摘要
对52例高黄痘胆汁郁积和30例慢重肝患者血浆和实验性肝内胆汁郁积动物的血浆和肝脏中 TXB_2、PGF_(1a)变化进行了观察。结果表明患者血浆 TXB_2、PGF_(1a)均高于正常值(P<0.01～0.05)。动物血浆中 TXB_2明显升高(P<0.01),而 PGF_(1a)则低于正常(P<0.01);肝脏中各值与正常差异无显著性(P>0.05)。临床血瘀血热及兼实证者 TXB_2,PGF_(1a)呈比例上升,兼虚证者则不成比例,故二者的 PGF_(1a)/TXB_2比值分别大干及小于正常。临床及实验研究证明:凉血活血中药有消退黄痘,降低 TXB_2、PGF_(1a)及调整其比值作用。协定处方Ⅱ号作用优于Ⅰ号。
Clinical observations and experimental studies were made in 52 cases of chronic cholestatic hepatitis,30 cases of chronic severe hepatitis,30 healthy control persons,and 30 animals with experimental intrahepatic cholestasis.The results were as follows:Plasma TXB_2 and PGF_(1α)were higher than their normal values both in cases of chronic cholestatic hepatitis and in cases of chronic severe hepatitis(P<0.01),the ratio of TXB_2 and PGF_(1α)was normal in cases of chronic severe hepatitis and lower than normal value in cases of chronic cholestatic hepatitis(P<0.01).The cases were divided into 4 types(hepatitis dueto blood stasis and blood heat,blood stasis and blood heat accompanying symptoms of fluid retention in the epigastrium,damp-heat,and composite factors) according to differentiation of symptoms and signs on the basic theories of TCM.Significant difference was found in TXB_2,PGF_(1α),PGF_(1α)/TXB_2 and bilirubin when compared with each other in the 4 types of hepatitis patients(P<0.01).Bilirubin,TXB_2,PGF_(1α)and PGF_(1α)/TXB_2 in the survivors became normal or close to normal after they were treated with blood-cooling and circulation- promoting Chinese herbal medicine and prescriptions by changing their dosages according to differentiation of symptoms and signs on the basic theories of TCM.The therapeutic effect of prescription Ⅱ was more satisfactory than that of prescription Ⅰ.Changes of plasma TXB_2 and PGF_(1α) in the experimental animals were more significant than those both in the control group and in the group treated with prescriptions Ⅰ and Ⅱ(p<0.01),but in the liver only the ratio of TXB_2 and PGF_(1α) was lower than that in normal animals(P<0.01).Though both prescriptions Ⅰ and Ⅱ were effective in decreasing the levels of TXB_2 and PGF_(1α),and prescription Ⅱ was more effective than prescription Ⅰ,they had no noticeable effect on regulating their ratio.It has proved in clinical observations and animal experiments that blood-cooling and circulation-promoting Chinese herbal medicine and prescriptions with their dosages changed according to differentiation of symptoms and signs on the basic theories of TCM are effective both in decreasing TXB_2 and PGF_(1α) and in regulating their ratio.
