠脉宁口服液辅助治疗气虚血瘀型冠心病稳定型心绞痛患者的临床疗效及对血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、内脏脂肪素(Visfatin)的影响。方法1.动物实验研究利用高脂饲料喂养ApoE-/-小鼠造动脉粥样硬化模型,以冠脉宁口服液进行干预,并设立对照组,12周后比较各组小鼠血脂及血清IL-6、hs-CRP、Visfatin水平的变化,HE染色观察小鼠主动脉组织病理形态学变化。2.临床研究选取我院心内科就诊的120例符合入选条件的冠心病稳定型心绞痛患者,随机分为观察组(60例)和对照组(60例),对照组采用西医常规药物治疗,观察组在此基础上给予冠脉宁口服液口服,疗程均3个月。观察并比较治疗后两组的临床疗效及两组患者治疗前后心电图、冠状动脉CT和冠状动脉造影阳性率、血脂、血流变学指标、血清IL-6、hs-CRP、Visfatin水平的变化。结果1.动物实验:(1)模型组、冠脉宁组、复方丹参组血清TC、TG、LDL-C水平及血清hs-CRP、Visfatin、IL-6水平高于空白对照组(P0.01或0.05),HDL-C含量低于空白对照组(P0.05)。(2)与模型组比较,冠脉宁组、复方丹参组血清TC、TG、LDL-C水平及血清hs-CRP、Visfatin、IL-6水平降低(P均0.05),而HDL-C水平升高(P0.05)。(3)冠脉宁组与复方丹参组比较,上述指标的差异无统计学意义(P0.05)。(4)空白对照组主动脉未见动脉粥样硬化改变,模型组、冠脉宁组和复方丹参组都有主动脉组织内膜增厚及粥样斑块的形成。与模型组比较,冠脉宁组和复方丹参组组织病理损伤程度较轻,斑块面积较小。2.临床研究:(1)观察组和对照组临床疗效的总有效率分别是96.7%和95.0%,比较二者差异无统计学意义(P0.05)。(2)两组心电图疗效及分布无明显差异(P0.05)。(3)两组均能降低冠状动脉CTA和冠状动脉造影总阳性率(P0.05),二者效果差异无统计学意义(P0.05)。(4)两组均能明显降低血清TC、TG和LDL-C水平(P均0.05),观察组降低血清TC、TG和LDL-C的效果优于对照组(P0.05)。(5)两组均能明显降低高切还原黏度(Hηre)、低切还原黏度(Lηre)、全血黏度(BV)、红细胞聚集指数(RAI)、红细胞刚性指数(RRI)、纤维蛋白原(Fb)、红细胞压积(HCT)、血沉(ESR)等血液流变学指标(P均0.05),且观察组的作用更明显(P0.05)。(6)观察组和对照组治疗后血清IL-6、hs-CRP、Visfatin水平较本组治疗前降低(P均0.05)。观察组降低血清IL-6、hs-CRP、Visfatin水平的作用优于对照组(P均0.05)。(7)两组治疗前后血、尿、大便常规及肝、肾功能等化验指标比较,差异无统计学意义P0.05)。两组患者治疗期间均无明显不良反应。结论1.冠脉宁口服液可提高ApoE-/-动脉粥样硬化小鼠的活跃度,降低血脂及血清hs-CRP、Visfatin及IL-6水平,减少动脉粥样硬化斑块面积,作用优于复方丹参片,具有一定的抗动脉粥样硬化作用。2.西医常规治疗加用冠脉宁口服液可有效缓解冠心病患者心绞痛症状,改善心肌供血和冠状动脉管腔狭窄,改善血液黏度,降低血脂和hs-CRP、IL-6及Visfatin等炎症因子水平,作用优于单纯西药治疗,且无明显不良反应。
[Abstract]:Objective to investigate 1. animal experiments of Guanmaining oral liquid on ApoE knockout mice (ApoE-/- mice) influence atherosclerosis model and mechanism, further observation of therapeutic effect of.2. Guanmaining oral liquid adjuvant treatment of coronary heart disease clearly Guanmaining oral liquid stable clinical efficacy in patients with angina pectoris and on serum interleukin -6 (IL-6), high sensitive C reactive protein (hs-CRP), visfatin (Visfatin) method. The influence of 1. animal experiments using high-fat diet ApoE-/- mice model of atherosclerosis, in Guanmaining oral liquid to intervene, and set up the control group after 12 weeks, compared blood lipid and serum IL-6, mouse hs-CRP, change the level of Visfatin, to observe the pathological changes of mouse aorta.2. clinical research in our hospital department of Cardiology for treatment of 120 cases of eligible stable coronary heart disease and angina HE staining The pain of patients, were randomly divided into observation group (60 cases) and control group (60 cases), the control group were treated with routine drug treatment, the observation group was given oral Guanmaining oral liquid, the course of treatment was 3 months. To observe and compare the clinical efficacy of the two groups after treatment of ECG and two groups of patients before and after treatment, the positive rate of coronary CT and blood lipids, blood rheology indexes, serum IL-6, hs-CRP, Visfatin levels in 1.. Results: (1) experimental animal model group, Guanmaining group, Salvia miltiorrhiza group, serum TC, TG, LDL-C and serum levels of hs-CRP, Visfatin, IL-6 levels higher than the control group (P0.01 or 0.05), the HDL-C content is lower than the blank control group (P0.05). (2) compared with the model group, Guanmaining group, Salvia miltiorrhiza group, serum TC, TG, LDL-C and serum levels of hs-CRP, Visfatin, IL-6 decreased (P 0.05), and increased the level of HDL-C (P0.05) (3. Guanmaining) group and Salvia miltiorrhiza group Comparison, no statistically significant difference between the index (P0.05). (4) blank control group no aortic atherosclerosis model group, Guanmaining group and Salvia miltiorrhiza group have formed aorta intimal thickening and plaque. Compared with the model group, Guanmaining group and Danshen group the pathological damage to a lesser extent.2., small patch clinical research: (1) observation group and the control group clinical total effective rate were 96.7% and 95%, there was no significant difference between the two (P0.05) (2). No significant difference between the two groups of ECG and distribution (P0.05). (3) the two groups can reduce the total the positive rate of coronary artery CTA and coronary artery angiography (P0.05), no statistically significant difference between the two effects (P0.05). (4) the two groups could significantly reduce serum TC, TG and LDL-C levels (P 0.05), the observation group decreased the serum levels of TC, TG and LDL-C, the effect is better than that of control group (P0.05) (. 5)涓ょ粍鍧囪兘鏄庢樉闄嶄綆楂樺垏杩樺師榛忓害(H畏re),浣庡垏杩樺師榛忓害(L畏re),鍏ㄨ��榛忓害(BV),绾㈢粏鑳炶仛闆嗘寚鏁，

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