中药蛇伤胶囊调控TM/PC通路治疗竹叶青蛇伤凝血障碍机制研究

Snakebite capsule (Min pharmacists word Z06106044) is a traditional Chinese medicine prescription of Huang Shoulin who is a Chinese famous snake injury expert.Several clinical researches have reported that the therapeutic results are satisfactory to the coagulation dysfunction caused by Trimeresurus snakebites, but the mechanism is still unclear. This research aiming at the key link of the coagulation dysfunction caused by Trimeresurus snakebites - - the vascular endothelial cell thrombomodulin/protein C (TM/PC) pathway.According to the theory of traditional Chinese Medicine,Trimeresurus venom is flaming fire which can force the blood, while Snakebite capsule can be therapeutic by cooling and detoxificating. Snakebite capsule is expected to affect blood coagulation by regulating the vascular endothelial TM/PC pathway, affecting the levels of TM,PC,thrombin-thrombomodulin complex (T-TM),the combination of PC and endothelial protein C receptor (EPCR),and the activity of coagulation factors FVa, FⅧa, FXa, FIXa activity. This rearsch is able to clarify the mechanism of Snakebite capsule,and provides a objective basis for clinical application and development of new drugs .

蛇伤胶囊（闽药制字Z06106044）是我国著名蛇伤病学专家黄守林老中医的经验方，治疗竹叶青蛇伤凝血功能障碍临床效果肯定，但其作用机制尚未明确。本课题针对竹叶青蛇伤凝血障碍关键环节- - 血管内皮细胞血栓调节蛋白/蛋白C(TM/PC)通路，根据竹叶青蛇毒火毒炽盛，迫血妄行、耗血动血的特点，以具有泻火解毒、凉血止血功能的蛇伤胶囊治疗。可望通过调控血管内皮细胞TM/PC通路，影响TM、PC、凝血酶-血栓调节蛋白复合物（T-TM）的水平及PC与血管内皮细胞蛋白C受体(EPCR)的结合，改变凝血因子FVa、FⅧa、FXa、FIXa的活性，影响凝血功能；阐明蛇伤胶囊的作用机制，为临床应用和新药研发提供客观依据。

摘要：蛇伤胶囊（闽药制字Z06106044）是我国著名蛇伤病学专家黄守林老中医的经验方，治疗竹叶青蛇伤凝血功能障碍临床效果肯定，但其作用机制尚未明确。（1）本课题根据资助计划书进行1年的动物实验研究，具体实验内容包括：复制竹叶青蛇伤兔子模型，按分组治疗方案干预，检测凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB），检测血浆血栓调节蛋白（TM）、凝血酶-血栓调节蛋白复合物(T-TM)、活性蛋白C（APC）水平。（2）结果：MX组TT、APTT较KB组延长(P<0.01)，FIB较KB组减少（P<0.05），TM较KB组升高(P<0.05)；ZY组TT、APTT较MX组缩短（P<0.05），GY组、ZY组FIB、TM较MX组增多（P<0.05，P<0.01）。蛇伤胶囊可以治疗竹叶青蛇伤凝血障碍，可能是通过减少凝血因子消耗、抗纤溶、抗血管内皮损伤来实现的。