世界中医药

目的：观察血府逐瘀汤对冠心病模型鼠的治疗作用，探讨其对PI3K-AKT信号通路相关蛋白的影响。方法：将45只SD大鼠随机分为空白组、模型组及中药组，每组15只。将模型组及中药组大鼠冠心病造模，中药组用2 g/mL血府逐瘀汤药液灌胃，空白组及模型组用等量的生理盐水灌胃，3组均连续灌胃10 d。观察各组大鼠造模前后ST段变化、心肌细胞凋亡、颈总动脉形态学变化、血脂水平、心肌组织PI3K、AKT、p-AKT蛋白水平变化及大鼠腹主动脉血Bax及Bcl-2水平变化。结果：1）心电图显示经过冠心病模型制备大鼠心电图ST段变化高于空白组，差异有统计学意义(P<0.05)，其中中药组较模型组改善，差异有统计学意义(P<0.05)；2）经过冠心病模型制备的大鼠血脂代谢均出现紊乱，总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、Bax明显升高，高密度脂蛋白胆固醇(HDL-C)及Bcl-2明显下降，与空白组比较，差异有统计学意义(P<0.05)；经过中药干预后，大鼠血脂水平高于模型组，差异有统计学意义(P<0.05)；3）Tunel检测显示经过冠心病模型制备大鼠心肌细胞凋亡率高于空白组，差异有统计学意义(P<0.05)，中药组心肌细胞凋亡率低于模型组，差异有统计学意义(P<0.05)；4）HE染色显示空白组大鼠冠状动脉管壁结构厚薄均匀，中内膜形状规则，结构完整；模型组内中膜明显增厚，动脉管壁明显凹凸不平，管腔狭窄，出现明显斑块；中药组管壁较模型组平滑，斑块较模型组减小；5）冠心病模型大鼠PI3K、p-AKT、Bcl-2水平低于空白对照组，Bax水平高于空白组，差异有统计学意义(P<0.05)；中药干预后，大鼠上述指标表达改善效果优于模型组，差异有统计学意义(P<0.05)，各组AKT表达水平相近，差异无统计学意义（P>0.05）。结论：血府逐瘀汤可明显逆转冠心病病理改变，其作用机制可能与抑制心肌细胞凋亡有关。

English Summary:

To observe the therapeutic effect of Xuefu Zhuyu Decoction on coronary heart disease(CHD)model rats and explore its effect on PI3K-AKT signaling pathway related proteins.Methods:A total of 45 SD rats were randomly divided into a blank group，a model group and a traditional Chinese medicine(TCM)group，with 15 rats in each group.CHD model was set up for the rats in the model group and the TCM group.The rats in TCM group were given 2 g/mL Xuefu Zhuyu Decoction by gavage.The rats in the blank group and the model group were given the same amount of normal saline by gavage.All the 3 groups were given gavage continuously for 10 days.The changes of ST segment，cardiomyocyte apoptosis，morphology of common carotid artery，blood lipid level，protein levels of PI3K，AKT and p-AKT in myocardial tissue，and the levels of Bax and Bcl-2 in abdominal aorta were observed before and after modeling.Results:1)ECG showed that the ST segment change of rats after CHD model preparation was higher than that of the blank group(P<0.05)，and the TCM group was better than that of the model group(P<0.05); 2)the blood lipid metabolism of rats after CHD model preparation was disordered，with a significant increase in TC，TG，LDL-C，Bax and a significant decrease in HDL-C，bcl-2; compared with the blank group，the differences were statistically significant(P<0.05).After the intervention of TCM，the blood lipid level of rats was higher than that of the model group(P<0.05); 3)TUNEL detection showed that the apoptosis rate of cardiomyocytes in the model group was higher than that of the blank group(P<0.05)，and the apoptosis rate of cardiomyocytes in the TCM group was lower than that of the model group(P<0.05); 4)HE staining showed that the thickness of the coronary artery wall in the blank group was uniform，the shape of the intima was regular，and the structure was complete; the intima-media in the model group was significantly thickened，the arterial wall was significantly uneven，the lumen was narrow，and obvious plaque appeared; the wall of the TCM group was smoother than that of the model group，and the plaque was smaller than the model group; 5)the levels of PI3K，p-AKT and Bcl-2 in the CHD model rats were lower than those in the blank group.The concentration of Bax in the control group was higher than that in the blank group(P<0.05)，and the improvement effect of the above indexes in the TCM group was better than that in the model group(P<0.05).Conclusion:Xuefu Zhuyu Decoction can significantly reverse the pathological changes of coronary heart disease，and its mechanism may be related to the inhibition of cardiomyocyte apoptosis.

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