从高血压肝火亢盛证的应激变化探讨肝主疏泄的生物学基础(1)
摘要 目的：通过比较分析应激状态下高血压肝火亢盛证大鼠的宏观表征及微观理化指标的变化，探讨肝主疏泄的生物学基础。方法：模拟现代社会的应激刺激，给予高血压肝火亢盛证大鼠和正常Wistar大鼠相同的应激刺激，动态监测其血压、易激惹程度、行为及血液中Ang-II、NE含量变化，进行多个维度的差异性及关联性分析。结果：高血压肝火亢盛证大鼠应激组与无应激组相比，应激组高血压肝火亢盛证大鼠血压升高幅度更大(P<0.05)，易激惹程度评分更高(P<0.05)，血液中Ang-II、NE含量升高(P<0.05)，且应激结束2周后各项指标仍然显著高于无应激组高血压肝火亢盛证大鼠(P<0.05)，而Wistar应激组与无应激组相比，虽然也各项指标均有升高(P<0.05)，但相较高血压肝火亢盛证大鼠较晚出现升高，且应激结束2周后与对照组无统计学意义(P>0.05)。结论：在肝疏泄功能正常的状态下，受到外界应激时，一定程度上机体可作出适应性反应，而高血压肝火亢盛证属肝失疏泄状态，应激刺激下出现应激损伤表现，其机制可能与外周Ang-II、NE含量升高有关。
关键词 高血压；肝火亢盛证；应激；肝主疏泄；生物学基础
Abstract Objective：To observe the macro and physicochemical changes of hypertensive rats with live-fire hyperactivity syndrome under stress， to evaluate the effects of stress in the process of hypertension， expounds the theoretical basis of liver governing the free flow of qi.Methods：Stress with same intensity was given to hypertension rats with liver fire hyperactivity (SHR 14-18 weeks old) and normal rats (Wistar at the same age). The blood pressure， irritability degree， behavior and content of Ang-II and NE in serum were dynamically meassured. The difference and correlation for multiple dimensions were analyzed.Results：The adaptability to stress of hypertensive rats with liver-fire hyperactivity was worse than normal rats. Compared with non-stress group of SHR， the pressure increased significantly (P<0.05)， and score of irritability degree was higher (P<0.05). The contents of Ang-II and NE in the blood was increased (P<0.05)， and 2 weeks after the stress stopped，the above indexes were still significantly higher than non-stress SHR (P<0.05). Although the indexes of normal Wistar Rats under stress increased (P<0.05)， but compared with the SHR which appeared in the late stage of stress later， and the indicators returned to normal level 2 weeks after stress stopped， and there was no significant difference (P>0.05).Conclusion：In normal physiological conditions， liver function is normal. The body can make adaptive response if affected by external stress in a certain extent， but under dysfunction of the liver， stress injury will occur， the mechanism of which may be related to the content increase of NE and Ang-II.
Key Words Hypertension； Liver-fire hyperactivity syndrome； Stress； Liver governing the free flow of qi； Biological basis
中圖分类号：R285.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.12.051
高血压是临床中最常见的慢性疾病之一，中医归属于“眩晕”“中风”范畴[1]。“诸风掉眩，皆属于肝”，因此中医认为高血压的发生与肝的功能异常有密切的联系。肝火亢盛证是高血压早期最常见的证候之一，其病机主要为肝失疏泄、气郁化火、上扰清窍。《黄帝内经》云“肝主疏泄”，在高血压肝火亢盛证期肝失疏泄、调畅情志的功能受到影响，故在受到应激刺激时较正常人难以自我调节，出现血压进一步升高、急躁易怒加重等表现。在本课题组的前期研究中证实，SHR大鼠在第14～18周龄为肝火亢盛证较为稳定的证候时间窗[2]，因此本研究给予高血压肝火亢盛证大鼠(SHR 14～18周龄)和正常Wistar大鼠(同周龄)应激实验，模拟现代社会人类受到的应激刺激，观察其血压、宏观表征及微观理化指标的变化，进一步阐释中医“肝主疏泄”的理论基础。, 百拇医药(马雪玲 王田 刘婧玮 李雪丽 邓冬 薛晓兴 赵慧辉 王娟 陈建新 王伟)
关键词 高血压；肝火亢盛证；应激；肝主疏泄；生物学基础
Abstract Objective：To observe the macro and physicochemical changes of hypertensive rats with live-fire hyperactivity syndrome under stress， to evaluate the effects of stress in the process of hypertension， expounds the theoretical basis of liver governing the free flow of qi.Methods：Stress with same intensity was given to hypertension rats with liver fire hyperactivity (SHR 14-18 weeks old) and normal rats (Wistar at the same age). The blood pressure， irritability degree， behavior and content of Ang-II and NE in serum were dynamically meassured. The difference and correlation for multiple dimensions were analyzed.Results：The adaptability to stress of hypertensive rats with liver-fire hyperactivity was worse than normal rats. Compared with non-stress group of SHR， the pressure increased significantly (P<0.05)， and score of irritability degree was higher (P<0.05). The contents of Ang-II and NE in the blood was increased (P<0.05)， and 2 weeks after the stress stopped，the above indexes were still significantly higher than non-stress SHR (P<0.05). Although the indexes of normal Wistar Rats under stress increased (P<0.05)， but compared with the SHR which appeared in the late stage of stress later， and the indicators returned to normal level 2 weeks after stress stopped， and there was no significant difference (P>0.05).Conclusion：In normal physiological conditions， liver function is normal. The body can make adaptive response if affected by external stress in a certain extent， but under dysfunction of the liver， stress injury will occur， the mechanism of which may be related to the content increase of NE and Ang-II.
Key Words Hypertension； Liver-fire hyperactivity syndrome； Stress； Liver governing the free flow of qi； Biological basis
中圖分类号：R285.5文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.12.051
高血压是临床中最常见的慢性疾病之一，中医归属于“眩晕”“中风”范畴[1]。“诸风掉眩，皆属于肝”，因此中医认为高血压的发生与肝的功能异常有密切的联系。肝火亢盛证是高血压早期最常见的证候之一，其病机主要为肝失疏泄、气郁化火、上扰清窍。《黄帝内经》云“肝主疏泄”，在高血压肝火亢盛证期肝失疏泄、调畅情志的功能受到影响，故在受到应激刺激时较正常人难以自我调节，出现血压进一步升高、急躁易怒加重等表现。在本课题组的前期研究中证实，SHR大鼠在第14～18周龄为肝火亢盛证较为稳定的证候时间窗[2]，因此本研究给予高血压肝火亢盛证大鼠(SHR 14～18周龄)和正常Wistar大鼠(同周龄)应激实验，模拟现代社会人类受到的应激刺激，观察其血压、宏观表征及微观理化指标的变化，进一步阐释中医“肝主疏泄”的理论基础。, 百拇医药(马雪玲 王田 刘婧玮 李雪丽 邓冬 薛晓兴 赵慧辉 王娟 陈建新 王伟)