益气健脾和血祛痰法对冠心病患者miR-126、炎症指标的影响研究

发布时间：2018-05-19 14:23

  本文选题：冠心病 + 从脾论治　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:本试验用益气健脾和血祛痰法治疗冠心病稳定型心绞痛脾虚痰浊证患者后,检测其血清mi R-126和炎症因子水平,揭示“从脾论治”冠心病稳定型心绞痛炎症机制发生的规律及其相关关系。材料与方法:1.试验对象:本试验采用多中心、盲法、区组随机、平行对照进行临床试验设计。对冠心病稳定型心绞痛脾虚痰浊证患者采用益气健脾、和血祛痰法联合西医基础治疗;2.分组方法:首先招募符合筛选标准的受试者,然后采用SPSS16.0统计软件,将受试者按1:1比例随机分配到试验组和对照组,两组各80例,同时招募正常受试者20例。3.干预措施:试验组给予具益气健脾、和血祛痰作用的中药颗粒剂(含党参、黄芪、白术、清半夏等中药)联合西医基础治疗,对照组予安慰剂作用的中药颗粒剂(含试验组中药颗粒剂成分的10%)联合西医基础治疗,疗程12周;4.观察方法:一般资料、mi R-126、炎性指标。除一般资料,均以入组后第0周、4周、12周为信息采集时间点;5.统计学方法:数据应用spss for windows 16.0整理、分析。计量资料以(-x±s)形式表示,p0.05差异具有统计学意义。结果:选取PPS数据集,最终完成的病例试验组75例,对照组70例。1.药物干预前,试验组和对照组mi R-126含量明显低于正常人组,差异均有统计学意义(P0.05),同时试验组和对照组没有差异(P0.05);药物干预后,试验组和对照组mi R-126的含量虽然有所增加,但是也没有达到正常人组的含量高度,与正常人组比差异均有统计学意义(P0.05),同时试验组比对照组的含量稍高,差异没有统计学意义(P0.05)。2.试验组中hs-CRP、MCP-1、VCAM-1这三个炎症指标给药后下降明显,与对照组比较有显著差异(P0.05),SR-A有下降趋势、SR-B有升高趋势。对照组中给药后炎症因子变化均无统计学意义(P0.05)。3.给药前,冠心病患者外周血mi R-126和粘附因子VCAM-1呈负相关(r=-0.694,P=0.000),mi R-126与其他炎症因子无直线相关关系;给药后mi R-126与炎症因子无直线相关关系。结论:1.冠心病稳定型心绞痛患者外周血中miR-126的含量低于正常人,给予试验药品后患者血清中SR-B之外的炎症因子含量降低。2.冠心病稳定型心绞痛患者外周血中mi R-126与粘附分子VCAM-1呈负相关,mi R-126可以作为反应冠心病严重程度的生物学标志。3.益气健脾和血祛痰法治疗冠心病稳定型心绞痛脾虚痰浊证患者有效,可升高外周血中mi R-126的水平,同时降低血清中SR-B之外的炎症因子的含量。
[Abstract]:Objective: after treating patients with spleen deficiency and phlegm turbid syndrome of stable angina pectoris with coronary heart disease, serum mi R-126 and inflammatory factor levels were detected after treating patients with syndrome of spleen deficiency and phlegm by supplementing qi and invigorating spleen and expelling phlegm. To reveal the regularity of inflammatory mechanism of stable angina pectoris of coronary heart disease from spleen treatment and its correlation. Materials and methods: 1. Subjects: a multicenter, blind, randomized, parallel controlled clinical trial design was conducted. Patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbid syndrome were treated with Yiqi Jianpi combined with blood expelling phlegm combined with western medicine basic treatment 2. Group method: first, the subjects who met the screening criteria were recruited, then the subjects were randomly assigned to the test group and the control group according to the 1:1 scale by using SPSS16.0 software, 80 cases in each group, and 20 cases. 3 cases in the normal subjects at the same time. Intervention measures: the experimental group was treated with traditional Chinese medicine granules (including Radix Codonopsis, Radix Astragali, Atractylodes macrocephala, Radix Pinellia ternata and so on), which had the effect of invigorating qi and invigorating spleen and removing phlegm. The control group was treated with placebo-acting traditional Chinese medicine granules (10% of the experimental group) combined with western medicine. The course of treatment was 12 weeks and 4. 5%. Observation method: general data: mi R-126, inflammatory index. Except for general data, the time of information collection was 5. 5% at the end of 4 weeks and 12 weeks after entering the group. Statistical methods: the data were collected and analyzed by spss for windows 16.0. There was statistical significance in measuring data in the form of-x 卤s. Results: 75 cases in the final trial group and 70 cases in the control group were selected from the PPS data set. Before drug intervention, the content of miR-126 in the experimental group and the control group was significantly lower than that in the normal control group (P 0.05), but there was no difference between the experimental group and the control group. But also did not reach the level of the normal group, the difference was statistically significant compared with the normal group, at the same time, the content of the experimental group was slightly higher than the control group, the difference was not statistically significant. In the experimental group, the hs-CRPU MCP-1 and VCAM-1 were significantly decreased after administration, and there was a significant difference compared with the control group. Compared with the control group, there was a decreasing trend of SR-B in the experimental group. The changes of inflammatory factors in the control group were not statistically significant (P 0.05. 3). Before administration, there was a negative correlation between mi R-126 and adhesion factor VCAM-1 in peripheral blood of patients with coronary heart disease. There was no linear correlation between mi R-126 and other inflammatory factors, but there was no linear correlation between mi R-126 and inflammatory factors after administration. Conclusion 1. The level of miR-126 in peripheral blood of patients with stable angina pectoris of coronary heart disease was lower than that of normal people, and the content of inflammatory factors other than SR-B in serum of patients with coronary heart disease stable angina pectoris was decreased by 0.2. 2. There is a negative correlation between mi R-126 and adhesion molecule VCAM-1 in peripheral blood of patients with stable angina pectoris of coronary heart disease. Mi R-126 can be used as a biological marker to reflect the severity of coronary heart disease. Invigorating qi and invigorating spleen and expelling phlegm were effective in treating patients with stable angina pectoris of coronary heart disease with deficiency of spleen and phlegm turbidity. It could increase the level of miR-126 in peripheral blood and decrease the content of inflammatory factors besides SR-B in serum.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
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本文编号：1910445