溃疡性结肠炎中医证型与凝血指标关系的临床研究

目的探讨溃疡性结肠炎（UC）中医证型与凝血指标之间的关系及临床意义。方法将89例患者辨证分为大肠湿热证、脾胃气虚证、脾肾阳虚证、肝郁脾虚证、阴血亏虚证和血瘀肠络证等6个证型,检测血小板（PLT）、纤维蛋白原（Fg）及血栓烷B2（TXB2）水平,比较各证型之间的差异。结果与正常对照组比较,大肠湿热证、血瘀肠络证的血小板计数、纤维蛋白原和TXB2差异均有统计学意义（P〈0.05）。肝郁脾虚证、阴血亏虚证血小板计数差异有统计学意义（P〈0.05）;血瘀肠络证血小板计数、纤维蛋白原和TXB2水平均高于各虚证组,差异有统计学意义（P〈0.05）;与正常对照组比较,肝郁脾虚证、阴血亏虚证的纤维蛋白原和TXB2,脾胃气虚证、脾肾阳虚证的血小板计数、纤维蛋白原和TXB2差异无统计学意义（P〉0.05）,但存在升高趋势。结论溃疡性结肠炎血液普遍存在高凝状态,在传统的辨证论治基础上,酌情加入活血祛瘀之品可以提高临床疗效。

Correlativity between Chinese medical syndromes and coagulation indexes of ulcerative colonitis

Objective To observe the correlativity between Chinese medical syndromes and coagulation indexes and its clinical significance.Methods Eighty nine cases of ulcerative colonitis were differentiated into damp-heat in large intestine syndrome,spleen-stomach qi deficiency syndrome,spleen-kidney yang deficiency syndrome,liver-depression and spleen-deficiency syndrome,yin-blood deficiency syndrome,and blood-stasis in intestine syndrome.The platelet（Plt）,fibrinogen（Fg） and thromboxane B2（TXB2） were analyzed in these six syndromes and normal control group.Results It is found that with regard to Plt,Fg and TXB2,there were statistical differences between damp-heat in large intestine syndrome,blood-stasis in intestine syndrome and normal group（P〈0.05）.The statistical significance in Plt was also found between liver-depression and spleen deficiency syndrome and yin-blood deficiency syndrome（P〈0.05）.There were significant differences in Plt,Fg and TXB2 between blood-stasis in intestine syndrome and the deciency syndromes（P〈0.05）.However,there were no differences in Fg and TXB2 between normal group and liver-depression and spleen deficiency syndrome and yin-blood deficiency syndrome,and in Plt,Fg and TXB2 between normal group and spleen-stomach qi deficiency syndrome,spleen-kidney yang deficiency syndrome.Conclusion Ulcerative colonitis usually accompanies hypercoagulable state,and blood-activating herbs should be applied.