活血益气法对大鼠股骨骨折后高凝血状态的影响  

Impact of Blood-activating and Qi-nourishing Therapy on Hypercoagulable State of Rats After Femur Fracture

作　　者：吴征杰 李灿辉 杨宇 曾焰辉 司徒晓鹏 何家雄 吴家盛 周健生 

机构地区：[1]广东省佛山市中医医院骨科,广东佛山528000

出　　处：《广州中医药大学学报》2017年第2期231-235,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药管理局课题(编号:2014ab00323);广东省佛山市科技局课题(编号:20141473)

摘　　要：【目的】探讨活血益气法对股骨骨折后大鼠模型高凝血状态的影响。【方法】将120只SD大鼠随机分为4组:正常组、模型组、低分子肝素钠(LMWH)组、LMWH+通脉汤组,每组30只。复制大鼠股骨创伤骨折模型。造模成功后,LMWH组给予低分子肝素钠注射液(600 U/kg)皮下注射;LMWH+通脉汤组给予LMWH(600 U/kg)皮下注射联合通脉汤(0.588 g/m L)灌胃。模型组大鼠给予等体积生理盐水皮下注射。治疗时间为术后1~7 d。观察各组大鼠左大隐静脉血管组织病理学改变并计算血管相对体积、厚度和数量;采用生化分析仪测定D-二聚体(D-D)、纤维蛋白原(FIB)水平;采用血流动力学检测仪测定低切变率下全血黏度(WBV-lsr)、高切变率下全血黏度(WBV-hsr)。【结果】成功造模后第7天,模型大鼠左大隐静脉镜下可见内皮细胞显著减少,红细胞显著凝聚,有大的血栓形成。与正常组比较,模型组大鼠血浆D-D、FIB、WBV-lsr、WBV-hsr水平明显升高,差异有统计学意义(P<0.05)。治疗7 d后,LMWH+通脉汤组和LMWH组血浆D-D、FIB、WBV-lsr、WBV-hsr水平明显低于模型组(P<0.05),且LMWH+通脉汤组的降低作用明显优于LMWH组。LMWH+通脉汤组血管内皮细胞排到相对整齐、宽度一致,无细胞水肿扩大现象。【结论】活血益气法可有效减轻骨折大鼠模型的血液高凝状态。Objective To explore the impact of blood-activatingand qi-nourishing therapy on the hypercoagulable state of rats after femur fracture. Methods One hundred and twenty SD rats were randomly divided into 4groups,namely normal group,model group,low-molecular-weight heparin（LMWH）group,combination group（LMWH ＋ Tongmai Decoction）,30 rats in each group. The rat model of femur fracture was established. After successful modeling, LMWH group was given subcutaneous injection of LMWH 600 U/kg, and the combination group was given subcutaneous injection of LMWH 600 U/kg together with gastric gavage of Tongmai Decoction,the model group was given subcutaneous injection of the same volume of normal saline. The treatment lasted for 1-7days after the surgery. The pathologic features of the left great saphenous vein were observed by HE staining method,and the relative volume,thickness and quantity of the blood vessels were also measured. The plasma D-dimer（D-D） and fibrinogen（FIB） levels were determined by biochemical analyzer, and the plasma levels of whole blood viscosity at low shear rate（WBV-lsr）and whole blood viscosity at high shear rate（WBV-hsr）were measured with hemodynamic detector. Results On day 7 after the modeling,less endothelium cells,agglomerative red cells, and large thrombi were found in the great saphenous vein tissue section of the model group under microscope. Compared with the normal group, the levels of D-D, FIB, WBV-lsr and WBV-hsr in the model group at various time points were increased,the difference being significant（P〈0.05）. After 7-day treatment,the levels of D-D,FIB,WBV-lsr and WBV-hsr in LMWH group and combination group were lower than those of the model group,and the decrease in the combination group was superior to LMWH group（P〈0.05）. The blood vessel endothelium cells in the combination group were arranged neatly with same cellular width while without enlargement or swelling, the effect being superior to that of LMWH group. Conclusion Blood-activating and Qi-nou

关 键 词：活血益气法 通脉汤 股骨骨折 高凝血状态 疾病模型 动物 大鼠 

分 类 号：R285.5[医药卫生—中药学]