【作者】 彭敏；

【导师】 丁书文；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2008， 博士

【摘要】 理论研究阐明热毒在急性冠状动脉综合征中的发病中的重要地位,提出热毒是血栓形成的始动因素、热毒导致血栓形成的靶部位是络脉的论点,并立清热解毒通络法,通过实验及临床研究验证解毒通络合剂对血栓形成的治疗作用。动物实验观察解毒通络合剂对角叉菜胶所致大鼠尾部血栓形成的影响,用角叉菜胶构建尾部血栓模型,观察不同时间的黑尾长度,查AT-Ⅲ活性、D-二聚体含量,及炎性因子IL-1β、TNF-α的含量。研究结论解毒通络合剂有减轻角叉菜胶所致的大鼠尾部血栓形成的作用,通过预防性给药,可以使IL-1β、TNF-α值降低,抑制炎症反应,使AT-Ⅲ活性活性增强,D-二聚体含量降低,从而减轻血栓形成,而中剂量即是其发挥疗效的最佳剂量。临床观察解毒通络合剂治疗不稳定型心绞痛患者的疗效,对照组45例,采取西药常规治疗,试验组48例,加服解毒通络合剂,疗程4周。研究显示解毒通络合剂治疗不稳定型心绞痛有较好的疗效,能减轻炎症反应,改善血管内皮功能,改善血液粘聚状态,改善心功能。临床观察解毒通络合剂干预介入术后心绞痛的作用,对照组14例,予西药常规治疗,试验组20例,加服解毒通络合剂,疗程3个月。研究结果解毒通络合剂对介入术后复发心绞痛有较好的疗效,能减轻炎症反应,调节凝血与纤溶。更多还原

【Abstract】 Theoretical study elucidates that heat-toxin play an important role in the pathogenesis of acute coronary syndrome, it is the initial factor of thrombosis, and the target position is collateral. Hereby establish therapeutic principle of clearing heat, dispelling toxin and dredging collateral, and then validate the curative effect of Dispelling toxin and dredging collateral mixture on thrombosis through experimental and clinical research.Animal experiment observed the effect of Dispelling toxin and dredging collateral mixture on thrombisis. Carrageen used to make the tail thrombus model, measured the length of black tail at different time and examed the activeness of AT-III and the content of D-dimer, as well as the content of inflammatory factor IL-1β、TNF-α. Drew conclusion that Dispelling toxin and dredging collateral mixture had the function of alleviating the thrombus caused by carrageen. Through preventive administration, Dispelling toxin and dredging collateral mixture can decrease the value of IL-1βand TNF-α, inhibit the inflammatory reaction, also can enhance the activity of AT-Ⅲand reduce the content of D-dimer, thus alleviate thrombosis. The middle dose of Dispelling toxin and dredging collateral mixture is found the optimal dose to be effective.Clinical research observed the effect of Dispelling toxin and dredging collateral mixture on unstable angina. The control group,45 patients,treated with the routine therapy, while the test group,48 patients,added Dispelling toxin and dredging collateral mixture, treatment last for four weeks. The results show that Dispelling toxin and dredging collateral mixture has a very good therapeutic effect on unstable angina, and can alleviate the inflammation, improve the function of VEC, abate the blood mucosity and increase heart function. The other clincal research observed the intervention of Dispelling toxin and dredging collateral mixture on angina recurrence. The control group,14 patients,treated with routine medicine while the test group,20 patients,added Dispelling toxin and dredging collateral mixture, treatment last for three months. The results show that Dispelling toxin and dredging collateral mixture has curative effect on angina recurrence postoperation PCI, and can alleviate inflammation and adjust cruor and fibrinolysis.更多还原