赵瑞华教授中药辅助子宫内膜异位症体外受精-胚胎移植经验

体外受精-胚胎移植(IVF-ET)是治疗子宫内膜异位症不孕的主要手段之一。赵瑞华教授对于中药辅助子宫内膜异位症不孕患者IVF-ET有着丰富的临床经验,采用因病制宜、病证结合分期疗法,改善卵巢功能和子宫内膜容受性,提高IVF-ET的成功率。降调节期以辨证论治为主,常用活血消异方加减;超促排卵及取卵期补肾健脾,调畅气机兼以活血;黄体期健脾补肾,调和营卫;孕期注重保胎,以补肾健脾,固冲安胎为法。     

李月梅应用“通元针法”辅助体外受精-胚胎移植经验

李月梅基于月经周期疗法,将体外受精-胚胎移植(IVF-ET)降调期、控制性超促排卵期、取卵至移植期及移植后期与"通元针法"相结合,通过通督调神(督脉及背俞穴为主)、引气归元(任脉、腹部募穴为主)配合辨证取穴,以促进卵泡发育成熟及内膜增生,改善子宫内环境,提高IVF-ET临床妊娠率。     

王瑞平教授治疗多原发癌的经验

王瑞平教授认为"异病同治""治未病""体质"理论在治疗多原发癌中发挥着重要作用,通过辨证论治,以治脾胃为主,辅以化瘀解毒抗癌,虚实兼治,兼顾调理体质,可改善肿瘤发生的内环境,从而改善患者的症状,提高生存质量。     

胡国华治疗持续性HPV感染临床经验撷英

胡国华教授认为脾失健运,肝肾不足,正气虚弱,不能托邪外出是人乳头状瘤病毒(HPV)持续感染的主要病机。当以健脾祛湿、清肝益肾为法,并主张药食同源,调体调神,从源头改善体质。附验案1则以佐证。     

滋肾育胎丸在体外受精-胚胎移植中效果的研究

目的:探讨滋肾育胎丸对体外受精-胚胎移植(IVF-ET)结局的影响。方法:选取2016年1月23日至2016年9月11日西北妇女儿童医院生殖中心接受IVF-ET助孕的女性随机双盲分为滋肾育胎丸药物组及安慰剂组,均采用长方案,降调日起服药,至移植后35 d停药,比较2组超排卵的治疗过程及结局;结果:共入组205例,药物组(103例)和安慰剂组(102例)基础数据没有差异,2组促排卵时间、促排卵药物总量、HCG日子宫内膜厚度、优胚率亦没有统计学意义。药物组HCG日每成熟卵泡对应E2值、新鲜移植胚胎种植率及临床妊娠率均高于安慰剂组,差异有统计学意义(P0.05);结论:IVF-ET过程中配合应用滋肾育胎丸能够改善卵细胞质量,促进胚胎种植,最终可提高IVF-ET助孕效率。     

左归丸加减对卵巢储备功能降低肾阴虚证不孕患者体外受精-胚胎移植治疗的影响

目的探讨左归丸加减在卵巢储备功能降低(DOR)肾阴虚证不孕患者体外受精-胚胎移植(IVF-ET)治疗中的应用价值。方法回顾性分析2016年1月-2018年6月上海交通大学医学院附属第九人民医院辅助生殖科行IVF-ET治疗至少2个促排卵周期的20例DOR患者的临床资料。第1周期(未使用左归丸加减)为中药处理前组(52周期);之后予左归丸加减口服至少3个月(中药持续干预),再次进入促排卵周期为中药处理组(46周期)。比较患者2个周期促排卵结局。结果经左归丸加减治疗后,再次接受IVF-ET治疗可获得有效胚胎的周期比率由28.3%升至57.6%(P0.05)。治疗前后周期的促性腺激素(Gn)用量、促排天数、治疗结束直径≥10 mm卵泡数、治疗结束直径≥14 mm卵泡数、获卵数(率)、成熟卵数(率)、受精卵数(率)及可用胚胎数比较差异无统计学意义(P0.05)。结论左归丸加减可提高DOR肾阴虚证不孕患者获得有效胚胎的周期比率,在一定程度上提高IVF-ET治疗效率。     

电针干预对多囊卵巢综合征患者纺锤体及卵子质量的影响

目的观察超促排卵过程中加电针干预对行体外受精——胚胎移植（in vitro fertilization-embryo transfer, IVF-ET）多囊卵巢综合征（polycystic ovarian syndrome, PCOS）患者卵子质量的影响。方法选择217例行IVF-ET的PCOS患者,按随机数字表分为电针组（119例）和对照组（98例）,均给予长方案超促排卵,降调节及促排卵过程中电针组加用电针干预,直至取卵日。观察两组患者纺锤体（纺锤体与极体的位置关系）、获卵数、受精率、卵裂率、优质胚胎率、卵巢过度刺激综合征（ovarian hyperstimulation syndrome,OHSS）发生率、临床妊娠率、早期自然流产率、促性腺激素（gonadotropins,Gn）用量、时间、绒促性素（human chorionic gonadotropin, HCG）日E2、孕酮（progesterone, P）、促黄体生成素（luteinizing hormone, LH）水平。结果电针组纺锤体位于极体11点至1点的卵子数占卵子数的比例明显高于对照组（P<0.05）。纺锤体位于极体11点至1点的卵子数与HCG日E2水平及优胚率呈正相关（r=0.19,P<0.01）。与对照组比较,电针组优质胚胎率明显升高（P<0.05）,电针组Gn用量与用药时间减少（P<0.05）,临床妊娠率提高8.36%。结论纺锤体与卵子质量呈正相关;电针干预可以提高卵子质量,改善PCOS患者临床妊娠率。     

GnRH拮抗剂方案对重复IVF-ET周期助孕结局的影响

目的探讨促性腺激素释放激素拮抗剂方案对前次行长方案体外受精-胚胎移植(IVF-ET)治疗失败患者第2周期治疗结局的影响。方法选取2016年1月—2017年12月在哈尔滨医科大学附属第一医院生殖医学科因前次IVF-ET失败而再次行IVF-ET治疗患者33例。以患者第1周期促性腺激素释放激素激动剂(GnRH-a)长方案促排卵数据为对照组,第2周期拮抗剂方案促排卵数据为研究组,采用自身对照的方法比较2个周期的治疗情况和妊娠结局。结果2组患者的体质量指数(BMI)、基础小卵泡数目(AFC)、基础促卵泡激素(FSH)比较差异均无统计学意义(P均>0.05)。2组患者促性腺激素(Gn)用量、hCG注射日子宫内膜厚度、hCG注射日雌二醇(E 2)水平、获卵数、MⅡ卵数、移植胚胎数比较差异均无统计学意义(P均>0.05),但研究组Gn使用时间更短,2PN受精率、优质胚胎数、胚胎种植率和临床妊娠率均明显高于对照组(P均<0.05)。结论对前次GnRH-a长方案IVF-ET治疗失败的患者,选用拮抗剂方案可显著提高优质胚胎数、种植率和临床妊娠率。     

张良英中医辅助治疗体外受精-胚胎移植经验

云南中医学院张良英教授对进行体外受精-胚胎移植(IVF-ET)的不孕患者运用中医辅助治疗,获得满意效果。其采用以补肾为主、辨病结合辨证的治疗方法,强调术前调理、心理调适、适当取舍,有助于改善IVF-ET妊娠率低及并发症多的问题。     

中医辨证预治疗对体外受精-胚胎移植妊娠结局的影响

目的：探讨体外受精-胚胎移植（IVF-ET）前中医辨证预治疗对IVF-ET妊娠结局的影响。方法：收集在安徽省立医院生殖医学中心求治的不孕女性400例,根据不孕症中医辨证标准进行中医症候分析。将400例患者分为研究组和对照组各200例。研究组在西医常规处理基础上对患者进行中医辨证预治疗,对照组仅行西医常规处理。观察对IVF-ET中促排卵过程、胚胎质量、hCG日子宫内膜厚度以及妊娠结局的影响。结果：纳入研究的接受IVF-ET的不孕症患者中,血瘀胞络证比例高达80.5%,其次是肝郁气滞证,达70.25%,肾阳虚症比例为58.5%、肾阴虚证相对较少,仅12.75%。中医辨证预治疗后,可增加hCG日子宫内膜厚度,提高优质胚胎率,增加种植率、临床妊娠率和抱婴回家率。结论血瘀胞络证、肝郁气滞证、肾阳虚症为不孕症的常见症候,中医辨证预治疗可通过增加hCG日子宫内膜厚度和提高胚胎质量达到改善妊娠结局的目的。     

微波消解-电感耦合等离子体质谱法测定脉络宁注射液中25种矿物质元素

目的建立微波消解-电感耦合等离子体质谱(ICP-MS)直接稀释测定脉络宁注射液中25种矿物质元素(Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V、As、Cd和Hg)的方法。方法分别对微波消解条件和测试条件进行考察;样品经微波消解后,采用电感耦合质谱仪测定25种矿物质元素,并对测定方法学进行考察。结果确定最佳消解条件为3步缓慢升温:400 W 80℃升温10 min,保留5 min;600 W 120℃升温10 min,保留5 min;900 W 200℃升温20 min,保留20 min;25种矿物质元素在各自的线性范围内线性关系良好,r≥0.999 6,精密度、稳定性和重复性试验的RSD均符合定量分析要求;加标回收率为94.7%~106.1%,RSD在0.34%~2.79%。脉络宁注射液中检测出Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V,未检出As、Cd和Hg。结论该方法简便、迅速、准确,适用于脉络宁注射液中25种矿物质元素的同时测定。     

Die Lateralität und Lateralitätsinstabilität in der Diagnostik und Therapie

The disturbance and instability of laterality are obstacles to diagnostics and therapy. Correction prior to starting therapy is required. They also predispose toward defined health problems and unspecific diseases. Numerous research activities provide evidence of the relevance of undisturbed laterality in diagnostics and therapy. Techniques of testing and therapeutic corrections will allow for optimized therapy success.     

Journal of Acupuncture and Tuina Science Instructions for Authors

The Journal of Acupuncture and Tuina Science, a journal with an international scope （IS SN 1672-3597, CN 31-1908/R, Bimonthly）, is embodied by ＇Springer Verlag＇ Database, Index Copernicus （IC） and Chinese Scientific and Technical Paper and Citations Data （CSTPCD）. You can search full text on http：//www, springerlink, com/content/1672 -3597.     

Yerba Mate or Paraguay Tea

正Beverages based on Ilex paraguariensis A.St.-Hil.are used in the south Brazil and other Latin American countries located at the so-called southern cone.It is known as chimarro or mate in south and southeast Brazil,tererêin     

Ethnopharmacologic study of chinese rhubarb

This paper deals with an interdisciplinary study covering historic, botanical, phytochemical, pharmacological and clinical aspects of rhubarb and related species, to lay stress on the correlation between plant phylogeny, chemical constituents and purgative activity.

It was found that the official rhubarbs were exclusively restricted in the Sect. Palmata e.g. Rheum palmatum R. palmatum var. tanguticum R. officinale; the following criteria may serve as their standard, viz., the presence of sennoside derivatives and rhein, the occurrence of the reduced form of rhein and aloe-emodin, the leaves with any kind of palmate incision. Comprehensive multivariate analyses showed that there is a very close relationship between the leaf incision, existence of sennosides or rhein and purgative activity.     

Wirksamkeit der Akupunktur bei der Therapie von idiopathischen Schmeckstörungen: Eine randomisierte Placebo-kontrollierte Studie

Background

At present, the state-of-the-art medication in treating idiopathic taste disorder (gustatory dysfunction) is zinc. If zinc medication was unsuccessful, not tolerated or if it is contraindicated the persons affected can hardly be helped.

Objectives

In a randomized placebo-controlled clinical trial an attempt was made to determine the efficacy of acupuncture.

Methods

The treatment group was treated with acupuncture needles, the placebo group with an inactive acupuncture-laser. Endpoints of the study were changes in the taste test, the quality of life and the severity of symptoms of depression (BDI) as well as mood changes (ZMS). Satisfaction with the success of the respective therapy was also evaluated. Data were collected before and after therapy and again for the treatment group 10 weeks after completion of the treatment period.

Findings

Treatment with real acupuncture showed a significant improvement in gustatory function as well as a significant improvement in psychological symptoms. Greater satisfaction with the treatment results was evident in the treatment group. The treatment results of acupuncture remained stable over a period of ten weeks after completion of the treatment.

Conclusion

Acupuncture was effective in the therapy of idiopathic taste disorders and therefore it is an effective alternative when zinc medication is not tolerated or unsuccessful. But it is also suitable as a therapy of first choice. Acupuncture can be considered as an extension of the therapeutic spectrum in the difficult treatment of taste disorders.     

Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.     

瑞香科五属植物中酚性聚合物的结构特征、分布及药理活性研究进展

瑞香科植物广泛分布于世界热带和温带地区,其中多种植物可供药用。在对该科植物的研究中发现,黄酮类、木脂素和香豆素等酚性化合物的低聚体为其重要的特征性成分,药理活性主要表现在抗肿瘤、抗炎、抗氧化、抗菌和抗病毒等方面。对已发现的酚性聚合体的化学结构、植物来源及药理活性进行综述,为瑞香科植物今后的研究和开发利用提供参考。     

HPLC法同时测定沉香化滞丸中11种成分

目的采用HPLC梯度洗脱法同时测定沉香化滞丸中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚11种成分。方法采用Thermo Syncronis C18色谱柱(250 mm×4.6 mm,5μm),流动相为水-乙腈,梯度洗脱:0～10 min,20%乙腈;10～20 min,20%～40%乙腈;20～24 min,40%乙腈;24～26 min,40%～52%乙腈;26～30 min,52%乙腈;30～31 min,52%～90%乙腈;31～35 min,90%乙腈;35～40 min,90%～100%乙腈;40～43min,100%乙腈;43～45min,100%～20%乙腈;检测波长215nm,体积流量1.0m L/min,柱温30℃,进样量20μL。结果各成分在43 min内分离良好,沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚的线性范围分别为1.4～13.6、10.0～200.0、31.5～315.0、1.0～120.1、1.8～50.6、0.93～10.1、1.8～30.0、0.2～40.3、1.8～18.1、1.7～25.0、0.45～10.70μg/mL;样品中各成分的平均回收率均在98.90%～100.87%;11种成分精密度RSD在0.55%～1.54%;供试品溶液在30 h内稳定性良好,RSD在0.75%～1.94%;重复性RSD在0.39%～1.73%。6批次样品中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚质量分数分别为92.0～201.0、511.5～9 033.0、5 475.0～12 635.5、54.5～5 095.5、192.0～2 137.5、117.0～391.5、106.5～1 281.5、13.0～136.5、93.5～199.0、177.0～1 207.0、33.5～251.5μg/g。结论本方法准确、快速、简便,重复性好,精密度高,适用于沉香化滞丸中多种活性成分的定量分析。