【摘要】 目的:观察血府逐瘀汤对兔心肌缺血再灌注损伤的保护作用,为其临床上治疗心肌梗死等疾病,促进心功能的恢复提供理论依据。方法:实验于2005-05在河北省职工医学院病理生理学教研室完成,清洁级大耳白兔40只,雌雄不限,体质量2.0～2.3kg。随机分组5组,每组8只,即假手术组,模型组,血府逐瘀汤0.78g/mL组、血府逐瘀汤1.46g/mL组、血府逐瘀汤2.34g/mL组。血府逐瘀汤:当归9g,生地9g,桃仁12g,红花9g,枳壳6g,赤芍6g,柴胡3g,甘草6g,桔梗4.5g,川芎4.5g,牛膝9g。煎前经清水漂洗,蒸馏水浸泡30min后,直火煮沸30min,药渣再加蒸馏水,煎沸20min,合并两次滤液、过滤,浓缩至每毫升含生药0.78g、1.46g及2.34g3种,冷藏备用,生药由保定市中药公司提供。假手术组与模型组生理盐水灌胃,血府逐瘀汤组分别以0.78g/mL,1.46g/mL,2.34g/mL血府逐瘀汤药液灌胃10mL/d,共7d,末次灌胃1h后行手术。采用结扎兔左冠状动脉前降支的方法制备缺血再灌注模型,观察血府逐瘀汤对兔血清中磷酸激酶,心肌组织的丙二醛、超氧化物歧化酶、肌酸激酶含量的影响;对心电图ST段的影响;对血液流变学的影响。采用光镜观察,标本用甲醛固定,石蜡包埋,苏木精-伊红染色,400倍光镜观察心肌形态结构。结果:实验动物全部进入结果分析。①兔心肌缺血再灌注后模型组心肌组织肌酸激酶、丙二醛含量与假手术组比较差异显著[(155.469±29.196),(250.415±37.533)U/mg;(6.474±1.741),(3.278±0.782)μmol/g;P<0.01];血府逐瘀汤0.78g/mL,1.46g/mL,2.34g/mL组肌酸激酶、丙二醛含量、超氧化物歧化酶、磷酸激酶与模型组比较差异显著(P<0.01)。②模型组ST段显著抬高,同模型组比较,血府逐瘀汤0.78g/mL,1.46g/mL,2.34g/mL组ST段抬高的程度呈下降趋势。③血府逐瘀汤1.46g/mL,2.34g/mL组全血黏度(5s-1,30s-1,200s-1)、血浆比黏度、纤维蛋白原与对照组比较差异均有显著性(P<0.01～0.05)。④假手术组心肌形态结构基本正常,有少量中性粒细胞浸润;模型组有心肌间质出血、细胞变性、组织灶性坏死和炎性细胞浸润,有较大范围细胞凝聚、崩解;血府逐瘀汤0.78g/mL组少量细胞变性、组织灶性坏死,血府逐瘀汤1.46g/mL,2.34g/mL组仅有少量炎细胞浸润和间质出血。结论:血府逐瘀汤通过抑制脂质过氧化反应,减少对超氧化物歧化酶的消耗,减少血清中磷酸激酶、心肌组织中的丙二醛,有效的保护心肌细胞,对心肌缺血再灌注损伤有较强的保护作用。更多还原

【Abstract】 AIM: To observe the effect of xuefu zhuyu decoction on ischemia-reperfusion injury of myocardium of rabbits and provide evidence for treatment of myocardial infarction and recovery of cardiac function in clinic.METHODS: The experimentation was completed at Department of Pathophysiology, Hebei Staff and Workers Hospital in May 2005. Totally 40 rabbits, with big ears, of clean grade, of either gender, weighting 2.0-3.0 kg, were divided randomly into 5 groups: sham operation group, model group, xuefu zhuyu decoction group of 0.78 g/mL, 1.46 g/mL and 2.34 g/mL with in each group. The prescription of xuefu zhuyu decoction consisted of angelica 9 g, shengdi 9 g, peach 12 g, safflower 9 g, zhike 6 g, paeonia veitchii Lynch 6 g, chaihu 3 g, licorice 6 g, jiegeng 4.5 g, chuanxiong 4.5 g and niuxi 9 g. Before decoction, xuefu zhuyu decoction was rinsed with water, doused in distilled water for 30 minutes, boiling for 30 minutes with normal fire, boiling of the medical remainder with new distilled water for another 20 minutes, filtrated the mixture of twice medical liquids, concentrated to the different xuefu zhuyu decoction consistency (0.78 g, 1.46 g and 2.34 g), then bestowed in refrigeration. The raw material was provided by Traditional Chinese Medicine Company of Baoding. Rabbits in the sham operation group and the model group were perfused with saline, but rabbits in xuefu zhuyu decoction group were perfused with 0.78 g/mL, 1.46 g/mL and 2.34 g/mL xuefu zhuyu decoction especially with 10 mL per day for 7 successive days. Then the operation was performed after the last perfusion. Models of ischemia-reperfusion injury was established with the branch-ligation of left coronary artery so as to observe effect of xuefu zhuyu decoction on contents of phosphokinase (CPK) in rabbit serum, malondialdehyde (MDA), superoxide dismutase (SOD) and creatine kinase (CK) in myocardium tissue, on ST segment of electrocardiograph, and on hemorheology. Structures of cardiac muscle were observed with light microscope (× 400); and samples were fixed with formaldehyde, embedded with paraffin and stained with haematine-eosin staining. RESULTS: All experimental animals entered the final analysis. ① After ischemia-reperfusion, the contents of CPK and MDA in myocardium tissue in model group were significantly different as compared with those in sham operation group (155.469±29.196), (250.415±37.533) U/mg; (6.474±1.741), (3.278±0.782) μmol/g; P < 0.01, but the contents of CPK, MDA, SOD and CK in xuefu zhuyu decoction group (0.78 g/mL, 1.46 g/mL and 2.34 g/mL) were significantly different as compared with those in model group (P < 0.01). ② ST segment was upward in model group; but increase of ST segment was decreased in xuefu zhuyu decoction groups (0.78 g/mL, 1.46 g/mL and 2.34 g/mL) as compared with that in model group. ③ Viscosity of all blood (5 s-1, 30 s-1, 200 s-1), mucosity of plasma and fibrinogen in xuefu zhuyu decoction groups (1.46 g/mL and 2.34 g/mL) were significantly different as compared with those in control group (P < 0.01-0.05). ④ Form and structure of myocardium were normal in sham operation group, but a few part of infiltration of neutrophilic granulocytes were observed. Hemorrhage of myocardial stroma, cell degeneration, focal necrosis of tissue and infiltration of inflammatory cells were observed in model group and combined with agglomeration and burst apart of cells in a large area. A few of cell degeneration and focal necrosis of tissue were observed in 0.78 g/mL xuefu zhuyu decoction group, and a few of infiltration of inflammatory cells and interstitial hemorrhage were observed in 1.46 g/mL xuefu zhuyu decoction group and 2.34 g/mL xuefu zhuyu decoction group.CONCLUSION: Xuefu zhuyu decoction can reduce the consumption of SOD, decrease CPK in serum and MDA in myocardial tissue, protect myocardial cells, and inhibit ischemia-reperfusion injury of myocardium through inhibiting lipid peroxidation.更多还原