CAJ | 학술논문

目的观察土三七在建立的肝小静脉闭塞(HVOD)大鼠模型中对血液系统毒性和血管内皮分泌功能的影响,为临床治疗土山七所致的HVOD提供依据和思路.方法取60只SD大鼠,雌雄各半,分成5组,设空白对照组(蒸馏水20 ml/kg),土三七低剂量组(5 g/kg)、中剂量组(10 g/kg)、高剂量组(20 g/kg)和三七对照组(10 g/kg),连续给药4周.观察土三七对大鼠血细胞分类、凝血功能、血管内皮分泌功能及脾脏组织病理的影响.组间比较采用方差分析(One-WayANOVA).结果给药4周后,土三七各组大鼠体质量降低;白细胞数、中性粒细胞数、淋巴细胞数、单核细胞数和嗜酸粒细胞数均显著升高;血小板数和血小板压积显著降低,平均血小板体积和血小板分布宽度均显著升高;血液凝血酶原时间、活化部分凝血酶原时间、凝血酶时间、凝血酶原比值、凝血酶原国际标准化比值和纤维蛋白原时间均明显升高,血小板压积、纤维蛋白原和血小板聚集率显著降低;内皮素和一氧化氮水平均显著升高;与空白对照组比较,均P＜0.01或P＜0.05.脾脏中脾小结明显减少,未见生发中心,大量淋巴细胞弥漫分布,红髓血窦减少. 结论土三七对正常大鼠血液系统有一定毒性作用,能降低血小板和血小板压积,抑制血液凝血时间和血小板聚集作用,提高血管内皮分泌功能,减少脾脏中脾小结和生发中心.目前临床治疗土山七所致HVOD的观点,中药以活血化瘀、西药以抗凝抗血小板聚集为主的治疗方案是否妥当值得商榷.
목적 관찰토삼칠재건립적간소정맥폐새(HVOD)대서모형중대혈액계통독성화혈관내피분비공능적영향,위림상치료토산칠소치적HVOD제공의거화사로.방법 취60지SD대서,자웅각반,분성5조,설공백대조조(증류수20 ml/kg),토삼칠저제량조(5 g/kg)、중제량조(10 g/kg)、고제량조(20 g/kg)화삼칠대조조(10 g/kg),련속급약4주.관찰토삼칠대대서혈세포분류、응혈공능、혈관내피분비공능급비장조직병리적영향.조간비교채용방차분석(One-WayANOVA).결과 급약4주후,토삼칠각조대서체질량강저;백세포수、중성립세포수、림파세포수、단핵세포수화기산립세포수균현저승고;혈소판수화혈소판압적현저강저,평균혈소판체적화혈소판분포관도균현저승고;혈액응혈매원시간、활화부분응혈매원시간、응혈매시간、응혈매원비치、응혈매원국제표준화비치화섬유단백원시간균명현승고,혈소판압적、섬유단백원화혈소판취집솔현저강저;내피소화일양화담수평균현저승고;여공백대조조비교,균P＜0.01혹P＜0.05.비장중비소결명현감소,미견생발중심,대량림파세포미만분포,홍수혈두감소. 결론 토삼칠대정상대서혈액계통유일정독성작용,능강저혈소판화혈소판압적,억제혈액응혈시간화혈소판취집작용,제고혈관내피분비공능,감소비장중비소결화생발중심.목전림상치료토산칠소치HVOD적관점,중약이활혈화어、서약이항응항혈소판취집위주적치료방안시부타당치득상각.
Objective To observe the effects ofGynura segetum in rats with hepatic veno-occlusive disease (HVOD).Methods Sixty Sprague-Dawley rats were assigned to a blank control group,one of three Gynura segetum treatment groups (low-dose group,5.0 g/kg; mid-dose group,10 g/kg; high-dose group,20 g/kg),or a pseudo-drug group (10 g/kg of pseudo-ginseng).After 28 days of treatment,effects on white blood cell count,coagulation,secreted factors from vascular endothelium,and histopathology of the spleen were observed and inter-group differences were statistically assessed.Results After the 4-week administration,all rats in the Gynura segetum treatment groups showed decrease in body weight,increases in numbers of leukocytes,neutrophils,lymphocytes,monocytes and eosinophils.decreases in platelets and platelet hematocrit,and increases in mean platelet volume and platelet distribution.In addition,the Gynura segetum treatments increased the prothrombin time,activated partial thromboplastin time,thrombin time,prothrombin ratio and international normalized ratio,but decreased the PT％,fibrinogen level and platelet aggregation.Serum levels of endothelin and nitric oxide were also elevated by the Gynura segetum treatments.All measured parameters showed significant differences from the control group (P ＜ 0.01 or ＜ 0.05).Finally,the splenic follicles were significantly reduced and the spleens showed an absence of germinal centers along with a large number of diffuse lymphocytes and reduced red pulp sinusoids.Conclusion The Gynura segetum treatment has some toxic effects; it can reduce platelet count and platelet hematocrit,inhibit blood clotting time and platelet aggregation,increase the secretion of factors from the vascular endothelium and disrupt spleen histology.