清热解毒凉血化瘀治疗温病湿热证的实验研究  

Experimental studies on the treatment of clearing away heat and removing toxic substances(清热解毒),cooling blood to dissipate blood stasis(凉血化瘀) on dampheat syndrome of seasonal febrile disease(温病湿热症)

作　　者：张艺平[1] 韩鹏[1] 刘仕昌[2] 彭胜权[2] 

机构地区：[1]解放军第一五七医院,广东广州510510 [2]广州中医药大学温病教研室

出　　处：《中国中西医结合急救杂志》2002年第3期162-165,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广州中医药大学博士论文部分

摘　　要：目的 :探讨清热解毒、凉血化瘀对温病湿热证的作用 ,并从微观角度探讨温病湿热证血瘀的客观性。方法 :采用复合因素复制新西兰兔温病湿热证模型 ,设立黄连解毒汤组 (A组 ) ,黄连解毒汤加丹参、赤芍组(B组 ) ,王氏连朴饮组 (C组 ) ,王氏连朴饮加丹参、赤芍组 (D组 ) ,湿热证模型组和正常对照组 ,观察各组症状及体温变化 ,同时检测血浆内毒素 (ET)、肿瘤坏死因子 (TNF)、白介素 1(IL 1)、血液流变学、血小板、凝血功能、血栓素 B2 (TXB2 )、6酮前列腺素 F1α(6 keto PGF1α)等指标变化。结果 :药物 B组症状表现较轻 ;药物A组和 B组体温升高较小。药物治疗各组 ET、TNF和 IL 1均较模型组显著降低 (P<0 .0 5或 P<0 .0 1) ,A组和 B组 ET、IL 1的含量均低于 C组 (P均 <0 .0 5 )。湿热模型组血液流变学各参数、血小板计数及聚集率、凝血指标、TXB2 、6 keto PGF1α与正常对照组比较均有显著性差异 (P均 <0 .0 1)。药物 B组和 D组改善上述指标效果较好 ,优于 A组和 C组 (P<0 .0 5或 P<0 .0 1)。结论 :清热解毒对于温病湿热证具有较好的治疗作用。温病湿热证存在传统四诊不易察觉的微观血瘀 ,治疗时加入凉血化瘀之品 ,可获佳效。Objective:To explore the effects of clearing away heat and removing toxic substances(CAHRTS,清热解毒),cooling blood to dissipate blood stasis(CBDBS,凉血化瘀)on dampheat syndrome of seasonal febrile disease(DHSSFD,温病湿热证),and to study objectivity of blood stasis of DHSSFD from microcosmic angle.Methods:New Zealand rabbit DHSSFD models were established by compound factors and randomly divided into Huanglian Jiedu decoction(黄连解毒汤) group(group A),Huanglian Jiedu decoction plus salvia miltiorrhiza (SM,丹参)and paeonia lactiflora (PL,赤芍) group(group B),Wangshi Lianpu drink(王氏连朴饮)group(group C),Wangshi Lianpu drink plus SM and PL group(group D),DHSSFD group (group E),normal control group(group F).The changes in following parameters,including symptom and temperature,plasma levels of endotoxin(ET),tumor necrosis factor(TNF),interleukin1(IL1),thromboxin B 2(TXB 2), 6ketoprostaglandin F 1α (6ketoPGF 1α ),platelet,thrombin parameters,blood rheology(BR) parameters were observed.Results:Comparing with model group,group B has a slighter symptom.There was a smaller increase in temperature in group A and group B.The contents of ET,TNF and IL1 in plasma in every treatment groups decreased significantly than those in model group( P <0 05 or P <0 01).The contents of ET and IL1 in plasma in group A and group B were significantly lower than those in group C.BR parameters, platelet,thrombin parameters,the rate between TXB 2 and 6ketoPGF 1α of model group had significant difference compared with normal control group (all P <0 01),group B and group D had better curative effect than group A and group C on improving abovementioned parameters ( P <0 05 or P <0 01). Conclusions: The method of CAHRTS plays an important part in treating DHSSFD.Microcosmic blood stasis of DHSSFD is existed objectively.Treating with the drugs of CBDBS results in better curative effect.

关 键 词：清热解毒 凉血化瘀 治疗 湿热证 黄连解毒汤 王氏连朴饮 丹参 赤芍 

分 类 号：R254.2[医药卫生—中医内科学]