中药腹腔灌注对家兔急性出血坏死性胰腺炎血液流变学影响的实验研究

Hemorheological influences of abdominal irrigation of Chinese herbs in treatment of acute hemorrhagic necrotic pancreatitis in rabbits

目的探讨中药治疗急性出血坏死性胰腺炎（ＡＨＮＰ）的病理与血液流变学改变．方法应用血液流变学的检测方法，观察兔ＡＨＮＰ时通过活血化瘀中药（丹参，红花，木香，元胡，大青叶，栀子，鱼腥草，二芍，厚朴，枳壳及大黄）腹腔灌注治疗后血液流变学的各种变化．将兔分为ＡＨＮＰ模型组（ｎ＝２０）、中药腹腔灌注组（ｎ＝１９）及对照组（ｎ＝１１）．ＡＨＮＰ模型组和中药腹腔灌注组分别于２，６，２４和４８ｈ取血做血液流变学检查．同时作病理学观察比较．结果中药腹腔灌注组２４ｈ全血还原粘度、血小板聚集性降低．全血还原粘度为４２３６±２７７，血小板聚集性为４２５±３１５，而ＡＨＮＰ模型组中２４ｈ全血还原粘度为５７７±９５２，血小板聚集性为１８１２±７２６（Ｐ＜００５）．中药腹腔灌注组４８ｈ全血粘度、全血还原粘度、血小板聚集性明显降低，全血粘度为１３８０±４６８，全血还原粘度为３４７１±１５２５，血小板聚集性为３０８±０５５，而ＡＨＮＰ模型组４８ｈ全血粘度为３０７１±２７９，全血还原粘度为８５４７±７２２，血小板聚集性为２０９３±６０１（Ｐ＜００１）．结论早期应用活血化瘀中药，可以纠正血液流变学的异?

AIMS To investigate the pathology and hemorheological changes of Chinese herbs in treatment of acute hemorrhagic necrotic pancreatitis (AHNP). METHODS By means of hemorheological tests, we observed hemorheological indices of AHNP rabbits treated by abdominal irrigation of the herbs of invigorating the circulation of blood ( Radix Salviac Miltiorrhizae, Flos Carthami, Radix Aucklandiae, Rhizoma Corydalis, Folium Isatidis, Fructus Gardeniae, Herba Houttuyniae, Radix Paeoniae Alba, Cortex Magnoliae, C. aurantium L, Radix et Rhizoma Rhei ). The rabbits were divided into three groups: AHNP group ( n =20), abdominal irrigation of herbs group ( n =19) and control group ( n =11). Hemorheological tests in AHNP group and abdominal irrigation of herbs group were made at 2, 6, 24 and 48 hours, respectively. The observation and comparision of pathology was made at the same time. RESULTS Reduced viscosity and platelet aggregation at 24 hours in abdominal irrigation of herbs group were lower than AHNP group ( P <0 05). Reduced viscosity was 42 36±2 77 at 24 hours in abdominal irrigation of herbs group and 57 7±9 52 in AHNP group; platelet aggregation was 4 25±3 15 vs 18 12±7 26. Blood viscosity, reduced viscosity and platelet aggregation at 48 hours in abdominal irrigation of the herbs group were significantly lower than AHNP group ( P <0 01). Blood viscosity was 13 80±4 68 at 48 hours in abdominal irrigation of herbs group and 30 71±2 79 in AHNP group; reduced viscosity was 34 71±15 25 vs 85 47±7 22; and platelet aggregation was 3 08±0 55 vs 20 93±6 01. CONCLUSIONS The early administration of the herbs of invigorating the circulation could correct the abnormal hemorheological alterations, because these herbs can alleviate the pancreatic microcirculatory stasis and eliminate the vicious circle of AHNP.