【作者】 栗明；

【导师】 栗德林；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2007， 博士

【摘要】 本论文全面深入地总结中、西医对糖尿病并发冠心病病因病机及诊治进展，并结合导师临床实践经验，对其诊治糖尿病并发冠心病的主要学术思想和临床经验进行系统的总结。通过实验研究观察芪玄益心胶囊治疗糖尿病并发冠心病的疗效，采用免疫组化、原位杂交技术评价芪玄益心胶囊对相关细胞因子的影响，进而探讨其治疗作用机理。结果表明：(1)芪玄益心胶囊可以明显降低实验性糖尿病大鼠的血糖、糖化血清蛋白及血脂水平，升高血清胰岛素；可明显改善垂体后叶素造成的心肌缺血损伤，对抗T波的升高，改善心脏功能，抑制心肌酶的释放。(2)芪玄益心胶囊能够抑制糖尿病大鼠胰腺中NF-κB、IκBα的降解，进而抑制NF-κB的激活，且其各剂量对胰腺作用均优于丹参滴丸，而高剂量则优于美吡达；芪玄益心胶囊各剂量均能抑制糖尿病大鼠急性缺血心肌中NF-κB与IκBα的分解，进而抑制NF-κB的激活，且疗效优于美吡达，而高剂量芪玄益心胶囊疗效则优于丹参滴丸。(3)芪玄益心胶囊各剂量组能够明显降低糖尿病大鼠胰腺组织中IL-1β蛋白与其mRNA表达水平，其作用优于丹参滴丸，高剂量优于美吡达；芪玄益心胶囊各剂量组能够明显降低糖尿病大鼠急性缺血心肌组织中IL-1β蛋白及其mRNA的水平，且其作用优于美吡达组，高剂量组疗效优于丹参滴丸组。(4)形态学研究：HE染色和电镜结果观察到芪玄益心胶囊对缺血心肌和胰腺有确切的保护作用。高剂量组效果最好，其作用分别优于美吡达组及丹参滴丸组。更多还原

【Abstract】 This thesis summarized comprehensively the progress of pathogeny, pathology, therapy and diagnose of diabet accompanied by coronary heart disease in the area of traditional Chinese medical and modern medical. This thesis also systematically summarized academic idea of diagnose and treatment for diabet accompanied by coronary heart disease by Dr. Linde Li, which was based on the large number of clinical cases. Treatment effect of capsule Qixuanyixin on diabet accompanied by coronary heart disease was observed in vivo. Using the mechanism of capsule Qixuanyixin against diabet accompanied by coronary heart disease was investigated using immunohistochemical and molecular biology technology.(1) The results showed that capsule Qixuanyixin reduced blood glucose, glycosylated serum protein, and blood-fat, elevated Ins. It can significantly improve posterior pituitary induced myocardial ischemia and cardiac function. It can inhibit release of myocardial enzymes. ( 2 ) Capsule Qixuanyixin inhibit the degradation of NF-κB and IκBα, and also inhibit the activation of NF-κB in acute myocardial ischemia of diabetic rat model. The protective effect to acute myocardial ischemia in each concentration was better than Minidiab. The effect of capsule Qixuanyixin in the high concentration was superior to Danshendiwan. Capsule Qixuanyixin could inhibit the degradation of NF-κB与IκB aprotein and the activation of NF-κB in pancreas. The protective effect to pancreas in each concentration was better than Danshendiwan. The protective effect was superior to Minidiab in high concentration of capsule Qixuanyixin. (3) Capsule Qixuanyixin reduced the protein and mRNA products of IL-1βin both myocardial tissue and pancreas tissue in acute myocardial ischemia of diabetic rats model in all tested concentrations. The effect was better than Minidiab and Danshendiwan control in high concentration. (4) Morphology study showed that the protective effects of capsule QiXuanyixin to ischemia myocardial and pancreas in the high concentration were superior to Minidiab and Danshendiwan respectively by HE stain and electro-microscope observation.更多还原