益气温阳、活血利水法预防急性肺血栓栓塞的实验研究

目的探讨益气温阳、活血利水法在预防急性肺血栓栓塞（APTE）的作用及其可行性。方法48只健康新西兰大耳白兔,随机分为4组,每组12只,即空白对照组、栓塞对照组、益气温阳活血利水中药防治组（中药组）、华法林组。每只兔均经耳缘静脉取血,制成自体血栓栓子备用。4组均给予常规饲料喂养,中药组加益气温阳活血利水作用的中药灌胃,含生药0.8g/kg,华法林组加华法林溶液灌胃,0.06mg/kg,每日1次。空白对照组、栓塞对照组同时给等量生理盐水灌胃。1周后,分别经右股静脉注入自体血栓栓子,于栓塞后1h,4h采血测定动脉血气分析、一氧化氮（NO）、内皮素-1（ET-1）、血栓素B2（TXB2）,并于4h后处死兔,进行肺病理学观察。结果益气温阳、活血利水中药组栓塞后病理损伤明显轻于其他组,注入栓子1h,4h后,中药组NO、血氧分压（PaO2）水平均高于栓塞对照组（P〈0.05）,ET-1,TXB2均低于栓塞对照组（P〈0.05）,血二氧化碳分压（PaCO2）与栓塞对照组无统计学意义;中药组NO,PaO2高于华法林组,ET-1低于华法林组,PaCO2和TXB2与华法林组无统计学意义。结论预防性应用益气温阳活血利水法可减轻APTE后肺缺血损伤,改善缺氧状态,调节血管内皮功能,抑制血小板分泌血栓素A2（TXA2）。此法在预防APTE方面具有可行性,有效性。

Yiqiwenyang-huoxuelishui Therapy for Prevention of Acute Pulmonary Thromboembolism

Objective To explore Yiqiwenyang-huoxuelishui Therapy (YHT) for prevention of acute pulmonary thromboembolism (APTE). Methods Forty-eighty rabbits were divided randomly into four groups:Saline control group (n=12), APTE control group(n=12), YHT group(n=12), Warfarin group(n=12). A week later, APTE models were made via infusing self-body throboembolism through right femoral vien beside rabbits in saline control group. Blood gas analysis, endothelin-1(ET-1), nitric oxide(NO), levels of thromboxane B2(TXB2) serum were detected in 1 h and 4 h after APTE. Results Pulmonary pathological change of rabbits in the YHT group was milder than that in other groups.Serum level of NO and PaO2 increased more significantly in the YHT group(P<0.01), and serum level of ET-1 and TXB2 was lower as compared with that in the APTE control group(P<0.05).Serum level of NO and PaO2 significantly increased in the YHT group, and serum level of ET-1 was lower as compared with that in the Warfarin group. Conclusion YHT therapy could release APTE anoxia, regular APTE serum level of NO, ET-1 and TXA2,and might be feasible and effective in preventing APTE.