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目的从血管内皮细胞形态学方面探讨益气凉血生肌方降低冠心病介入术后远期心血管事件的作用机制。方法 20只大白兔随机分为正常组、生理盐水组、中药组、西药组和中西医结合组,每组4只。中药组灌胃益气凉血生肌方2.3 g/(kg·d),西药组灌胃氯沙坦钾片0.115 g/(kg·d),中西医结合组间隔30 min分别灌胃等剂量的益气凉血生肌方和氯沙坦钾片,生理盐水组灌胃等量0.9%Na Cl溶液,正常组不做任何处理。连续灌胃5天后耳缘静脉采血,无菌分离血清。采用体外实验的方法,对人脐静脉内皮细胞(HUVECs)采用血管紧张素Ⅱ(AngⅡ)建立细胞损伤模型,分为对照组、模型组、中药组、西药组、中西医结合组,依次加入相应的0.15 ml 15%药物血清。培养箱培养4~6 h后采用倒置显微镜观察细胞整体形态变化、透射电镜观察细胞超微结构变化。结果光镜下模型组细胞较对照组形态紊乱、生长缓慢,进行药物干预后,细胞生长加快,形态恢复,中西医结合组更明显。透射电镜下与模型组比较,中药组、西药组和中西医结合组损伤内皮细胞的细胞核边界清楚、内质网增多增密、线粒体数目增加,中药组和中西医结合组的内质网折叠更明显,线粒体饱满、数目较西药组增多。结论益气凉血生肌方在形态学上对损伤性血管内皮细胞有促进修复的作用,能保护血管内皮的完整性,从而减轻冠状动脉介入治疗对内皮细胞的损伤。
Objective To investigate the mechanism of Yiqi Liangxue Shengji Recipe in reducing long-term cardiovascular events after coronary intervention. Methods Twenty rabbits were randomly divided into normal group, normal saline group, traditional Chinese medicine group, western medicine group and traditional Chinese and western medicine group with 4 rats in each group. The rats in the traditional Chinese medicine group were treated with 2.3 g / (kg · d) Yiqi Liangxue Shengji Recipe, losartan potassium tablets 0.115 g / (kg · d) in the western medicine group, The Yiqi Liangxue Shengji Fang and losartan potassium tablets, normal saline group was orally administered 0.9% Na Cl solution, the normal group without any treatment. Five days after continuous gavage, blood was collected from the ear vein and aseptically isolated. The model of cell injury was established by using angiotensin Ⅱ (AngⅡ) on human umbilical vein endothelial cells (HUVECs) in vitro. The models were divided into control group, model group, TCM group, western medicine group and integrated traditional Chinese and western medicine group, Of 0.15 ml of 15% drug serum. After cultured for 4 ~ 6 h in the incubator, the morphological changes of the cells were observed by inverted microscope. The ultrastructural changes of the cells were observed by transmission electron microscope. Results Compared with the control group, the cells in the model group were disordered and grew slowly under light microscopy. After drug intervention, the cell growth was accelerated and the morphology was restored. The combination of TCM and WM was more obvious. Compared with the model group, the nucleus boundary of endothelial cells in Chinese medicine group, western medicine group and integrated traditional Chinese and western medicine group were clear, the endoplasmic reticulum was more dense and the number of mitochondria increased, the endoplasmic reticulum folding Obviously, full of mitochondria, the number increased more than the western medicine group. Conclusion Yiqi Liangxue Shengji Recipe has the morphological function of promoting the repair of injured vascular endothelial cells, and can protect the integrity of vascular endothelium, thereby reducing the damage of endothelial cells by coronary intervention.