本文選題：創(chuàng)傷修復(fù) + 冠心病��； 參考：《北京中醫(yī)藥大學(xué)》2015年博士論文

【摘要】：本文包括文獻(xiàn)綜述及課題研究?jī)刹糠郑痪C述分為中醫(yī)綜述和西醫(yī)綜述,課題研究分為臨床觀察和基礎(chǔ)實(shí)驗(yàn)研究。一、文獻(xiàn)綜述文獻(xiàn)綜述從中醫(yī)和西醫(yī)兩方面詳細(xì)的論述了對(duì)冠心病介入治療遠(yuǎn)期預(yù)后的現(xiàn)有研究和認(rèn)識(shí),為更科學(xué)的防治冠心病的進(jìn)展及各種并發(fā)癥提供理論支持。二、臨床研究目的：觀察益氣涼血生肌方對(duì)冠心病介入術(shù)后患者遠(yuǎn)期心血管事件及生存質(zhì)量的影響。方法：采用臨床隨訪的方法,將國(guó)家中醫(yī)藥管理局中醫(yī)藥科研專項(xiàng)課題(2005)97例冠心病介入治療后7.5～9.1年的患者,分為51例中藥治療組和46例對(duì)照組,觀察7.5-9.1年后遠(yuǎn)期心血管事件發(fā)生情況、二級(jí)預(yù)防情況、遠(yuǎn)期心血管事件干預(yù)因素、生存曲線情況,對(duì)兩組間數(shù)據(jù)進(jìn)行統(tǒng)計(jì)比較分析。結(jié)果：①與對(duì)照組相比中藥治療組的遠(yuǎn)期復(fù)發(fā)心絞痛、心肌梗死、心衰和心源性死亡的單獨(dú)心血管事件發(fā)病率無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05),但是所有心血管事件發(fā)病率與對(duì)照組比較具有統(tǒng)計(jì)學(xué)差異(P0.05)；②兩組在規(guī)律治療及良好生活習(xí)慣等冠心病二級(jí)預(yù)防方面無(wú)統(tǒng)計(jì)學(xué)差異；③中藥干預(yù)(服用益氣涼血生肌方)和定期門診復(fù)查進(jìn)入了Logistic回歸(P0.05),兩者對(duì)心血管事件有保護(hù)作用；與對(duì)照組相比中藥治療組遠(yuǎn)期生存曲線有更好趨勢(shì),但沒有統(tǒng)計(jì)學(xué)上的差異(P0.05)結(jié)論：①早期服用益氣涼血生肌方可降低冠心病介入治療后遠(yuǎn)期心血管事件的發(fā)生率。②益氣涼血生肌方改善冠心病介入治療的遠(yuǎn)期預(yù)后。三、基礎(chǔ)實(shí)驗(yàn)研究目的：基于中醫(yī)創(chuàng)傷修復(fù)理論,觀察益氣涼血生肌方對(duì)血管內(nèi)皮細(xì)胞增殖遷移及損傷修復(fù)的作用,探討益氣涼血生肌方改善冠心病介入術(shù)后遠(yuǎn)期預(yù)后的作用機(jī)制。方法：采用體外實(shí)驗(yàn)的方法,對(duì)人臍靜脈內(nèi)皮細(xì)胞(HUVECs)損傷造模,分為益氣涼血生肌中藥組、ARB西藥組、中西醫(yī)結(jié)合組、模型組、對(duì)照組；采用CCK-8法檢測(cè)細(xì)胞增殖率、透射電鏡觀察細(xì)胞超微結(jié)構(gòu)變化、活細(xì)胞工作站檢測(cè)細(xì)胞遷移率、硝酸還原法檢測(cè)一氧化氮(NO)濃度、熒光探針法檢測(cè)活性氧自由基(ROS)含量、酶聯(lián)免疫吸附法檢測(cè)內(nèi)皮素(ET-1)濃度、RT-PCR檢測(cè)ET-1蛋白基因表達(dá)水平等；并對(duì)組間數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析比較。結(jié)果：①與模型組相比,益氣涼血生肌方組和ARB西藥組均對(duì)損傷后的內(nèi)皮細(xì)胞具有增殖作用且細(xì)胞增殖率50%,兩者增殖率相比無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),中西醫(yī)結(jié)合治療組與中藥組和西藥組兩者相比均有統(tǒng)計(jì)學(xué)差異(P0.05)；②與模型組比較,中藥組、ARB西藥組和中西醫(yī)結(jié)合組透射電鏡下?lián)p傷內(nèi)皮細(xì)胞的細(xì)胞核邊界清楚、內(nèi)質(zhì)網(wǎng)增多增密、線粒體數(shù)目增加,中藥組和中西醫(yī)結(jié)合組的內(nèi)質(zhì)網(wǎng)折疊更明顯,線粒體飽滿、數(shù)目較西藥組增多;③與模型組相比ARB西藥組和中西醫(yī)結(jié)合組細(xì)胞遷移顯著加快(P0.05),中西醫(yī)結(jié)合組優(yōu)于ARB西藥組,中藥組整體遷移曲線優(yōu)于模型組,但未表現(xiàn)出明顯的差異(P0.05)；④與模型組相比,進(jìn)行藥物干預(yù)后N0含量上升(P0.05),ROS無(wú)明顯差異、ET-1含量下降(P0.05),中西醫(yī)結(jié)合組的促NO釋放、抑制ET-1釋放作用與中藥組和ARB西藥組相比有統(tǒng)計(jì)學(xué)差異(P0.05)；⑤ RT-PCR示模型組的Ct均值高于對(duì)照組,藥物干預(yù)后Ct均值下降,中藥組和中西醫(yī)結(jié)合組均值低于西藥組,治療后血管內(nèi)皮細(xì)胞的ET-1基因表達(dá)含量降低,但沒有統(tǒng)計(jì)學(xué)顯著性差異(P0.05)結(jié)論：①益氣涼血生肌方對(duì)損傷性血管內(nèi)皮細(xì)胞有促進(jìn)增殖的作用；②益氣涼血生肌方減輕血管內(nèi)皮細(xì)胞的超微結(jié)構(gòu)的損傷；③益氣涼血生肌方對(duì)血管內(nèi)皮細(xì)胞損傷劃痕模型有促遷移的作用；④益氣涼血生肌方增加血管活性物質(zhì)N0的釋放、減輕細(xì)胞損傷因子ET-1的濃度,并影響ET-1蛋白基因表達(dá)水平。⑤中西醫(yī)結(jié)合治療對(duì)血管內(nèi)皮細(xì)胞的增殖、遷移、細(xì)胞超微結(jié)構(gòu)、細(xì)胞因子濃度及基因表達(dá)的損傷修復(fù)作用優(yōu)于單純中藥治療或西藥治療。
[Abstract]:This paper includes two parts : literature review and subject research .
This review is divided into a review of TCM and a review of western medicine . The study is divided into clinical observation and basic experiment research . The clinical research aim : To observe the effect of Yiqi Liangxue Shengji on the long - term cardiovascular events and the quality of life of coronary heart disease after interventional therapy .
( 2 ) There was no statistical difference between the two groups in the secondary prevention of coronary heart disease , such as regular treatment and good living habits ;
( 3 ) Logistic regression ( P0.05 ) was entered into the traditional Chinese medicine intervention ( taking Yiqi Liangxue Shengji Fang ) and regular clinic examination , both had protective effect on cardiovascular events ;
Objective : To observe the effect of Yiqi Liangxue Shengji on the long - term prognosis of coronary heart disease after percutaneous coronary intervention .
CCK - 8 method was used to detect the cell proliferation rate , the ultrastructural changes of the cells were observed by transmission electron microscope , the concentration of nitric oxide ( NO ) was detected by the living cell workstation , the concentration of nitric oxide ( NO ) was detected by nitrate reduction method , the concentration of reactive oxygen free radical ( ROS ) was detected by fluorescence probe method , the concentration of ET - 1 was detected by enzyme linked immunosorbent assay , and the expression level of ET - 1 protein gene was detected by RT - PCR .
Results : 鈶，

本文編號(hào)：1918823