【摘要】目的：探讨视网膜静脉阻塞(RVO)患者血浆血栓素B2(TXB2)、6-酮-前列腺素F1α(6-K-PGF1α)改变与气血辨证的内在关系。方法：对53例患者进行中医气血辨证与TXB2、6-K-PGF1α水平对比观察。结果：RVO患者血浆TXB2及6-K-PGF1α水平明显高于正常对照组（P <0.01）,其结果与瘀血的形成机理相吻合。气虚血瘀型与气滞血瘀型相比较则无显著性差异（P >0.05）。结论：本病在中医辨证中不论病因如何，其客观结果皆是瘀血形成为致盲的首要因素。注重急症的瘀血证候，而不着重强调原发病因，这和中医的“急则治其标”的认识是相吻合的，提示治疗应以活血化瘀为主。
【关键词】 视网膜静脉阻塞 血栓素 6-酮-前列腺素F1α 气血辨证
Study of the relationship between the changes in plasma B2(TXB2),F1α(6-K-PGF1a) and the differentiation of symptoms and signs qi and blood in patients with RVO
AbstractAIM: In order to find the inherent relationship between the changes in plasma B2(TXB2), F1α(6-K-PGF1a) and the differentiation of syndromes in qi and blood in patients with RVO. ·METHDS: we studied 53 cases and made observation of B2(TXB2) , F1α(6-K-PGF1a) . RESULT: The level of plasma B2(TXB2), F1α(6-K-PGF1a)in the patients with RVO is much higher than the ordinary comparing group (P <0.01) , these results agreed with the mechanism of the forma significant . No significant difference (P >0.05) was found in the comparing between stagnancy of blood due to deficiency of qi to stagnancy of blood and qi. CONCLUSIONS: Regardless of the causes of the obstruction in the differentiation of symptoms and signed in Traditional Chinese Medicine, the final result was the formation of blood stasis which leaded to blindness. So it was believed that the symptoms of blood stasis should be emphasized, while the original mechanism of the diseases should be emphasized. This was identical to the traditional Chinese medicine theory of "When in urgency the illness is cured superficially", which showed that treatment should be based on promoting blood circulation and removing blood stasis. .
· KEYWORDS: RVO; B2(TXB2); F1α(6-K-PGF1a); differentiation of symptoms and signs in qi and blood
0引言
RVO是常见的急发致盲眼病，属中医“暴盲”范畴。气血辨证认为其病因在气，其标在血[1]。研究表明，RVO患者血瘀证候与TXB2、6-K-PGF1α的改变关系密切 [2,3]。为探讨中医辨型与TXB2、6-K-PGF1α的关系，我们对53例RVO患者进行观察，报告如下。
1对象和方法
1.1对象 本组RVO患者系我院1999-07/2002-07门诊及住院患者，均经眼底检查和眼底荧光血管造影确诊。53例中男33例，女20例，年龄25~76（平均52.8）岁；病程 1d～1mo；其中中央静脉阻塞36例，分支静脉阻塞17例，完全阻塞31例，不完全阻塞22例；中医辨证气虚血瘀型27例，气滞血瘀型26例。均经全面体格检查，排除心、脑血管疾病及肝炎、肾炎、糖尿病、周血管疾病等。正常对照组系我院自愿体检者25例。其中，男14例，女11例；年龄23～75（平均50.6）岁，排除眼部及全身任何器质性、血管性疾病。
1.2方法 嘱患者停服一切可能影响本指标的药物1wk后，均于早晨7～8时，空腹，静息20min后抽取肘静脉血3mL，标本置于含5g/L消炎痛液20μL的试管中（以抑制前列腺素的体外合成），分离血浆，吹干后置于-70℃低温冰箱中保存。血浆TXB2和6-K-PGF1α(单位为pg／mL)均采用125I标记放射免疫法，药盒由苏州医学院止血与血栓研究室提供，操作按试剂盒说明进行。
统计学处理：数据采用SPSS 10.0 for Windows 统计分析软件进行处理。数据以均数（ ）±标准差(s )表示，组间比较用t 检验。
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