Relation of pale tongue, purple tongue and TXA2-PGI2 regulation system

This paper analysed the relationship between pale tongue, purplish tongue and TXB2, 6-keto-PGF1 alpha levels in plasma of 70 cases with coronary heart disease (CHD) and 45 normal subjects. The results showed the following characteristics: The pale tongue group (217.76 +/- 30.5 pg/ml) showed no significant difference in TXB2 level compared with the normal group (164.49 +/- 10.85 pg/ml, P greater than 0.05), while both showed significant difference compared with the purplish tongue group (360.1 +/- 31.3 pg/ml) and that with purple spots (485.07 +/- 106.1 pg/ml, P less than 0.01). The pale tongue group (179.29 +/- 9.08 pg/ml) showed a significant difference in 6-keto-PGF1 alpha level compared with the normal group (244 +/- 19.31 pg/ml, P less than 0.01), but it showed no significant difference compared with the purplish tongue group (185.08 +/- 17.07 pg/ml) and that with purple spots (229.3 +/- 33.2 pg/ml, P greater than 0.05). The comparison between the groups of purplish tongue and that with purple spots and the normal group showed no significant difference (P greater than 0.05). The pale tongue group (1.33 +/- 0.18) showed a marked difference in TXB2/6-keto-PGF1 alpha ratio compared with the normal group (0.72 +/- 0.04, P less than 0.01), the purplish tongue group (2.12 +/- 0.22, P less than 0.01) and that with purple spots (2.25 +/- 0.55, P less than 0.05). The purplish tongue group and that with purple spots showed significant difference compared with the normal group (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

紫暗舌与舌血流关系的研究

目的探索紫暗舌与舌血流的关系.方法运用激光多普勒血流仪分别对56例紫暗舌及54例正常舌从舌面多部位测试舌血流灌注量及流速,同时进行对照分析. 结果紫暗舌组患者的舌血流灌注量明显低于正常舌组(P ＜0.01),而流速明显增快(P ＜0.01).舌体各部位(舌尖、舌中、舌边)之间的舌血流灌注量及流速参数接近,无统计学差异. 结论紫暗舌患者舌血流灌注量降低、流速增快.舌微循环障碍可能是紫暗舌形成的主要因素之一.     

血瘀证模型大鼠舌象评价标准研究

目的通过模型动物舌体颜色及其光泽度的变化,判定血瘀证并建立血瘀证动物模型评价标准。方法40只SD大鼠随机分为5组,正常大鼠、寒凝血瘀证模型大鼠、肾上腺素皮下注射致血瘀证模型大鼠、10%大分子右旋糖苷尾静脉注射致血瘀证模型大鼠,采用数码相机拍摄舌象,分析比较所有舌腹面色泽深浅和舌下脉络呈色长短。结果舌腹面色泽深浅分级如下:舌质色泽红润记0分;舌质色泽红润略暗记1分;舌质色泽紫暗记2分;舌质色泽紫黑记3分。舌腹面舌下脉络色泽与长短分级如下:舌下脉络色泽红润,显色约1/3舌体长,记0分;舌下脉络色泽紫暗,显色大于1/3小于1/2舌体长,记1分;舌下脉络色泽紫暗,显色约1/2舌体长,记2分;舌下脉络色泽紫黑,显色约2/3舌体长,记3分。结论建立了血瘀证模型动物舌体色泽和舌下脉络的半定量评价标准,为血瘀证和活血化瘀药物的客观化研究提供了科学依据。     

Relation of coronary heart disease based on traditional Chinese medicine syndrome differentiation and prostaglandin, blood platelet function, and protein C]

The relationship between 68 cases of thromboxane B2(TXB2), 6-keto-prostaglandin F1 alpha (6-K-PGF1 alpha), beta-thromboglobulin (beta TG), platelet factor 4 (PF4), protein C antigen (PC:Ag), total-proteins (T-Ps) with coronary heart disease (CHD) based on TCM syndrome differentiation were studied. 45 cases of male, 23 cases of female, they were divided into 30 cases of blood stasis group and 38 cases of Qi syndrome group. 39 healthy subjects of same age and sex were chosen as the control group. The results were as follows: The TXB2, beta TG, PF4 in CHD were higher than those of control. 6-K-PGF1 alpha was lower (P less than 0.05, P less than 0.01) respectively. The TXB2 in blood stasis was significantly higher than that of Qi syndrome while the 6-K-PGF1 alpha in Qi Syndrome was significantly lower than that of blood stasis syndrome (P less than 0.01). The PC:Ag, T-Ps in CHD were higher than those of the control. The PC:Ag in blood stasis was lower and was higher in Qi syndrome (P less than 0.01). It showed that microthrombosis formed in blood stasis group caused blood flow slowly, while coronary-pathy and/or coronary spasm were the major pathologic change in Qi syndrome. Elevated PC:Ag, T-Ps in Qi syndrome showed that there were complementary action to hypercoagulation in Qi syndrome to eliminate coagulation factor to prevent coagulation happening and stimulation of fibrinolysin activator, promoting fibrinogenolysis.(ABSTRACT TRUNCATED AT 250 WORDS)     

大肠癌化疗前后舌象变化的临床观察

目的：观察大肠癌患者化疗前后的舌象特点与变化规律。方法：采用数码相机拍摄大肠癌患者化疗前后的数字舌图，并进行统计学分析。结果：化疗前，有较高比例的患者表现为基本正常的舌象。舌象观察指标的异常率从高到低依次为苔色〉舌色〉苔质〉舌形。化疗后紫舌、瘀斑舌的出现率明显增加。黄苔的程度有加重，舌苔增厚，或变腻苔。结论：在化疗实施前应注重观察舌苔，以观察胃气的强弱。在化疗过程中应注重观察舌色是否有变紫倾向，防止和减轻气血的凝滞。     

寒凝血瘀证表征模型的建立

目的建立寒凝血瘀证表征模型,为探讨血瘀证生物学基础提供实验模型。方法采用多次冰水冷冻刺激法诱导寒凝血瘀证大鼠模型,采用数码相机拍摄实验大鼠证候表征变化。结果模型大鼠舌质紫暗,舌下脉络增粗增长,与正常大鼠舌质鲜红润泽舌下脉络清晰有明显差异。模型大鼠耳廓润泽、微血管清晰但显暗红较正常大鼠耳廓、微血管略有变化。模型大鼠血液流变学全血黏度和还原黏度高切和低切各项指标与正常组比较均有升高(P<0.05);模型大鼠聚集指数、聚集面积显著高于正常大鼠(P<0.05);模型大鼠血小板最大聚集率显著高于正常大鼠,模型大鼠凝血酶时间和凝血酶原时间显著短于正常大鼠(P<0.05)。结论冰水冷冻20次后,血瘀证表征尤其舌质紫暗和舌下脉络增粗增长显现,符合寒凝血瘀证表征模型评价的基本条件。多次冰水冷冻刺激法造模,方法简单,模型稳定性好。     

An analysis of blood cell pouring on the tongue surface in 3032 healthy persons

This paper deals with the utilizing laser frequency multiplexing technique and Doppler effect, successfully to build up LDB-1 type of laser microcirculation blood flow meter. It was used to carry on a determination for blood cell pouring amount on tongue surface in 3032 healthy persons. The results were shown as follows. The average tongue blood cell pouring amount of healthy persons was 4.74 +/- 0.50, in which the male was 4.82 +/- 0.50, and the female was 4.66 +/- 0.49. Apparently, there was a great difference between them (P less than 0.01). Following the increase of age, the tongue blood cell pouring amount was gradually decreased. The average blood cell pouring amount of a group of 1-9 years old was 6.14 +/- 0.79, of over 60 years old was 3.89 +/- 0.39 (P less than 0.01). In the light red tongue, the average tongue blood cell pouring amount was 4.95 +/- 0.93, which was considered to be the highest; in the purple tongue, it was 3.96 +/- 0.44 which was considered the lowest. The average pouring amount in the red tongue was 4.94 +/- 0.77, and in the light white tongue was 4.21 +/- 0.52. The more red the tongue showed, the greater the tongue blood cell pouring amount would be; whereas, the more purple the tongue showed, the lower the tongue blood cell pouring amount would be. It obviously indicated that the tongue blood cell pouring amount would be. It obviously indicated that the tongue blood cell pouring amount could correctly reflect the different tongue characters and tongue blood circulation condition.     

冠心病血瘀证患者外周血细胞微粒结合体水平的研究

目的探讨冠心病不稳定心绞痛(UA)患者外周血血小板微粒(PMP)与白细胞微粒(LMP)、内皮细胞微粒(EMP)、红细胞微粒(RMP)间形成的结合体与冠心病严重程度的关系。方法将冠心病患者分为血瘀证组和非血瘀证组。利用显微成像流式细胞术观察冠心病UA患者PMP与LMP、EMP、RMP间形成的结合体水平并观察其形态,检测结合体在冠心病UA血瘀证及非血瘀证患者外周血细胞中的差异。结果冠心病UA血瘀证患者PMP、LMP、EMP、RMP、PMP-EMP结合体、PMP-RMP结合体表达水平高于非血瘀证患者(P0.05),且与血瘀证呈正相关(P0.01)。结论 PMP、LMP、EMP、RMP、PMP-EMP结合体、PMP-RMP结合体参与了冠心病UA血瘀证的形成。     

Observation on the fluidity of human erythrocyte membranes in patients with blood stasis syndrome

In order to approach the relationship between the TCM typology of blood stasis syndrome and the fluidity of human erythrocyte membrane, the fluidity of human erythrocyte membrane was examined in 14 healthy volunteers, 21 patients with coronary heart disease and 14 patients with cancer by measuring the degree of fluorescence polarization using DPH as a fluorescent probe. The patients with coronary heart disease and the cancer patients were all of the TCM typology of blood stasis syndrome. The results showed: (1) The fluorescence polarization (P) of normal group was 0.294 +/- 0.007, and the microviscosity (pi) was 3.656 +/- 0.237. (2) The P of the group of coronary heart disease with blood stasis syndrome was 0.328 +/- 0.013, and the pi was 6.787 +/- 1.028. Both were significantly higher than those of the normal group (P less than 0.05). (3) The P of the group of cancer with blood stasis syndrome was 0.333 +/- 0.011, and the pi was 6.698 +/- 1.357. Both were significantly higher than those of the normal group (P less than 0.05). (4) Yet no significant difference was noticed between the group of coronary heart disease and the group of cancer (P greater than 0.05). The higher the pi of erythrocyte membrane, the lower the fluidity of erythrocyte membrane. The lower fluidity of erythrocyte membrane in patients with blood stasis syndrome can result in the declined ability of erythrocytic deform which can accelerate the disturbance of microcirculation. This accords with the TCM theory about blood stasis syndrome.     

气滞血瘀证大鼠舌部基因表达谱变化初探

目的采用基因芯片技术研究气滞血瘀证模型大鼠舌部全基因表达谱的变化以及差异基因涉及的生物过程和通路,以期为研究血瘀证相关理论和药物治疗提供科学依据。方法采用高脂饲料复合慢性不可预知刺激复制气滞血瘀动物模型,利用基因芯片技术分析正常大鼠与模型大鼠舌中全基因表达谱的变化以及所涉及通路。结果气滞血瘀证大鼠与正常大鼠比较,结果显示差异表达基因有277个,其中上调基因68个,下调基因209个。GO和Pathway分析结果显示气滞血瘀证分别与炎症、脂代谢、免疫反应等生物过程以及补体与凝血级联通路、PPAR信号通路、细胞色素P450异物代谢通路等7条通路的改变有关。结论 CYP450以及补体与凝血级联通路、PPAR信号通路中的差异基因可能涉及血瘀证的发病机制,为血瘀证以及相关药物的研究提供依据。     

Pre-, post-operation and before death of blood stasis syndrome in patients with gastric malignant tumor

In the past three years, the authors observed substance of tongue and 5 indexes of blood coagulation (AT-III, Fn, Fa, VIII R:Ag and beta TG) for a long time in 140 patients of gastric malignant tumor pre-operation, one month post-operation and 3 months before death. All patients were verified as gastric carcinoma by pathological section. The results showed that the positive rate of substance of tongue in patients pre-operation was as high as 58% (51/88), 5 indexes of blood coagulation in patients had obvious difference (P less than 0.001) comparing to that of healthy persons. This implied it existed relationship between gastric malignant tumor and blood stasis in TCM and accorded with diagnosis of blood stasis syndrome. With the resection of tumor focus, the states of blood stasis in patients had been improved to a certain extent. But the positive rate of substance of tongue post-operation was still as high as 51.1% (45/88) comparing to that pre-operation (P greater than 0.05), 5 indexes of blood coagulation in patients post-operation had no obvious improvement comparing to those pre-operation. This showed that the simple resection did not basically improve blood stasis in patients. The another important result was that the substance of tongue and 5 indexes of blood coagulation of 23 patients in last 3 months before death had more obvious blood stasis comparing to those post-operation even those pre-operation. This explained that blood stasis is one of the main characters of gastric malignant tumor before death. In conclusion, the extent of blood stasis syndrome can be used as an objective index to judge seriousness and prognosis of gastric malignant tumor patients' condition.     

Tongue picture of blood stasis symptom-complex

The objective indices of tongue picture of blood stasis symptom-complex in 400 patients with portal hypertension, primary hepatic carcinoma, coronary heart disease, pulmonary heart disease, intermediate and advanced gastric carcinoma were observed during the period of past 6 years. Pale purplish tongue, purplish tongue, bluish purplish tongue, deep-red purplish tongue, dark tongue, yellow purplish tongue etc. were found in these patients. All these were the tongue colour of blood stasis. Ecchymosis, patechiae, streaks, the width of sublingual vein, the appearance of veins and prominences, B mode ultrasonic examination displaying the width of intralingual vein and tissue sound transmission of the tongue body, the blood stasis changes of tongue tip microcirculation, the wave form changes of tongue rheogram had an important significance for diagnosis of blood stasis. There were significant differences in these variables between the subject group and the healthy group or the subject group and the blood non-stasis group statistically (P less than 0.001).     

冠心病痰瘀证与载脂蛋白E基因多态性关系的研究

目的:探讨冠心病(coronary heart disease, CHD)不同痰瘀证候与载脂蛋白E(apolipoprotein E, ApoE)基因第4外显子多态性的关系.方法:选择符合条件的CHD痰证、瘀证、痰瘀互阻证和非痰非瘀证(其他证型)患者200例,另选100名健康志愿者作为对照.常规检测所有样品的血脂水平.提取全血DNA,用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism, PCR-RFLP)技术检测ApoE基因型.采用SAS软件对基因多态性和痰瘀证候的辨证类型进行相关性分析.结果:(1)冠心病患者中ε4等位基因频率(19.5%)明显高于健康对照组(9.5%),具有统计学意义(P<0.05),其中尤以E 3/4基因型更为多见(P<0.01).(2)携带ε4等位基因者的总胆固醇(total cholesterol, TC)、总甘油三酯(total triglycerides, TG)和低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)水平明显高于非携带者(P<0.01).(3)痰证特别是E3/4基因型患者中E3/4型和ε4等位基因的频率明显高于血瘀证患者(P<0.05).结论:ApoE ε4等位基因是冠心病的危险因素,携带此基因的患者与痰证关系较为密切,推测其可能是CHD痰证的主要易感基因之一.     

冠心病痰瘀互结证文献系统评价

[目的]采用文献系统评价方法评价冠心病痰瘀互结证辨证依据的规律。[方法]制定合格检索策略,全面收集冠心病痰瘀互结证相关文献,从中西医病名、病因病机、证候名称、临床症状、舌象、脉象进行归类分析,运用聚类分析和因子分析降维处理,提练冠心病痰瘀互结证的核心辨证依据。[结果]共检索文献1 540篇,相关专著136本,最后共有合格研究文献89篇,专著67本。综合文献系统评价、聚类分析和因子分析结果,得出冠心病痰瘀互结证辨证依据：胸闷胸痛,倦怠乏力,心悸,气短,脘痞满,恶心欲呕,面色晦暗,唇甲青紫,口黏,肢体困重,有痰,舌质暗,舌有瘀斑、斑点,苔腻,白腻苔,脉弦,脉滑。[结论]本研究结果中冠心病痰瘀互结证舌象、脉象与相关文献一致,临床症状覆盖了文献相关诊断标准的内容,提示冠心病痰瘀互结证候较复杂,兼证较多,可兼气滞、气虚、阳虚、气阴两虚,也可寒化和热化,但这一结果还需临床实践的进一步证实。     

Long-term changes in the different types of coronary diseases treated with traditional Chinese and Western medicine

64 cases with TCM differential types of CHD treated with TCM-WM in long term (an average of 10.5 years) were divided into four types according to deficiency of Yang [including weakness of Q1], deficiency of Yin, blood stasis and disorder of Qi and phlegm. Compared with pre-treatment 42 cases (65.62%) with TCM differential types showed improvement or no change in group I, II (clinical total effective rate 92.86%, the significantly effective rate 40.98%). While 22 cases (34.38%) with TCM differential type became aggravated or worse (clinical total effective rate 54.54%, the significantly effective rate 13.63%). The report indicated that the results in comparing group I, II with group III, IV were statistically significant; age (P less than 0.01), course of disease (P less than 0.01), impairment of myocardium (P less than 0.05), complication (P less than 0.05), ratio of deficiency of Yang (P less than 0.01), blood stasis (P less than 0.01) and high coagulation of blood (P less than 0.01). Therefore the author suggests that it is necessary to protect Yang-Qi and prevent and treat the complication of the CHD patients.     

急性脑缺血大鼠模型血瘀证舌象表现的评价方法及其与血液流变学的关系

目的：用舌体组织血氧饱和度评价急性脑缺血大鼠血瘀证舌象表现，并探讨其与血流变异常的相关性，进一步验证急性脑缺血大鼠模型的血瘀证特征。方法：28只SD大鼠随机分为假手术对照组和模型组，用线栓法制备大鼠大脑中动脉阻塞缺血再灌注模型。缺血2h再灌注24h后观察大鼠舌体组织血氧饱和度、神经功能缺损以及血液流变学等指标。结果：与假手术对照组比较，脑缺血模型组大鼠舌体组织血氧饱和度和红细胞变形指数显著降低；全血和血浆黏度以及纤维蛋白原含量升高；凝血酶时间缩短。红细胞变形指数与舌体组织血氧饱和度呈正相关。结论：局灶性脑缺血大鼠模型急性期存在血瘀表现；舌组织血氧饱和度可以作为评价血瘀证动物模型舌象的客观指标。     

应用差异显示筛查冠心病血瘀证相关基因及分析

目的探讨冠心病血瘀证证候基因组学研究方法。方法临床选择冠心病血瘀证患者,采用外周血mRNA差异显示结合反向Northern法,筛查病证结合证候相关基因,并进行临床验证。结果差显出现95条差异条带,经反向Northern后得到28条真实差异片段,经克隆、测序,去除相同序列,通过生物信息学分析,其中有5条与人类98%以上同源的基因序列,经相关文献资料和临床验证结果分析,它们与冠心病血瘀证病理改变密切相关。结论差异显示结合反向Northern和临床验证的方法,适用于筛查病证结合证候基因的研究。     

应用舌诊综合信息分析系统对原发性肝癌舌质颜色的定量分析

目的　探讨原发性肝癌的舌质颜色特征。方法　应用舌诊综合信息分析系统对不同临床分期的原发性肝癌患者和其他肿瘤患者的舌质颜色及RGB值进行定量分析。结果　原发性肝癌患者舌质颜色较其他肿瘤患者青紫舌比例高 (P <0 .0 5) ,R、G、B 3个分量均较其他肿瘤患者低 (P <0 .0 1) ;临床Ⅲ期的原发性肝癌患者青紫舌的比例较Ⅰ期、Ⅱ期高 (P <0 .0 5)。结论　舌质青紫是原发性肝癌舌象的重要特征     

缺血性脑卒中气虚血瘀证大鼠模型的研究

目的 建立缺血性脑卒中气虚血瘀证病证结合大鼠模型的制作方法和评价体系.方法 通过持续力竭性游泳复合线栓法(大脑中动脉阻塞)建立缺血性脑卒中气虚血瘀证大鼠模型.观察模型鼠在表征、舌象、血液流变学及脑组织形态学等指标的变化,建立该模型的评价体系.结果 持续力竭性游泳过程中模型鼠表现出体重增长相对缓慢,进食时间相对延缓,舌质变黯、舌下络脉增长等反映气虚血瘀状态的表征,线栓法手术后模型鼠表现出少动或不动、无力抵抗、偏瘫、舌色紫黯、舌下络脉青紫粗长等反映脑缺血气虚血瘀证的表征,血液流变学检测提示模型鼠血液黏度增高、血浆纤维蛋白含量增加、血小板聚集性增高,脑组织形态学符合脑缺血改变.结论 持续力竭性游泳复合线栓法可制备缺血性脑卒中气虚血瘀证大鼠模型,表征、舌象、血液流变学及脑组织形态学等几方面指标的综合评价可构成该模型的评价体系.     

建立中风病血瘀证宏观辨证量化标准的方法探讨

试采用非条件和ｋｌｉ：ｋ２ｉ 配对的条件ｌｏｇｉｓｔｉｃ 回归的分析方法, 对２２１ 例中风病人的临床中医证候特征进行比较分析, 建立急性期中风病血瘀证的证候预测模型, 并采用临床调查的结果对模型进行验证, 以探讨建立中风病血瘀证宏观辨证量化标准的方法。结果： 非条件与条件ｌｏｇｉｓｔｉｃ 回归均提示口唇紫暗或面色晦暗、舌有瘀点或舌有瘀斑、舌背脉络瘀张青紫、舌紫暗是鉴别血瘀证与非血瘀证的重要指标, 且４ 项指标与急性期中风病血瘀证发生概率均呈正相关。将另外的一组与本研究无关、但研究对象的选择相似的临床数据作为检验样本代入模型得到的诊断准确率达９９ ．０６％ （１０５／１０６）。结论： 模型对急性期中风病血瘀证具有较好的预测作用。条件和非条件ｌｏｇｉｓｔｉｃ 统计模型以及ｋ１ｉ：ｋ２ｉ 的配对方法用于急性期中风病血瘀证的研究有助于宏观辨证量化标准的建立, 并且这些方法可以推广应用到非急性期中风病以及其他系统疾病的血瘀证或其他证候的量化研究中