[关键词]
[摘要]
目的 观察通脉养心丸对小型猪心肌缺血再灌注损伤后期气阴两虚证的干预作用。方法 将24只小型猪随机分为假手术组、心肌缺血气阴两虚证模型组、通脉养心丸(0.36 g/kg)组和生脉胶囊(0.14 g/kg)组,每组6只。除假手术组外,其他各组采用介入技术球囊封堵冠状动脉左前降支30 min后撤出球囊进行再灌注损伤。术后给药4周,检测各组动物无创血流动力学改变;根据症状分级评分方法,分析各组动物冠心病气阴两虚证舌象和脉象评分的变化;数码拍照方法检测各组动物舌面色泽变化;采用伊文思蓝和TTC染色分析心肌缺血和梗死面积。结果 与假手术组比较,模型组小型猪心脏缺血区和梗死区的面积明显增加,心输出量(CO)、每搏输出量(SV)均明显降低,而血管外周阻力(SVR)和左室做功(LCW)上升,同时舌面色泽出现异常,相应的舌象和脉象评分明显增加(P<0.05、0.01);与模型组比较,通脉养心丸和生脉胶囊可明显降低小型猪心肌梗死和缺血面积,增加CO和LCW,同时舌面色泽变化接近正常,相应的舌象和脉象评分明显降低;通脉养心丸还可降低SVR(P<0.01)。结论 小型猪心肌缺血再灌注损伤后期表现出部分气阴两虚证的特点,通脉养心丸能够改善冠心病气阴两虚证小型猪舌和脉象的变化,保护心肌组织,恢复心脏血流动力学的异常状态。
[Key word]
[Abstract]
Objective To observe the intervening effects of Tongmai Yangxin Pills on miniature pigs with syndrome of deficiency of both qi and yin in later stage of myocardial ischemia reperfusion injury. Methods A total of 24 miniature pigs were randomly divided into the sham-operated group, the model group (syndrome of deficiency of both qi and yin in myocardial ischemia), the Shengmai Capsules group (0.14 g/kg), and Tongmai Yangxin Pills groups (0.36 g/kg) with six pigs in each group. Except for the sham-operated group, the left anterior descending artery in other groups had been occluded for 30 min by inflation balloons and arterial reperfusion injury was acquires by withdraw balloons. After the operation, the groups were administered with drugs for four weeks. The parameters of noninvasive hemodynamics were measured at the end of study. The tongue color was recorded by digital camera. The tongue and pulse manifestation of the miniature pigs were evaluated according to the symptom-graded scoring method. The size of myocardial ischemia and infarction was analyzed by Evens and TTC staining. Results Compared with the sham-operated group, the area of myocardial ischemia and necrosis in the model group increased significantly. The noninvasive hemodynamics showed a reduction in cardia coutput (CO) and stroke volume (SV), an augment in systemic vascular resistance (SVR) and left cardiac woke (LCW) of the model group compared with the sham-operated group. Moreover, the scores of tongue and pulse manifestation were also significantly increased in the model group with abnormal color of tongue (P < 0.05, 0.01). Compared with the model group, Shengmai Capsules and Tongmai Yangxin Pills reduced the area of myocardial ischemia and infarction, increased the values of CO and SV, decreased the scores of tongue and pulse manifestation and improved tongue color (P < 0.05, 0.01). In addition, Tongmai Yangxin Pills also reduced SVR (P<0.01).Conclusion The syndrome of deficiency of both qi and yin in mini pigs could be partly manifested in later stage of myocardial ischemia reperfusion injury. Tongmai Yangxin Pills can improve tongue and pulse signs, protect myocardial tissue, and recover abnormal hemodynamics, which can establish foundation for the further clinical application.
[中图分类号]
[基金项目]
国家自然科学基金面上项目(81573650);中国中医科学院西苑医院苗圃课题[XYKY-MP(2013)-32]