【作者】 胡金霞；

【导师】 安冬青；

【作者基本信息】 新疆医科大学 ， 中医内科学， 2007， 硕士

【摘要】 目的:通过观察中药天香丹治疗冠心病患者的临床疗效及血管内皮生长因子(VESF)、一氧化氮(NO)以及一氧化氮合酶(NOS)含量的影响,进一步从促进血管新生角度来探讨天香丹治疗冠心病的作用机理。方法:将99例冠心病患者随机分为治疗组(天香丹组)36例、对照Ⅰ组(通心络胶囊组)34例,对照Ⅱ组(西医基础治疗组)29例。1月为一疗程,观察患者治疗前后心绞痛发作频率和持续时间、含服硝酸甘油用量以及缓解时间、中医证候综合指标与心电图的变化,并观察血清VESF、NO以及NOS含量的变化。结果:(1)三组患者心绞痛发作频率及持续时间均有明显改善,差异有统计学意义(P<0.01);治疗组与对照Ⅱ组心绞痛发作次数相比,差异有统计学意义(P<0.05)。(2)三组患者含服硝酸甘油用量以及缓解时间均明显减少,差异有统计学意义(P<0.01);治疗组与对照Ⅱ组含服硝酸甘油用量相比,差异有统计学意义(P<0.05)。(3)三组患者心电图均较治疗前改善,差异无统计学意义(P>0.05)。(4)三组患者总体中医综合证候均有改善,差异有统计学意义(P<0.05),治疗组与对照Ⅱ组相比,差异有统计学意义(P<0.01)。(5)三组患者血清NO和VEGF含量均较治疗前明显升高,差异有统计学意义(P<0.01),治疗组患者血清NOS含量较治疗前明显升高,差异有统计学意义(P<0.01);治疗组患者血清NO、NOS和VEGF含量较对照Ⅱ组高,差异有统计学意义(P<0.05),治疗组患者血清NOS含量较对照Ⅰ组高,差异有统计学意义(P<0.05)。结论:天香丹不仅能明显改善冠心病心绞痛患者临床心绞痛症状及中医证候,而且能明显升高血清VEGF、NO以及NOS含量,保护血管内皮功能,舒张血管,增加血流,通过血管新生相关因子的作用,可能使缺血心肌组织发生血管新生,或重塑、修复已有的侧枝循环,恢复血运,以改善心肌缺血,这可能是天香丹治疗冠心病的作用机理之一。更多还原

【Abstract】 Objective: To investigate the effect of Tianxiangdan on serum vascular endothelial growth factor (VEGF) and nitric oxide(NO) / oxide nitric synthase(NOS) in patients with stable angina pectoris. Method: 99 stable angina patients were randomized into three groups, 36 cases as treatment group,in which a basic western medicine combined with Tianxiangdan be applied.34 cases as controlled I group, with basic western medicine combined with Tongxinluo Capsule and another 29 cases as controlled II groupwith basic western medicine combined with Isosorbide Dinitrate Tablet. One courses of treatment which lasted for one month were undergone. While observing the outbreak frequncy, duration of the angina, Dosage and catabatic time of Glonoin keeping in mouth,EKG reading and symptoms of Chinese medicine ,we measure the levels of serum VEGF ,NO and NOS before and after therapy in these three groups. The curative effectiveness was evaluated. Results: (1) After 30 days treatment, the frequency of angina and duration of the angina were significance in the three groups (P<0.01),and the frequency of angina were significance between treatment group and controlled II group (P<0. 05). (2) Dosage and catabatic time of Glonoin keeping in mouth decrease obviously among three groups(P<0. 01).Between treatment group and controlled II group, dosage of Glonoin has significance of statistics (P<0. 05). (3) Three groups improve curative effect of EKG, but the discrepancy in three groups have no signifcance of statistics (P>0.05).(4)Three groups improve the symptoms of Chinese medicine ,therefor the discrepancyhave signifcance of statistics between treatment group and controlled II group(P<0.01). (4) There was no significant difference in serum VEGF, NO and NOS among three groups before treatment (P>0.05).After treatment, the levels of VEGF and NOwere obviously elevated in three group (P<0.01). The levels of NOS in serum were obviously elevated in treatment group. The levels of VEGF,NO and NOS in serum was significant changes between treatment group and controlled II group (P<0. 05) .Between treatment group and controlled I group,the level of NOS in serum has significance of statistics(P<0. 05). Conclusions : Based on Tongbukaixie Law, Tianxiangdan can not only improve angina patients symptom clinical and Chinese Medicinal,but aslo evidently elevate the levels of serum VEGF , No and NOS. It can protect vascular endothelium function in order to improve the lack of oxygen in the cardiac muscle via these vascular angiogan active matter speeding angiogan. That is one of mechanisms curing Coronary heart disease.更多还原