降脂通脉丸治疗高脂血症的临床和实验研究-中西医结合临床专业论文.docxVIP

提 提 要 目的：运用降脂通脉丸治疗高脂血症，并从临床、实验和理论等方面对其降血脂、 保护血管内皮细胞的机理及高脂血症和痰瘀的关系进行探讨。 方法：128例高脂血症患者按照证型、年龄、血脂水平相近的原则随机分成两组。 降脂通脉丸组65例，地奥脂必妥组63例；两组分别给予降脂通脉丸和地奥脂必妥治 疗。观察治疗前后临床症状和实验室指标的变化。35只大鼠喂饲高脂饲料造成高脂 血症模型后，随机分为降脂通脉丸组、地奥脂必妥组和高脂组。三组大鼠均饲以高脂 饲料。同时，降脂通脉丸组和地奥脂必妥组分别灌服降脂通脉丸和地奥脂必妥，观察 实验室指标的变化。 结果：降脂通脉丸组患者用药3个月后，临床症状明显改善，血清总胆固醇(TC)、 甘油三脂(TG)、脂蛋白LP(a)水平降低，而高密度脂蛋白胆固醇(HDL。c1水平升 高。临床症状改善和降脂总有效率均为93．8％，明显优于对照组地奥脂必妥组 (P0．05)。同时，患者血清内血管皮素(ET)、丙二醛(MDA)、氧化型低密度脂蛋 白(LDL-c)含量以及内皮素／降钙素基因相关肽(CGRP)、内皮素／一氧化氮(ET／N0) 的比值明显降低，一氧化氮(NO)、超氧化物歧化酶(SOD)活性明显升高，且降低 和升高的疗效明显优于对照组(P0．05)。动物实验研究证实了降脂通脉丸具有与临 床相同的降脂、抗氧化、调节血管活性物质的作用。另外，大鼠血管病理切片显示： 降脂通脉丸具有明显的保护血管内皮，抑制脂质沉积和泡沫细胞的形成等作用。 结论：降脂通脉丸具有明显的缓解临床症状，降低血脂水平和保护血管内皮的作 用。从而在一定程度上说明了高脂血症和痰瘀有密切的关系。 关键词高脂血症；降脂通脉丸；中医药疗法 Clinical Clinical and Experimental Study on Tongmaijianzhi Pills in Treating Hyperlipidemia Specialty：The Study of Cardiovascular Diseases，Internal Medicine of Integrated Traditional Chinese and Western Medicine Author：Sun Chuanqi Tutor：Professor Guo Weixing Abstract objective：To observe the clinical effect of Tongmaijianzhi Pills rTMJZ)on hyperlipidemia and to explore the relationship between hyperlipidemia and phlegmatical disease． Methods：128 cases of patients with hyperlipidemia were divided into two groups according to their symptoms，ages，and the principle of leveled blood fat,of which 65 cases were treated witll TMJZ and 63 wi也Di’aozhibituo(DAZBT)．The changes of clinical sympotoms and laboratory indexes in all the patients were observed before and after treatment．35 rats witll hyperlipidemia were divided randomly into TMJZ group．DAZBT group and Blood Fat group．The three groups were fed晰t11 11i曲fat diet and TMJZ group and DAZBT group were given TMJZ and DAZBT respectively at the same time． Laboratory indexes in all the rats were determined． Results：After three months’treatment with TMJZ，clinical symptoms were effectively improved．The serum total cholesterol(TC)，triglyceride(TG)，lipoprotein(a) 【LP(a)】in the patients decreased wlfile the serum hi曲density