温病气分证病理实质与治则的研究

目的:探讨温病气分证病理实质与治则。方法:将60只大白兔随机分为正常组、模型组、清气组、清气养阴组、清气化瘀组和清热化瘀养阴组,进行症状和体征、体温、实验室相关指标及脏器组织病理形态学观察。结果:清热化瘀养阴组症状最轻,热势最低,饮水较少,并能使血小板最大聚集率(MPAG)下降,凝血酶原时间(PT)、白陶土部分凝血活酶时间(KPTT)延长;血浆鱼精蛋白副疑固试验(3P)对照组和清气组100％阳性,清热化瘀养阴组仅10％阳性;纤溶酶原活性(PLg·A)活性清热化瘀养阴汤与对照组、清气组比较差异显著(P<0.01);脏器组织瘀血、出血、炎症等改变,清气养阴组,清气化瘀组病变较轻微,清热化瘀养阴组病变最轻微。结论:气分证病理变化的实质为热炽、血瘀、阴伤,治则为清热、化瘀、养阴。

Study on Pathological Essence and Treatment Principle of Syndrome of Qi System in Epidemic Febrile Diseases

Purpose: To approach to pathological essence and treatment principle of syndrome of Qi system of epidemic febrile disease. Methods: 60 rabbits were randomly divided into normal group, control group . clearing away Qi group, clearing Qi and nourishing Yin group, clearing away Qi and removing blood stasis group, and clearing away heat and blood stasis and nourishing Yin group. Symptoms and signs, body temperature, laboratory correlative indexes and pathological morphology of viscera and tissues were investigated. Results: The symptoms was the mildest and the heat state was the lowest with less drinking, and the MPAR decreased. PT and KPTT prolongated in the clearing away heat and blood stasis and nourishing Yin g;roup; plasma protamine paracoagulation test in both the control and clearing away Qi groups were positive, and in the clearing away heat and blood stasis and nourishing Yin group only 10% was positive with a significant difference as compared with the control group and the clearing away Qi group in activity of PLg ( P<0. 01) : the pathological lesion of blood stasis, bleeding and inflammation in the viscera and tissue in the clearing away Qi and nourishing Yin group and the clearing away Qi and blood stasis group were milder, and the mildest in the clearing away heat and blood stasis and nourishing Yin group. Conclusion: The essence of the pathological changes of syndrome of Qi system are heat excess, blood stasis, insufficiency of Yin. and the treatment principle is clearing away heat, removing blood stasis and nourishing Yin.