水蛭内科临床应用研究进展

Research Progress on Clinical Application of Hirudo in Internal Medicine

以"水蛭"为关键词,通过文献检索总结近10年来关于水蛭的相关报道,归纳并且综述水蛭的内科临床应用的研究进展,期望能为深入开发利用水蛭,提高水蛭临床疗效提供参考。文献研究发现:水蛭在治疗脑梗死、脑出血、眩晕、心绞痛、慢性肾病(如原发性肾病综合征、肾病综合征高凝血症、狼疮性肾炎)、桥本氏甲状腺炎等诸多疾病中均取得良好疗效。随着当前疾病谱的变化,以心脑血管病、肾脏病等为代表的慢性病患者增长迅速,"久病入络,慢病多瘀",慢病的瘀血证型呈增多趋势,故当前多用活血化瘀的治疗方法,水蛭能活血化瘀不伤气,且药性安全温和,临床应用广泛,但相较于丹参、三七,对水蛭的研究还比较欠缺,目前水蛭的临床研究有样本数量较少、缺少合理的研究设计的问题。今后关于水蛭的研究,应该更多的荟萃历代应用水蛭文献,并且整理和挖掘当代著名医家应用水蛭的经验,以期发现和归纳水蛭的功效。在实验研究方面,应该更多地临床药理研究,在临床研究方面,应该更多地进行样本数量更大,设计更严谨的研究方案,以期进一步深入细致的研究。相信随着探究的深入,水蛭将发挥出更大的作用。

This article took"leech"as the key word,summarized the relevant reports on leech in the past ten years through literature retrieval,and reviewed the research progress of leech’s internal medicine clinical application,hoping to provide reference for further development and utilization of leech and improvement of leech’s clinical efficacy.Literature research found that Hirudo has achieved good therapeutic effects in the treatment of cerebral infarction,cerebral hemorrhage,vertigo,angina pectoris,chronic nephropathy(such as primary nephrotic syndrome,nephrotic syndrome hypercoagulability,lupus nephritis),Hashimoto’s thyroiditis and many other diseases.With the changes of the current disease spectrum,patients with chronic diseases such as cardiovascular and cerebrovascular diseases and kidney diseases are growing rapidly."Chronic diseases can involve collaterals and chronic diseases cause more blood stasis".And blood stasis syndrome types of chronic diseases are on the increase.Therefore,the current multi-purpose treatment methods are promoting blood circulation and removing blood stasis.Leeches can promote blood circulation and remove blood stasis without damaging Qi,and have safe and mild drug properties and wide clinical application.However,compared with Danshen(Salvia miltiorrhiza)and Sanqi(Panax notoginseng),the research on leeches is still relatively lacking.The current clinical research on leeches has the problems of small sample number and lack of reasonable research design.In the future researches on leeches,we should gather more literature on the application of leeches in past dynasties,and sort out and excavate the experience of famous contemporary doctors in the application of leeches,so as to discover and summarize the efficacy of leeches.In the aspect of experimental research,more clinical pharmacological researches should be carried out,and in the aspect of clinical research,more samples and more rigorous research schemes should be designed in order to make further in-depth and detailed research.It is believed leeches will play a greater role with the further exploration.