CAJ | 학술논문

目的研究黄芪勇安汤对断指再植术后血管新生和血液流变学的影响,初步探讨其在微循环恢复过程中的作用机制.方法自2010年3月至2013年4月,60例行断指再植术患者随机分为对照组和试验组.对照组术后常规予以抗感染及补液治疗,口服200 ml矫味剂作为安慰剂,试验组根据辨证施治原则每日服用一剂黄芪勇安汤,两组服药时间均为术后1周.观察术后2周患者疗效,术后6、12、24、48、72、120 h采用流式细胞术检测各时间点患者外周血碱性成纤维细胞生长因子(bFGF)和血管内皮生长因子(VEGF)含量,全自动血液流变仪检测血液流变学各指标.结果试验组患者术后2周的疗效较对照组明显提高(P＜0.05);试验组术后48h和72h的bFGF和VEGF表达均明显高于对照组,差异有统计学意义(P＜0.05);试验组全血黏度、全血还原黏度、红细胞聚集指数以及电泳指数较对照组均有所降低,而红细胞变形指数则升高.结论黄芪勇安汤通过上调断指再植患者术后外周血bFGF和VEGF的表达而促进指体连接部位新生血管的产生,降低血黏度,改善患者再植指体的血运效率.
목적 연구황기용안탕대단지재식술후혈관신생화혈액류변학적영향,초보탐토기재미순배회복과정중적작용궤제.방법 자2010년3월지2013년4월,60례행단지재식술환자수궤분위대조조화시험조.대조조술후상규여이항감염급보액치료,구복200 ml교미제작위안위제,시험조근거변증시치원칙매일복용일제황기용안탕,량조복약시간균위술후1주.관찰술후2주환자료효,술후6、12、24、48、72、120 h채용류식세포술검측각시간점환자외주혈감성성섬유세포생장인자(bFGF)화혈관내피생장인자(VEGF)함량,전자동혈액류변의검측혈액류변학각지표.결과 시험조환자술후2주적료효교대조조명현제고(P＜0.05);시험조술후48h화72h적bFGF화VEGF표체균명현고우대조조,차이유통계학의의(P＜0.05);시험조전혈점도、전혈환원점도、홍세포취집지수이급전영지수교대조조균유소강저,이홍세포변형지수칙승고.결론 황기용안탕통과상조단지재식환자술후외주혈bFGF화VEGF적표체이촉진지체련접부위신생혈관적산생,강저혈점도,개선환자재식지체적혈운효솔.
Objective To observe the effect of Huang Qi Yong An decoction on angiogenesis and hemodynamics after finger replantation and investigate its mechanism in restoring blood circulation.Methods Sixty patients who had replantation of severed fingers from March 2010 to April 2013 were involved in the study.The patients were randomly divided into the control group and the experimental group.Patients in the control group were treated with conventional therapy and took orally 200ml taste masking agent as a placebo everyday for a week.Based on the principles of evidence-based medicine,patients in the experimental group took Huang Qi Yong An decoction everyday for a week.Postoperative symptoms and signs were observed for two weeks.Expression of bFGF and VEGF in the peripheral blood was detected using flow cytometry at 6,12,24,48,72 and 120 postoperative hours.Blood viscosity was measured with an automatic blood rheometer.Results Patients in the experimental group had improved results than those in the control group after two weeks (P ＜ 0.05).The expressions of bFGF and VEGF in the experimental group were significantly higher than those in the control group at 48 and 72 hours (P ＜ 0.05).Whole blood viscosity,whole blood reduced viscosity,red cell assembling index and electrophoresis index in the experimental group were significantly lower comparing to those in the control group (P ＜ 0.05).On the other hand erythrocyte deformation index was significantly higher (P ＜ 0.05).Conclusion Huang Qi Yong An decoction can upregulate the expression of bFGF and VEGF in the peripheral blood in finger replantation patients and promote angiogenesis at the repair site,decrease blood viscosity,and improve blood supply efficiency of the replanted fingers.