针刺提插补泻法对血虚证模型家兔血清铁蛋白、总铁结合力的影响
摘要
针刺提插与捻转手法是针刺的两大基本补泻手法,被广泛运用于临床中。但补泻手法究竟是否存在,决定补泻效果的因素有哪些,是否与针刺时的深度、角度、力度、频率、刺激量存在着关系,至今仍然存在着很大的争论。针刺手法有着很大的主观性而使得其缺少临床规范,导致在很多实验中难以达到较高的可重复性。因此,建立一个针刺手法规范的量化就显得尤其重要,从而为今后的临床及实验研究提供操作基础。
第一部分文献综述
文献综述共两篇。第一篇介绍了关于针刺提插补泻手法的古代文献及理论研究,提插深度、角度、频率、刺激量等客观指标的研究及提插补泻手法的实验研究概况。第二篇论述中医对血虚证病因、病机等方面的古代、现代的认识,研究概况及治疗方案。
第二部分动物实验
研究目的：通过研究提插“补”、“泻”手法对血虚证家兔所产生的补泻效果,观察对于血虚证家兔：①针刺提插补法与泻法所产生的补泻效果是否不同；②针刺提插补法的效果是否优于提插泻法；③其研究结果将为提插补泻手法提供客观科学依据,也为临床针刺治疗血虚证提供客观依据。
实验方法：将60只家兔随机分为5组：A组(空白组)、B组(模型对照组)C组(留针组)、D组(提插补法组)、E组(提插泻法组),每组12只,后三组统称为治疗组。A组不进行任何处理,正常同步喂养,其余四组均采用放血加适当限食的方法制备血虚证模型。造模成功后,B组：只做捆绑固定,不进行任何治疗,让其自然恢复；C组：针刺家兔双侧足三里进行治疗,不做补泻手法,进针得气后,留针15分钟；D组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插补法；E组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插泻法。间日治疗一次,共计10次。分别于造模前、造模后、治疗结束后的第2天、第17天、第32天在耳缘静脉取血,检测家兔外周血中的血清铁蛋白及总铁结合力。采用SAS软件对数据进行统计分析。
结果：
一、造模前后结果对比
1.造模前各组间家兔的SF、TIBC值对比无差异；2.造模后B、C、D、E组的SF值与造模前对比明显下降,TIBC值与造模前对比明显升高；③造模后B、C、D、E组的SF、TIBC值在同一时间段与空白组对比有显著差异,而四组间对比无明显差异。从以上两个指标来看可以判定血虚证模型家兔造模成功。
二、治疗前后结果对比
1.治疗后第2天,各组家兔的SF值及TIBC值与针刺前相比无明显差异；各组与A组(空白组)比较SF值仍偏低,TIBC值仍偏高。
2.治疗后第17天：
(1)SF值：①D、E两组(补法组、泻法组)的SF值与针刺前相比明显升高；在此时间点,E组的SF值(泻法组)明显高于B组(模型组)(P<0.05),而D组与B组比较虽无统计学意义,但由于其基础值较低,因此SF值上升的趋势也很明显。②C组(留针组)的SF值与治疗前相比有所上升,其上升幅度要高于B组(但无统计学意义),其与A、B两组相比较均无统计学差异,说明C组有一定升高SF值的效果,但不如D、E两组明显。③D、E两组间比较无统计学意义(P>0.05),说明补法组与泻法组升高SF值的补泻效果无明显区别。
(2) TIBC值：①D、E两组(补法组、泻法组)的TIBC值与针刺前相比明显下降,且要低于此时的B组(模型组),与A组(空白组)比较已无明显差异。②C组(留针组)的TIBC值与针刺前相比有所降低(但无统计学意义),其与A、B两组相比较均无统计学差异,说明C组有一定降低TIBC值的效果,但不如D、E两组明显。③D、E两组相比无统计学意义(P>0.05),说明补法组与泻法组降低TIBC值的补泻效果无明显区别。
3.治疗后第32天,各组的TIBC及SF值与治疗前相比均明显恢复,各组与A组(空白组)比较已无明显差异(P<0.05)。
结论：1.针刺治疗后第17天,D、E两组(补法组、泻法组)家兔的SF值比治疗前明显升高(P<0.05),C组虽无统计学意义,但其SF值升高趋势也较明显,说明针刺治疗可有效升高失血后家兔的SF值。2.针刺治疗后第17天,D、E两组(补法组、泻法组)家兔的TIBC值比治疗前明显降低(P<0.05),C组虽无统计学差异,但其SF值也有降低的趋势,说明针刺可有效纠正失血后异常升高的TIBC值。3.本实验中针刺提插补法与泻法对于治疗血虚证家兔降低的SF与升高的TIBC均有较好的疗效,其效果要优于静留针法。4.本实验中的提插补法对比提插泻法,改善SF及TIBC值的差异不明显,无统计学意义,因而不能推断提插补法的治疗效果要优于提插泻法。
As two basic reinforcing and reducing methods of acupuncture, lting-thrusting method and whirling method are widely used in clinic. There are still many different points of view about them:whether the reinforcing and reducing effect really exists, which factors affect the reinforcing and reducing effect, whether reinforcing and reducing effect has relation with the depth, angle, force and frequency of needle insertion. Because the subjectivity of acupuncture manipulation, it's hard to standardized in clinic and leads to low repeatability in experiments. Therefore, it is very important to establish the quantization of acupuncture manipulation, which will provide with a base for the clinical and experimental research in future.
Section one:Literature Summary
There are two literature reviews. The first article is involved in the study about antique literature and theories; the depth, angle, force and frequency of the lting-thrusting method; and the research profile about experimental study. Section two:animal experiment
Objective:
To observe the effectiveness of reinforcing and reducing by lifting and thrusting to blood deficiency rabitts:①To study whether the effect is different between lifting-thrusting reinforcement method and lifting-thrusting reduction method on blood-deficiency rabbits;②To study whether the effect of lifting-thrusting reinforcement method is better than lifting-thrusting reduction method on blood-deficiency rabbits;③To evaluate objectively acupuncture manipulation of lifting-thrusting reinforcement and reduction.
Methods:
60 Rabitts were divided into five groups randomly:Blank Group(Group A), Model Group (Group B), quiet stay needle group (Group C), reinforcing group(Group D) and reducing group (Group E),12 rabitts per group. Drew blood from central veins and central artery and ear margin vein of rabit ears except Blank Group, once per two days and 10 ml per time, totally 5 times, (the volume of withdraw blood is 10% of the whole body blood). Change their normal fed rules since the date of building model, with adequate food and restriction alternately. Drew periphery blood of the rabitts after model built 2 days,17 days and 32 days, test serum ferritin and total iron binding capacity of blood serum after Centrifugal. Data analyze in SAS software.
Results:
Results contrasting between pre-modeling and post-modeling
1. There are no differences in the SF and TIBC indexs among the five groups before modeling.2. Contrast with pre-modeling, the SF index of Group B, C, D,E are sharply decreased, the TIBC index are obviously increased.3. After modeling, the SF and TIBC index of Group B, C, D, E are significantly different with the blank group at the same time, and there are no differences among the four groups. Therefore we could concluded that the model is successfully established.
Results contrasting between pre-treatment and post-treatment
1.2 days after treatment, there are no differences in the SF and TIBC indexs compared with pre-treatment every group, compared with the blank group, the SF index are still lower and the TIBC index are still higher in Group B, C,D,E.
2.17 days after treatment:
SF index:①Group D and E are much higher than pre-treatment, Group E is significantly higher than Group B (P<0.05), though there is no statistic difference between Group D and B, the SF index of Group D are also obvious because of the relatively lower basic index.②The SF index of Group C are higher than pre-treatment,it is also higher than Group B(not statistically), which showed Group C could increase the SF index, but not so obviously as Group D and E.③There are no statistic differences between Group D and E, which showed no difference between reinforcing and reducing effect for the SF index.
TIBC index:①Group D and E are much lower than pre-treatment, and also much lower than Group B at this time.②The TIBC index of Group C are relatively lower than pre-treatment, it is also lower than Group B(not statistically), which showed Group C could decrease the TIBC index, but not so obviously as Group D and E.③There are no statistic differences between Group D and E, which showed no difference between reinforcing and reducing effect for the TIBC index.
3.32 days after treatment:the SF and TIBC index of group B,C,D,E are obviously recovered, and no more significant differences compared with Blank Group. (P<0.05)。
Conclusion:
1. Acupuncture treatment could effectively increase the index of SF of blood loss rabitts.2. Acupuncture treatment could effectively lower the index of SF of blood loss rabitts.3. the treatment of reinforcing and reducing by lifting and thrusting is good for the index of decreasing SF and increasing TIBC of blood deficiency rabitts and better than quiet stay needle treatment.4. there is no difference between reinforcing and reducing by lifting and thrusting for improving the index of SF and TIBC, no difference statistically between them, so we can not draw a conclusion that the method of strongly thrusting and lightly lifting is better than and lightly thrusting and strongly lifting.
第一部分文献综述
文献综述共两篇。第一篇介绍了关于针刺提插补泻手法的古代文献及理论研究,提插深度、角度、频率、刺激量等客观指标的研究及提插补泻手法的实验研究概况。第二篇论述中医对血虚证病因、病机等方面的古代、现代的认识,研究概况及治疗方案。
第二部分动物实验
研究目的：通过研究提插“补”、“泻”手法对血虚证家兔所产生的补泻效果,观察对于血虚证家兔：①针刺提插补法与泻法所产生的补泻效果是否不同；②针刺提插补法的效果是否优于提插泻法；③其研究结果将为提插补泻手法提供客观科学依据,也为临床针刺治疗血虚证提供客观依据。
实验方法：将60只家兔随机分为5组：A组(空白组)、B组(模型对照组)C组(留针组)、D组(提插补法组)、E组(提插泻法组),每组12只,后三组统称为治疗组。A组不进行任何处理,正常同步喂养,其余四组均采用放血加适当限食的方法制备血虚证模型。造模成功后,B组：只做捆绑固定,不进行任何治疗,让其自然恢复；C组：针刺家兔双侧足三里进行治疗,不做补泻手法,进针得气后,留针15分钟；D组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插补法；E组：针刺家兔双侧足三里进行治疗,按预先录制好的操作口令行提插泻法。间日治疗一次,共计10次。分别于造模前、造模后、治疗结束后的第2天、第17天、第32天在耳缘静脉取血,检测家兔外周血中的血清铁蛋白及总铁结合力。采用SAS软件对数据进行统计分析。
结果：
一、造模前后结果对比
1.造模前各组间家兔的SF、TIBC值对比无差异；2.造模后B、C、D、E组的SF值与造模前对比明显下降,TIBC值与造模前对比明显升高；③造模后B、C、D、E组的SF、TIBC值在同一时间段与空白组对比有显著差异,而四组间对比无明显差异。从以上两个指标来看可以判定血虚证模型家兔造模成功。
二、治疗前后结果对比
1.治疗后第2天,各组家兔的SF值及TIBC值与针刺前相比无明显差异；各组与A组(空白组)比较SF值仍偏低,TIBC值仍偏高。
2.治疗后第17天：
(1)SF值：①D、E两组(补法组、泻法组)的SF值与针刺前相比明显升高；在此时间点,E组的SF值(泻法组)明显高于B组(模型组)(P<0.05),而D组与B组比较虽无统计学意义,但由于其基础值较低,因此SF值上升的趋势也很明显。②C组(留针组)的SF值与治疗前相比有所上升,其上升幅度要高于B组(但无统计学意义),其与A、B两组相比较均无统计学差异,说明C组有一定升高SF值的效果,但不如D、E两组明显。③D、E两组间比较无统计学意义(P>0.05),说明补法组与泻法组升高SF值的补泻效果无明显区别。
(2) TIBC值：①D、E两组(补法组、泻法组)的TIBC值与针刺前相比明显下降,且要低于此时的B组(模型组),与A组(空白组)比较已无明显差异。②C组(留针组)的TIBC值与针刺前相比有所降低(但无统计学意义),其与A、B两组相比较均无统计学差异,说明C组有一定降低TIBC值的效果,但不如D、E两组明显。③D、E两组相比无统计学意义(P>0.05),说明补法组与泻法组降低TIBC值的补泻效果无明显区别。
3.治疗后第32天,各组的TIBC及SF值与治疗前相比均明显恢复,各组与A组(空白组)比较已无明显差异(P<0.05)。
结论：1.针刺治疗后第17天,D、E两组(补法组、泻法组)家兔的SF值比治疗前明显升高(P<0.05),C组虽无统计学意义,但其SF值升高趋势也较明显,说明针刺治疗可有效升高失血后家兔的SF值。2.针刺治疗后第17天,D、E两组(补法组、泻法组)家兔的TIBC值比治疗前明显降低(P<0.05),C组虽无统计学差异,但其SF值也有降低的趋势,说明针刺可有效纠正失血后异常升高的TIBC值。3.本实验中针刺提插补法与泻法对于治疗血虚证家兔降低的SF与升高的TIBC均有较好的疗效,其效果要优于静留针法。4.本实验中的提插补法对比提插泻法,改善SF及TIBC值的差异不明显,无统计学意义,因而不能推断提插补法的治疗效果要优于提插泻法。
As two basic reinforcing and reducing methods of acupuncture, lting-thrusting method and whirling method are widely used in clinic. There are still many different points of view about them:whether the reinforcing and reducing effect really exists, which factors affect the reinforcing and reducing effect, whether reinforcing and reducing effect has relation with the depth, angle, force and frequency of needle insertion. Because the subjectivity of acupuncture manipulation, it's hard to standardized in clinic and leads to low repeatability in experiments. Therefore, it is very important to establish the quantization of acupuncture manipulation, which will provide with a base for the clinical and experimental research in future.
Section one:Literature Summary
There are two literature reviews. The first article is involved in the study about antique literature and theories; the depth, angle, force and frequency of the lting-thrusting method; and the research profile about experimental study. Section two:animal experiment
Objective:
To observe the effectiveness of reinforcing and reducing by lifting and thrusting to blood deficiency rabitts:①To study whether the effect is different between lifting-thrusting reinforcement method and lifting-thrusting reduction method on blood-deficiency rabbits;②To study whether the effect of lifting-thrusting reinforcement method is better than lifting-thrusting reduction method on blood-deficiency rabbits;③To evaluate objectively acupuncture manipulation of lifting-thrusting reinforcement and reduction.
Methods:
60 Rabitts were divided into five groups randomly:Blank Group(Group A), Model Group (Group B), quiet stay needle group (Group C), reinforcing group(Group D) and reducing group (Group E),12 rabitts per group. Drew blood from central veins and central artery and ear margin vein of rabit ears except Blank Group, once per two days and 10 ml per time, totally 5 times, (the volume of withdraw blood is 10% of the whole body blood). Change their normal fed rules since the date of building model, with adequate food and restriction alternately. Drew periphery blood of the rabitts after model built 2 days,17 days and 32 days, test serum ferritin and total iron binding capacity of blood serum after Centrifugal. Data analyze in SAS software.
Results:
Results contrasting between pre-modeling and post-modeling
1. There are no differences in the SF and TIBC indexs among the five groups before modeling.2. Contrast with pre-modeling, the SF index of Group B, C, D,E are sharply decreased, the TIBC index are obviously increased.3. After modeling, the SF and TIBC index of Group B, C, D, E are significantly different with the blank group at the same time, and there are no differences among the four groups. Therefore we could concluded that the model is successfully established.
Results contrasting between pre-treatment and post-treatment
1.2 days after treatment, there are no differences in the SF and TIBC indexs compared with pre-treatment every group, compared with the blank group, the SF index are still lower and the TIBC index are still higher in Group B, C,D,E.
2.17 days after treatment:
SF index:①Group D and E are much higher than pre-treatment, Group E is significantly higher than Group B (P<0.05), though there is no statistic difference between Group D and B, the SF index of Group D are also obvious because of the relatively lower basic index.②The SF index of Group C are higher than pre-treatment,it is also higher than Group B(not statistically), which showed Group C could increase the SF index, but not so obviously as Group D and E.③There are no statistic differences between Group D and E, which showed no difference between reinforcing and reducing effect for the SF index.
TIBC index:①Group D and E are much lower than pre-treatment, and also much lower than Group B at this time.②The TIBC index of Group C are relatively lower than pre-treatment, it is also lower than Group B(not statistically), which showed Group C could decrease the TIBC index, but not so obviously as Group D and E.③There are no statistic differences between Group D and E, which showed no difference between reinforcing and reducing effect for the TIBC index.
3.32 days after treatment:the SF and TIBC index of group B,C,D,E are obviously recovered, and no more significant differences compared with Blank Group. (P<0.05)。
Conclusion:
1. Acupuncture treatment could effectively increase the index of SF of blood loss rabitts.2. Acupuncture treatment could effectively lower the index of SF of blood loss rabitts.3. the treatment of reinforcing and reducing by lifting and thrusting is good for the index of decreasing SF and increasing TIBC of blood deficiency rabitts and better than quiet stay needle treatment.4. there is no difference between reinforcing and reducing by lifting and thrusting for improving the index of SF and TIBC, no difference statistically between them, so we can not draw a conclusion that the method of strongly thrusting and lightly lifting is better than and lightly thrusting and strongly lifting.
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[1]肖香群,浅谈脾血虚证[J].辽宁中医药大学学报,2008,10(2)：78-79.
[2]刘建文,发与血关系的实验研究[J].河南中医,1994,14(2)：82-83.
[3]刘卫民,暴宏伶,等.中医血虚证与现代医学贫血的相关性研究[J].中国自然医学杂志,2004,9(6)：200-201.
[4]秦林,刘更生,等.试论四物汤血虚证与贫血症的关系[J]2004,10(2)：48-50.
[5]陈昌华,石林阶,等.肝血虚证15项实验指标同步检测的分析[J].湖南医科大学学报,2001,26(4)：337-339.
[6]陈如采,梁毂,等.血虚证红细胞免疫功能和变形性,淋巴细胞转化功能及自由基代谢的研究[J].中西医结合实用临床急救,1999,6(4)：151-153.
[7]陈如泉.梁毅,等.血虚证红细胞免疫功能和变形性、淋巴细胞转化功能及自由基代谢的研究[J].中西医结合实用临床急救,1999,6(4)：151-153.
[8]梁毅,鲁新华,等.中医血虚证研究进展[J].中国中医药信息杂志,1999,6(1)：16-18.[9]梁春敏,王贤喜,袁栎.复方六一汤对血虚小鼠脾重和组织学结构的影响[J].皖南医学院学报,2000,19(1)：13-15.
[10]龙子江,吕晓英,等.血虚对小鼠生育功能影响的实验研究[J].中国中医药科技,2000.7(6)：372.
[11]亢泽峰,庄曾渊,等.血虚证大鼠视网膜病理改变的研究[J].中国中医基础医学杂志,2001,7(3)：43-46.
[12]梁忠,黄波,等.中医血虚证生化客观指标的临床研究[J].湖北中医杂志,2010,32(2)：20-21.
[13]石林阶,陈昌华,等.肝血虚证辅助实验诊断指标的初步研究[J].湖南中医学院学报,1999,19(12)30-32.
[14]陈小野.中医证候模型制备方法概论[J]上海实验动物科学,1999,19(3)：191-193.
[15]周梦圣.对控制饲料量所致小白鼠虚证动物模型的研究和探讨.[J]辽宁中医杂志,1989,13(20)：10-11.
[16]周梦圣.模拟中医气虚动物模型的研究[J].中医杂志,1989,30(9)：41-43.
[17]高月.血虚证实质及四物汤反证研究[J].中国实验方剂学杂志.2003,9(4)：58-60.
[18]贲长恩.血虚动物模型初讨[J].上海中医药杂志,1981,15(6)：38-39.
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[21]苗明三,方晓艳等.血虚动物模型复制的思考[J].光明中医,2003,18(106)：8-9.
[22]焦立红,任雷鸣,等.四种血虚小鼠模型制备方法的比较[J].时珍国医国药,2006.17(6)：1001-1002.
欧敏,陈如泉.血虚家兔模型红细胞变形性与SOD,LPO变化的实验研究[J]湖北中医杂志,1996,18(3)：52-53.
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[33]彭渝.血清铁蛋白在急性失血患者中的临床意义[J].现代医药卫生,2003,19(1)：12-13.
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[1]肖香群,浅谈脾血虚证[J].辽宁中医药大学学报,2008,10(2)：78-79.
[2]刘建文,发与血关系的实验研究[J].河南中医,1994,14(2)：82-83.
[3]刘卫民,暴宏伶,等.中医血虚证与现代医学贫血的相关性研究[J].中国自然医学杂志,2004,9(6)：200-201.
[4]秦林,刘更生,等.试论四物汤血虚证与贫血症的关系[J]2004,10(2)：48-50.
[5]陈昌华,石林阶,等.肝血虚证15项实验指标同步检测的分析[J].湖南医科大学学报,2001,26(4)：337-339.
[6]陈如采,梁毂,等.血虚证红细胞免疫功能和变形性,淋巴细胞转化功能及自由基代谢的研究[J].中西医结合实用临床急救,1999,6(4)：151-153.
[7]陈如泉.梁毅,等.血虚证红细胞免疫功能和变形性、淋巴细胞转化功能及自由基代谢的研究[J].中西医结合实用临床急救,1999,6(4)：151-153.
[8]梁毅,鲁新华,等.中医血虚证研究进展[J].中国中医药信息杂志,1999,6(1)：16-18.[9]梁春敏,王贤喜,袁栎.复方六一汤对血虚小鼠脾重和组织学结构的影响[J].皖南医学院学报,2000,19(1)：13-15.
[10]龙子江,吕晓英,等.血虚对小鼠生育功能影响的实验研究[J].中国中医药科技,2000.7(6)：372.
[11]亢泽峰,庄曾渊,等.血虚证大鼠视网膜病理改变的研究[J].中国中医基础医学杂志,2001,7(3)：43-46.
[12]梁忠,黄波,等.中医血虚证生化客观指标的临床研究[J].湖北中医杂志,2010,32(2)：20-21.
[13]石林阶,陈昌华,等.肝血虚证辅助实验诊断指标的初步研究[J].湖南中医学院学报,1999,19(12)30-32.
[14]陈小野.中医证候模型制备方法概论[J]上海实验动物科学,1999,19(3)：191-193.
[15]周梦圣.对控制饲料量所致小白鼠虚证动物模型的研究和探讨.[J]辽宁中医杂志,1989,13(20)：10-11.
[16]周梦圣.模拟中医气虚动物模型的研究[J].中医杂志,1989,30(9)：41-43.
[17]高月.血虚证实质及四物汤反证研究[J].中国实验方剂学杂志.2003,9(4)：58-60.
[18]贲长恩.血虚动物模型初讨[J].上海中医药杂志,1981,15(6)：38-39.
[19]贲长恩.血虚动物模型的进一步探讨[J].中医杂志,1981,22(6)：69-72.
[20]金若敏,宁炼,等.血虚模型动物制备及当归补血汤的作用研究[J].中成药,2001。23(4)：268-271.
[21]苗明三,方晓艳等.血虚动物模型复制的思考[J].光明中医,2003,18(106)：8-9.
[22]焦立红,任雷鸣,等.四种血虚小鼠模型制备方法的比较[J].时珍国医国药,2006.17(6)：1001-1002.
欧敏,陈如泉.血虚家兔模型红细胞变形性与SOD,LPO变化的实验研究[J]湖北中医杂志,1996,18(3)：52-53.
[24]陈奇.中药药理研究方法学[M].北京：人民卫生出版社,1993,1004,1007,1011,1018.
[25]梁毅,鲁新华,等.血虚证免疫功能变化规律的临床及实验研究[J].实用中西医结合杂志,1998,11(11)：961-962.
[26]梁毅,方碧琴,等.血虚证小鼠模型骨髓细胞红系祖细胞,粒单系祖细胞变化规律及中药复方对其的影响[J].湖北中医学院学报,2001,3(3)：13-15.
[27]欧敏,陈如泉.血虚家兔模型红细胞变形性与SOD,LPO变化的实验研究[J].辽宁中医杂志,1996,23(3)：139-140.
[28]郭平.血虚证动物模型研究概况[J].山东中医药大学学报,2006,30(1)：83-86.
[29]田野,赵杰修,等.“抗运动性贫血复合剂”营养补充对运动性贫血大鼠红细胞血象和血清EPO水平的影响[J].体育科学,2004,24(1)：20-24.
[30]杨岚,祝彼得,等.血虚证动物模型的标准化研究初探[J].四川动物,2006,25(1)：160-164.
[31]苗明三,方晓艳,等.血虚证动物模型复制的思考[J].光明中医,2003,18(106)：8-9.
[32]卞志强.临床检查结果判解[M].北京：北京人民卫生出版社,31991,07.
[33]彭渝.血清铁蛋白在急性失血患者中的临床意义[J].现代医药卫生,2003,19(1)：12-13.
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