冠心通络方对糖尿病大鼠心肌缺血的干预研究

Intervention of Guanxin Tongluo Recipe on myocardial ischemia in diabetic rats

目的探讨冠心通络方治疗糖尿病大鼠心肌缺血的药物疗效。方法 60只SD大鼠,随机分为正常组、造模组、冠心通络方组、阿司匹林组,每组15只。正常组大鼠正常喂养,不追加任何干预措施;造模组施加干预措施,制造糖尿病大鼠心肌缺血模型;冠心通络方组在造模大鼠的基础上予以灌服冠心通络方汤剂治疗;阿司匹林组在造模大鼠的基础上予以灌服阿司匹林治疗。1个月后比较四组大鼠的心功能参数, ST段和T波变化值,血糖、总胆固醇变化情况,左心室舒张末期容积(LVEDV)、左心室舒张末期内径(LVIDd)、左心室射血分数(LVEF)。结果模型组大鼠心电图ST段压低值、T波倒置值分别为(0.41±0.25)、(0.56±0.38)mV高于正常组的(0.11±0.23)、(0.13±0.58)mV,差异具有统计学意义(P<0.05);追加干预措施以后,冠心通络方组大鼠心电图ST段压低值(0.23±0.21)mV、T波倒置值(0.24±0.41)mV低于模型组的(0.41±0.25)、(0.56±0.38)mV及阿司匹林组的(0.35±0.24)、(0.42±0.37)mV,差异具有统计学意义(P<0.05);阿司匹林组和模型组ST段压低值、T波倒置值比较,差异无统计学意义(P>0.05)。模型组总胆固醇(8.41±3.13)mmol/L、血糖(21.3±6.36)mmol/L高于正常组的(4.67±2.45)、(6.46±2.34)mmol/L,差异具有统计学意义(P<0.05);追加干预措施以后,冠心通络方组大鼠总胆固醇(6.34±2.25)mmol/L、血糖(11.35±4.44)mmol/L低于模型组的(8.41±3.13)、(21.3±6.36)mmol/L及阿司匹林组的(7.25±3.42)、(19.9±5.63)mmol/L,差异具有统计学意义(P<0.05);阿司匹林组和模型组总胆固醇、血糖水平比较,差异无统计学意义(P>0.05)。模型组大鼠LVEDV(0.87±0.33)ml、LVIDd(9.32±0.89)mm高于正常组的(0.51±0.23)ml、(5.82±1.13)mm, LVEF(50.34±5.35)%低于正常组的(75.97±7.56)%,差异具有统计学意义(P<0.05);追加干预措施以后,冠心通络方组LVEDV(0.58±0.39)ml、LVIDd(6.01±1.22)mm低于模型组的(0.87±0.33)ml、(9.32±0.89)mm, LVEF(64.38±6.45)%高于模型组的(50.34±5.35)%,差异具有统计学意义(P<0.05);阿司匹林组和模型组LVEDV、LVIDd、LVEF指标水平比较,差异无统计学意义(P>0.05)。结论冠心通络方能有效改善糖尿病大鼠心脏微循环,缓解心肌缺血症状,其机制可能与其抑制血糖、血脂有关。

Objective To discuss the efficacy of Guanxin Tongluo Recipe on myocardial ischemia in diabetic rats. Methods A total of 60 SD rats were randomly divided into normal group, model group, Guanxin Tongluo Recipe group and aspirin group, with 15 rats in each group. Normal group were fed normally without any additional interventions, model group received intervention measures to create a model of myocardial ischemia in diabetic rats, Guanxin Tongluo Recipe group received Guanxin Tongluo Recipe on the basis of the modeled group, and aspirin group received aspirin on the basis of modeled rats. 1 month later, cardiac function parameters, ST segment and T wave changes, blood glucose and total cholesterol changes, left ventricular end-diastolic volume(LVEDV), left ventricular internal diameter at end-diastole(LVIDd) and left ventricular ejection fraction(LVEF) were compared among the four groups. Results ST-segment depression value and T wave inversion value of the model group were respectively(0.41±0.25) and(0.56±0.38) mV, which was higher than that of the normal group(0.11±0.23) and(0.13±0.58) mV, and the difference was statistically significant Significance(P<0.05). After additional interventions, ST-segment depression value and T wave inversion value of Guanxin Tongluo Recipe group were respectively(0.23±0.21) mV and(0.24±0.41) mV, which was lower than that of model group [(0.41±0.25) and(0.56±0.38) mV] and aspirin group [(0.35±0.24) and(0.42± 0.37) mV], and the difference was statistically significant(P<0.05). There was no statistically significant difference in ST-segment depression value and T wave inversion value between aspirin group and model group(P>0.05). The total cholesterol(8.41±3.13) mmol/L and blood glucose(21.3±6.36) mmol/L of the model group were higher than that of normal group(4.67±2.45) and(6.46±2.34) mmol/L, and the difference was statistically significant(P<0.05). After additional interventions, total cholesterol(6.34±2.25) mmol/L and blood glucose(11.35±4.44) mmol/L was lower than that of model group [(8.41±3.13) and(21.3±6.36) mmol/L] and aspirin group [(7.25±3.42) and(19.9±5.63) mmol/L], and the difference was statistically significant(P<0.05). There was no statistically significant difference in total cholesterol and blood glucose between aspirin group and model group(P>0.05). LVEDV(0.87±0.33) ml and LVIDd(9.32±0.89) mm of the model group was higher than that of the normal group(0.51±0.23) ml,(5.82±1.13) mm, and LVEF(50.34±5.35)% was lower than that of the normal group(75.97±7.56)%, and the difference was statistically significant(P<0.05). After additional interventions, LVEDV(0.58±0.39) ml, LVIDd(6.01±1.22) mm of Guanxin Tongluo Recipe group was lower than that of model group(0.87±0.33) ml,(9.32±0.89) mm, and LVEF(64.38±6.45)% was higher than that of model group(50.34±5.35)%, and the difference was statistically significant(P<0.05). There was no statistically significant difference in LVEDV, LVIDd and LVEF between aspirin group and model group(P>0.05). Conclusion Guanxin Tongluo Recipe can effectively improve the cardiac microcirculation of diabetic rats and relieve the symptoms of myocardial ischemia. Its mechanism may be related to its inhibition of blood glucose and blood lipids.