基于HIS真实世界的病毒性肝炎患者中西药物临床实效研究

病毒性肝炎是临床多发的具有较强传染性的疾病,为充分了解其中西药物临床使用特征及合并用药规律,该研究以17家三级甲等医院信息系统(hospital information system,HIS)中41 180例病毒性肝炎住院患者为研究对象,采用频数统计及关联规则方法对其中西药物临床使用情况进行分析,按药物种类分析,发现西药以还原性谷胱甘肽使用频率最高,共14 079例(支持度为34.61%),中药以甘草酸二胺使用频率最高,共14 058例(支持度为34.56%),中西药物联合使用以甘草酸二铵合并还原型谷胱甘肽使用频率最高,共8 607例(支持度为25.09%);按药物作用分析,中药、西药均以降酶类药物使用比例最高,中药降酶药物使用者10 983例(支持度为27.01%),西药降酶药物使用者9 595例(支持度为23.59%),中西药物合并用药以清热利湿类药合并降酶类药使用频率最高,5 621例(支持度为13.82%)。通过以上分析可以看出,病毒性肝炎的治疗应以中西医结合治疗为主;中药清热利湿类药物合并西药降酶类药物是临床最常出现的中西联合用药方案,中药清热利湿类药合并西药降酶类药和核苷(酸)类似物是临床最常出现的三药联合用药方案。     

芒果叶浸膏香烟的实验研究与临床观察小结

<正> 香烟对人体的有害成份主要是烟碱(尼古丁),焦油(主要是8、4苯并芘),一氧化碳,致咳质等。为了寻找出能降低香烟中上述有害成分的药物,以减轻对人体的危害,我们于1981年3月至1982年12月,从多种中草药中筛选出有镇咳、祛痰、平喘作用的芒果叶,通过实验研究及临床观察,试制成掺入1.4%芒果叶浸膏的香烟(简称试制烟),经中国烟草工业科学研究所作烟雾测定,证明其所含烟碱及焦油都比对照烟低。现将实验研究及临床观察结果报导如下。     

知母合剂对白念珠菌的黏附抑制作用

目的探讨抗真菌中药复方(知母合剂)对白念珠菌的黏附抑制作用。方法将知母合剂配成高、中、低3个浓度(3组浓度依次为:10,5,2.5 mg/ml),分别对白念珠菌标准菌株(ATCC14053、CCCMCla)和临床分离菌株(C1-1、C1-4)预处理,再加入从人口腔黏膜分离的上皮细胞,37℃孵育1 h,观察药物对白念珠菌不同菌株的黏附作用及药物浓度对菌株黏附作用的影响。结果知母合剂对ATCC14053、CCCMCla和C1-1、C1-4 4株试验菌均具有黏附抑制作用,而且药物对不同菌株黏附上皮细胞的抑制作用具有显著性差异(P<0.001),对标准菌株(ATCC14053、CCCMCla)黏附抑制作用较强,对临床分离菌株(C1-1、C1-4)的黏附抑制作用较弱;抑制作用的强弱与药物浓度呈正相关,尤其对C1-4的黏附作用具有显著影响,高浓度药物组黏附细胞数最少(黏附抑制作用强),其次是中浓度药物组,空白对照组黏附细胞数最多,四组间该指标总的差别有统计学意义(P<0.001)。结论知母合剂能明显抑制白念珠菌标准菌株(ATCC14053、CCCM-Cla)和临床分离菌株(C1-1、C1-4)对口腔黏膜上皮细胞的黏附作用,抑制作用的强弱因菌株不同而具有显著差异并与药物浓度密切相关。     

无锡伤药的药理研究

无锡伤药是以理气、活血化瘀,消肿止痛药物组成的胶囊剂。临床治疗软组织损伤,总有效率为97.6%。药理研究结果表明,本品能对抗急性、慢性实验动物炎症模型,其作用强度优于水杨酸钠。镇痛试验,采用热板法结果证明,其痛阈提高212.99%;光电甩尾法镇痛试验结果表明,其镇痛效应在给药后二小时作用达峰值(p<0.01),作用维持4h以上;6h作用消失。     

傣医“解药”探讨

“解药”,傣语称之为YaGei(雅给),英文名为ANTIDOTE,狭义的“解药”内容包括解除食物毒性、解除毒性动物叮咬中毒、解除毒热、解除药物毒性和解除药物作用五个方面;“解药”应归为药物的第二级分类中;傣医解药分为解除食物毒性类、解除毒性动物叮咬中毒类、解除药物毒性及药物作用类、解热类和其他共五类。系统的整理研究傣医“解药”,有助于傣医的临床应用和傣药的开发。     

淫羊藿对成骨细胞增殖的血清药理学研究

探索淫羊藿抗骨质疏松症的作用机理,以血清药理学研究方法,进行了动物实验方面的工作。研究表明:服淫羊藿后的大鼠血清碱性磷酸酶活性显著增高(P<0.05)细胞内蛋白质含量增高,成骨细胞的数量增多(P<0.05),培养基中钙含量明显降低(P<0.05),剂量与作用呈正相关性,表明该药是抗骨疏松症的理想药物之一。     

张锡纯补络补管汤实验研究和临床应用现状

目的对近年来补络补管汤及其组成药物的实验研究和临床应用进行总结与归纳。方法采用文献整理与回顾的方法,对近年来补络补管汤及其组成药物的实验研究和临床应用予以归纳。结果实验研究发现,龙骨、牡蛎具有促凝作用,山萸肉、三七均具有促凝和抗凝的双重作用,该方能缩短小鼠、家兔出血时间(BT)、凝血时间(CT)、血浆凝血酶原时间(PT),临床应用于咯血、上消化道出血等疾病疗效显著。结论补络补管汤止血作用确切。     

试论中药药理学的基础研究

药物的药理学研究是药物研究全过种中最重要的一个环节,它常可以决定某种物质能否成为一个特殊商品——药物。广义上讲药理学研究的主要目的是为了提高现有药物的临床疗效,发展新药,发现老药新用途,或以药物为研究工具促进基础医学的发展。但是具体到某个药物时,药理学的主要任务是确定所试药物的作用谱(治疗作用和不良反应)、作用特点、作用原理和为临床用药提供剂量、剂型、给药途径及用药间隔时间的科学依据。     

清宫龙凤宝抗阳痿的实验研究

目的:研究中药复方“清宫龙凤宝”治疗阳痿的药理药效。方法:采用肾虚小白鼠动物模型观察药物对实验动物机体状况的改善,运用去势小白鼠观察药物的雄激素活性作用,通过大白鼠交配实验及血清性激素(T、LH、FSH)的检测,对中药复方清宫龙凤宝的补肾壮阳的药理药效进行了研究。结果:①清宫龙凤宝能升高肾虚小白鼠体温(P<0.05),增加其自动活动次数(P<0.05),延长肾虚小白鼠低温游泳成活时间(P<0.05),但对肾虚小白鼠体重的增加作用不明显(P<0.05)。②清宫龙凤宝对去势小白鼠附性器官重量的增加作用不明显(P<0.05);③清宫龙凤宝能增加雄性大白鼠扑捉雌鼠的次数(P<0.05),但作用远逊于丙酸睾丸素;对小白鼠血清性激素的影响:服用清宫龙凤宝后,血清睾酮浓度升高(P<0.05),黄体生成素浓度降低(P<0.05),卵泡刺激素浓度降低(P<0.05)。结论:具有补肾壮阳作用的清宫龙凤宝,虽有一定的类性激素样作用,但绝不是仅有单纯的类性激素样作用;推测清宫龙凤宝是通过调节下丘脑-垂体-性腺轴发生性激素样作用。     

针刺内关治疗早搏研究概况

近年来,抗心律失常药物广泛应用于临床,但抗心律失常的药物具有负性肌力、负性传导作用,尤其是Ib、Ic类抗心律失常药物致心律失常的发生日益增多[1].我们在临床中发现针刺内关穴可产生辅佐抗心律失常药物的作用,并且内关穴本身对心律失常具有治疗作用,现就针刺内关穴治疗早搏的研究归纳如下: 1 针刺治疗 高氏等用心电图作为指标,针刺治疗早搏42例,选穴内关、神门、夹脊胸4～5(或心俞、厥阴俞),每资助选用1～2穴.     

Effects of promethazine on acupuncture analgesia

Promethazine, one of histaminergic H1-receptor antagonist, was often used as an adjuvant drug prior to and during acupuncture anesthesia in clinics, However, its effects was not known clearly. By using potassium iontophoretic dolorimetry and stimulating unilateral "Hegu" and "Waiguan" points with electroacupuncture (EA) in 42 rabbits, we found that Promethazine could drop the pain threshold in small dosages (0.5 mg/kg, 1 mg/kg) and raise the pain threshold in relatively large dosages (2 mg/kg, 4 mg/kg). In different dosages (1 mg/kg, 2 mg/kg), promethazine could attenuate the analgesic effect of EA. It was suggested that promethazine should be used carefully in acupuncture anaesthesia.     

咪唑啉受体参与痛觉调制和针刺镇痛

目的 :观察咪唑啉受体在痛觉调制和针刺镇痛中的作用。方法 :本文以辐射热照射致甩尾反射潜伏期作为测痛的指标 ,采用蛛网膜下腔注射 (ith)咪唑啉受体的激动剂和拮抗剂的方法观察咪唑啉受体对痛阈和针刺镇痛效应的影响。结果 :ith可乐宁和电针双侧“次”穴可产生明显的镇痛效应 ,均可被事先注射咪唑啉受体的拮抗剂苯恶唑 (Idazoxan)所阻断。结论 :说明激活咪唑啉受体可能是可乐宁和电针镇痛效应的共同脊髓机制 ,但是没有观察到可乐宁明显加强针刺镇痛的协同作用     

不同穴位电针治疗大鼠慢性神经源性痛的疗效比较

目的 :比较不同经穴电针治疗大鼠慢性神经源性痛的疗效。方法 :选用大鼠L5/L6 脊神经结扎慢性神经源性痛模型 ,给予不同经穴的电针治疗 ,穴位选用“夹脊”(L5)、“环跳”、“委中”、“阳陵泉”和“足三里”。采用引起缩足的机械刺激阈值 ( 50 %缩足阈值 )来评价机械性痛觉超敏 ,用大鼠 5min内在 5± 1℃冷板上的抬脚次数来反映冷诱发的持续性疼痛。分别于电针后即刻、2 4hr、48hr和 72hr检测冷诱发的持续性疼痛 ;电针后即刻、电针后 1 2hr、2 4hr和 48hr检测机械性痛觉超敏 ( 50 %缩足阈值 ) ,以观察其疗效。结果 :以上五个穴位单次电针均有较好的镇痛作用。对冷诱发的持续性疼痛的抑制均可持续至电针后 2 4hr,其中“委中”对冷诱发的持续性疼痛的抑制作用可持续至电针后 48hr;对机械性痛觉超敏的镇痛作用即刻效果较好 ,电针后 1 2hr消失。五个穴位镇痛强度之间在统计学上无显著差异。结论 :临床经验提示穴位选择是影响针刺镇痛效果的重要因素之一。在本实验条件下 ,“委中”穴电针后的镇痛作用持续时间最长 ,可以认为效果最优     

电针对佐剂性关节炎大鼠炎症局部δ阿片受体mRNA表达的影响

目的:从阿片受体角度观察电针(EA)对佐剂性关节炎(AA)大鼠产生镇痛的外周机制。方法:将32只SD大鼠随机分为正常组、模型组、EA组和单针组。于实验第1天在模型组、EA组大鼠右后足垫部向踝关节方向注入弗氏(Freund s)完全佐剂0.1 mL造模。以“悬钟”“昆仑”为EA穴位,刺激参数为2~4 V,20~100 Hz,每天1次,每次20 min,连续6 d。以原位杂交等为检测方法,在EA治疗后观测大鼠痛阈、炎症局部δ阿片受体(DOR)mRNA的表达。结果:①EA可明显提高炎症痛大鼠的痛阈,EA组与模型组比较有显著性差异(P<0.01),而与正常组无显著性差异(P>0.05);②EA组炎症局部DOR mRNA的表达明显高于模型组(P<0.01)。结论:EA对AA大鼠有明显镇痛效应,且镇痛效应的产生与大鼠炎症局部的DOR mRNA表达增强有关。     

氯胺酮对针刺镇痛的影响

<正> 临床针麻手术有配合使用氯胺酮提高其效果,但也有持相反的意见。在我们以往的一些工作中主要是观察大鼠在清醒状态下的行为反应,因此一些必要的手术是在氯胺酮麻醉下完成的。由于氯胺酮的作用时间较短,动物可很快恢复,便于进行实验,但是否会影响到针刺镇痛作用的研究,这是个值得考虑的问题。有报导氯胺酮有拮抗     

电针与预电针对糖尿病神经痛大鼠痛觉敏化及脊髓背角P2X7R表达的影响

目的:观察腹腔注射链脲佐菌素(STZ)后糖尿病大鼠出现神经痛的时间及脊髓背角嘌呤能离子通道型受体7(P2X7R)表达情况,以及电针和预电针对糖尿病神经痛(DNP)大鼠热痛阈和脊髓背角P2X7R表达的影响,探讨电针防治DNP的可能作用机制.方法:第一部分:从64只雄性SD大鼠中随机选取30只作为对照组;余下大鼠以65 m...     

Involvement of taurine in penicillin-induced epilepsy and anti-convulsion of acupuncture: a preliminary report

The potential role of taurine on epilepsy and acupuncture anti-convulsion was addressed in the present study. Epilepsy was induced by micro-injection of penicillin into hippocampus of Wistar rats. Taurine was applied by intraperitioneal (i.p.) injection. Electro-acupuncture (EA) was performed on acupoints of DU 20 "Bai Hui" and DU 16 "Feng Fu" along DU channel. Epileptic grades were evaluated by electro-encephalography (EEG) and behavior score. We featured the dose-response relationship between taurine-treated epilepsy and epilepsy-only subjects, detected the effect of exogenous taurine on epilepsy and acupuncture treatment, and investigated taurine transporter immuno-activity in hippocampus using immunohistochemistry. It was found that: 1), taurine had a significant antiepileptic effect as applied at i.p. 20 mg/kg, 40mg/kg, 80mg/kg, especially at 40mg/kg in the rat model of penicillin-induced seizure. Animals were improved by one to three Racine grades in behavior and in frequency and amplitude of EEG. 2), Exogenous taurine enhanced the anti-convulsive effect of EA. Both behavior and EEG were improved in taurine-treated rats. EA inhibited epilepsy. Exogenous taurine improved epilepsy in a synergistic manner to EA. 3), EA increased the concentration of taurine transporter in hippocampus by comparing EA-treated epilepsy with normal control and penicillin only, or EA-treated plus taurine-treated epilepsy with taurine-treated only epilepsy and penicillin only. The resulting data suggested that taurine may play an inhibitory role against epilepsy as an inhibitory amino acid in the central nervous system and EA may inhibit epilepsy via upregulating the concentration of taurine transporter to increase the release of taurine.     

Study on the analgesic effect of acupuncture with opioid receptors agonist in induced arthritic rats

Our previous study demonstrated that acupuncture increased pain threshold of the body, especially in the inflammatory area. Because acupuncture can promote the release of enkephalin in the brain, it is possible that analgesic effect of acupuncture could be further strengthened by administration of fentanylan opioid receptor's agonist and droperidol-dopamine receptor's agonist at same time. In present study arthritic rats induced by freund's complete adjuvant were divided into two groups. All of them received electro-acupuncture on bilateral "Hung-Tiao" points for 15 minutes. The first group animals were also given with common dose of fenanyl 10 micrograms/kg and droperidol 0.5 mg/kg by intraperitoneal injection. Pain threshold increased very soon after needling and drugs given. The analgesic effect lasted as long as 180 minutes. There is a statistical significant difference between this common dose group and acupuncture control group which only kept analgesic effect 90 minutes, P less than 0.01. When only 1/5 dose of these drugs with acupuncture was applied to arthritic rats, not only the pain threshold reached to 180 + 3% (P less than 0.01), but also the analgesic effect persisted as long as 120 minutes (P less than 0.01). The results from mentioned above suggested that if a small dose of drug is no effect in usual treatment, it could still play a role and reduce the pharmacological side effect by way of combining acupuncture application.     

PAIN AND SENSORY DETECTION THRESHOLD CAN BE MODULATED BY THE ASSOCIATION BETWEEN COPING STRATEGY AND ACUPUNCTURE SENSATION IN ACUPUNCTURE STIMULATION

Introduction: Although acupuncture reduces pain and is important in its effect, the role of coping strategy on acupuncture modulation of pain and sensory thresholds, and the association between acupuncture sensation and these modulatory effects, is currently unknown.Methods: Electroacupuncture(EA) was applied at acupoints ST36 and GB39 in 61 healthy adults.Two coping conditions were experimentally designed to form an active coping strategy group(AC group), who thought they could control EA stimulation intensity, and a passive coping strategy group(PC group), who did not think they had such control.However, the EA intensity was not changed.Quantitative sensory testing was performed before and after EA, and vibration(VDT), mechanical(MDT),warm(WDT), and cold(CDT) detection thresholds, and pressure(PPT), mechanical(MPT), heat(HPT) and cold(CPT) pain thresholds were measured.Autonomic measures, skin conductance response(SCR), were also acquired to quantify physiological response to EA under different coping conditions.Results: The AC group showed greater SCR to EA than the PC.Acupuncture sensation did not differ between the AC and PC groups.Increased pain/sensory threshold and acupuncture sensation were positively correlated in the AC group(VDT change vs.MI: r=0.58; CDT change vs.tingling: r=0.53; CPT change vs.tingling: r=0.55; CPT change vs.dull: r=0.55), and were negatively correlated in the PC group(CDT change vs.intensity: r=-0.52; WDT change vs.fullness: r=-0.57).Additionally, subjects in the AC group demonstrated reduced PPT following EA.Conclusion: Active coping strategy increased pain and sensory detection threshold when acupuncture sensation was high, while passive coping strategy produced an opposite association.Theassociation of descending cortical(psychological coping strategies) and ascending sensory afference(acupuncture sensation) might affect periaqueductal grey to modulate pain and sensory processing.Clinically, our findings suggest that acupuncture analgesia can be maximized by matching physical stimulation intensity with the psychological coping strategy inherent to different naturalistic subject-specific acupuncture contexts.     

电针降低神经病理性疼痛大鼠脊髓白细胞介素-6的表达

目的:观察电针对神经病理性疼痛大鼠脊髓白细胞介素-6(IL-6)蛋白表达以及痛敏状态的影响,探讨电针治疗神经病理性疼痛的可能机制。方法:雄性SD大鼠24只,分为假手术组、手术组和电针治疗组。采用大鼠坐骨神经慢性压迫性损伤(CCI)模型,电针“委中”与“环跳”穴,观察其对大鼠机械性痛阈和热痛阈的影响,并应用免疫组化技术观察大鼠脊髓IL-6的变化。结果:假手术组大鼠脊髓IL-6免疫阳性细胞平均光密度值为0.1361±0.0113,CCI手术可以显著降低大鼠痛阈,并且大鼠手术侧脊髓IL-6免疫阳性细胞平均光密度值增加(0.5152±0.0372),而电针治疗后则明显抑制大鼠脊髓IL-6蛋白(0.3527±0.0379)的表达,并显著减轻CCI大鼠的痛敏状态。结论:电针治疗神经病理性疼痛可能与下调脊髓IL-6的表达有关。