桃紅湯對於大鼠血栓所誘發血液流變性障礙之影響

Effects of Tao-Hung-Tang on Haemorheological Disturbance Induced by Thrombus Formation in Rats

血栓症(thrombosis)及其所誘發的腦中風和心肌梗塞等心腦血管疾病，始終佔居國內十大死亡原因的前位。據研究指出血栓性疾病常有“血液高黏症綜合症(blood hyperviscosity syndrome)”的發生，不僅會加深病情的惡化，更會對患者的生命產生威脅。然而，臨床上至今對於血栓性疾病和血液高黏滯症的治療，尚無突破性發展。但在我國中醫學上，早已發展獨特的活血化瘀療法，有效的防治血栓性疾病的發生和發展。在活血化瘀方劑中，常應用桃仁、紅花、川芎和赤芍等四味基本活血化瘀藥材的配伍。有關這四種關單味藥或任一配伍在抗血小板聚集和體外纖溶作用的研究，早有報告。唯有關這四味藥配伍對於血液流變學的影響，尚未見研究報告。因此，我們將此四味藥合成方劑而名之為桃紅湯，並探討其對血液流變性障礙之影響，冀從中醫藥的領域中，能尋得具有預防血栓和改善血液黏度的藥物。本實驗以大鼠下腔靜脈結紮的方式誘導血栓形成及血液流變性異堂狀態，並依血液流變學的理論，測定影響血液黏滯性的因子：紅血球聚集性和變形性(red cell aggregation and deformability)、血球比容積(hematocrit)、血漿和全血黏度(plasma and whole blood viscosity)和血漿纖維蛋白原濃度(plasma fibrinogen concentration)等各項血液流變指標，以探討桃紅湯對於血液流變性的影響及登機轉。結果獲至如下：(1)桃紅湯以0.75g/kg和3.00g/kg對血栓形成的抑制作用最明顯。(2)桃紅湯(0.75g/kg)能減少血漿纖維蛋白原濃度。(3)桃紅湯(0.75g/kg)能降低各切速的全血黏度值，但對血漿黏度沒有明顯的影響。(4)桃紅湯能降低平均血球血紅素濃度和表紅血球變形能力的TK值。俸錘瓜Neoalsomitra integrifoliola, (Curcurbitaceae)臺灣民間用於發炎、肝炎及甲狀腺腫。本研究的目的在於使用各種不同的實驗動物模式來探討棒錘瓜的抗發炎作用。由大實驗的結果顯示，桃紅湯能有效的抑制大鼠體內血栓的形成並且改善因血栓所誘發的血液流變性異常的情形。這些作用可能是桃紅湯影響紅血球聚集性和變形性二項流變因子所致。對於其能增強紅血球變形功能的作用機理，是否因為穩定紅血球細胞膜表面電荷或是改善紅血球內黏度（主要取決於平均血球血紅素濃度），則有待更進一步的研究證實。

TAO-HUNG-TANG (THT) is widely used for activating blood circulation and removing blood stasis in Chinese medicine. The purpose of this study was to investigate the effects of THT on haemorheological variables (hematocrit, plasma viscosity, whole blood viscosity, red cell aggregation and red cell deformability) and the plasma fibrinogen concentration were determined in blood sample from rats with ligature in the inferior vena cava (IVC) for 15 hours. The effects of THT on thrombus formation induced by ligating the IVC for 2 hours in rats was also studied. The thrombus weight, incidence of thrombosis and blood clotting factors (prothrombin time and partial thromboplastin time) and plasma fibrinogen concentration were examined. THT (0.75; 3.0g/kg) inhibited the thrombus formation significantly. For blood-clotting factors, THT had no effect on prothrombin time and partial prothromboplastin time, but reduced the fibrinogen concentration at a dose of 0.75g/kg THT. As for haemorheological parameters, THT decreased the whole blood viscosity at every shear rate but had no obvious effect on plasma viscosity. It also reduced the mean corpuscular hemoglobin concentration and enhanced red cell deformability. It is postulated that the inhibition of thrombus formation in rats by THT may be related to erythrocyte disaggregation. Furthermore, THT might act on erythrocyte aggregation and deformability to improve haemorheological disturbance in rats.