2023年上海娜娜中文摘要.doc

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 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。 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 inflammatory correlation factors (IL-18, MMP-9, ppar-γ) in patients with coronary heart disease with QI deficiency and blood stasis. 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响及提高缺氧心肌细胞活性的作用。 Observing the effect of living heart on hypoxia cardiomyocytes, and whether 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-γ and hif-1α gene expression in cardiomyocytes were studied. 方法 1、 临床局部：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，活心方加载组那么在常规西药治疗的根底上加服活心方〔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。 The part of clinic: In this study, 60 patients with coronary heart disease with QI deficiency and blood stasis were treated by randomized controlled method, 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 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-γ indexes, assessing the syndromes of TCM syndromes and evaluating the quality of life, disposal the data to collating and analyzing it. Finally, analyzing and discussing the results. 2、 实验局部：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适宜活心方浓度。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〔No HXF mean组〕和缺氧加药组〔HXF mean组〕，分别采用PCR、Western blot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。 The part of 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 drug 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-γ、HIF-1αmRNA levels and protein expression, and analyzing and discussing it. 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。 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 group, effective rate is 96% (P<0.05); (2) The quality of life scale of patients with live heart loading group was significantly higher than that of conventional treatment group. 〔P〕3) There was no significant difference in serum IL-18 level compared with conventional treatment group in patients with live heart loading group. (P>0.05); The serum MMP-9 level of the patients in the live Heart loading group was significantly lower than that in the conventional treatment group, it is statistically significant by comparing it’s difference (P<0.05); The serum PPAR-γ 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 it’s difference. 〔P<0.05〕 2、 体外实验研究：〔1〕CCK-8与药物最大有效率预实验：选取适宜活心方浓度为1‰，活心方对常氧下正常心肌细胞无显著影响〔)；〔2〕缺氧处理6h后，心肌细胞IL-18、MMP-9、HIF-1α的表达水平升高，PPAR-γ表达水平的下降；〔3〕缺氧情况下，参加活心方干预后，缺氧加药组心肌细胞IL-18、MMP-9的表达水平明显低于缺氧不加药组〔P<0.05〕，缺氧加药组PPAR-γ、HIF-1α的表达水平明显高于缺氧不加药组〔P<0.05)。 The experimental Study in vitro: (1) CCK-8 and drug maximum efficiency pre-test: Choose the right living heart of the concentration of 1%, the living heart of normal myocardial cells without significant effect ();(2) After hypoxia treatment 6h, the expression level of IL-18, MMP-9 and hif-1α of cardiac myocytes increased, PPAR-γ 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 (P<0.05and the expression level of PPAR-γ and hif-1α in hypoxia plus drug group was higher than that of hypoxia without drug group ( P<0.05) 结论 1、 活心方加载治疗冠心病患者能降低炎性因子MMP-9水平，促进PPAR-γ水平表达，能改善患者临床病症，提高生活质量。 The treatment of coronary heart disease with live heart can reduce the MMP-9 level of inflammatory factor, promoting the expression of PPAR-γ leve