消栓通脉颗粒调节Toll受体介导的炎症反应治疗深静脉血栓  

Effects of Xiaoshuantongmai granules on inflammatory response mediated by Toll-like receptors in deep venous thrombosis

作　　者：王彬[1] 李霞[2] 张玥[1] 刘政[1] 

机构地区：[1]山东中医药大学附属医院周围血管病科,山东济南250011 [2]山东省医学科学院基础医学研究所山东省罕少见病重点实验室,山东济南250062

出　　处：《中国新药与临床杂志》2012年第5期254-259,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：国家自然科学基金资助项目(81102600);国家自然科学基金资助项目(30901918);山东省优秀青年科学家奖励基金(BS2010YY069);山东省中医药发展计划(2011-091)

摘　　要：目的探讨Toll样受体介导的炎症反应在下肢深静脉血栓(DVT)发病中的作用及消栓通脉颗粒治疗DVT的靶点与机制。方法 60例急性期DVT患者随机分为中西医结合组(结合组)30例和西药组30例。西药组给予尿激酶20万单位静滴,1次.d-1,低分子肝素钙4 100单位皮下注射,1次.d-1,均连续用药14 d。结合组在西药组基础上口服消栓通脉颗粒,每次10 g,2次.d-1,连续用药14 d。30例健康查体者为正常组。RT-PCR法检测治疗前后外周血单核细胞中TLR2、TLR4、IL-6、TNF-α、IFN-γmRNA表达,测量患肢肢围变化,观察静脉再通情况。结果与正常组比较DVT患者外周血TLR2、TLR4与IL-6、TNF-α、IFN-γmRNA表达均升高(P<0.05),且TLR2、TLR4 mRNA水平与IL-6、TNF-α、IFN-γmRNA水平呈正相关(P<0.05);结合组外周血TLR2、TLR4与IL-6、TNF-α、IFN-γmRNA表达较治疗前显著降低(P<0.05)。结论 Toll样受体介导的炎症反应可能在DVT形成中发挥着重要作用,消栓通脉颗粒通过靶向TLR2、TLR4,减少炎性细胞因子产生,保护血管内皮细胞,从而对DVT有治疗作用。AIM To investigate the effects of Xiaoshuantongmai granules on inflammatory response mediated by Toll-like receptors （TLR2 and TLR4） in the treatment of deep venous thrombosis （DVT）, and discuss the mechanisms by which Xiaoshuantongmai granules modulating inflammatory response mediated by Toll-like receptors. METHODS Sixty acute DVT patients were randomly allocated to control group or trialgroup. The patients in the control group were administered with urokinase （200 000 U, iv, qd） and heparin calcium injection （4 100 U, sc, qd） for 14 days, and the patients in the trial group were administered with urokinase （200 000 U, iv, qd）, heparin calcium injection （4 100 U, sc, qd） and Xiaoshuantongmai granules （10 g, po, bid） for 14 days. Thirty healthy volunteers were recruited as normal group. The TLR2, TLR4, IL-6, TNF-α, and IFN-γmRNA of peripheral blood mononuclear cell were analyzed by RT-PCR before and after the treatment. The affected limbs were measured and the recanalization rates were observed. RESULTS Compared with the normal group, the expression of TLR2, TLR4, IL-6, TNF-α, IFN-γ mRNA in the control group and the trial group increased significantly （P 〈 0.05）. In addition, the level of TLR2, TLR4 mRNA and the level of IL-6, TNF-α, IFN-γ mRNA were in positive correlation （P 〈 0.05）. Compared with the control group, the expressions ofTLR2, TLR4, IL-6, TNF-α, IFN-γ mRNA in the trial group were downregulated obviously （P〈 0.05）. CONCLUSION The inflammatory response mediated by Toll-like receptors may play an important role in the development of DVT, and can be downregulated by Xiaoshuantongmai granules, which might be the mechanism of Xiaoshuantongmai granules in the treatment of DVT.

关 键 词：消栓通脉颗粒 TOLL样受体 炎症反应 静脉血栓形成 

分 类 号：R654.4[医药卫生—外科学]