三七总苷对高黏血症患者血小板活化分子表达和血小板聚集的影响

目的 为考查中药有效组分与作用环节的关系，采用多组分的三七总苷(血塞通软胶囊)与阿斯匹林作对照，观察血塞通胶囊对高黏血症患者血小板活化分子表达和血小板聚集的影响。方法 120例高黏血症的患者，依据随机双盲双模拟原则分为两组。血塞通(简称PNS)组和肠溶阿斯匹林(简称ASP)组各60例，治疗28天后观察治疗前后两组中医临床证候疗效，血小板黏附和聚集、内皮素、前列环素、血栓素、P选择素(CD62P)、糖蛋白(CD41)变化。结果两组中医临床证候疗效比较，PNS组总有效率86．67％，AsP组为56．67％，两组比较，差异有显著性(P<0．05)。两组治疗后血小板聚集率、血小板黏附、内皮素、前列环素、血栓素与治疗前比较，差异有显著性(P<0．0l，P<0．05)。PNS组CD62P、CD41治疗前后比较，差异亦有显著性(P<0．01)，但ASP组差异无显著性。两组甘油三酯(TG)、胆固醇(TC)、极低密度脂蛋白胆固醇(VLDLC)治疗前后比较，差异均无显著性。结论PNS抑制血小板活化的途径可能是多组分通过多环节实现的，这与仅通过抑制花生四烯酸(AA)代谢而抑制血小板聚集的ASP相比较，应有所不同。PNS具有显著降低血小板表面活性、抑制血小板黏附和聚集、抗血栓形成、改善微循环等作用，临床证候疗效亦优于阿斯匹林。

Effect of Radix Notoginseng Saponins on Platelet Activating Molecule Expression and Aggregation in Patients with Blood Hyperviscosity Syndrome

OBJECTIVE: In order to explore the relationship between the active components and the functional links of Chinese herbs, the effect of Xuesaitong capsule, a preparation made of multi-component Panax notoginseng saponins (PNS) on platelet activating molecule expression and aggregation in patients with blood hyperviscosity syndrome (BHS) was observed, with aspirin (ASP) as a control. METHODS: One hundred and twenty patients with BHS were divided, adopting randomized, double-blinded and double simulated principle into 2 groups, the PNS group and the ASP group, 60 in each group. Changes of the TCM clinical syndrome, platelet adhesion and aggregation, endothelin (ET), prostacyclin, thromboxane, CD62P and CD41 before treatment and after 28 days treatment were observed. RESULTS: Comparison between the therapeutic effects of the two groups on TCM clinical syndrome showed that the total effective rate in the PNS group was 86.67% and that in the ASP group 56.67%, showing significant difference (P < 0.05). Compared with before treatment, after treatment, levels of platelet adhesion and aggregation, endothelin, prostacyclin and thromboxane were significantly different in both groups (P < 0.05 or P < 0.01); levels of CD62P and CD41 in the PNS group were also significantly different, but the difference was insignificant in the ASP group; no significant difference was shown in both groups in levels of triglyceride, total cholesterol and very low density lipoprotein-cholesterol. CONCLUSION: PNS may inhibit activation of platelet through multiple components and multiple pathways, which is different from that of ASP, only through inhibition on arachidonic acid metabolism to suppress platelet aggregation. PNS has effects of decreasing platelet superficial activation, inhibiting platelet adhesion and aggregation, preventing thrombosis and improving microcirculation, and its therapeutic effect on clinical syndrome is better than that of ASP.