藤玄降压方治疗高血压病阴虚阳亢证临床疗效及对血管内皮保护机制研究

发布时间：2018-12-18 04:33

【摘要】：目的:探讨藤玄降压方治疗高血压阴虚阳亢证临床疗效,及其对血管内皮的保护机制,以期为临床治疗提供理论依据。方法:1.临床研究:纳入70例高血压病阴虚阳亢证患者,随机分为试验组35例,对照组35例。试验组给予藤玄降压方,对照组给予缬沙坦胶囊,为期28天,观察降压疗效、中医证候改善及安全性状况。2.实验研究:将Wistar大鼠随机分为藤玄组、缬沙坦组、模型组及正常组,利用L-NNA腹腔注射制备高血压模型。分别给予藤玄降压方、缬沙坦、生理盐水灌胃6周,观察大鼠血压变化,内皮依赖性舒张功能,测定血清NO、T-AOC、SOD及MDA水平,Western Bolt及RT-PCR检测主动脉NADPH nox4及eNOS水平。结果:1.临床研究:藤玄降压方能降低患者血压(P0.05),其降压疗效与缬沙坦相当(P0.05),并能减轻患者中医临床症状(P0.05),改善疗效优于缬沙坦(P0.05),未见不良反应。2.实验研究:藤玄降压方可降低高血压大鼠血压(P0.05),改善主动脉内皮依赖性舒张功能(P0.05),提高血清NO、T-AOC、SOD水平,降低MDA水平(P0.05),下调NADPH nox4表达,上调eNOS活性(P0.05),其作用与缬沙坦疗效相当(P0.05)。结论:藤玄降压方治疗高血压病阴虚阳亢证,临床疗效肯定,其作用机制与下调NADPH nox4表达、上调eNOS活性,减轻内皮氧化应激损伤,保护血管内皮有关。
[Abstract]:Objective: to explore the clinical effect of Fuxuan Jiangya decoction on hyperactivity of yin deficiency and yang hyperactivity of hypertension and its protective mechanism on vascular endothelium in order to provide theoretical basis for clinical treatment. Methods: 1. Clinical study: 70 cases of hypertension with yin deficiency and yang hyperactivity were randomly divided into trial group (n = 35) and control group (n = 35). The experimental group was given Fuxuan Jiangya decoction, the control group was given valsartan capsule for 28 days, the curative effect of hypotension, the improvement of TCM syndromes and the safety condition were observed. 2. Experimental study: Wistar rats were randomly divided into Fuxuan group, valsartan group, model group and normal group. Hypertension model was established by intraperitoneal injection of L-NNA. The changes of blood pressure, endothelium-dependent diastolic function, serum NO,T-AOC,SOD and MDA levels, Western Bolt and RT-PCR levels of aorta NADPH nox4 and eNOS were measured after 6 weeks of oral administration of Fuxuan Jiangya decoction, valsartan and normal saline respectively. Results: 1. Clinical study: Fuxuan Jiangya prescription can lower the blood pressure of patients (P0.05), its antihypertensive effect is similar to valsartan (P0.05), and can alleviate the clinical symptoms of patients (P0.05), improve the efficacy is better than valsartan (P0.05), No adverse reactions. 2. Experimental study: Fuxuan Jiangya decoction decreased blood pressure (P0.05), improved aortic endothelium-dependent diastolic function (P0.05), increased serum NO,T-AOC,SOD level and decreased MDA level (P0.05). The expression of NADPH nox4 was down-regulated and the activity of eNOS was upregulated (P0.05), and the effect was similar to that of valsartan (P0.05). Conclusion: the clinical effect of Fuxuan Jiangya decoction in treating hyperactivity of yin deficiency and yang in hypertension is confirmed. Its mechanism is related to down-regulation of NADPH nox4 expression, upregulation of eNOS activity, abatement of oxidative stress injury of endothelium and protection of vascular endothelium.
【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】：2016
【分类号】：R259

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