慢性痛症患者的甲襞毛细血管管径和流速变化及机理探讨

作者	单位
贾钰华	第一军医大学中医系
胡庆茂	第一军医大学中医系
吕志平	第一军医大学中医系
薛秀琼	第一军医大学中医系
陈宝田	第一军医大学中医系

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中文摘要:

本研究运用新型甲襞微循环参数测试系统（ＹＪＤ）临床微循环图像分析仪，对９０例慢性痛症患者的甲襞毛细血管管径和流速实施精确测量分析，并与３１例健康人进行对照比较。结果：（１）不论疼痛部位如何，微血管管袢均缩短（Ｐ＜０．０１），流速减慢；（２）长期疼痛微循环障碍更显著，主要表现为流速缓慢（输入枝０．１９±０．０９ｍｍ／ｓ）和袢顶增大（直径１５．８６±６．５０μｍ），与健康人比较（０．３５±０．１３ｍｍ／ｓ、１４．０１±３．３１μｍ）Ｐ均＜０．０１。（３）按中医辨证分型，血虚型输入枝为９．２３±１．６５μｍ，与其他型比较，Ｐ＜０．０１。流速则以血瘀型减慢明显（输入枝０．１８±０．０８ｍｍ／ｓ），与健康人比较，Ｐ＜０．０１。这种微循环变化的机制与血液粘度增高，及通过影响神经体液调节引起微血管痉挛或舒张有关，有组胺等多种体液因子参与。

英文摘要:

Diameter of nailfold capillaries and their blood flow speed in 90 patients with pain syndrome were measured accurately by using YJD clinical microcirculatory image analyser, and the data obtained were compared with that of 31 normal subjects. The results showed (1) Shortening of capillary loop and slow down of blood flow were revealed in patients no matter where the location of pain was; (2) The disturbance of microcirculation was more prominent in case of chronic pain patient, manifested chiefly as slow down of blood flow speed (0.19±0.09mm/s in afferent branch)and increase of loop diameter (15.86±6.50μm),as compared with those in normal subjects (0. 35±0.13mm/s and 14.01±3.31μm respectively),the difference were significant, P<0. 01;(3) Typing according to Syndrome Differentiation of TCM, the afferent loop diameter of the Blood Stasis type were 9.23±1.65μm, it was significantly different from that of other types; and the blood flow speed of this group was markedly slowing down (0. 18± 0. 08 mm/s in afferent branch),the change was of significant difference in comparing with normal group, P <0. 01. Authors considered that the mechanism of changes in microcirculation was related to increase of blood viscosity and spasm or diastole of capillaries induced by neurohumoral regulation, and many humoral factors, as histamine,may take part in this procedure.

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