血液粘滞性与中医证的研究

A Study on TCM Zheng and Blood Viscosity

本研究按全国统编教材《中医诊断学》的辨证标准,采用上海第一医科大学生产的毛细管式粘度计,对气血两虚、脾肾阳虚、阴虚阳亢、痰湿内阻及气滞血瘀证患者进行了血液粘滞性测定。结果发现随证的不同,血液粘滞性的改变有明显差异。气血两虚与脾肾阳虚证处于低血粘状态,而其他各证则处于高血粘状态。从血液流变学角度揭示了虚、实证的实质不同,它们的形成与血液粘滞性的降低或升高直接相关。从血液粘度微观指标分析,各证又呈现特异性改变,气血两虚与脾肾阳虚证是因红细胞压积的减少引起低粘状态,它们有共同的病理基础,与脾肾功能低下气血化生不足,致使血液中有形成份减少直接相关。而阴虚阳亢证则红细胞压积显著增加,使血液表现出高浓状态,是引起肝风内动的病理基础。痰湿证血浆粘度明显增高,使血液中表现出高粘状态及临床上表现出“重浊而粘腻”的特性,与脾为湿困,健运失调,机体对(?)微物质的代谢紊乱有关。气滞血瘀证之红细胞聚集能力最强,使血细胞易于聚集成堆、淤滞不通而成瘀,与肝之疏泄、藏血、调血功能失调有关。这一规律性改变,反映出机体内血液中有形或无形成份的异常是中医证病理变化的物质基础,在某种意义揭示了有关证的实质,认为血液粘滞性的测定似可作为辨别有关证的客观指标,无论在临床或在理论上对中医证的认识或研究都是有意义的。

In order to understand the relation between blood viscosity and TCM zheng, determination of blood viscosity, including viscosity at low and high shear rate, aggregation index, hematocrit and plasma viscosity was made in 60 healthy persons, 51 patients with deficiency of both qi and blood, 56 with insufficiency of boch spleen- and kidney-yang, 5l with hyperactivity of yang and deficiency of yin, 84 with stagnancy of qi and blood and 46 with stagnation of phlegm-dampness. It was found that blood viscosity of the patients with deficiency of qi and blood and those with insufficiency of spleenand kidney-yang was lower than that of healthy persons, while blood viscosity of other patients was higher. The results show that there is a close relation of the formation of asthenia-zheng and sthenia-zhe ng to blood viscosity. It is indicated that the blood of the patients with yang hyperactivity and yin deficiency is in a state of high concentration, the blood cells of the patients with stagnancy of qi and blood is easy to accumulate to form blood stasis, and the blood of the patients with stagnation of phlegm-dampness is in a state of high stickiness and there is a ''sticky' and 'greasy' particularity in clinical manifestation of those patients. It is concluded that: 1) Various TCM zheng have their own particular manifestations of blood rheology. 2) The determination of blood viscosity is of significance in the study of TCM zheng.