活心方加载治疗对冠心病患者炎性因子的影响及相关机制研究中文摘要目的1、本研究采用随机、对照方法,观察活心方加载治疗对气虚血瘀型冠心病患者的临床中医症候积分、生活质量表积分及炎性相关因子(IL-18、MMP-9、PPAR-γ)的疗效作用。Inthisstudy,arandomizedandcontrolledmethodwasusedtoobservethetherapeuticeffectsoflive-heart-loadedtherapyonTCMsyndromes,scoresofqualityoflifeandinflammatorycorrelationfactors(IL-18,MMP-9,ppar-γ)inpatientswithcoronaryheartdiseasewithQIdeficiencyandbloodstasis.2、通过培养体外心肌细胞,观察缺氧条件下活心方加载干预后,心肌细胞IL-18、MMP-9、PPAR-γ、HIF-1α基因表达的变化,来探讨活心方对缺氧心肌细胞的影响,是否能抑制其炎症反应及提高缺氧心肌细胞活性的作用。Observingtheeffectoflivingheartonhypoxiacardiomyocytes,andwhetheritcouldinhibittheinflammatoryreactionandenhancetheactivityofhypoxiacardiomyocytesbyculturingcardiomyocytesinvitroandobservethechangesofIL-18,MMP-9,PPAR-γandhif-1αgeneexpressionincardiomyocyteswerestudied.方法1、临床部分:本研究通过随机对照的方法,将符合为冠心病气虚血瘀型的患者60例,随机分为活心方加载组(简称治疗组)及常规治疗组(简称对照组),每组各30例,常规治疗组给予单纯西药治疗,活心方加载组则在常规西药治疗的基础上加服活心方(免煎颗粒剂),3个月为一疗程,分别在治疗前、治疗后检测患者血清IL-18、MMP-9、PPAR-γ指标,记录中医症候积分、进行生活质量评价,并整理数据,进行统计分析,对结果分析讨论。Thepartofclinic:Inthisstudy,60patientswithcoronaryheartdiseasewithQIdeficiencyandbloodstasisweretreatedbyrandomizedcontrolledmethod,randomlydividedintoliveheartloadinggroup(referredtoasthetreatmentgroup)andconventionaltreatmentgroup(referredtoasthecontrolgroup),eachgroupof30cases,theconventionaltreatmentgrouptogivesimpleWesternmedicinetreatment,liveheartloadinggrouponthebasisofconventionalWesternmedicinetreatmenttoaddthelivingheart(No-fryinggranules),3monthsforonecourseoftreatment,respectively,beforeandaftertreatment,recordingthepatients’serumIL-18,MMP-9,PPAR-γindexes,assessingthesyndromesofTCMsyndromesandevaluatingthequalityoflife,disposalthedatatocollatingandanalyzingit.Finally,analyzinganddiscussingtheresults.2、实验部分:对体外心肌细胞(AC16)继代培养并进行实验,通过CCK-8与药物最大有效率预实验测定合适活心方浓度。对培养后的心肌细胞分组:包括常氧对照组(Normoxia组),缺氧不加药组(NoHXFmean组)和缺氧加药组(HXFmean组),分别采用PCR、Westernblot方法检测各组分别在24、48、72h的IL-18水平及蛋白表达变化趋势,并进行分析讨论。Thepartofexperiment:Invitrocultureofcardiomyocytes(AC16)andexperimental,throughtheCCK-8anddrugstodeterminethemaximumefficiencyofthetestoftheappropriatelivingheartconcentration.Groupingofculturedcardiomyocytes:includingoxygencontrolGroup(Normoxiagroup),hypoxiawithoutdruggroup(noHXFmeangroup)andhypoxiaplusdruggroup(HXFmeanGroup),respectivelyusingPCR,Westernblotmethodtodetecteachgroupin24,48,72hofIL-18、MMP-9、PPAR-γ、HIF-1αmRNAlevelsandproteinexpression,andanalyzinganddiscussingit.结果1、临床研究:(1)活心方加载组患者中医症候积分较常规治疗组明显降低(P0.05),有效率达(96%);(2)活心方加载组患者生活质量量表积分较常规治疗组明显升高(P<0.05);(3)活心方加载组患者血清IL-18水平较常规治疗组相比没有显著差异(P>0.05);活心方加载组患者血清MMP-9水平较常规治疗组明显下降,两组相比差异有统计学意义(P<0.05);活心方加载组患者血清PPAR-γ水平较常规治疗组明显升高,两组相比差异有统计学意义。Theresearchofclinic:(1)TheTCMsymptompointsofthepatientsinth...