摘要
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.
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.
出处
《中华手外科杂志》
CSCD
北大核心
2014年第4期295-298,共4页
Chinese Journal of Hand Surgery
基金
无锡市科技计划（科技支撑-医疗卫生）项目（CSEW1N1105）
关键词
血液流变学
血管
断指再植
黄芪勇安汤
Hemodynamics
Blood vessel
Finger replantation
Huang Qi Yong An decoction
