疮疡的血液流变学研究及临床观察

Study and clinical observation of hemorheology of sore

目的 从血液流变学角度验证疮疡的发病机制 ,探讨阴证、阳证临床表现不同的物质基础 ;观察活血化瘀药物在阳证疮疡治疗中的效果。方法 根据中医外科辨阴证、阳证的要点 ,选择阳证疮疡组 5 0例 (分为双黄连组和丹参组 ) ,阴证疮疡组 2 4例 ,正常组 2 0例 ,检测 3组的血液流变学指标 ,并进行相关统计分析。结果 血液流变学检测阳证组全血黏度低切、血浆黏度、血沉、血沉K值、纤维蛋白原高于正常组 (P <0 .0 5或P <0 .0 1) ;阴证组除红细胞比积外 ,其余各项指标均明显高于正常组 (P <0 .0 1)。阴证组血浆黏度明显高于阳证组 (P <0 .0 1)。阳证组治疗后血液流变学特征性指标下降明显 (P <0 .0 5或P <0 .0 1) ,丹参组与双黄连组比较无差异 (P >0 .0 5 )。治愈时间丹参组优于双黄连组 (P <0 .0 5 )。结论 疮疡患者在血液流变学上表现为“高黏”、“高凝”、“高聚”状态。血浆黏度增高幅度的差异可能为阴证、阳证临床表现不同的病理基础之一。清热解毒配合活血化瘀在阳证疮疡的治疗中具有较好的协同作用。

Objective To study mechanism of cause of sore disease and observe effect of method of heat clearing and detoxifying and promoting blood and circulation removing stasis on sore with Yang-syndrome. Methods Based on the differentiation of Yin-syndrome and Yang-syndrome according to TCM surgical theory, 50 cases of yang-syndrome and 24 cases of Yin-syndrome were selected, and 20 normal people were selected to control group. Index of hemorheology in three groups was determined. Shuanghuanglian and Danshen were taken orally respectively in Yang-syndrome group. Results Viscosity at low shear rate, viscosity, erythrocyte sedimentation rate and fibrinogen in Yang-syndrome was significant higher than those in control group (P<0.05～0.01). Viscosity in Yin-syndrome was higher than that in Yang-syndrome (P<0.01). Reduce of index of hemorheology after treatment in Yang-syndrome group was significant higher (P<0.05～0.01). Conclusions Cases with sore express hyper-viscosity, hyper-coagulable and hyper-convergence states in hemorheology. Difference of Increase degree of viscosity can be cause of difference of signs in Yin- and Yang-syndrome. Method of heat clearing and detoxifying and promoting blood and circulation removing stasis can produce a good effect on sore.