理气活血通络法治疗不稳定性心绞痛的临床及实验研究-中西医结合临床专业论文.docxVIP

提 提 要 目的：本文通过对多例不稳定性心绞痛(unstable an91na，UA)患者临床表现 及病因病机的的研究，认为气滞血瘀、心络受损是其重要的发病机制，理气活血通络 是其重要的治法，并以此拟方疏络定痛饮，旨在观察理气活血通络法治疗UA患者的 l临床疗效和初步探讨其作用机制。方法：将62例uA患者随机分为疏络定痛饮治疗 组32例和对照组30例，两组均加服常规药物。分别对两组患者进行临床症状、心电 图改变、血脂、血压、心功能等临床观察；制作60只SD大鼠气滞血瘀型急性心肌 缺血模型成功后，观察疏络定痛饮对心电图，血栓素B2(TXB2)、ET、SOD、NO、 CD62p、CD63等指标的影响。结果：具有理气活血通络功效的疏络定痛饮可以明显 改善患者的临床症状、心电图、心功能和心肌缺血，降低血脂，对于合并高血压者有 降压作用；动物实验表明：此方可显著改善气滞血瘀型急性心肌缺血大鼠模型心电图 缺血性改变：临床和动物实验均表明：本方可以降低TXB2、ET、CD62p、CD63水 平，提高NO水平和SOD含量。结论：临床和实验研究均证实理气活血通络法可以 从抗心肌缺血缺氧，改善血管内皮功能，降低血小板活化水平，缓解冠状动脉痉挛多 方面有效治疗UA，说明理气活血通络法是治疗UA的重要的治法。 关键词理气活血通络法；疏络定痛饮：不稳定性心绞痛：胸痹心痛 The The Study of clinical and experiment Oil the way of regulating qi，promoting blood circulation and removing obsru ction in the collaterals in treating coronary heart disease and unstable angina Speciality：Internal Medicine Cardioangiology ofTCM(Traditional Chinese Medicine) Author：ZhuShu Advisor：Duan XueZhong Abstract objeetives：We hypothesize that stagnation of qi and blood and damage of heart collaterals are important causal mechanism ofUA，and the way of regulating qi，promoting blood circulation and removing obsruction in the collaterals ale effective treatment principle through extensive empirical studies of clinical symptom and pathology of UA patients．Based on that，we developed a concrete treatment approach shuluodingtongyin， aiming to study the efficacy and mechanism ofthis approach． Methods：We randomly assigned 62 UA patients into treatment(32)and control(30) groups，and we studied two groups in terms of their clinical symptom，change of electrocardiogram，blood lipid，blood pressure，and function ofheart respectively．Based on the successful building acute myocardial model in 60 cases of rats,we were able to compare differences between treatment and control groups in terms of change of electrocardiogram，TXB2，ET,SOD，NO，CD62p，CD63． Results：We found that shuluoding tongyin，which has the efficacy of regulating qi，promoting blood circulation and remo“ng obsruction in the collaterals，obviously