孙络疏失(微血管缺血)的中医微观病理特征及通心络干预研究

Traditional Chinese Medicine Microscopic Pathological Characteristics of Collateral Rarefaction(Micro⁃vascular Ischemia)and the Intervention of Tongxinluo

目的阐明孙络疏失的中医微观病理特征及通心络的干预效果。方法50只雄性SD大鼠随机均分为空白组,模型组,通心络低、中、高剂量组。通心络低、中、高剂量组分别应用400、800、1600 mg/kg通心络超微粉灌胃给药,空白组和模型组予等量0.9%氯化钠注射液灌胃,连续7 d。第7天灌胃4 h后,麻醉大鼠,腹部正中做纵向切口,采用夹闭肠系膜上动静脉30 min后再灌注60 min的方法制作大鼠肠系膜微血管缺血模型(空白组不夹闭)。应用正立共聚焦显微镜观察并记录造模前后肠系膜微血管参数,比较造模前后微血管血流状态、侧支数目、侧支长度和出血的情况。应用SPSS软件进行统计学分析,应用主成分分析方法进行数学模型分析。结果空白组微血管无显著异常,模型组微血管侧支数量减少、侧支长度减少,并出现出血情况及微血管内血流速度减慢,结果与空白组比较差异明显(P<0.05);通心络能显著抑制微血管侧支数量、长度的减少,抑制出血趋势,维持微血管内血液正常流动,结果与模型组比较差异明显(P<0.05)。数学模型分析结果显示,模型组主成分得分的分布较正常组差异大,通心络干预各组有向空白组恢复的趋势,主要病理特征指标为:微血管长度减少比例。结论孙络疏失以孙络数目的减少、孙络运行气血功能丧失为特征,伴有气血溢出孙络外的表现。通心络干预能够减弱孙络疏失的病理变化。

Objective:To study the microscopic pathological characteristics of collateral rarefaction and the in⁃tervention effect of Tongxinluo.Methods:50 male SD rats were randomly divided into 5 groups(the blank group,the model group,Tongxinluo low,medium and high dose groups).Tongxinluo ultrafine powder was administered to the low,middle and high dose groups by intragastric administration of 400,800 and 1600 mg/(kg·d)respectively.The blank group and the model group were administered with the same amount of saline for 7 days before model⁃ing.4 hours after the 7th day of intragastric administration,the rats were anesthetized with longitudinal incision in the middle of abdomen.Rat model of mesenteric microvascular ischemia was established by clamping the superior mesenteric artery and vein for 30 minutes and reperfusion for 60 minutes(the blank group was not clamped).Mes⁃enteric microvascular parameters were observed and recorded by confocal microscopy before and after modeling.Blood flow status,number of collateral branches,length of collateral branches and bleeding were compared before and after modeling.SPSS software was used for statistical analysis and principal component analysis was used for mathematical model analysis.Results:There was no significant abnormality in the micro-vessels of the blank group,but the number and length of the collateral vessels in the model group were decreased,and the bleeding and the blood flow velocity in the micro-vessels decreased in the model group.The results were significantly differ⁃ent from those in the blank group(P<0.05).Tongxinluo intervention significantly inhibited the decrease of the number and length of micro-vascular collateral,inhibited the bleeding trend,and maintained the normal blood flow in the micro-vascular.The results were significantly different from the model group(P<0.05).The results of math⁃ematical model analysis showed that the distribution of principal component scores in the model group was signifi⁃cantly different from that in the normal group.Tongxinluo intervention groups showed a tendency to recover to the blank group,and the main pathological characteristic index was the decrease proportion of micro-vascular length.Conclusion:Collateral rarefaction is characterized by the decrease of the number of collateral and the loss of function of Qi and blood in collateral,accompanied with the overflow of Qi and blood.Tongxinluo pre-administra⁃tion can alleviate or inhibit collateral rarefaction to a certain extent.