养血清脑颗粒预防和治疗偏头痛的临床研究

目的研究养血清脑颗粒(主要成分为当归、川芎、白芍、细辛等)治疗偏头痛的疗效及其不良反应.方法112例偏头痛患者,男性42例,女性70例,年龄19～75岁,平均年龄为(38.1±9.8)岁,进行了多中心、随机、双盲、安慰剂对照研究.结果(1)养血清脑颗粒对偏头痛的治疗中治疗组比安慰剂组较明显地减少总发作次数(分别为3.1±2.5和4.2±2.7,Z=2.16,P=0.03)和总发作时间(h)分别为31.0±48.0和51.2±73.8,Z=2.86,P=0.004.(2)治疗组和安慰剂组总发作次数减少率(%)分别为4.9±0.3和3.0±0.5,两组比较差异有显著意义(Z=5.76,P<0.001).(3)治疗组和安慰剂组中偏头痛伴随症状,如恶心、呕吐、畏光、怕声的观察表明无明显差异.(4)治疗组发生不良反应3例(5.4%),安慰剂组1例(1.8%).(5)血尿常规和血生化检查治疗前后无特殊改变.结论养血清脑颗粒可用于治疗偏头痛,可减少偏头痛的发作次数和缩短发作时间,但对偏头痛发作过程中出现的伴随症状的作用不明显.     

养血清脑颗粒治疗青少年偏头痛60例临床观察

目的 观察养血清脑颗粒治疗青少年偏头痛的临床疗效.方法 将90例病人随机分为2组,治疗组(60例)采用养血清脑颗粒治疗,对照组(30例)给予氟桂利嗪胶囊口服.结果 养血清脑颗粒总有效率为95.0% ,对照组总有效率为77.3%.结论 养血清脑颗粒对青少年疗效可靠、安全,不良反应小.     

养血清脑颗粒治疗血管性头痛的疗效观察

目的 探讨养血清脑颗粒治疗偏头痛的临床疗效.方法 治疗组104例采用养血清脑颗粒治疗,对照组94例采用复方丹参片治疗.60 d后分别观察2组患者的临床疗效,同时监测肝、肾功能及药物不良反应.结果 总有效率养血清脑颗粒治疗组为88.5%(92/104),复方丹参片对照组为68.1%(64/94),差异有统计学意义(P＜0.05).结论 养血清脑颗粒治疗偏头痛的疗效优于复方丹参片,是治疗偏头痛的理想药物.     

养血清脑颗粒联合尼莫地平治疗偏头痛临床观察

目的探讨养血清脑颗粒联合尼莫地平治疗偏头痛患者的疗效。方法将100例临床确诊为偏头痛的病人随机分为2组,养血清脑颗粒联合尼莫地平组(治疗组)60例,单用尼莫地平组(对照组)40例。治疗组给予养血清脑颗粒4g/次,3次/d口服;尼莫地平20 mg,3次/d口服。对照组给予尼莫地平20 mg,3次/d口服。2组均连续治疗30d。结果治疗组总有效率为95.0%与对照组77.5%比较,有统计学意义。结论养血清脑颗粒联合尼莫地平可明显改善偏头痛病人的头痛发作程度。     

养血清脑颗粒联合西比灵治疗偏头痛临床观察

目的 探讨养血清脑颗粒联合西比灵治疗偏头痛的疗效.方法 将100例临床确诊为偏头痛的病人随机分为2组,养血清脑颗粒联合西比灵组(治疗组)60例,单用西比灵组(对照组)40例.治疗组给予养血清脑颗粒4g/次,3次/d,口服;西比灵10mg,每晚睡前服.对照组给予西比灵10mg每晚睡前服.2组均连续治疗30d.结果 治疗组总有效率为95.0%,与对照组77.5%比较差异有统计学意义.结论 养血清脑颗粒联合西比灵可明显改善偏头痛病人的头痛发作程度.     

养血清脑颗粒治疗偏头痛的临床随机对照研究

目的 临床研究养血清脑颗粒(当归、川芎、熟地、白芍等)治疗偏头痛的疗效。方法 对我院神经内科门诊256例偏头痛患者进行随机对照研究。256例中男性104例,女性152例,平均年龄(33.62±8.71)岁,轻度头痛118例,中度头痛80例,重度头痛58例。入组病例按Richid随机分配表,治疗组给予养血清脑颗粒4.0g(1袋)/次,3次/日,对照组给予去痛片,1片/欠,重度头痛患者首次剂量均加倍。结果 疗效判定分为治愈,显效(症状减轻50％以上),有效(症 状减轻25％～50％),治疗组128例中,总有效率为81.25％。对照组总有效率为44.53％,两组疗效经统计学处理有显著差异(P<0.01)。结论 养血清脑颗粒对偏头痛治疗有效,可显著减轻发作的程度。     

A型肉毒毒素治疗慢性每日头痛的疗效与安全性

目的 观察A型肉毒毒素治疗慢性每日头痛的疗效与安全性.方法 治疗组给予A型肉毒毒素50 U,对照组给矛利多卡因加泼尼松龙5 ml.2组均用固定位点注射,分别于0、30、60、90 d观察头痛发作时间、头痛程度、生活质量及不良反应.结果 (1)治疗后30、60、90 d时,每月头痛发作天数在肉毒毒素治疗组为(14.0 ±7.8)d、(13.0±6.8)d和(13.0±6.4)d,对照组为(19.0±6.1)d、(21.0±6.1)d和(21.0±5.8)d,组间差异有统计学意义(Z=2.895、4.544、4.878,P＜0.01).(2)治疗后30 d肉毒毒素治疗组VAS评分为(3.6±1.5)分,对照组为(3.8±1.3)分,差异无统计学意义(Z=1.254,P=0.210);而60、90 d时肉毒毒素治疗组为(3.2±1.5)分和(3.1±1.6)分,对照组为(4.7±1.3)分和(5.0±1.5)分,差异有统计学意义(Z=4.950、5.096,均P=0.000).(3)2组生活质量均稍有改善.(4)肉毒毒素治疗组治疗慢性偏头痛效果好,未服预防性药物者效果较好.(5)各组不良反应均较轻.结论 A型肉毒毒素治疗慢性每日头痛有效、安全.     

养血清脑颗粒对偏头痛患者LPA、TNF水平影响的研究

目的 探讨养血清脑颗粒对偏头痛患者溶血磷脂酸(LPA)、肿瘤坏死因子(TNF)水平的影响.方法 治疗组:160例,采用盐酸氟桂利嗪胶囊加养血清脑颗粒治疗;对照组:58例,单独使用盐酸氟桂利嗪胶囊;健康组:35例.均采用酶免法及严格按试剂说明书操作,对3组受检者外周血LPA、TNF水平进行了检测.结果 治疗组偏头痛患者外周血LPA及TNF水平在用药24h前和用药2周均较健康组高(P＜0.01),用药4周基本恢复健康组水平(P＞0.05);治疗组在用药2周、4周LPA、TNF水平均较对照组低(P＜0.05).而对照组在用药的2周、4周均较健康组高(P＜0.01),P＜0.05).结论 采用盐酸氟桂利嗪胶囊加养血清脑颗粒较单独使用盐酸氟桂利嗪胶囊治疗能更显著的降低偏头痛患者外周血LPA及TNF水平,并能更快更好的缓解头痛症状.提示LPA、TNF增高在偏头痛发作期的发病中发挥一定作用,养血清脑颗粒可有效降低偏头痛发作时LPA、TNF水平和缓解头痛症状.     

褪黑素和丙戊酸在预防偏头痛中的临床研究

目的探讨褪黑素与丙戊酸(VPA)预防偏头痛的疗效。方法选取2014年6月至2015年8月本院收治的偏头痛患者192例,随机分为3组:安慰剂组(n=64)、VPA组(n=64)和褪黑素组(n=64)。安慰剂口服安慰剂600mg·d~(-1);VPA组口服VPA 600mg·d~(-1);褪黑素组每晚睡前服用3mg·d~(-1)褪黑素,3组持续治疗2个月。比较3组治疗前、治疗后1个月和治疗后2个月头痛发作频率、头痛发作持续时间、头痛程度评分(VAS)、镇痛剂使用、偏头痛残疾程度(MIDAS评分)、不良反应。结果治疗期间失访34例(17.7%)。158例患者中安慰剂组54例、VPA组52例、褪黑素组52例。治疗后,VPA组和褪黑素组头痛发作频率、头痛持续时间、VAS评分、镇痛剂使用次数及MIDAS评分均显著低于治疗前和治疗后安慰剂组(P0.05)。治疗期间,安慰剂组1例(1.9%)、VPA组11例(21.2%)、褪黑素组3例(5.8%)出现不良反应。VAP组不良反应发生率显著高于安慰剂组和褪黑素组(χ~2=12.738,P=0.002)。结论褪黑素辅助治疗优于安慰剂,与VPA临床疗效相当,且不良反应少。褪黑激素能够作为VPA替代品用于预防偏头痛。     

西比灵联合养血清脑颗粒治疗偏头痛临床观察

目的观察西比灵联合养血清脑颗粒治疗偏头痛的临床疗效。方法120例偏头痛患者随机分为治疗组60例和对照组60例。对照组按偏头痛常规方法加西比灵治疗,治疗组在对照组治疗的基础上加用养血清脑颗粒(4.0 g冲服,3次/d,共1个月)治疗。2组患者根据临床相关症状改善进行疗效评定。结果治疗组临床控制35例,显效15例,无效10例;对照组依次为25例,17例,18例。2组间有效率比较差异有显著性(P<0.05)。结论养血清脑颗粒联合西比灵治疗偏头痛获较好疗效。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -     

Summary of legislation of 1941 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -     

Asymmetry of on- and off-pathways of blue-sensitive cones of the retina of macaques

Macaque retinal ganglion cells whose receptive-field center recieves input from blue-sensitive cones show an overt asymmetry of the frequency of ON-center and OFF-center varieties, an asymmetry not present in ganglion cells whose center receives input from the other two cone types. A similar asymmetry of ON/OFF responses is found in the local electrotetinogram (d-wave) mediated by signals from blue-sensitive cones. ‘Blue-ON-center’ ganglion cells have larger receptive-field centers and shorter conduction latencies than other opponent-color varieties, suggesting an appreciable degree of receptor convergence and presumably large cell bodies. Intracellular stainings of these neurons with Procion Yellow show that they correspond to diffuse stratified (Parasol) ganglion cells whose flat-topped dendritic arborization stratifies in the sclerad half of the inner plexiform layer. In view of the known characteristics of macaque bipolar cells and of the ON/OFF asymmetry, it is proposed that these ganglion cells are postsynaptic to cone-specific flat bipolars possibly mediating sign-inverting synaptic contacts. The results also indicate a reversal, for the blue-cone pathway, of the ON/OFF lamination of the inner plexiform layer that has recently been described in other species.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.