胸痹心血瘀阻证动态演变模型的构建与评估  

Construction and Evaluation of a Dynamic Evolution Model for Chest Obstruction and Heart Blood Stasis Syndrome

作　　者：罗晓欣 金梦雨 白思杨 杨欣雨 简维雄[1] LUO Xiaoxin;JIN Mengyu;BAI Siyang;YANG Xinyu;JIAN Weixiong(Hunan University of Chinese Medicine,Changsha 410208,China;Nanchang Hongdu Hospital of TCM,Nanchang 330038,China)

机构地区：[1]湖南中医药大学,长沙410208 [2]南昌市洪都中医院,南昌330038

出　　处：《中国中医基础医学杂志》2024年第12期2048-2052,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金项目(81973753,82374334);湖南省自然科学基金项目(2022JJ30433);湖南省研究生科研创新项目(CX20230794);湖南中医药大学研究生科研创新课题(2023CX83)。

摘　　要：目的复制胸痹心血瘀阻证动态演变过程,为构建更系统完善的胸痹心血瘀阻证动物模型评价体系提供参考。方法36只健康SD雄性大鼠,随机分为正常组和模型组。模型组大鼠以高脂饲养加维生素D3灌胃、异丙肾上腺素注射构建胸痹心血瘀阻证动态演变模型。造模后检测舌象、血脂、心电图、心脏彩超、血液流变学等指标。结果亚血瘀证期大鼠舌质R值较血瘀证前期下降(P<0.05),心血瘀阻证期大鼠舌质R、G值较亚血瘀证期显著下降(P<0.05);血瘀证前期大鼠血浆总胆固醇、低密度脂蛋白较正常组显著升高(P<0.05),亚血瘀证期大鼠高密度脂蛋白较血瘀证前期显著升高(P<0.05),心血瘀阻证期大鼠血浆总胆固醇与高、低密度脂蛋白较正常组显著升高(P<0.05);血瘀证前期与心血瘀阻证期大鼠较正常组全血黏度低、中、高切变率显著升高(P<0.05);心血瘀阻证期大鼠心电图S-T段抬高大于0.1 mV,左室收缩末期内径、左室收缩末期容积指数较正常组显著升高(P<0.05),射血分数较正常组显著下降(P<0.05)。主动脉病理结果显示血瘀证前期大鼠内膜完整性被部分破坏;亚血瘀证期大鼠主动脉内膜厚薄不均,外膜完整性被破坏,中膜弹性纤维紊乱;心血瘀阻证期大鼠主动脉内膜明显增厚凸出,内膜下存在空腔,内有胆固醇结晶、细胞堆积,中膜弹性纤维排列紊乱,外膜完整性受损。结论本研究建立了胸痹心血瘀阻证动态模型,科学、全面地评估了心血瘀阻证动态演变过程中“痰”“浊”“瘀”的严重胶着状态,可为构建更系统完善的胸痹心血瘀阻证动物模型评价体系提供参考。Objective To replicate the dynamic evolution process of chest obstruction heart blood stasis syndrome,and to provide a more systematic evaluation system for the animal model of chest obstruction heart blood stasis syndrome.Methods 36 healthy SD male rats were randomly divided into normal and model groups.The model group was fed with high fat plus vitamin D3 by gavage and isoproterenol injection to construct a dynamic evolution model of chest obstruction heart blood stasis syndrome.Tongue,blood lipid,electrocardiogram,cardiac ultrasound,blood rheology and other indicators were observed.Results Tongue R values decreased in the sub-blood stasis syndrome stage compared with the pre-blood stasis syndrome stage(P<0.05),tongue R,G values decreased significantly in the heart blood stasis syndrome stage compared with the sub-blood stasis syndrome stage(P<0.05).Plasma total cholesterol and low-density lipoproteins increased significantly in the pre-blood stasis rats compared with the normal group(P<0.05),high-density lipoproteins increased significantly in the sub-blood stasis rats compared with the Pre-blood stasis rats(P<0.05),total plasma cholesterol,high-and low-density lipoproteins were significantly higher in rats with heart blood stasis syndrome than in the normal group(P<0.05).Low,medium,and high shear rates of whole-blood viscosity were significantly higher in rats with pre-blood stasis and heart blood stasis syndrome than in the normal group(P<0.05).The electrocardiogram S-T of rats with heart blood stasis syndrome elevated more than 0.1 mV,and the left ventricular end-systolic internal diameter,left ventricular end-systolic volume index were significantly higher(P<0.05),while ejection fraction was significantly lower(P<0.05)than that of the normal group.The pathological results of aorta showed that the intima-media integrity was partially destroyed in rats in the pre-blood stasis syndrome.The intima-media of rats in the sub-blood stasis syndrome was unevenly thick and thin,the integrity of the outer membrane was

关 键 词：胸痹 心血瘀阻证 动态演变 模型评价 

分 类 号：R256.22[医药卫生—中医内科学]