【作者】 周杰；

【导师】 周建民；

【作者基本信息】 延边大学 ， 中西医结合， 2009， 硕士

【摘要】 目的:冠心病属于中医“胸痹”、“心痛”范畴,是威胁人类健康最严重的疾病之一,本课题通过对温肾活血法(三仙养心胶囊)的试验研究,探讨其治疗冠心病的作用机理,为温肾活血法(三仙养心胶囊)治疗冠心病的有效性提供科学依据。方法:①三仙养心胶囊对实验性心肌梗死犬的影响:通过结扎麻醉犬冠状动脉左前降支下1/3处造成急性心肌梗死,结扎冠状动脉15分钟后,待ST段明显升高,即为模型成立。经十二指肠给药,模型组给予等容量生理盐水,阳性药物对照组给予心宝丸2.76g/kg,三仙养心胶囊0.204、0.102、0.051g/kg(含药物80、40、20mg/kg)三个剂量组,记录给药后10、30、45、60、90、120、150分钟各项指标,同时取下心脏,利用染色法计算心肌梗死面积,观察三仙养心胶囊对心肌梗死面积、心肌缺血程度、范围及心肌三酶的影响;②三仙养心胶囊对麻醉犬血流动力学和心肌耗氧量的影响:通过对正常麻醉犬给药前后10、20、30、45、60、90、120、150 min各项指标的观察,利用公式计算血流动力学和心肌耗氧量各项指标的变化,以观察三仙养心胶囊抗心肌缺血的作用机制。结果:1、三仙养心胶囊能降低心肌缺血程度、减小心肌缺血范围、缩小心肌梗死面积、降低AST,CPK,对LDH降低不明显;2、三仙养心胶囊在不影响麻醉犬血压和心率的情况下,能明显增加冠脉血流量,改善心肌血液供应;降低冠脉阻力及外周阻力;减少心肌耗氧量;增加心输出量、心搏出量、心脏指数、心搏指数等指标。结论:1、温肾活血法(三仙养心胶囊)通过降低心肌梗死程度、减少心肌梗死范围、缩小心肌梗死的面积、降低心肌酶,从而减轻心肌细胞的损伤,具有明显抗心肌缺血的作用。2、温肾活血法(三仙养心胶囊)通过增加冠脉血流量,降低外周阻力,减少心肌耗氧量等,明显的改善了心脏血流动力学及氧代谢,对缺血心肌有明显的保护作用。3、温肾活血法(三仙养心胶囊)是治疗冠心病的有效方法,其作用机制可能是通过改善心脏血流动力学和降低心肌耗氧量起到抗心肌缺血的作用。温肾活血法作用机理进一步的探讨,这还有待于做下一步做大规模的试验研究。4、本课题探讨标本兼治之法,与单纯控制心绞痛发作的一些药物相比,本法活血的同时重视温肾阳以治本,这对防止冠心病反复发作有更重要意义,也是中医治病求本的一个优势所在。更多还原

【Abstract】 Objective:Coronary Heart Disease is the Chinese medicine "chest","pain" area,is a threat to human health,one of the most serious diseases,the subject of Wenshen Huoxue (Sanxian yangxin capsule) pilot study to examine its treatment of crown the mechanism of heart disease for Wenshen Huoxue(Sanxian yangxin capsule) the effectiveness of the treatment of coronary heart disease to provide a scientific basis.Methods:①Sanxian yangxin capsules on the impact of myocardial infarction in dogs: The coronary artery ligation in anesthetized dog under the left anterior descending coronary artery 1/3 caused by acute myocardial infarction,coronary artery ligation for 15 minutes,to be significantly elevated ST segment,model is set up.After duodenal administration,such as the capacity of the control group given saline,the positivecontrol group given the drug pill Xinbao2.76g/kg,Sanxiancapsulebenefits0.204,0.102,0.051g/kg(containingdrug80,40,20mg/kg )inthreedosegroups,Record10,30,45,60,90,120,150minutes after administration of the target, at the same time to remove the heart,the use of staining method to calculate the area of myocardial infarction was observed Sanxian yangxin capsule benefits of area of myocardial infarction,myocardial ischemia extent,scope and impact of enzymes;②Sanxian yangxin capsule benefits hemodynamics in anesthetized dogs and the effects of myocardial oxygen consumption:through the normal anaesthetized dogs before and after administration of the target 10,20,30,45,60,90,120,150 min of observation,the use of formula hemodynamics and myocardial oxygen consumption changes in the target in order to observe the Sanxian capsule benefits of anti-myocardial ischemia in rats.Results:1、Wenshen Huoxue(Sanxian yangxin capsule) by reducing the extent of myocardial infarction,reduce the scope of myocardial infarction,to reduce the size of myocardial infarction,reduce the enzyme,so as to reduce the myocardial cell damage,a clear role of anti-myocardial ischemia;2、Wenshen Huoxue(Sanxian yangxin capsule) through an increase in coronary blood flow,reducing peripheral resistance,reducing myocardial oxygen consumption and so on,significant improvements in cardiac hemodynamics and oxygen metabolism of ischemic myocardium significantly protection;3、Wenshen Huoxue(Sanxian yangxin capsule) is an effective method of treatment of coronary artery disease,its mechanism may be through the improvement of cardiac hemodynamics and reduced myocardial oxygen consumption has played the role of anti-myocardial ischemia.Wenshen Huoxue Act further explore the mechanism,which has yet to be done so the next large-scale pilot study;4、To explore this topic both temporary and permanent cures of law,and simple control of angina pectoris compared to some drugs,this emphasis on temperature,while promoting blood circulation to cause kidney,which is the prevention of recurrent coronary heart disease have a more important significance,but also in the treatment of a disease for the advantage.Conclusion:1,Wenshen Huoxue(Sanxian yangxin capsules) can significantly lower in dogs with acute myocardial infarction the extent of myocardial infarction,reduce the scope of myocardial infarction can reduce the size of myocardial infarction,reduce the enzyme,so as to reduce the myocardial cell damage,of acute myocardial ischemia has a significant therapeutic effect;2,Wenshen Huoxue(Sanxian yangxin capsules) to the expansion of coronary blood vessels,increase coronary blood flow and improve myocardial blood supply; to reduce coronary resistance and peripheral resistance reduce myocardial oxygen consumption;by increasing cardiac output,cardiac output,cardiac index,cardiac index, improve heart pump function,significantly improved cardiac hemodynamics and oxygen metabolism of ischemic myocardium hassignificantly retaining the role of insurance;3,the goods against the role of myocardial ischemia was stronger than the positive control group, and the former effect quickly,the role of strong and lasted for a long time.更多还原