活心方加載治療對冠心病患者炎性因子的影響及相關機制研究中文摘要

1、活心方加載治療對冠心病患者炎性因子的影響及相關機制研究 中文摘要目的 1、 本研究采用隨機、對照方法，觀察活心方加載治療對氣虛血瘀型冠心病患者的臨床中醫(yī)癥候積分、生活質(zhì)量表積分及炎性相關因子（IL-18、MMP-9、PPAR-）的療效作用。In this study, a randomized and controlled method was used to observe the therapeutic effects of live-heart-loaded therapy on TCM syndromes, scores of quality of life and inflammat

2、ory correlation factors (IL-18, MMP-9, ppar-) in patients with coronary heart disease with QI deficiency and blood stasis.2、 通過培養(yǎng)體外心肌細胞，觀察缺氧條件下活心方加載干預后，心肌細胞IL-18、MMP-9、PPAR-、HIF-1基因表達的變化，來探討活心方對缺氧心肌細胞的影響，是否能抑制其炎癥反應及提高缺氧心肌細胞活性的作用。Observing the effect of living heart on hypoxia cardiomyocytes, and whe

3、ther it could inhibit the inflammatory reaction and enhance the activity of hypoxia cardiomyocytes by culturing cardiomyocytes in vitro and observe the changes of IL-18, MMP-9, PPAR- and hif-1 gene expression in cardiomyocytes were studied.方法1、 臨床部分：本研究通過隨機對照的方法，將符合為冠心病氣虛血瘀型的患者60 例，隨機分為活心方加載組（簡稱治療組）

4、及常規(guī)治療組（簡稱對照組），每組各30 例，常規(guī)治療組給予單純西藥治療，活心方加載組則在常規(guī)西藥治療的基礎上加服活心方（免煎顆粒劑），3個月為一療程，分別在治療前、治療后檢測患者血清IL-18、MMP-9、PPAR-指標，記錄中醫(yī)癥候積分、進行生活質(zhì)量評價，并整理數(shù)據(jù)，進行統(tǒng)計分析，對結果分析討論。The part of clinic: In this study, 60 patients with coronary heart disease with QI deficiency and blood stasis were treated by randomized controlled m

5、ethod, randomly divided into live heart loading group (referred to as the treatment group) and conventional treatment group (referred to as the control group), each group of 30 cases, the conventional treatment group to give simple Western medicine treatment, live heart loading group on the basis of

6、 conventional Western medicine treatment to add the living heart ( No-frying granules), 3 months for one course of treatment, respectively, before and after treatment, recording the patients serum IL-18, MMP-9, PPAR- indexes, assessing the syndromes of TCM syndromes and evaluating the quality of lif

7、e, disposal the data to collating and analyzing it. Finally, analyzing and discussing the results.2、 實驗部分：對體外心肌細胞（AC16）繼代培養(yǎng)并進行實驗，通過CCK-8與藥物最大有效率預實驗測定合適活心方濃度。對培養(yǎng)后的心肌細胞分組：包括常氧對照組（Normoxia組），缺氧不加藥組（No HXF mean組）和缺氧加藥組（HXF mean組），分別采用PCR、Western blot方法檢測各組分別在24、48、72h的IL-18水平及蛋白表達變化趨勢，并進行分析討論。The part o

8、f experiment: In vitro culture of cardiomyocytes (AC16) and experimental, through the CCK-8 and drugs to determine the maximum efficiency of the test of the appropriate living heart concentration. Grouping of cultured cardiomyocytes: including oxygen control Group (Normoxia group), hypoxia without d

9、rug group (no HXF mean group) and hypoxia plus drug group (HXF mean Group), respectively using PCR, Western blot method to detect each group in 24, 48, 72h of IL-18、MMP-9、PPAR-、HIF-1mRNA levels and protein expression, and analyzing and discussing it. 結果 1、 臨床研究：（1）活心方加載組患者中醫(yī)癥候積分較常規(guī)治療組明顯降低（P0.05），有效率

10、達（96%）；（2）活心方加載組患者生活質(zhì)量量表積分較常規(guī)治療組明顯升高（P0.05)；活心方加載組患者血清MMP-9水平較常規(guī)治療組明顯下降，兩組相比差異有統(tǒng)計學意義（P0.05）；活心方加載組患者血清PPAR-水平較常規(guī)治療組明顯升高，兩組相比差異有統(tǒng)計學意義。The research of clinic: (1) The TCM symptom points of the patients in the live heart loading group were significantly lower than those in the conventional treatment gr

11、oup, effective rate is 96% (P0.05); (2) The quality of life scale of patients with live heart loading group was significantly higher than that of conventional treatment group. （P0.05); The serum MMP-9 level of the patients in the live Heart loading group was significantly lower than that in the conv

12、entional treatment group, it is statistically significant by comparing its difference (P0.05); The serum PPAR- level of the patients with live heart loading group was significantly higher than that in the conventional treatment group, and it is statistically significant by comparing its difference.

13、（P0.05） 2、 體外實驗研究：（1）CCK-8與藥物最大有效率預實驗：選取合適活心方濃度為1，活心方對常氧下正常心肌細胞無顯著影響（)；（2）缺氧處理6h后，心肌細胞IL-18、MMP-9、HIF-1的表達水平升高，PPAR-表達水平的下降；（3）缺氧情況下，加入活心方干預后，缺氧加藥組心肌細胞IL-18、MMP-9的表達水平明顯低于缺氧不加藥組（P0.05），缺氧加藥組PPAR-、HIF-1的表達水平明顯高于缺氧不加藥組（P0.05);(2) After hypoxia treatment 6h, the expression level of IL-18, MMP-9 and hif

14、-1 of cardiac myocytes increased, PPAR- expression level decline; (3) Under the condition of hypoxia, the expression level of IL-18 and MMP-9 of cardiomyocytes in hypoxia plus drug group was significantly lower than that of hypoxia without drug group (P0.05and the expression level of PPAR- and hif-1

15、 in hypoxia plus drug group was higher than that of hypoxia without drug group ( P0.05)結論 1、 活心方加載治療冠心病患者能降低炎性因子MMP-9水平，促進PPAR-水平表達，能改善患者臨床癥狀，提高生活質(zhì)量。The treatment of coronary heart disease with live heart can reduce the MMP-9 level of inflammatory factor, promoting the expression of PPAR- level, imp

16、roving the clinical symptom of patients and enhancing the quality of life.2、 在缺氧情況下，心肌細胞的HIF-1、MMP-9、IL-18的表達水平有所升高，PPAR-的表達水平有所下降，活心方能有效降低IL-18、MMP-9的表達，能提高HIF-1、PPAR-的活性，抑制炎癥反應；增強低氧適應性，從而起到保護心肌細胞的作用。Under the condition of oxygen-poor, the expression level of hif-1, MMP-9 and IL-18 of cardiomyocytes will increased, the expression level of PPAR- decreased, the expression of IL-18 and MMP-9 could be reduced effectively, and the activity of hif-1 and PPAR- could be improved and the inflammation reaction could be