【作者】 孔俊虹；

【导师】 石磊；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：观察益肾活血法对冠心病心绞痛肾虚血瘀证患者的症状改善及其治疗前后一氧化氮(NO)、内皮素(ET)、超氧化物歧化酶(SOD)指标的变化,同时说明对其干预冠心病内皮功能及抗氧化作用,评价益肾活血方治疗冠心病心绞痛的临床疗效、对内皮功能的影响及抗氧化作用。方法：采用随机对照的临床试验方案进行研究。选择2009年4月—2010年2月期间在江苏省中医院心内科住院病人中符合纳入冠心病心绞痛诊断标准及中医肾虚血瘀证患者共50例,按照1：1的比例随机分成治疗组和对照组,在给予西药治疗的基础上,治疗组加用益肾活血方治疗,疗程为4周。观察治疗前后中医症候及ET、NO、SOD的变化。结果：中医症候：两组中医证候积分均有明显改善(P<0.05),治疗组改善程度明显优于对照组(P<0.01)。中医症候临床疗效方面治疗组总有效率为96%,明显优于对照组的68%,两组具有显著性差异(P<0.05)。NO、ET变化：治疗组NO水平较治疗前升高,ET水平下降,两者均有显著性差异(P<0.01)。组间比较治疗后的治疗组NO水平升高优于对照组,有统计学差异(P<0.05)；治疗后的治疗组ET水平下降优于对照组,有显著统计学差异(P<0.01)。SOD变化：治疗组治疗后SOD水平明显升高(P<0.01),对照组治疗后SOD稍升高(P=0.34)；组间比较治疗后治疗组SOD水平升高明显优于对照组,有显著统计学差异(P<0.01)；且两组治疗前后差值比较有显著性差异(P<0.01)。结论：益肾活血方能有效改善冠心病患者的临床症状,中医证候积分改善方面明显优于单纯西药对照组,有较好的临床疗效。益肾活血方明显下调ET水平,上调NO、SOD水平,表明益肾活血方能改善血管内皮功能,提高机体抗氧化能力,延缓动脉粥样硬化的进展。更多还原

【Abstract】 Objective:To observe clinical effect of the principle of Supplementing Kidney and Activating Blood on ameliorating the clinical symptoms of kidney deficiency and blood stasis of Coronary Heart Disease(CHD)-angina pectoris and the changes of nitric oxide (NO),endotheli(ET),superoxide dismutase(SOD) before and after the treatment. To illustate the intervention of the principle of Supplementing Kidney and Activating Blood in coronary endothelial function and antioxidant, and evaluate its clinical effect on CHD-angina pectoris, endothelial function and antioxidant activity.Methods:A randomized single-blind controlled clinical trial is adopted.50 patients were choosed who conform to the CHD-angina pectoris standard and TCM syndrome of kidney deficiency and blood stasis from the heart internal medicine department in JiangSu Province Traditional Chinese medicine hospital during April,2008 to February,2010.According to the ratio of 1:1 composition, the patients were randomly divided into the treatment group and the control group.The treatment group was treated with Supplementing Kidney and Activating Blood Prescription beside the western medicine. The paitients were treated 4 weeks as one treatment course. Observe the changes of Chinses symptoms and ET, NO,and SOD before and after the treatment.Results:TCM syndrome:symptom score in both groups were significantly improved(P <0.05),the treatment group improved significantly better than the control group (P<0.01). The total effective rate of Chinese symptoms was 96%,which was significantly higher than that of the control group(68%).There was significant difference between the two groups (P<0.05).NO, ET:NO level in treatment group increased after treatment, and ET level decreased, both of which were significant difference(P<0.01).Between the two groups after treatment, the increase of NO level in the treatment group was higher than that of the control group, and there was statistical difference (P<0.05);The decrease of ET level after treatment in the treatment group was more significant than that of the control group, and there was significant difference(P＜0.01).SOD:SOD level was significantly higher after treatment in the treatment group(P<0.01), and in the control group it was slightly increased(P=0.34);Between the two groups after treatment, The increase of SOD level in treatment group was more significant than that of the control group, and there was significant difference (P<0.01);and the difference between the two groups before and after treatment were significant (P<0.01).Conclusion: Supplementing Kidney and Activating Blood Prescription could effectively ameliorate the clinical symptoms of coronary heart disease, and the symptom score improvement was better than the control group,so it has good clinical efficacy.It could decrease the level of ET, increase the level of NO,SOD,which indicates that Supplementing Kidney and Activating Blood Prescription could improve endothelial function, improve antioxidant capacity, and delay the progress of atherosclerosis.更多还原