试析理气活血化痰通络法治疗不稳定性心绞痛的临床及实验研究.pdfVIP

提 要 目的：通过对不稳定性心绞痛患者临床表现及病因机的的研究，认为气滞痰瘀互 组、心络受损是其重要的发病机制，理气活血化痰通络是其重要的治法，并以此拟方 舒心活络饮，旨在观察理气活血化痰通络法治疗不稳定性心绞痛的临床疗效并探讨其 作用机制。方法：临床观察以西医常规治疗加舒心活络饮为治疗组，以西医常规治疗 为对照组，共观察 60 例患者(治疗组 30 例,对照组 30 例) 。观察其临床症状、心电图、 血压、血脂、血液流变学、CD62p、CD63 等指标。动物实验采用 Wistar 大鼠 60 只， 复制异丙肾上腺素致急性心肌缺血模型，观察舒心活络饮对其心电图、SOD、MDA 、 ET 、TXB2 的影响。结果：临床观察表明,中药治疗组在改善患者临床症状,调血脂、 降血压,降低血液粘度和血小板活化等方面均优于对照组(P0.01 或 P0.05) 。动物实 验研究表明,舒心活络饮可明显改善急性心肌缺血大鼠心电图缺血性改变,降低MDA 、 ET 、TXB2 ，提高NO 水平和 SOD 含量。结论：理气活血化痰通络法能缓解冠脉痉挛, 改善血管内皮功能,清除氧自由基,抑制脂质过氧化,降低血液粘度和血小板活化,从而 起到延缓动脉粥样硬化,防止血栓形成的作用，说明理气活血化痰通络法是治疗不稳 定性心绞痛的重要的治法。 关键词 理气活血化痰通络法；不稳定性心绞痛；胸痹心痛；舒心活络饮 The Study of Clinical and experimental research to regulate qi and promote blood circulation and reduce phlegm in the collaterals in the treament of unstable angina Spacilicity: cardioangiology of combination of TCM and west medicine Author: LiuYiZong Tutor: DuanXuezhong Abstract Objective:We hypothesize that stagnation of qi and blood and damage of heart collaterals are important casual mechanism of UA,and the way of regulating qi , promoting blood circulation and reducing phlegm in the collaterals are effective treatment principle through extensive empirical studies of clinical sympotom and pathology of UA patients.Based on that,we developed a concrete treatment approach Shuxinhuoluo Yin,aiming to study the efficacy and mechanism of this approach.Methods:Forthe clinical research, devided 60 patients into two groups, the treatment group(30patients) and the comparative group(30patients),and treat them separately with Shuxinhuoluo Yin besides common west medicine and common west medicine.And study the clinical sympto