活血解毒中药组分配伍对急性心肌梗死后缺血心肌病理形态和心功能的影响  

The protective effects of component compatibility of Huoxue and detoxification on ischemic myocardium and cardiac function after acute myocardial infarction

作　　者：董国菊[1,2] 刘剑刚[1,2] 张庆翔[1,2] 张蕾[1,2] 张大武[1,2] 

机构地区：[1]中国中医科学院西苑医院心血管病中心 [2]中国中医科学院心血管病研究所,北京100091

出　　处：《环球中医药》2015年第11期1340-1345,共6页Global Traditional Chinese Medicine

基　　金：国家自然青年科学基金(81001517);国家自然科学基金面上项目(81273929);科技部国际科技合作与交流项目(2014DFG32700)

摘　　要：目的探讨活血解毒中药（赤芍总苷、黄连生物碱）组分配伍对实验性急性心肌梗死大鼠早期心室重构的缺血心肌病理形态及心功能的影响。方法实验用健康Wistar大鼠,雄性,体质量180~200 g,水合氯醛腹腔麻醉,结扎冠状动脉左前降支造成急性心肌梗死模型,手术成活大鼠随机分为模型组、中药活血组（赤芍总苷）、中药解毒组（黄连生物碱）、活血解毒组（赤芍总苷＋黄连生物碱）、辛伐他汀组共5组,每组10只,术后连续给药14天。另设假手术组（结扎线穿过冠状动脉左前降支,不接扎）10只,和模型组给予等量蒸馏水。末次给药后空腹16小时,然后麻醉做心脏超声多普勒检测,结束后腹主动脉取血,放射免疫方法检测血清中的白细胞介素-1β,肿瘤坏死因子-α和高敏C-反应蛋白的炎症水平,心肌组织分别取材处理,光镜和电镜观察心肌组织的结构变化。结果和模型组比较,赤芍总苷组、黄连生物碱组和活血解毒组分配伍对大鼠血清白细胞介素-1β,肿瘤坏死因子-α和高敏C-反应蛋白含量均有显著抑制作用（P〈0.05,P〈0.01）,赤芍总苷组和活血解毒组治疗的心肌细胞形态较为整齐,炎症细胞浸润明显减少,心肌线粒体结构较为完整;和模型组比较,活血解毒组大鼠的左心室面积显著缩小（P〈0.05）,心脏超声显示的左室舒张末内径和收缩末内径减少（P〈0.05）,左室射血分数显著提高（P〈0.05）。结论赤芍总苷和黄连生物碱配伍具有一定的综合优势。活血解毒组配伍能够干预急性心肌梗死后早期心室重构,抑制血清炎症水平,保护缺血心肌细胞,促进心脏功能的恢复。Objective To discuss the protective effects of component compatibility of total paeony glycoside（ TPG） and alkaloids of rhizome（ AR） on ischemic myocardium and cardiac function of ventricular remodeling（ VR） rats after acute myocardial infarction（ AMI）. Methods The Wistar rats were random Ly divided into 6 groups,including sham-operated group,model group,simvastatin group,TPG group,AR group,total TPG and AR group. Continuously administrated drugs for 14 days. The sham-operated and model group were given the same dosage distilled water. 16 hours after the last administration,anesthetized and detected the cardiac doppler ultrasound,the level of interleukin-1 beta（ IL-1β）,tumor necrosis factor alpha（ TNF-α） and hypersensitive C-reactive protein（ hs-CRP）. The pathological structural changes of myocardial tissue were observed by light microscope and electron microscope. Results Compared with themodel group,the level of IL-1β,TNF-αand hs-CRP significantly decreased than those in TPG,AR and both TPG and AR group（ P 0. 05,P 0. 01）; The morphology of cardiac muscle cells and mitochondrion is more regular and less inflammatory cells infiltration in TPG and both TPG and AR group; compared with the model group,the left ventricular area obviously reduced in the TPG,AR,simvastain and both TPG and AR group（ P 0. 05）; 1eft ventricular end-systole dimension（ LVEDs） and left ventricular end-diastole dimension（ LVEDd） significantly decreased and left ventricular ejection fraction（ LVEF） significantly increased in the TPG,AR,simvastain and both TPG and AR group（ P 0. 05）. Among them,the both TPG and AR group show greater advantages. Conclusions The component compatibility of TPG and AR could intervene the early VR after AMI,inhibit the inflammation factors,protect ischemic myocardium and promote the recovery of cardiac function.

关 键 词：急性心肌梗死 心室重构 赤芍总苷 黄连生物碱 活血解毒 组分配伍 

分 类 号：R285[医药卫生—中药学] R542.22[医药卫生—中医学]