小型猪痰瘀互结证冠心病的方证相应研究

Relationship between prescription and syndrome on mini-swine phlegm-stasis syndrome of coronary heart disease

观察比较了丹蒌片(方证相应)和生脉胶囊(方证不相应)对于小型猪冠心病痰瘀互结证的影响。随机将24只小型猪分为正常对照组、模型组、丹蒌片组(0.24 g×kg^(-1))及生脉胶囊组(0.14 g×kg^(-1))。采用高脂饲料喂养结合冠脉球囊拉伤内皮方法建立小型猪冠心病痰瘀互结证模型。于给药8周后分别测定小型猪血脂水平、血液流变学指标、超声心动图测定心室壁和室间隔厚度及心功能改变,硝基四氮唑蓝液(NBT)染色测定心室梗死面积,中医四诊评分法测定动物主症、兼症、舌象及脉象改变。结果显示,方证相应药物丹蒌片可以显著降低小型猪血脂总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)水平(P<0.05或P<0.01),改善血液流变学(P<0.01),改善心室射血分数(EF)及缩短分数(FS)值(P<0.05或P<0.01),减小心肌梗死面积/心室面积(P<0.01),显著降低中医四诊评分(P<0.05或P<0.01)。方证不相应的生脉胶囊可以改善血液流变学指标(P<0.05或P<0.01),改善心功能EF及FS值(P<0.05),降低舌象和脉象评分(P<0.05),但对血脂代谢、心肌梗死面积及主症和兼症评分等方面无显著影响。以上结果表明,虽然用于气阴两虚证冠心病的生脉胶囊在干预痰瘀互结证冠心病动物在一些指标上表现出治疗效果,但模型的主要症状改善等方面受益有限。当方证相应时,用于治疗痰瘀互结证的丹蒌片则对小型猪痰瘀互结证冠心病模型表现出全面和较好的治疗效果。

This study was conducted to investigate the effects of Danlou（correspondence between prescription and syndrome）tablet and Shengmai capsule（non-correspondence between prescription and syndrome）on mini-swine phlegm-stasis syndrome of coronary heart disease（CHD）.24 mini-swines were randomly divided into normal control group,model group,Danlou tablet group（0.24 g×kg^（-1））and Shengmai capsule group（0.14 g×kg^（-1））.Phlegm-stasis syndrome of coronary heart disease was established by high-fat feeding and coronary intervention balloon injury.After 8 weeks of administration,blood lipid levels and blood rheology was detected.Echocardiography was used to examine the changes in heart function,and the extent of infarction was determined by nitro blue tetrazolium（NBT）staining method.The main symptoms,accompanied symptoms,tongue and pulse signs of the coronary heart disease mini-swine with phlegm-stasis syndrome were observed according to the symptom-graded scoring method.The results showed that Danlou tablet decreased serum total cholesterol（TC）,triglyceride（TG）and low-density lipoprotein cholesterol（LDL-C）（P〈0.05 or P〈0.01）,improved the blood rheology（P〈0.01）and cardiac function,increased the left ventricular ejection fraction（EF）and fraction shortening（FS）value（P〈0.05 or P〈0.01）,reduced the myocardial infarction area/ventricular area（P〈0.01）,significantly lowered the scores of four diagnosis in traditional Chinese medicine（P〈0.05 or P〈0.01）.Shengmai capsule improved the hemorheology indices（P〈0.05 or P〈0.01）,EF and FS value（P〈0.05）,reduced the tongue and pulse signs scores（P〈0.05）.However,Shengmai capsule failed to show therapeutic effects on blood lipid metabolism,the myocardial infarction area and primary symptom and syndrome score.The results suggest that as a drug for the treatment of Qi and Yin deficiency syndrome of CHD,Danlou tablet has limited therapeutic effects on phlegm-stasis syndrome of CHD.Only by the prescription correspondence with syndrome,using drug for the treatment of phlegm-stasis syndrome of CHD to treat phlegm-stasis syndrome of CHD,the prescription has a comprehensive therapeutic effect.