温阳益气、活血化瘀复方对海洛因依赖患者微循环改变的影响

Influence of a Compound Prescription on Heroinism Patients' Microcirculation

目的 :为了探讨机体微循环在阿片类物质依赖、戒断、康复过程中的不同变化 ,验证作者提出的阿片类物质依赖戒断综合征的中医“证”本质在于“肾阳虚损、瘀血阻滞”这一病机假说 ,为中医临床辨治该类疾病提供新的思路。方法 :将患者随机分为治疗组 34例 ,对照组 32例 ,运用甲襞微循环分析仪观察海洛因依赖患者无名指甲襞 ,检测甲襞微循环加权积分的 16项指标。结果 :海洛因依赖者的微循环有特异性的改变 ,表现为管袢顶瘀滞、变窄明显 ,管袢数目减少 ,长度缩短 ;白细胞增多 ,红细胞聚集 ,血流速度减慢呈粒流、粒缓流、粒摆流甚或停滞 ;袢周有渗出。温阳益气、活血化瘀复方在控制戒断症状的同时 ,对上述微循环紊乱有极其显著的稳定作用。结论 :在临床辨治海洛因依赖时 ,配伍活血化瘀药物可以疏通瘀滞的微循环 ,改善组织的血氧供应 ,不仅对戒断症状有治疗作用 ,还使毒品易于排出体外 。

OBJECTIVE: To explore the microcirculation changes during the process of opium-dependence, withdrawal and recovery, to prove the authors' pathogenic hypothesis, which opium-dependent comprehensive syndrome is caused by kidney-Yang deficiency and accumulation of blood stasis. METHOD: Grouped the opium-dependent patients randomly, 34 cases in treatment group were treated with the compound prescription of warming Yang, replenishing Qi and promoting blood circulation to remove stasis, 32 cases in another group were treated with buprenorphine chloride, then observed their nail folds of ring finger by microcirculation analyzing apparatus, and tested the 16 indexes of weighted accumulate points for nail folds microcirculation. RESULT: It was discovered that there existed apparent abnormal changes in the nail folds microcirculation of opium-dependent patients, which was expressed in: stagnation and narrow on the top of less, shorter vessel trips; leukocytosis, sympexis, slow granular or swinging or stagnated blood flow; the perimeter of vessel trips with effusion. The above-mentioned compound prescription had a stable effect on these disorders in the meanwhile of controlling the withdrawal symptoms. CONCLUSION: In clinical differentiation and treatment of opium-dependence, the compatibility of the above-mentioned compound prescription is effective in treating withdrawal and follow-up delayed symptoms, namely, dredging the stagnated microcirculation, improving the blood oxygen supply in tissue, and eliminating drugs from the body.