凉血止血法与活血通络法调节RVO兔模型凝血因子及微循环作用机制的研究

Research on blood coagulation factors and microcirculation in RVO rabbits with treatment of Liangxue Zhixue method and Huoxue Tongluo method

目的探讨凉血止血法及活血化瘀法调节兔RVO凝血因子及微循环的作用机理。方法按照随机对照实验设计,采用新西兰兔39只(共78眼),其中正常对照组3只(6眼),余36只应用光化学方法建立RVO兔模型,随机分为4组:模型组、止血组、活血组、止血+活血组,每组9只(18眼),分别予生理盐水、十灰散、血府逐瘀汤、十灰散合血府逐瘀汤干预,观察血清凝血因子ATⅢ、PLG及微血管舒缩因子TXB2/6-Keto-PGF1α变化情况。结果 1.止血组在3 d以内降低ATⅢ活性,有促凝血作用;3～14 d使ATⅢ、PLG升高,有抗凝作用;28 d PLG仍升高而ATⅢ趋向正常。3～14 d下调TXB2/6-Keto-PGF1α比值,呈舒血管状态;28 d比值上调,血管趋于收缩。2.活血组1～14 d升高ATⅢ、PLG活性,以7 d内最显著,具有抗凝作用;28 d时下调ATⅢ、PLG,有促凝作用。3 d下调TXB2/6-Keto-PGF1α比值,呈舒血管状态;7～28 d上调比值,血管趋于收缩。3.止血+活血组以升高ATⅢ、PLG为主,具有抗凝作用,在7 d时上调ATⅢ最明显,在28 d时上调PLG较明显。3 d下调TXB2/6-Keto-PGF1α比值,呈舒血管状态;7～28 d上调比值,呈缩血管状态。结论凉血止血法以极早期(3天内)促凝及早中期的抗凝和舒张血管作用为主;活血通络法以早中期的抗凝和舒血管及中后期的促凝和收缩血管作用为主;两法合用者各期均以抗凝作用为主,其早期有较强的舒张血管作用,中晚期有收缩血管作用。三组中药对凝血及微循环调节的作用强度及时间点各有不同。

OBJECTIVE To study the mechanism of blood coagulation factors and microcirculation in RVO rabbits treated with Liangxue Zhixue method,Huoxue Tongluo method.METHODS Researched on 39 rabbits（78 eyes） with randomized controlled trials.There were 3 rabbits（6 eyes） in normal control group.Others were established to be RVO model with photochemical method.Divided models into 4 groups,9 rabbits（18 eyes） each,then treated model-controlled group with physiological saline,Zhixue group with Shihui Powder,Huoxue group with Xuefu Zhuyu Decoction,Zhixue-Huoxue group with both prescriptions.Tested level of antithrombin Ⅲ and plasminogen in blood,TXB 2 /6-Keto-PGF 1α in retinal tissue.RESULTS 1.In Zhixue group,the level of ATIII had reduced in first 3 days,it tended to procoagulanting.In 3～14d,the activity of both ATIII and PLG had risen,led to effect of anticoagulanting.At 28th day,ATIII presented to normal level.In 3～14 d,the activity of TXB 2 /6-Keto-PGF 1α had down-regulated,presented effect of expanding vascular.At 28th day,the activity of TXB 2 /6-Keto-PGF 1α had risen,presented effect of concentrating vascular.2.In Huoxue group,the activity of ATIII and PLG had increased in 1～14d,especially in first 7 days,led to effect of anticoagulanting.At 28th day,the level of ATIII and PLG had reduced,tended to pro-coagulanting.The level of TXB 2 /6-Keto-PGF 1α had decreased at 3rd day,presented effect of expanding vascular;then increased in 7 ～28 d,presented effect of concentrating vascular.3.In Huoxue Zhixue group,the activity of ATIII and PLG had increased in each period,AT Ⅲ was the highest at 7th day,PLG the highest at28th day,led to effect of anticoagulanting.The level of TXB 2 /6-Keto-PGF 1α had decreased at 3rd day,presented effect of expanding vascular;then increased in 7～28 d,presented effect of concentrating vascular.CONCLUSIONS Liangxue Zhixue method had effect of procoagulanting in first 3 days,then had anticoagulanting and expanding vascular in early period and mid-term.Huoxue Tongluo method had effect of anticoagulanting and expanding vascular in early period and mid-term,but concentrating vascular in mid-term and later period.With two methods combined,it had obvious effect of anticoagulanting in each period,the stronger effect of expanding vascular than other groups in early period,and the similar effcct with Huoxue Tongluo method of concentrating vascular in mid-term and later period.In summary,there were differences in time points and intensity among three treatment groups.