Lin S, Lian Q, Pang M
Affiliated Hospital of Fujian College of Traditional Chinese Medicine, Fuzhou 350004.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Dec;20(12):911-4.
To explore the multiple parameters of TCM Syndrome-types and the acute cerebral infarction (ACI) with blood stasis type.
Sixty-six acute cerebral infarction patients with blood stasis Syndrome, various vascular active factors such as tissue plasminogen activator (t-PA), the activity of plasminogen activator inhibitor (PAI), the concentration of prostaglandin F1 alpha (6-keto-PGF1 alpha) etc. were determined.
(1) In Incidental Syndrome, those "Phlegm" and "stasis" predominant, mainly manifested as Wind-Phlegm-Blood stasis (WPBS), Qi deficiency-blood stasis (QDBS) and Phlegm-Heat-bowel excess (PHBE) Syndrome all showed t-PA activity lowered, among them, QDBS Syndrome lowered more obviously (P < 0.01); and in fundamental deficiency predominant Syndrome such as Yin-deficiency and Wind-move (YDWM) Syndrome, the active t-PA content increased (P < 0.05); in Liver Yang ascending (LYA) Syndrome and YDWM Syndrome, the 6-keto-PGF1 alpha lowered very significantly. (2) Through regression analysis, although influencing the severity of acute blood stasis was related with 3 factors (t-PA activity, nervous system defect score and age growth), but single factor linear relationship analysis indicated that did not existed positive-negative relationship. (3) Through statistical analysis, the factor influencing nervous system defect scores was positively related with blood stasis score (r = 0.70, P < 0.01).
(1) The basis of WPBS, QDBS and PHBE Syndrome mainly was fibrinolytic system activity lowering, and YDWM and LYA Syndrome prostaglandin system activity lowering. Comprehensive analysis of multiple parameters would be helpful to differentiate the ACI blood stasis stage. (2) Single parameter would not help to differentiate the types of ACI blood stasis stage, its change merely denoted the existence of blood stasis, its type should be differentiated after comprehensive analysis. (3) Those influencing nervous system scoring, mainly was blood stasis score, which suggested that the importance of activating blood circulation to remove stasis in preventing and treating ACI. (4) Put forward ACI blood stasis, and the quantification for new standard of Syndrome for discussion.
探讨急性脑梗死（ACI）血瘀证中医证型的多项参数。
对66例血瘀证急性脑梗死患者，检测组织型纤溶酶原激活剂（t-PA）、纤溶酶原激活剂抑制剂（PAI）活性、前列腺素F1α（6-酮-前列腺素F1α）等多种血管活性因子。
（1）在兼夹证中，以“痰”“瘀”为主的风痰瘀阻（WPBS）、气虚血瘀（QDBS）、痰热腑实（PHBE）证t-PA活性均降低，其中QDBS证降低更明显（P<0.01）；以本虚为主的阴虚风动（YDWM）证，活性t-PA含量升高（P<0.05）；肝阳上亢（LYA）证和YDWM证6-酮-前列腺素F1α降低非常显著。（2）经回归分析，影响急性血瘀严重程度虽与3个因素（t-PA活性、神经功能缺损评分、年龄增长）有关，但单因素线性关系分析表明不存在正负相关关系。（3）经统计学分析，影响神经功能缺损评分的因素与血瘀评分呈正相关（r=0.70，P<0.01）。
（1）WPBS、QDBS、PHBE证的基础主要是纤溶系统活性降低，YDWM、LYA证是前列腺素系统活性降低。综合分析多项参数有助于鉴别ACI血瘀证阶段。（2）单一参数无助于鉴别ACI血瘀证阶段类型，其变化仅提示血瘀存在，应综合分析后鉴别类型。（3）影响神经功能评分的主要是血瘀评分，提示活血化瘀在防治ACI中的重要性。（4）提出ACI血瘀证及证候量化新标准供讨论。
