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1.
目的 评价益髓生血颗粒(Yisui Shengxue granule,YSSXG)治疗血红蛋白H病(HbH病)的临床疗效。方法 自1989~2013年1月,采用补肾益髓代表方益髓生血颗粒治疗HbH病共237例,其中缺失型HbH病62例,非缺失型HbH病175例,疗程3个月,动态检测237例患者治疗前后的血液指标[血红蛋白(Hb)、红细胞(RBC)、网织红细胞(Ret) ]水平的变化,并对其中206例HbH患者治疗前后的中医症候(面色萎黄、头晕目眩、心慌心悸、动则气喘、潮热盗汗、口咽干燥、腰膝酸软)进行中医症候量化评分,观察益髓生血颗粒的临床治疗效果。结果 HbH病患者自服药第1~第3个月,血液指标Hb、RBC与疗前相比均显著提高(P<0.01)。经益髓生血颗粒治疗3个月,HbH病患者面色萎黄、头晕目眩、心慌心悸、动则气喘、潮热盗汗、口咽干燥、腰膝酸软的中医症候量化评分与疗前相比显著降低,临床症状显著改善。237例HbH病患者经3个月治疗后,总有效率为74.26%;其中缺失型HbH患者有效率为72.00%;非缺失型患者的有效率为80.65%。两种型别的HbH病患者的有效率比较,差异无统计意义。结论 补肾益髓代表方益髓生血颗粒治疗HbH病疗效显著,提高HbH病患者Hb、RBC水平,同时能改善HbH病患者的中医症候。血液指标水平的提高和中医症状改善相一致。  相似文献   

2.
目的 探讨益髓生血颗粒对血红蛋白H(HbH)病患者铁负荷和抗氧化损伤水平的影响.方法 采用随机安慰剂平行对照的方法,实验组45例患者服用益髓生血颗粒,安慰剂组15例患者服用安慰剂治疗,疗程均为3个月.检测患者治疗前后Hb、SI、SF、SOD、MDA、GSH-Px水平.结果 (1)益髓生血颗粒治疗3个月后,治疗组45例HbH病患者Hb、SOD、GSH-Px水平与疗前相比显著升高(P<0.01),MDA水平与疗前相比显著降低(P<0.01),SI和SF于疗前相比差异无统计学意义(P>0.05).安慰剂组治疗3个月后,Hb、SI、SF、MDA、GSH-Px、SOD水平治疗前后无明显变化(P>0.05).(2)益髓生血颗粒治疗3个月后,缺失型HbH病患者和非缺失型HbH病患者Hb、SOD、GSH-Px水平与疗前相比显著升高(P <0.01);MDA水平与疗前相比显著降低(P<0.01).缺失型HbH病患者SI、SF水平与疗前相比无明显变化(P>0.05);非缺失型HbH病患者SI水平与疗前相比显著降低(P<0.01),SF水平与疗前相比无明显变化(P>0.05).结论 HbH病患者尤其非缺失型HbH病患者需要警惕铁超载,应定期复查SI水平.益髓生血颗粒改善HbH病患者临床疗效的可能机制之一可能与降低体内铁负荷有关,仍需要进一步临床试验进行验证.  相似文献   

3.
益髓生血颗粒治疗血红蛋白H病25例临床观察   总被引:1,自引:0,他引:1  
目的:研究益髓生血颗粒治疗血红蛋白H(hemoglobin H,HbH)病的临床效果及安全性。方法:观察益髓生血颗粒治疗前后25例HbH病患者血红蛋白(hemoglobin,Hb)浓度、红细胞(red bloodcell,RBC)计数、HbH含量及网织红细胞(reticulocyte,Ret)计数的动态变化及疗效;同时检测患者的基因类型,比较益髓生血颗粒治疗前后不同基因型患者血液参数的变化及疗效。结果:25例患者自服药第1个月起至疗程(3个月)结束,血液参数Hb、RBC、Ret水平均明显提高,与治疗前比较,差异有统计学意义(P〈0.01)。经益髓生血颗粒治疗后,12例基因缺失型患者Hb、RBC、Ret明显提高(P〈0.05,P〈0.01),13例基因非缺失型患者Hb、Ret明显提高(P〈0.05,P〈0.01)。25例患者经3个月治疗后的总有效率为84%,中药对基因缺失型和非缺失型患者的疗效比较,差异无统计学意义。治疗期间患者未出现任何不良反应。结论:益髓生血颗粒治疗HbH病疗效显著,用药安全,可明显提高患者Hb、RBC、Ret水平,尤其以基因缺失型患者为佳。  相似文献   

4.
目的探讨补肾益髓法夏季治疗中间型地中海贫血临床疗效。方法选取具有相同中医证候(肝肾阴虚精血不足证),不同基因型的两种中间型地中海贫血患者(α-,β-型),用补肾益髓法的代表方益髓生血颗粒加麦冬进行治疗,采用安慰剂平行对照方法,疗程3个月,动态观察患者中医证候、疗效性血液指标(H11、RBC、Ret、HbF)、患者血清及红细胞抗氧化指标(SOD、MDA、GSH—PX)、血清造血相关细胞因子(SCF、GM—CSF、IL-3)活性的变化。结果与治疗前比,治疗组患者主要疗效性血液指标血红蛋白(Hb)自疗程第1~3个月疗程结束均有升高(P〈0.05),而安慰剂组无明显改善;中医证候量化评分统计结果显示,治疗组α-地中海贫血患者临床表现面色萎黄、头晕盗汗、手足心热、爪甲色淡等症状疗后明显减轻(P〈0.05),而安慰剂组疗效不明显;治疗组β-地中海贫血患者临床表现食少纳呆、潮热盗汗、手足心热等临床症状,治疗后症状明显减轻(P〈0.05);与治疗前比,治疗组患者血清SOD疗后有上升(P〈0.05)、红细胞SOD治疗后有上升(P〈0.05);对血清造血相关细胞因子活性检测结果显示,治疗组SCF和GM—CSF治疗后较治疗前有上升趋势,但无统计意义。结论益髓生血颗粒加麦冬治疗夏季地中海贫血患者贫血,对同一证候(肝肾阴虚、精血不足证)不同基因型的两种地中海贫血(α-型,β-型)患者均有明显疗效,在夏季应用益髓生血颗粒加麦冬治疗地贫符合中医临床不同季节适时辩证施治特点,有助于改善患者贫血状况,提高生存质量。  相似文献   

5.
补肾益髓法治疗中间型珠蛋白合成障碍性贫血临床研究   总被引:2,自引:1,他引:1  
目的 探讨补肾益髓法从肾论治治疗两种不同类型(α-,β-型)中间型珠蛋白合成障碍性贫血的临床疗效.方法 选取具有相同中医证候(肝肾阴虚,精血不足证),不同基因型的两种中间型地中海贫血患者(α-,β-型),用补肾益髓法的代表方益髓生血颗粒进行治疗,疗程3个月,采用自身对照方法,动态观察患者疗效性血液指标Hb、RBC、Ret、HbH的变化.结果 益髓生血颗粒治疗中间型β-地中海贫血96例,有效78例,无效17例,有效率81.3%.有效病例患者的血液指标(Hb、RBC、Ret、HbF),自治疗第1个月起至3个月疗程结束均明显升高(均P<0.01); 治疗中间型α-HbH病81例,有效62例,无效18例,有效率76.5%. 有效病例患者临床血液指标Hb、RBC、Ret,自第1个月起至3个月疗程结束均明显升高(P<0.01).益髓生血颗粒治疗中间型地中海盆血总有效率为79.1%,β-地中海贫血和α-HbH病的疗效差异无统计学意义,服药后患者临床症状的明显改善与血液学指标的提高相一致.结论 补肾益髓法治疗相同中医证候(肝肾阴虚精血不足证)不同基因型的(β-地中海贫血,α-HbH病)两种类型的中间型地中海贫血患者,均有明显疗效.  相似文献   

6.
目的 分析血红蛋白H(hemoglobin H,HbH)病患者常见基因型之间肝脾肿大程度的差异,探讨相关风险因素,为HbH病的临床诊疗和预后评估提供指导。方法 对141例经基因诊断确诊的HbH病患者进行腹部超声影像学检查,观察肝脾肿大程度,记录患者基本信息,并进行统计分析。结果 68例患者同时存在肝脾肿大,缺失型HbH病6例(4.26%,6/141),非缺失型HbH病62例(43.97%,62/141)。HbH病患者年龄与肝脏超声指标肝左叶上下径、前后径、右叶斜径、右叶厚径呈显著正相关(P均<0.01),与脾脏超声指标脾厚、脾肋下、脾长径呈显著正相关(P均<0.01)。男性非缺失型HbH病患者肝脾肿大风险更高。结论 非缺失型HbH病患者的临床表现较缺失型HbH病患者严重,43.97%的非缺失型HbH病患者同时有肝脾肿大,面临着更高的切脾风险。  相似文献   

7.
多重PCR方法检测缺失型和非缺失型α地中海贫血基因型   总被引:4,自引:1,他引:3  
目的:建立多重聚合酶链反应(PCR)方法,对广西地区α地中海贫血HbH病进行基因诊断。方法:外周血提取DNA,应用多重PCR、DNA测序等方法进行α地中海贫血基因型诊断。结果:298例HbH病患者检出154例缺失型HbH病(-α^3.7缺失型HbH病104例,-α^4.2缺失型HbH病50例);非缺失型HbH病144例包括138例Hb CS-H病,5例Hb QS-H病及1例罕见的东南亚缺失型α地中海贫血-1复合α2珠蛋白基因密码子30缺失。基因型检测结果提示缺失型HbH病占51.68%,非缺失型HbH病占41.32%。而非缺失型HbH病中,以Hb CS-H病为主.占非缺失型的95.83%。结论:文中所建立的单管多重PCR方法可同时检测4种缺失型和2种非缺失型α地贫基因型.操作简便、快速.结果准确。  相似文献   

8.
目的:研究中间型β珠蛋白生成障碍性贫血患者的中医证候与遗传背景的关系。 方法:调查中间型β珠蛋白生成障碍性贫血患者(78例)及其父母(120例)的中医证候类型,检测各家系成员的基因突变类型。根据基因突变型对各家系的遗传特点进行归类,分别分析不同家系类型的子代与亲代在中医证候出现频率和中医证候积分方面的差异。 结果:根据各家系的遗传特点可将所调查的全部73个家系归为两类。家系类型1的遗传特点是亲代中一人的基因型正常,子代的基因型与亲代中另一人完全相同,均为杂合子。在这22个家系中,杂合子子代出现频率较高的症状体征有6项:自汗、口干咽燥、面色淡白或萎黄、潮热盗汗、倦怠乏力、爪甲色淡;杂合子亲代出现频率较高的症状体征有5项:腰膝酸软、头晕目眩、畏寒肢冷、耳鸣、口干咽燥;正常亲代出现频率较高的症状体征有3项:腰膝酸软、头晕目眩、自汗。杂合子子代中医证候积分高于杂合子亲代及正常亲代,但差异无统计学意义(P〉0.05)。家系类型2的遗传特点是亲代均为杂合子,子代为亲代基因突变型的双重组合。在这51个家系中,子代出现频率较高的症状体征有9项:面色淡白或萎黄、自汗、口干咽燥、爪甲色淡、潮热盗汗、倦怠乏力、易感冒、手足心热、身目发黄;亲代出现频率较高的症状体征有3项:腰膝酸软、畏寒肢冷、头晕目眩;子代中医证候积分明显高于亲代,差异有统计学意义(P〈0.01)。 结论:在本次所调查的两种不同类型的家系中,其子代(中间型β珠蛋白生成障碍性贫血患者)的中医证候(临床表现)以阴血亏虚为主,而亲代的中医证候则偏重于肾虚。子代与亲代在中医证候(临床表现)方面的差异可能与基因突变型以及一些遗传修饰成分等都有关。  相似文献   

9.
《右江医学》2019,(5):336-342
目的了解广西中间型α地中海贫血(血红蛋白H病,HbH病)患者不同基因型的贫血、铁超载状况及其与表型的关系。方法利用地贫管理系统,收集2011~2018年共8年间就诊于右江民族医学院附属医院、中国人民解放军联勤保障部队第九二三医院的1110例血红蛋白H病患者的一般资料、基因型结果、血液学参数和铁过载指标;将HbH病患者按缺失型、非缺失型分成两组,观察两组血常规及血清铁蛋白(SF)的检测结果,比较缺失型与非缺失型HbH病患者血红蛋白H量、Hb、MCV、MCH及铁负荷情况;贫血及铁蛋白随年龄变化的情况。利用SPSS 19.0软件对相关数据进行分析处理。结果 1110例HbH病患者共检出8种基因型,缺失型有:-α~(3.7)/--~(SEA) 142例(占18.0%)、-α~(4.2)/--~(SEA) 56例(占7.1%)、-α~(3.7)/--~(THAI) 3例(占0.4%)、-α~(4.2)/--α~(WS)1例(占0.1%),非缺失型主要基因型有:-α~(CS)/--~(SEA) 562例(占71.3%)、-α~(QS)/--~(SEA) 18例(占2.3%)、-α~(CS)/--~(THAI) 4例(占0.5%)、-α~(WS)/--~(SEA) 2例(占0.3%),其中以非缺失型为主。1110例HbH病患者中,平均Hb<30 g/L占0.2%,30~60 g/L占4.7%,60~90 g/L占66.3%,>90 g/L占28.8%。非缺失型HbH病患者贫血程度较缺失型患者严重,其MCV、MCH及HbH含量高于缺失型患者。非缺失组SF水平、铁超载和重度铁超载比例均高于缺失型患者。缺失组、非缺失组平均Hb水平与年龄均无明显相关性;缺失组、非缺失组的SF与年龄呈正相关(r值分别为0.38和0.21,P<0.01)。结论广西地区的HbH患者基因型以非缺失型为主,大部分为中度贫血,部分为重度贫血,铁过载随着年龄的增加而增加,非缺失型铁超载程度较缺失型严重。  相似文献   

10.
目的 研究益髓生血颗粒对血红蛋白H病患者抗氧化损伤和造血相关细胞因子水平的影响。方法 采用安慰剂平行对照实验方法,选择30例血红蛋白H病患者,随机分为治疗组和对照组,每组15例,治疗组给予益髓生血颗粒进行治疗,对照组给予安慰剂进行治疗,疗程均为3个月。动态监测治疗前后患者Hb、RBC、HbH的水平;检测治疗前后血清及红细胞氧化与抗氧化损伤指标(SOD、MDA、GSH-PX)和细胞因子(SCF、GM-CSF、IL-3)活性。结果 自益髓生血颗粒治疗1~3个月,治疗组患者疗效性血液指标Hb水平与治疗前相比显著升高(P<0.01,P<0.05);RBC疗后1、3个月水平与疗前相比显著升高(P<0.05);Ret水平治疗后有升高的趋势。对照组经安慰剂治疗后血液指标Hb、RBC 、Ret水平与疗前相比均无明显改善。经益髓生血颗粒治疗3个月后,治疗组患者红细胞SOD、GSH-Px水平与疗前相比显著升高(P<0.01);MDA水平与疗前相比,显著降低(P<0.01);血清SOD水平与疗前相比显著升高(P<0.01);对照组各指标水平均无明显变化。经益髓生血颗粒治疗3个月后,治疗组患者SCF水平与疗前相比显著升高(P<0.05);GM-CSF、IL-3水平与疗前相比无明显变化;对照组各指标水平均无明显变化。结论 益髓生血颗粒治疗地中海贫血有良好的临床疗效,能显著改善患者血液参数水平。益髓生血颗粒的疗效生物学机制之一与提高HbH病患者抗氧化损伤能力和造血正调控细胞因子SCF活性有关。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

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Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

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Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.  相似文献   

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In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.  相似文献   

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Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.  相似文献   

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目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

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Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

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