世界中医药

作者	单位
王珺1，张雅月2，王佳3，王冲2，陈科4，陈信义2，郎海燕5	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

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中文摘要:

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NOS3检测值显示明显下调（P<0.05）；与正常对照组比较，实验各组PGI2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PGI2、TM检测值，平衡促凝与抗凝因子密切相关。

English Summary:

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,NOS3 values in all groups were expressively reduced (P<0.05) except for Guipi Decoction group.Compared with normal control group,PGI2 detection value in experimental groups was significantly cut down (P<0.01).Compared with normal control group,TM detection values in experimental groups were greatly reduced (P>0.05).Conclusion:PLT count in peripheral blood of ITP model mice from the treatment of spleen theory is increased,and effectively hemostasis is taken,which has a close correlation between increasing TXA2 and VCAM-1,PGI2 and TM detection values are decreased,and balancing pro-coagulation and anticoagulation factors.

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