微循环障碍与“血瘀”及“活血化瘀”

为了从微循环角度探讨中医学关于血瘀证的本质和活血化瘀的作用原理,本文就近年来我们应用人体和动物多部位微循环检查的方法,进行的一些临床观察和动物实验,结合部分国内文献及中医对血瘀的论述,讨论血瘀与微循环障碍的联系,以及"活血化瘀"改善微循环障碍的可能机制。一、血瘀患者微循环障碍的具体表现1.微血管畸形、微血流缓慢和淤滞:我们曾对46例瘀证患者与26例非瘀证患者的手指甲皱和球结膜微循环作了比较观察,发现瘀证患者微血管中血细

英文摘要:

Clinical investigation and experimental observation of patients with"blood stasis symptoms"have suggested that there are various general and local disturbances of circulation,particularly in microeirculatory disturbances in these cases.The major changes of these disturbances are as follows:1.abnormal morphology of microvessels and stasis of micro-bloodstream; 2.aggregation of blood cells,blood sludge and/or decrease of deformability of RBC;3.hemorrhage and exudation around microvessels;4.constriction and occlusion of microvessels,etc.For example,in patients with bluish purple tongue,there is a high incidence of above-mentioned microcirculatory disturbances,i.e.,26.04-28.89% in the nail-fold and 7.5-56.1% in the tip of tongue.After the treatment of"activating blood and relieving stasis"in animals or patients with abnormal microcirculation,acceleration of micro-bloodstream,improvement of blood cell aggregation,decrease of stasis in loop-apex of capillary,disappearance(or decrease)of exudation around microvessels and increase of capillary network occured.Clinical investigation has also shown that after the treatment of"activating blood and relieving stasis",the clinical manifestation of some patients with blood stasis symptoms was improved.This was followed by the improvement of microcirculation.The corresponding rate between them was 50-70%. Based on our experimental data and studies elsewhere in the country,the author holds the view that in the Chinese traditonal medicne the blood stasis symptom is a pathological process that is related to microcirculatory disturbances.The principle of"activating blood and relieving stasis"is related to the improvement of microcirculatory disturbances.The pathogenesis and problems which need to be solved have been discussed briefly.

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