糖皮质激素的合理应用

糖皮质激素主要影响糖和蛋白质的代谢，具有多种生理作用和药理作用，临床应用广泛。生理剂量的糖皮质激素主要影响正常的物质代谢过程，是维持机体生理功能的重要物质。超生理剂量的糖皮质激素则还有抗炎、抗过敏、抗免疫、抗病毒、抗休克等药理作用，临床用于治疗多种疾病，注意糖皮质激素的合理使用，避免不良反应显得极为重要，现综述如下。     

糖皮质激素在临床的合理应用

糖皮质激素是临床应用最广泛的药物之一,主要用于补充机体分泌不足和大剂量发挥药理作用诸方面.超生理量的糖皮质激素具有抗感染、抗过敏、抗休克和抑制免疫反应等多种药理作用,常被运用于治疗各类应急反应、免疫性疾病和炎性反应,但也有许多不良反应.     

糖皮质激素的临床应用

糖皮质激素（Glucocorticoids,GC）是肾上腺皮质分泌的一种甾体激素,具有调节机体的物质代谢和应激反应等功能,是临床用药甾体激素药物中十分重要的一种。本文在全面地阐述了糖皮质激素的生理作用和药理作用的基础上,通过对本院临床用药的分析并结合国内其他学者的用药经验,较为深入地分析了糖皮质激素的临床应用和不良反应以及相应的并发症,总结了糖皮质激素临床应用中的相关注意事项。     

半夏提取物抗菌抗炎及其抗肿瘤药理作用研究进展

半夏提取物对真菌、革兰阳性和革兰阴性细菌均有抗菌作用,其中有效成分半夏苷是其抗菌活性成分之一。半夏提取物对早期、增殖期炎症以及对变态反应性炎症均有抗炎作用,其抗炎作用机制可能与刺激糖皮质激素释放和抑制糖皮质激素消除代谢的糖皮质激素样作用有关。半夏提取物中生物碱、有机酸、苷、多糖等多种成分可能参与抗炎活性,经体外实验发现半夏提取物中的多种成分(包括蛋白类成分)具有抗肿瘤活性的作用,用半夏多糖给荷瘤小鼠灌胃,能抑制小鼠体内S180、H22、EAC等癌细胞的生长。综述半夏提取物的抗菌抗炎和抗肿瘤药理作用文献,并对其研究研进展做了分析。     

糖皮质激素的合理应用

糖皮质激素是维持生命的必需品,药理作用广,不适当的使用或长期大剂量使用可导致不良反应和并发症甚至危及生命。本文将糖皮质激素常见的不良反应作一总结,并就其合理使用提出几点看法。     

糖皮质激素类药物的临床合理应用

糖皮质激素是由肾上腺皮质中束状带分泌的一类甾体激素,生理剂量的糖皮质激素具有调节糖、脂肪、蛋白质的生物合成和代谢的作用,超剂量使用还具有抑制免疫应答、抗炎、抗毒、抗休克等药理作用。由于其作用广泛,在临床得到大量应用,但随着糖皮质激素药物的广泛应用,目前滥用现象较普遍。     

甘草酸及其苷元甘草次酸的糖皮质激素样作用

甘草酸在体内水解成甘草次酸,因此甘草酸是甘草次酸的前体药物,而甘草次酸的药理作用强于甘草酸.甘草次酸的化学结构类似于甾体激素.甘草次酸和甘草酸是甾体激素代谢失活酶抑制剂,可提高内源性和外源性糖皮质激素的活性.甘草次酸和甘草酸义町作为配体,与糖皮质激素受体结合,由于甘草次酸和甘草酸的糖皮质激素受体激动活性远低于糖皮质激素...     

糖皮质激素类药物的使用误区分析

糖皮质激素是由肾上腺皮质分泌的一类甾体激素,生理情况下产生的糖皮质激素在调节物质代谢过程中起着重要的作用,超生理剂量的糖皮质激素还具有抗炎、抗休克、免疫抑制等药理作用。该类药作用广泛而复杂,且不良反应较多。笔者就糖皮质激素临床应用中存在的误区进行分析,提出合理使用该类药物的方法,以促进临床合理、安全使用该类药物。     

米非司酮药理作用机制研究进展

米非司酮是1980年由法国Roussel-Uclaf公司的Philibert研究开发出的抗孕激素,是19-去甲基睾酮的衍生物,化学结构为17β羟-11β（4-二甲基苯胺）.17α-丙炔基-4,9双烯-3-酮,具有抗糖皮质激素、抗孕激素和流产作用。在终止妊娠、紧急避孕以及子宫肌瘤和子宫内膜异位症（EMs）等的治疗方面在临床上得到肯定。对其作用机制的研究也有较大进展,本文就近年来其中进一步的药理作用机制研究进展进行综述。     

糖皮质激素在眼科的应用

糖皮质激素是临床各科常用的药物之一。其在抗炎、抑制免疫方面有着显著的作用，眼科医生使用广泛。本文总结了其药理作用及眼科应用特点和不良反应。     

Pharmacology of glucocorticoids: beyond receptors

Glucocorticoid hormones are important regulators of homeostasis. They are used clinically as highly effective anti-inflammatory compounds and have been prescribed for more than fifty years for a variety of conditions. They mediate their genomic actions by binding to two different intracellular receptors in target cells. The pharmacology of glucocorticoids largely depends on ligand concentration and receptor expression levels in target tissue. However, their genomic actions also critically depend on coactivators and corepressors recruitment. We discuss how various non-receptor factors affect glucocorticoid potency and efficacy with respect to their genomic effects. Differential recruitment of coregulators may account for many ligand- and cell-specific effects of glucocorticoids. This is best illustrated by the recent identification of selective glucocorticoid receptor agonists that induce distinct conformational changes to the receptors resulting in altered protein–protein interactions and consequently different regulation of gene expression. We conclude that these new molecular insights will contribute to the design of safer glucocorticoids that retain full pharmacological properties with reduced side-effects.     

Glucocorticoids: exemplars of multi-tasking

Well over 80 years ago Philip Smith described the beneficial clinical effects of adrenocortical extracts in animal models of adrenal insufficiency. In the ensuing years, scientists across the globe have sought to understand the mechanisms by which adrenal hormones and their synthetic analogues produce their complex and varied actions. Particular attention has focused on the glucocorticoids, partly because they have a vital place in the treatment of inflammatory and autoimmune disorders but also because dysregulation of the secretion and/or activity of endogenous glucocorticoids is increasingly implicated in a number of common disorders that pose a growing clinical burden, such as obesity, type II diabetes, the metabolic syndrome, hypertension and depression. This review considers some of the key advances that have been made in our understanding of the physiology, pathology and pharmacology of the glucocorticoids. Emphasis is placed on the molecular mechanisms of glucocorticoid signalling and the complex mechanisms that regulate the access of steroids in the systemic circulation to their receptors in their various target cells and tissues. In addition, consideration is given to the irreversible 'organisational' actions of glucocorticoids in perinatal life and to the potential role of the steroids in the aetiology of disease.     

Will non-steroid approaches to the treatment of inflammation replace our need for glucocorticoids?

Glucocorticoids are widely used as anti-inflammatory agents, however, their use is limited by side effects. A long-term goal of pharmaceutical research has been the development of an agent that will mimic the anti-inflammatory actions of glucocorticoids without the undesirable side effects. This article reviews the diverse pharmacological approaches used to identify likely glucocorticoid substitutes and compares successful and unsuccessful approaches. All anti-inflammatory drugs that demonstrate clinical utility share an ability to modulate lymphocyte function. Given that glucocorticoids are also potent inhibitors of lymphocyte function, this property may be essential for clinically useful anti-inflammatory activity.     

活血化瘀药药理作用研究进展

目的探讨活血化瘀药药理作用的研究进展。方法检索近几年来有关活血化瘀药药理作用的研究资料。结果与结论对活血化瘀药药理作用及其机制方面的研究,主要集中在改善血流动力学、血液流变学、抗血栓和改善微循环等方面,并已大量应用于临床。     

玉郎伞多糖药理作用研究进展

目的：为玉郎伞多糖药理作用的深入研究提供参考.方法：通过参阅、检索2000 ～ 2013年国内外相关文献及资料,并进行整理、分析、归纳.结果：玉郎伞多糖具有保护肝脏、保护脑组织、抗老年痴呆、抗抑郁、抗肿瘤等多种药理作用.结论：玉郎伞多糖药理作用广泛,需要研究人员倍加关注并深入研究,进一步明确其药理作用及其作用机制.     

Genomic and non-genomic effects of different glucocorticoids on mouse thymocyte apoptosis

Glucocorticoids, widely used therapeutic agents for several pathologies, act upon diverse cells and tissues, including the lympho-haemopoietic system. Glucocorticoid-mediated apoptosis has been described as one of the mechanisms underlying their pharmacological and physiological effects. Glucocorticoids induce apoptosis in thymocytes through genomic and non-genomic signals. We tested thymocyte apoptosis rates as induced by a panel of glucocorticoids. Using four glucocorticoids that are widely adopted in clinical practice we compared their induction of thymocyte apoptosis and activation of non-genomic and genomic signals, including phosphatidylinositol-specific phospholipase C (PI-PLC), caspase-8, -9 and -3, and Glucocorticoid-Induced Leucine Zipper (GILZ). GILZ is a protein that is rapidly induced by glucocorticoids treatment and involved in apoptosis modulation. Results indicate different glucocorticoids have different apoptotic activity which is related to their ability to induce both genomic, evaluated as caspases activation and GILZ expression, and non-genomic effects, evaluated as PI-PLC phosphorylation.     

Molecular mechanisms involved in the regulation of prostaglandin biosynthesis by glucocorticoids

The anti-inflammatory properties of glucocorticoids are attributed in part, to their interference with prostaglandin synthesis. Phospholipases A₂ and cyclooxygenases, the key enzymes of prostaglandin biosynthesis, are targets of glucocorticoid action; the molecular mechanisms, however, are not yet understood in detail. Obviously, glucocorticoids can act at different levels of gene regulation depending on cell type and inducing stimulus. The current knowledge of glucocorticoid interference with phospholipase A₂ and cyclooxygenase expression is summarized. In comparison with other nonsteroidal anti-inflammatory drugs, glucocorticoids are unique inasmuch as they also inhibit cytokine synthesis and expression of other inflammation-related enzymes. Based on a more detailed understanding of glucocorticoid action, it may be possible to therapeutically exploit the anti-inflammatory effects and at the same time avoid the unwanted metabolic actions of these steroids.     

大黄素药理作用的分子机制研究进展

大黄素是中药大黄的主要有效单体,具有多种药理作用,具有较高的临床应用价值。近年来国内外有关大黄素药理作用分子机制的研究较多,特别对其消炎、抗肿瘤的作用高度关注。这些作用主要是通过改变离子浓度及转运、抗氧化和自由基、影响炎症因子的分泌和酶活性、细胞凋亡等途径实现的。该文对此进行了总结,希望能为其实际应用提供理论依据。     

益母草治疗痛经机制探索

目的探讨益母草治疗痛经的药理作用及机制.方法经十二指肠给予益母草水提液,观察豚鼠在体子宫收缩频率及幅度的变化.分别采用由缩宫素及15甲基-PGF2α所致的子宫痉挛模型,观察小鼠口服益母草提取液后的作用.采用二甲苯致小鼠耳廓肿胀及实验性大鼠子宫炎症模型,分别观察小鼠、大鼠口服益母草提取液的抗炎作用.用放射免疫法及化学分析法分别检测大鼠口服益母草水提液后血液雌、孕激素及子宫平滑肌PGF2α及PGE2含量的变化.结果益母草水提液能增强未孕正常豚鼠在体子宫的收缩.益母草能在一定程度上缓解由15M-PGF2α及缩宫素所致的小鼠子宫痉挛,能减轻二甲苯所致的小鼠耳廓肿胀的程度,改善实验性子宫炎症状况,且能降低子宫炎症时其平滑肌上PGE2的含量,亦能降低大鼠子宫平滑肌上PGF2α的含量.益母草水提液能升高血液孕激素的水平,而对雌激素却无明显影响.结论益母草对子宫具有比较广泛的药理作用,可能通过抑制痉挛子宫的活动、抗炎、降低子宫平滑肌上PGF2α,PGE2的含量及升高体内孕激素水平等多种途径缓解痛经症状.