六味地黄丸合加味逍遥丸治疗肾阴虚型围绝经期综合征临床观察

目的:对六味地黄丸合加味逍遥丸治疗肾阴虚型围绝经期综合征临床治疗效果进行分析。方法:选取某院2012年12月~2013年12月收治的84例肾阴虚型围绝经期综合征患者作为研究对象,将患者平均分为实验组和对照组,实验组患者服用六味地黄丸合加味逍遥丸,对照组则服用戊酸雌二醇片,两组患者均进行1个月的时间治疗。结果:实验组患者的临床症状改善率达到90.4%,明显高于对照组72.4%,且差异具有统计学意义(P0.05);对两组患者治疗前后的卵泡刺激素、黄体生成素和雌二醇进行测量和记录,经治疗后,实验组患者改善程度明显高于对照组,差异有统计学意义(P0.05)。结论:使用六味地黄丸合加味逍遥丸对肾阴虚型围绝经期综合征患者进行治疗,具有明显治疗效果,值得推广使用在该疾病的临床治疗上。     

六味地黄丸治疗围绝经期综合征226例临床疗效观察

围绝经期综合征(旧称更年期综合征),一般多发生在45～55岁之间的妇女[1],是由于妇女进入围绝经期卵巢功能逐渐消退,分泌雌激素减少,而下丘脑、垂体分泌促性腺激素增加,导致内分泌功能紊乱及植物神经功能失调,出现的临床综合症状[2,3].目前对围绝经期综合征的治疗多采用雌激素替代疗法,根据临床观察,副作用较大、禁忌证多.自1999-2003年我们采用六味地黄丸治疗围绝经期综合征226例,取得了满意的疗效,现总结如下.     

中西医结合治疗围绝经期功能失调性子宫出血30例临床观察

目的：观察米非司酮联合六味地黄丸治疗围绝经期功能失调性子宫出血的疗效。方法：选择30例围绝经期功能失调性子宫出血患者,随机分为中西医结合治疗组30例,常规米非司酮对照组30例,观察治疗前、后患者的临床症状、体征、血清生殖激素等指标的变化,以及治疗过程中不良反应的发生情况。结果：治疗组与对照组比较,在临床综合疗效、中医证候积分、血清生殖激素水平上差异有统计学意义（P〈0.05）,且两组治疗期间均未见明显严重不良反应。结论：米非司酮联合六味地黄丸治疗围绝经期功能失调性子宫出血安全、有效,有临床推广应用价值。     

黄芪生脉饮联合六味地黄丸治疗围更年期失眠疗效观察

目的 探讨黄芪生脉饮联合六味地黄丸治疗围更年期失眠的临床疗效及作用机制.方法 50例围更年期失眠患者随机分为治疗组和对照组,对照组行常规给予安定片、更年灵口服等治疗.治疗组给予黄芪生脉饮联合六味地黄丸治疗.治疗前后分别记录临床症状.结果 治疗组治疗后临床症状较治疗前明显改善.均优于对照组.且无明显不良反应.结论 黄芪生脉饮联合六味地黄丸对围更年期失眠有较好的疗效,值得推广.     

左归丸与六味地黄丸佐治肾阴虚型围绝经期功能失调性子宫出血的疗效观察

目的:观察左归丸与六味地黄丸佐治肾阴虚型围绝经期功能失调性子宫出血(以下简称"围绝经期功血")的疗效和安全性。方法:将180例明确诊断为围绝经期功血的患者,随机均分为左归组和六味组。2组均以去氧孕烯炔雌醇片作为基础治疗,左归组患者在此基础上口服左归丸9g,bid;六味组患者在此基础上口服六味地黄丸9g,bid。比较2组的疗效、出血控制情况和不良反应。结果:治疗后,左归组总有效率为95.6%,显著高于六味组(86.7%);左归组的出血时间和突破性出血发生率均显著少(低)于六味组,2组比较差异有统计学意义(P<0.05);2组出血控制时间和不良反应发生率比较,差异无统计学意义(P>0.05)。结论:左归丸较六味地黄丸更能有效减少子宫出血,是治疗肾阴虚型围绝经期功血的有效药物,且安全性较好。     

六味地黄丸治疗糖尿病肝肾阴虚50例疗效分析

目的:探讨六味地黄丸治疗糖尿病肝肾阴虚的疗效.方法:将100例2型糖尿病肝肾阴虚患者随机分成两组,一组服用格列齐特缓释片加六味地黄丸,另外一组单用格列齐特缓释片进行治疗,对改善患者肝肾阴虚症状的有关情况进行比较.结果:50例加服六味地黄丸的糖尿病患者肝肾阴虚症状较单用格列齐特缓释片治疗的糖尿病患者症状得到明显改善.结论:六味地黄丸可明显改善糖尿病的肝肾阴虚症状.     

六味地黄丸联合戊酸雌二醇片/雌二醇环丙孕酮片治疗围绝经期综合征的临床研究

目的探讨六味地黄丸联合戊酸雌二醇环丙孕酮片治疗围绝经期综合征的临床效果。方法选取2015年3月—2018年3月成飞医院收治的围绝经期综合征患者262例,随机分成对照组(131例)和治疗组(131例)。对照组口服戊酸雌二醇环丙孕酮片,1片/d,先服白片,再服用红片,无间断连用21 d后停药7 d,进入下一周期。治疗组在对照组基础上口服六味地黄丸,1丸/次,2次/d。两组均连续治疗6个月。观察两组患者临床疗效,同时比较治疗前后两组患者改良Kupperman绝经指数(KMI)评分、腰椎L2～4骨密度、性激素水平、脱氧吡啶啉(D-Pyr)和骨特异性碱性磷酸酶(BALP)水平及绝经期生存质量量表(MENQOL)评分。结果治疗后,对照组临床有效率为88.5%,显著低于治疗组的96.2%,两组比较差异具有统计学意义(P0.05)。治疗后,两组改良KMI评分显著下降(P0.05),腰椎L2～4骨密度显著增高(P0.05),且治疗组这两种指标明显优于对照组(P0.05)。治疗后,两组血清雌二醇(E2)浓度均显著上升(P0.05),血清BALP、卵泡刺激素(FSH)、促黄体生成素(LH)水平和D-Pyr浓度均显著降低(P0.05),且治疗组患者这些指标水平明显好于对照组患者(P0.05)。治疗后,两组患者MENQOL各评分及其总分均显著降低(P0.05),且治疗组患者MENQOL评分明显低于对照组患者(P0.05)。结论六味地黄丸联合戊酸雌二醇环丙孕酮片治疗围绝经期综合征可有效缓解患者绝经症状,提高骨密度,纠正骨代谢紊乱。     

围绝经期综合征的诊治分析

目的探讨妇女围绝经期综合征诊断、药物治疗和心理保健的有效方法。方法选择郑州公交医院门诊的围绝经期患者52例,采用激素替代疗法结合心理保健治疗。结果本组患者的症状有不同程度的改善、好转。92.3%的患者心血管症状得到改善,86.5%的神经精神症状好转,88.5%泌尿系统症状已消失。结论药物治疗围绝经期综合征同时,对其进行心理保健可以取得很好的效果。     

围绝经期综合征的临床诊治

目的 探讨妇女围绝经期综合征诊断、药物治疗和心理保健的有效方法.方法 选择我院门诊的围绝经期患者60例,采用激素替代疗法结合心理保健治疗.结果 本组患者的症状有不同程度的改善、好转.93.3%的患者心血管症状得到改善,85.0%的神经精神症状好转,88.3%泌尿系统症状已消失.结论 药物治疗围绝经期综合征同时,对其进行心理保健可以取得很好的效果.     

六味地黄丸对肾病综合征激素治疗者副作用的影响

目的:探讨六味地黄丸对肾病综合征激素治疗者副作用的影响.方法:从我院收治的肾病综合征患者中抽选98例作为临床研究对象.随机分组:对照组49例,采用糖皮质激素治疗;观察组49例,在采用糖皮质激素治疗的同时加用六味地黄丸.比较两组副作用发生情况.结果:观察组副作用发生率明显低于对照组,实验室检测指标明显优于对照组,差异显著(P<0.05).结论:六味地黄丸能够有效预防肾病综合征患者因使用激素治疗出现的副作用.     

基于网络药理学及分子对接探讨生姜治疗类风湿关节炎的作用机制

目的 基于网络药理学方法探讨生姜治疗类风湿关节炎（RA）的可能分子作用机制。方法 通过TCMSP平台筛选生姜主要活性成分，利用UniProt数据库将相应靶点蛋白名称进行转化为基因名，经Cytoscape 3.8.2软件构建网络图；在GeneCards数据库、OMIM数据库、TTD数据库中检索“rheumatoid arthritis”，获取RA疾病靶点，制作韦恩图获取生姜药物成分和RA共同靶点，并进行蛋白质相互作用（PPI）网络分析、基因本体论（GO）功能富集及京都基因与基因组百科全书（KEGG）通路分析。利用分子对接技术预测有效成分与靶点的潜在结合活性。结果 获取生姜5个成分及55个潜在靶点，RA疾病4 836个相关靶点，生姜与RA共同靶点26个，PPI网络中自由度靠前的3个靶点基因为前列素内环氧化物合成酶2（PTGS2）、转录因子AP-1（JUN）、半胱氨酸天冬氨酸蛋白酶-3（CASP3），GO功能富集分析和KEGG通路分析分别得到185个结果和59条信号通路。结论 生姜治疗RA具有多成分、多靶点效应，并涉及多条信号通路，这可能通过PTGS2、JUN、CASP3等靶点调控炎症反应、免疫调节作用治疗RA。     

Familial cold auto-inflammatory syndrome (FCAS): characterization of symptomatology and impact on patients' lives

ABSTRACT

Objective: Familial cold auto-inflammatory syndrome (FCAS), a subtype of cryopyrin-associated periodic syndromes (CAPS), is a rare, inherited disease that is virtually unknown to healthcare professionals. The aim of this patient survey was to characterize the symptomatology and evaluate the debilitating effects of FCAS on patients' daily lives.

Research design and methods: Patients included in a disease database consisting of 167 FCAS and Muckle-Wells syndrome (MWS) patients were provided an opportunity to voluntarily participate in a cross-sectional market-based survey. Upon assessment of eligibility, individual in-depth phone interviews were conducted by an independent research agency to characterize disease symptomatology, diagnosis, and disease impact on daily activities.

Results: Thirty patients with prior diagnosis of FCAS participated. The most common and recurring symptoms reported were rash, joint pain, chills, and fever. The majority of survey participants (90?%?) reported that they presented with symptoms as newborns or in early childhood?–?symptoms which became burdensome by school age, with patients reporting recurring symptoms and debilitating disease flares precipitated by environmental exposure to cooling temperatures. To cope with their underlying disease and to try to avoid symptomatic flares, patients reported limiting their work, school, family, and social activities. Seventy-eight percent of survey participants described an impact of the disease on their work, including absenteeism and impaired job advancement; frequently they quit their job as a consequence of their disease. Over 95?%?of survey participants reported that FCAS prevented participation in outdoor activities, while 83?%?indicated an impact on social activities, including relationships with friends and family. Limitations of this survey include the absence of a validated quality-of-life instrument, lack of correlation with patient medical records, and potential recall and responder bias. The number of participants appears small, but reflects 18?%?of the known FCAS population in the USA.

Conclusions: FCAS causes lifelong debilitating effects that restrict patients' daily lives. Poor recognition of this rare disease among healthcare professionals leads to delayed diagnosis and inappropriate or ineffective treatment. Healthcare providers need to be made aware of this serious debilitating disease to enable accurate and timely diagnosis and more compassionate management of this lifelong condition.     

复方夏天无片治疗轻度癌痛的临床观察

目的观察复方夏天无片治疗轻度癌痛的疗效。方法将76例符合入组标准的轻度癌病病患者随机分成两组各38例。治疗组用复方夏天无片口服,每日3次,每次2片,连续使用2周。对照组用非甾体抗炎药双氯酚酸钠肠溶片,每日3次,每次50mg,方法及疗程均与治疗组相同。结果治疗组总有效率89．5％,对照组的总有效率88.2％,两组比较无显著性差异（P〉0．05）;治疗组不良反应发生率仅为7．89％,且症状比较轻微;而对照组双氯酚酸钠不良反应发生率为23．68％,尤其是胃肠反应及肝、肾功能损害比较突出,症状也比较明显,患者耐受性较差,经统计分析有极显著差异（P〈0．01）。结论复方夏天无片治疗轻度癌痛与双氯酚酸钠肠溶片效果相似．但不良反应发生率少．     

基于指纹图谱、多指标定量及网络药理学的大黄质量标志物预测分析

目的 建立大黄HPLC指纹图谱及多指标定量分析方法,结合网络药理学预测大黄潜在质量标志物。方法 采用HPLC对20批掌叶大黄样品中的没食子酸、儿茶素、表儿茶素等13种指标性成分进行含量测定,采用中药色谱指纹图谱相似度评价系统进行相似度分析,以13种指标成分含量进行主成分分析、正交偏最小二乘判别分析,采用网络药理学预测大黄相关成分的作用靶点和通路,构建成分-靶点-通路网络图并对核心靶点进行器官定位分析以预测大黄的潜在质量标志物。结果 指纹图谱相似度在0.882～0.998,共确定了15个共有峰,大黄素甲醚、儿茶素、大黄素-1-O-葡萄糖苷、大黄素甲醚-8-O-葡萄糖苷、芦荟大黄素-8-O-葡萄糖苷是差异化合物,可用于鉴别和区分大黄质量。经筛选得到15个化合物,8个核心靶点,包括AKT1、TP53、JUN、HSP90AA1、CASP3、EGF、TNF、IL-6,涉及对氧化应激的反应、对脂多糖的反应、内肽酶活性,涉及脂质和动脉硬化、MAPK信号传导途径、AGE-RAGE信号通路在糖尿病并发症中的作用、非酒精性脂肪性肝病等通路,并构建成分-靶点-通路图,预测没食子酸、儿茶素、芦荟大黄素、大黄酸...     

骨碎补总黄酮治疗纤维肌痛综合征的随机对照研究

目的:观察骨碎补总黄酮对纤维肌痛综合征的治疗作用。方法:150例病人随机分为5组,分别给予美洛昔康(Ⅰ组)、美洛昔康加阿米替林(Ⅱ组),骨碎补总黄酮(Ⅲ组),骨碎补总黄酮加阿米替林(Ⅳ组),美洛昔康、骨碎补总黄酮、阿米替林3药联合(Ⅴ组),均治疗3 mo,记录各组治疗前和3 mo末的临床及实验室指标并进行比较。结果:3 mo末,共有142例病人完成试验。Ⅱ、Ⅲ、Ⅳ、Ⅴ组与治疗前及Ⅰ组比较,其抑郁评分、纤维肌痛影响因素问卷评分及压痛指数评分的比较差异有显著意义(P<0.05或P<0.01);Ⅱ、Ⅲ、Ⅳ组之间抑郁评分、纤维肌痛影响因素问卷评分差异无显著意义(P>0.05),Ⅴ组与Ⅱ组比较差异非常显著(P<0.01)。无明显不良反应。结论:骨碎补总黄酮可以有效治疗纤维肌痛综合征,而不良反应较轻。     

射干麻黄汤加味治疗儿童寒饮伏肺证咳嗽变异性哮喘371例

目的:观察射干麻黄汤加味治疗儿童寒饮伏肺证咳嗽变异性哮喘的疗效。方法:采用射干麻黄汤加味治疗,5 d为1个疗程,1个疗程后统计疗效。结果:痊愈275例(占74.1%),好转62例(占16.7%),无效34例(占9.2%),总有效率为90.8%。结论:射干麻黄汤加味治疗儿童寒饮伏肺证咳嗽变异性哮喘疗效确切。     

Indications of ‘atopic bowel’ in patients with self‐reported food hypersensitivity

Aliment Pharmacol Ther 31 , 1112–1122

Summary

Background An association between atopic disease and gastrointestinal complaints has been suggested. Aim To explore the association between atopic disease, gastrointestinal symptoms, and possible gastrointestinal manifestations of atopic disease in patients with self‐reported food hypersensitivity. Methods Symptoms, skin prick tests, serum markers of allergy and intestinal permeability were recorded in 71 adult patients. Eosinophils, tryptase‐ and IgE‐positive cells were counted in duodenal biopsies. Results Sixty‐six (93%) patients had irritable bowel syndrome (IBS) and 43 (61%) had atopic disease, predominantly rhinoconjunctivitis. All 43 were sensitized to inhalant allergens, 29 (41%) to food allergens, but food challenges were negative. Serum total IgE and duodenal IgE‐positive cell counts were significantly correlated (P < 0.0001) and both were significantly higher in atopic than in non‐atopic patients (P < 0.0001 and P = 0.003 respectively). IgE‐positive cells appeared to be ‘armed’ mast cells. Intestinal permeability was significantly elevated in atopic compared with non‐atopic patients (P = 0.02). Gastrointestinal symptoms and numbers of tryptase‐positive mast cells and eosinophils did not differ between groups. Conclusions Patients with self‐reported food hypersensitivity had a high prevalence of IBS and atopic disease. Atopic patients had increased intestinal permeability and density of IgE‐bearing cells compared with non‐atopic patients, but gastrointestinal symptoms did not differ between groups.     

Functional symptoms in inflammatory bowel disease and their potential influence in misclassification of clinical status

Background : Functional symptoms occur in inflammatory bowel disease probably more than in the general population. Existing disease indices rely heavily on symptoms that may be organic or functional. This may explain inconsistencies between recent therapeutic trials in inflammatory bowel disease. Clinically, misinterpretation can lead to over‐treatment of functional symptoms with potent agents, and to under‐treatment of inflammatory bowel disease when inflammatory features are more subtle. Aim : To assess functional symptoms in inflammatory bowel disease and to devise simple means of their evaluation. Methods : Patients with Crohn's disease, ulcerative colitis, and irritable bowel syndrome completed questionnaires, generating inflammatory bowel disease and irritable bowel syndrome indices. Data from outliers selected as exemplars were employed to create a new index. Results : One hundred and ninety patients completed questionnaires. Overall, Crohn's and irritable bowel syndrome patients had similar functional features. The new scoring system was based on the eight apparently discriminant symptoms. Prospective evaluation in a separate cohort of 180 inflammatory bowel disease patients yielded scores that are independent of established indices, inflammatory markers and psychometric scores. Conclusions : Patients with Crohn's report comparable rates of apparently functional symptoms to those with irritable bowel syndrome. A new score has been developed to help in their identification. This has the potential to guide therapeutic decisions and optimize future trial recruitment.     

薯蓣属植物中菲类化学成分及其药理活性研究进展

薯蓣属(Dioscorea)植物是中药材的重要来源，山药、穿山龙、粉萆薢、黄山药、绵萆薢等中药皆来源于该属植物。菲类化合物是该属植物中一类重要的化学成分，包括菲单体、二氢菲、四氢菲、菲醌和菲二聚体5种结构类型，具有抗肿瘤、抗炎、抗氧化、降血糖、抗肥胖、抗菌、抗病毒、神经保护等药理活性，其中一些菲类化合物活性多样且作用显著，有较好的开发利用前景。目前未见针对薯蓣属植物中菲类化学成分的系统性综述报道，本文对薯蓣属植物中的菲类化学成分及其药理活性进行综述，旨在为相关研究提供参考，以促进薯蓣属植物的开发利用。     

大柴胡汤加减联合硫酸氢氯吡格雷片对冠心病心绞痛患者临床疗效及LL-37、ILT3水平的影响

目的 探究大柴胡汤加减联合硫酸氢氯吡格雷片治疗冠心病心绞痛的临床疗效及对患者抗菌肽（LL-37）、免疫球蛋白样转录子（ILT3）水平的影响。方法 前瞻性选取2019年3月-2020年5月于北京核工业医院治疗的冠心病心绞痛患者150例为研究对象，随机分为对照组和试验组，每组各75例。对照组患者采用硫酸氢氯吡格雷片治疗，每次75 mg，每日1次，口服。试验组在对照组基础上加服大柴胡汤（组方：柴胡、枳实、黄芩各15 g，白芍、丹参、茯苓、陈皮各20 g，大黄、半夏、甘草各10 g），组方药材煎煮后取汁400 mL，分早晚2次服用，另随症加减。分别于治疗前及治疗后对两组患者行心脏超声检查，评价患者左室间隔厚度（IST）、左室后壁厚度（LVPWT）、左室等容舒张时间（IVRT）、左室射血分数（LVEF）。分别于治疗前后采集两组患者血清，检测可溶性细胞间黏附分子-1（sICAM-1）、白细胞介素-6（IL-6）、骨保护素（OPG）等炎症因子水平以及LL-37、ILT3水平。治疗前后对两组患者进行中医证候积分评价，同时评价患者的中医及西医疗效。结果 治疗后两组患者心功能指标IST、LVPWT、IVRT、LVEF较治疗前明显改善（P<0.05），且试验组好于对照组（P<0.05）；治疗后两组患者血清sICAM-1、CRP、OPG、IL-6、LL-37、ILT3水平较治疗前明显下降（P<0.05），且试验组显著低于对照组（P<0.05）；治疗后两组中医证候积分均较治疗前显著降低（P<0.05），且试验组显著低于对照组（P<0.05）；与对照组比较，治疗后试验组中医及西医总有效率均显著增加（P<0.05）；治疗过程中两组不良反应发生率差异无统计学意义（P>0.05）。结论 大柴胡汤加减联合硫酸氢氯吡格雷片治疗冠心病心绞痛，可明显改善患者心功能指标，抑制患者炎症反应，改善LL-37、ILT3水平，提高疗效。