斑秃的中医辨证分型与微循环障碍临床56例

目的　进一步观察并探讨斑秃的临床分期及中医的辩证分型与微循环障碍的关系。方法　采用血液粘度仪测定了5 6例斑秃患者的血液流变学的6项指标,按临床表现分为活动期与静止期,根据中医辩证分型分为实症组与虚症组。与正常对照组35例进行比较,统计学处理:采用t检验。结果　斑秃患者全血高切还原粘度、低切还原粘度、血浆粘度、RBC压积、RBC变形指数及RBC聚集指数与正常对照组比较,仅血浆粘度升高不显著外,其余5项指标均有显著差异(P <0 .0 5 ) ,除RBC变形指数明显低于对照组,余4项指标均显著高于对照组。活动期39例6项指标与对照组比较均有显著差异(P <0 .0 5 ) ,静止期17例仅全血还原低切粘度、RBC变形指数与聚集指数与对照组比较差异显著(P <0 .0 5 ) ,中医实症组35例6项指标与对照组比较也有显著差异(P <0 .0 5 ) ,中医虚症组2 1例全血低切还原粘度、RBC压积、RBC变形指数与聚集指数与对照组比较差异显著(P <0 .0 5 )。结论　斑秃患者血液流变学存在异常变化,血液粘度增高,微循环障碍与其病因或发病机制有关。且与病情的分期及严重程度有一定关系,我们可采用活血化瘀的方法来提高斑秃的治愈率。

The Relationship of TCM Grouping and Disturbance of Microcirculation in 56 Cases of Alopecia areata

Objective To study the relation between the c li nical stages,under the view of Traditional Chinese Medicine grouping and the dis turbance of microcirculation in 56 alopecia areatu patients. Methods 6 indices of hemorheology were measured by the bl ood viscometer in 56 alopecia areata patients.According to the clinical manifest ation and the view of Traditional Chinese Medicine grouping,these patients were divided into active stage and resting stage,excessiveness and deficiency groups respectively.Comparison with 35 normal person as control group was made,these tw o groups being dealt with statistics by t-test.Results Compared with control group,there was significant difference of reduced viscosity at high shear (RVHS) of whole blood,reduced vis cosity at low shear (RVLS),hematocrit (HCT),high-performance liquid chromatogra phy (HLC),aggregate degree of erythrocyte (EAI).The HLC of patients was much low er than normal person and the other four indices were adverse(P<0.05).The ri sing of plasma viscosity was insignificant.There was significant difference betw een six indices of 39 patients in active stage and control group,the same as RVH S,HCT and HLC of 17 patients in resting stage(P<0.05);and all six indices of 35 patients in excessiveness stage and RVHS,HCT,HLC,EAI of 21 patients in defic iency stage (P<0.05).Conclusion The index in active stage and excessive stage varied greatly than resting stage and deficiency stage.There was significant cha nges in indices of hemorheology in patients with alopecia areata.The increasing of blood viscosity and impairment of microcirculation might be involved in etiol ogy or related with the mechanism of causation.Various clinical stages of differ ent degree of severity were also related to the effective rate in treating alope cia areata.Invigorating the circulation and releasing the stenosis of blood were often adopted in the treament.