Research on the Related Factors at Different Stages of Blood Stasis Syndrome of TCM for Cerebrovascular Disease
- 厦门大学－已发表论文 
目的探讨脑血管病血淤证不同阶段血液系统及血管内皮细胞活性因子的改变。方法以脑血管硬化为血淤前期 ,急性脑梗塞为急性血淤期 ,脑卒中恢复期为慢性血淤期 ,分别观察血液流变学、血管内皮活性因子(tPA、PAI、PGFlα、TXB2、ⅧR:Ag、Fn)、抗脂质过氧化 (SOD、GSH、CAT、MDA)和微量元素 (Cu ++、Fe ++、Se ++、Zn ++)变化。结果①血淤前期脑血管硬化患者全血粘度、血浆粘度、全血还原粘度、血球压积、血沉K值增高 ,纤维蛋白原含量增高。脑血管硬化患者tPA活性降低、PAI活性增高 ,VOT后tPA活性增高、PAI活性降低。②急性血淤期以“痰”、“淤”为主的气虚血淤证 ,风痰血淤证 ,痰热腑实证 ,其纤溶系统活性下降 ,以tPA活性下降尤为显著 ;阴虚风动和肝阳上亢 ,其PGFlα下降显著 ,PGI2-TXA2 系统紊乱。③慢性血淤期患者中 ,肝阳暴亢证、痰热腑实证及气虚血淤证MDA含量显著增高 ,而SOD、GSH含量明显降低。痰热腑实证及阴虚风动证CAT含量明显降低。肝阳暴亢证、痰热腑实证、阴虚风动证和气虚血淤证血清硒含量显著降低 ,且与GSH含量变化呈正相关 ,阴虚风动证和气虚血淤证血清锌含量降低 ,且阴虚风动证血清铜降低 ,气虚血淤证则血清铁含量明显增高。结论脑血管病血淤证存在血淤前期、急性血淤期和慢性血淤期不同?Objective To investigate the changes of blood system and endothelial cell active factors at different stages of blood stasis syndrome of TCM for cerebrovascular disease.Methods To define the cerebral atherosclerosis (CAS) as the period before blood stasis,the acute cerebral infarction (ACI) as acute blood stasis period,the recovery phase of stroke (RPS) as chronic blood stasis period, and to observe the changes of hemorheology and endothelial active factors (tPA?PAI?PGFlα?TXB2?ⅧR:Ag?Fn),to observe the anti-lipid peroxidation (SOD?GSH?CAT?MDA) and the concentration of some microelements (Cu?Fe?Se?Zn).Results (1)The blood viscosity?plasma viscosity?blood reduced viscosity?HCT and ratio of K (ESR) increased in CAS patients during the period before blood stasis, while the concentration of fibrinogen increased,and the activity of tPA decreased while the activity of PAI increased. After VOT the concentration of tPA increased obviously, while the concentration of PAI decreased. (2)The decrease of fibrinolytic system's activity was shown frequently in the three types of TCM-syndrome-stagnancy of vital-energy and blood stasis, evil-wind sputum and blood stasis, evil-heat sputum and hollow-organ sthenia syndromes, which takes evil-sputum and blood stasis as their main pathogenesis. The activity of tPA decreased significantly in the three types of ACI patients. The disorder of PGI 2-TXA 2 system and the decrease of PGF1α were shown frequently in the types of wind-stirring of Yin-deficiency and hyperactivity of Liver-Yang.(3)In chronic blood stasis period (the RPS patients), the concentration of MDA increased significantly in the types of hyperactivity of Liver-Yang, evil-heat sputum and hollow-organ sthenia, vital-energy deficiency and blood stasis syndromes, while the concentration of plasma SOD and GSH decreased obviously. The concentration of CAT decreased in the types of evil-heat sputum and hollow-organ sthenia and wind-stirring of Yin-deficiency. The selenium in blood serum decreased significantly in the types of hyperactivity of Liver-Yang, evil-heat sputum and hollow-organ sthenia, wind-stirring of Yin-deficiency and vital-energy deficiency and blood stasis syndromes. The concentration of GSH was the main factor which affects the concentration of selenium in blood serum. The concentration of zinc in blood serum decreased in the latter two types. The type of wind-stirring of Yin-deficiency was accompanied by the decrease of copper in blood serum, while the type of vital-energy deficiency and blood stasis was accompanied by the increase of iron in blood serum.Conclusions The type of blood stasis of TCM syndrome in cerebrovascular diseases had three different periods which were period before blood stasis, acute blood stasis period and chronic blood stasis. there were different pathological basis in three periods.