基于血管活性因子特性探讨从脾论治ITP止血机制  

Hemostatic Mechanism of“Treated From Spleen”Therapy on ITP Based on the Characteristics of Vasoactive Factors

作　　者：王珺 张雅月[2] 王佳 王冲[2] 陈科 陈信义[2] 郎海燕[5] WANG Jun;ZHANG Yayue;WANG Jia;WANG Chong;CHEN Ke;CHEN Xinyi;LANG Haiyan(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Henan Cancer Hospital,Zhengzhou 450008,China;Shunyi Hospital,Beijing Traditional Chinese Medicine Hospital,Beijing 101300,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]浙江中医药大学附属第一医院,杭州310006 [2]北京中医药大学东直门医院,北京100700 [3]河南省肿瘤医院,郑州450008 [4]北京中医医院顺义中医院,北京101300 [5]北京中医药大学东方医院,北京100078

出　　处：《世界中医药》2021年第3期367-372,380,共7页World Chinese Medicine

基　　金：国家重点基础研究发展计划项目(2013CB531705);国家自然科学基金青年项目(81703903,81803904);浙江省中医药科技计划青年人才基金项目(2018ZQ019);浙江中医药大学校级科研基金项目(2018ZG02)。

摘　　要：目的:基于血管活性因子特性探讨“从脾论治”ITP疗效机制。方法:以被动型免疫造模法建立ITP小鼠模型,以强的松、健脾益气方、健脾益气摄血方、归脾汤为干预药物,酶联免疫吸附法(ELISA)检测模型小鼠血清ET-1、NO、NOS3、TXA2、PGI2、vWF、VCAM-1、TM含量。结果:1)升血小板疗效:与正常对照组比较,注射APS后各组小鼠外周血PLT计数明显下降(P<0.01);与模型对照组比较,给药第8天各组小鼠外周血PLT计数明显升高(P<0.01)。2)止血疗效:给药前除正常对照组外,实验各组均有不同程度出血倾向;给药第6天、第8天,与模型对照组比较,实验各组出血分级下降(P<0.01)。3)血管促凝因子:与正常组比较,各组ET-1检测值明显下调(P<0.01);与正常对照组、模型对照组比较,实验各组TXA2检测值明显上调(P<0.01);与正常组比较,实验各组vWF检测值明显下调(P<0.01);与正常对照组比较,实验各组VCAM-1检测值明显下调(P<0.01)。4)血管抗凝因子:与正常组比较,实验各组NO检测值明显下降(P<0.01);除归脾汤组外,与正常对照组比较,各组NOS 3检测值显示明显下调(P<0.05);与正常对照组比较,实验各组PGI 2检测值明显下调(P>0.01);与正常对照组比较,实验各组TM检测值明显下调(P>0.05)。结论:从脾论治方升高ITP模型小鼠外周血PLT计数以及有效止血与上调血管促凝因子TXA2、VCAM-1,下调PGI 2、TM检测值,平衡促凝与抗凝因子密切相关。Objective:To explore the ITP hemostatic mechanism of“treating from spleen”therapy based on the characteristics of vasoactive factors.Methods:The ITP mouse model was established by passive immunomodeling method.The prednisone,Jianpi Yiqi Formula,Jianpi Yiqi Shexue Formula and Guipi Decoction were used as intervention drugs.The content of serum ET-1,NO,NOS3,TXA2,PGI2,VWF,VCAM-1 and TM of the model mice were detected by enzyme-linked immunosorbent assay(ELISA).Results:1)Therapeutic effect of platelet enhancement:compared with normal control group,PLT count in peripheral blood of mice in each group was significantly decreased after APS injection(P<0.01);compared with model control group,PLT count in peripheral blood of mice in each group was significantly increased on the 8th day of injection(P<0.01).2)Hemostasis effect:except for the normal control group,all experimental groups had bleeding tendency to a greater or lesser extent before injection;compared with model control group,the grade of bleeding in experimental groups decreased on the 6th and 8th day of administration(P<0.01).3)Vascular coagulation factor:compared with normal group,ET-1 detection value in each group was significantly decreased(P<0.01);compared with normal control group and model control group,TXA2 detection values in experimental groups were significantly increased(P<0.01).Compared with normal group,VWF detection values in experimental groups were significantly down-regulated(P<0.01).Compared with normal control group,VCAM-1 detection value in experimental groups was significantly reduced(P<0.01).4)Vascular anticoagulant factor:compared with normal group,NO detection value in experimental groups was significantly decreased(P<0.01);Compared with normal control group,NOS 3 values in all groups were expressively reduced(P<0.05)except for Guipi Decoction group.Compared with normal control group,PGI 2 detection value in experimental groups was significantly cut down(P<0.01).Compared with normal control group,TM detection values in experimental g

关 键 词：脾主统血 脾不统血证 从脾论治 健脾益气摄血方 免疫性血小板减少症 血管活性因子 血管促凝因子 血管抗凝因子 

分 类 号：R242[医药卫生—中医临床基础] R558.2[医药卫生—中医学]