推拿五法对深静脉血栓模型大鼠凝血、纤溶功能的影响

Effect of five tuina manipulations on blood coagulation and fibrinolysis in rats with deep vein thrombosis

目的通过研究推拿五法对深静脉血栓模型大鼠凝血、纤溶功能的影响,探究推拿手法的安全应用。方法将72只雄性SD大鼠随机分为模型组、点法组、拨法组、揉法组、推法组、牵拉法组,通过不完全结扎法制作深静脉血栓模型。造模后第2天开始进行推拿手法干预(1次/d),点法组、揉法组、拨法组、推法组运用按摩推拿手法模拟仪分别定性模拟点法、揉法、拨法和推法,牵拉法组运用牵拉手法模拟仪定性模拟牵拉法。分别于干预3、10 d后取材。用全自动凝血分析仪检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白酶原(FIB),ELISA法检测D-二聚体、血栓素B2(TXB2)、6-酮前列腺素F1α(6-Keto-PGF1α)的含量,并统计分析数据。结果干预3 d后揉法组APTT与模型组比较时间缩短(P<0.05);干预10 d后拨法组与模型组比较PT时间缩短(P<0.05),APTT时间缩短(P<0.01)。TT和FIB在干预3 d和10 d后,各组与模型组比较差异均无统计学意义(P>0.05)。干预3 d后,拨法组与模型组比较D-二聚体含量增高(P<0.05)。干预3 d后,拨法组、推法组与模型组比较6-Keto-PGF1α含量增高(P<0.05),牵拉法组与模型组比较含量增高(P<0.01);干预10 d后,点法组与模型组比较TXB2含量增高(P<0.05),点法组、推法组、牵拉法组与模型组比较6-Keto-PGF1α含量降低(P<0.01),揉法组与模型组比较含量降低(P<0.05)。结论从凝血、纤溶功能角度分析,点法、推法、牵拉法作用于深静脉血栓大鼠安全性高,拨法、揉法作用于深静脉血栓大鼠存在一定风险。

Objective To explore the safe application of the tuina techniques through studying the effects of five tuina manipulations on the coagulation and fibrinolysis functions of deep vein thrombosis model rats.Methods Seventy-two male SD rats were randomly divided into 6 groups(n=12):the model group,pointing manipulation group,plucking manipulation group,kneading manipulation group,pushing manipulation group and pulling manipulation group.Deep vein thrombosis models were established by incomplete ligation.Tuina manipulation intervention was applied on the second day after modeling(1 time/day).The pointing,plucking,kneading and pushing groups were applied manipulations qualitatively by the tuina manipulation simulator,and the rats of pulling group were intervened by the pulling manipulation simulator.The materials were collected on day 3 and day 10 after the intervention respectively.Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(FIB)were detected by the automatic coagulation analyzer.D-dimer,thromboxane B2(TXB2)and 6-ketoprostaglandin F1α(6-Keto-PGF1α)were detected by ELISA.Results After 3 days of intervention,the APTT of the kneading manipulation group was shorter than that of the model group(P<0.05);after 10 days of intervention,the APTT of the plucking group was shorter than that of the model group(P<0.01).No statistic difference in TT and FIB was observed between the model group and other groups.After 3 days of intervention,the D-dimer content of the plucking group was higher than that of the model group(P<0.05);while in terms of 6-Keto-PGF1α,the content of plucking and pushing group was higher than that of the model group(P<0.05),and the content of the pulling group was higher than that of the model group(P<0.01).After 10 days of intervention,the TXB2 content of the pointing group was higher than that of the model group(P<0.05);while in terms of 6-Keto-PGF1α,the content of the pointing,pushing and pulling groups was lower than that of the model group(P<0.01),and the content of the kneading group was lower than that of the model group(P<0.05).Conclusion The pointing,pushing and pulling methods are probably safe,while the plucking and kneading methods might be of certain risks in deep vein thrombosis rats judging from the perspective of blood coagulation and fibrinolysis.