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1、安徽中医学院硕士学位论文益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究姓名：陈浩申请学位级别：硕士专业：中医内科学指导教师：胡业彬20060401益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究英文缩略词表缩略词TNFIL-6AMIECG英文全称Tumor Necrosis FactorInterleukin-6Acute myocardial ischemiaElectrocardiogram中文名称肿瘤坏死因子白细胞介素6急性心肌缺血心电图HRHeartrate心率TXA2PGI2RICHDThromboxane A2Prostaglandin I2Ischemical reperf
2、usion injuryCoronary atherosclerotic heart disease血栓素 A2前列环素缺血再灌注损损伤冠状动脉粥样硬化性心脏病ACSAcutecoronarysyndrome急性冠脉综合征PTCAPCIPercutaneous transluminal coronary angioplastyPercutaneous coronary intervention4经皮冠状动脉腔内成形术经皮冠状动脉介入治疗益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究中文摘要目的：观察益气活血解毒汤对急性心肌缺血大鼠心率、ST段、T波及细胞因子等的干预作用，探讨其治疗急性心肌
3、缺血可能的作用机制。方法:选择Wistar大鼠70只,雌雄各半，随机分为益气活血解毒汤高、中、低剂量组,复方丹参滴丸对照组、消心痛对照组、模型对照组和空白对照组。各组均进行相应灌胃给药。第六天灌胃后30min给予益气活血解毒汤高、中、低剂量组,复方丹参滴丸对照组、消心痛对照组、模型对照组大鼠腹腔注射异丙肾上腺素，空白对照组腹腔注射生理盐水2ml。并同时描记心电图，分别记录造模前、造模后0.5min、1min、2min、5min、10min心电图。第七天灌胃后30min，继续按第六天方法造模，造模后30min处死动物，取血检测肿瘤坏死因子、白细胞介素6等指标，同时观察心肌组织形态学和超微结构改变
4、。各数据采用统计学处理。结果：1.大鼠腹腔注射异丙肾上腺素可造成急性心肌缺血模型。造模后，心电图出现ST段压低、T波低平、倒置；血清肿瘤坏死因子、白细胞介素6升高。2.益气活血解毒汤可以降低ST段总偏移值、减少T波的偏移值；益气活血解毒汤可以降低血清肿瘤坏死因子、白细胞介素6水平；以高剂量组效果最为明显；4.益气活血解毒汤可减轻心肌缺血导致的心肌纤维扭曲紊乱、空泡样变性和间质水肿。可以减轻心肌缺血导致的微细结构变化，保持心肌细胞结构和功能的完整性；5.不同剂量治疗给药有一定的量效关系。结论：1.益气活血解毒汤能降低急性心肌缺血大鼠的ST段偏移，减少T波抬高或降低的平均值。对心肌组织形态学及心肌
5、微细结构的检测也发现益气活血解毒汤具有抗心肌缺血、心肌保护的作用。2.益气活血解毒汤的上述作用很可能与其抑制急性心肌缺血大鼠的炎症反应，降低TNF、IL6的水平而实现的。关键词：益气活血解毒汤急性心肌缺血血清肿瘤坏死因子白细胞介素6ST段、T波偏移心肌组织形态学和超微结构1益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究ABSTRACTObjectiveTo observe the curative effect and investigate the probably mechanismofactionofYiQiHuoXueJieDu(YQHXJD)soupintreatingexper
6、imental acute myocardial ischemia rats.MethodesResultsThe rats were randomly divided into 7 groups: Isosorbide Dinitrate group,FuFangDanShen dripping pills group, YQHXJD groups(including highdosage group,middle dosage group and low dosage group) and placebogroup.Another group were controlled one. Ev
7、ery groups wereadministrated daily until the seventh day. In the sixth day, afteradministrated 30 minutes, the placebo group were injected SodiumChloride into abdominal cavity.The other groups were injected ISO intoabdominal cavity , and then measured ECG in the 0.5min 1min 2min 5min and10min. In th
8、e seventh day, Every groups were treated similar to thesixth day, after injected 30 minutes, The concentrations of TNF-IL-6 were detected and the pathology of myocardium were observed.1.The rat injected ISO into abdominal cavity can lead to acute myocardialischemia.2.After theYQHXJD were administrat
9、ed in AMI rats,it can decrease the depression and elevation of ST segment and Twave. The concentration of TNF- IL-6were decreased.3. the YQHXJD can alleviate the pathological and microstructuralchange in myocardium caused by acute myocardial ischemia.4.There is a certain dose-effect relationship in
10、differentdosage.Conclusion1. TheYQHXJD can decrease the depression and elevation of ST2益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究segment and T wave. The examination in the pathological andmicrostructural change of myocardium indicate that YQHXJDhave effect on anti-myocardium ischemia and myocardium protection.2. The
11、 effect above-mentioned depends most probably on inhibitingInflammatory reaction of acute myocardium ischemia rat, loweringTNF-、IL-6level.Key wordsYiQiHuoXueJieDu(YQHXJD) soup ;Tumor necrosis factor(TNF);Acute myocardial ischemia;Interleukin-6(IL-6 )Depression and elevation of ST segment and T wave;
12、Myocardial pathology and microstructure.3益气活血解毒汤防治实验性急性心肌缺血大鼠的机理研究前言急性心肌缺血（AcuteMyocardialIschemia,AMI）是由于心肌供血不足和/或心肌耗氧量增加，引起一系列心肌血氧供需平衡障碍，可导致心肌坏死。心肌缺血最常见的原因是由于冠状动脉粥样硬化导致冠状动脉管腔狭窄或闭塞，以及在狭窄的基础上发生冠状动脉痉挛而出现急性或慢性心肌供血不足。另外，心肌的耗氧增多，如剧烈运动、情绪激动、快速心律失常、甲亢也可引起心肌缺血1。当前，随着生活方式的改变，冠心病的患病率、致残率和致死率呈逐年上升趋势，已成为影响和危害人民生命健康的主要疾病。根据世界卫生组织（WHO）调查，冠心病是西方国家的主要死因。从较大系列资料看来特别是近十年来我国冠心病死亡率上升趋势。卫生部全国统计年报资料(1996)表明我国部分城市冠心病死亡率为64.25/10万,位于各种疾病首位，同时冠心病的危险因素也在增长。冠心病主要是由于冠状动脉粥样硬化使管腔狭窄或闭塞和或因冠状动脉功能性改变(痉挛)导致心肌缺血、缺氧或坏死而引起的心脏病，亦称缺血性心脏病。其中急性心肌缺血是心绞痛和心肌梗死的
