2型糖尿病患者抑郁状况及相关因素分析

目的:探讨2型糖尿病患者抑郁状况,分析与抑郁相关的影响因素。方法:选取2016年3-5月在本院门诊就诊的2型糖尿病(T2DM)患者287例为研究对象,根据Zung氏抑郁自评量表(SDS)评分进行分组,SDS≥50分为抑郁状态,分为糖尿病非抑郁组169例和糖尿病抑郁组118例,同时收集年龄、性别、月收入、文化程度、居住方式、与糖尿病有关的一般资料(糖尿病病程、并发症、治疗等),测定糖化血红蛋白(Hb A1c),应用Logistic回归对抑郁影响因素进行统计分析。结果:本次研究中2型糖尿病患者并发抑郁的发生率为41.1%,与非抑郁组相比,抑郁组的女性、年龄较轻、独居、家庭月收入低,并发症、使用胰岛素治疗比例均较高(均P0.01)。Logistic回归分析显示女性、独居、并发症、治疗方式均为抑郁发生的危险因素。结论:2型糖尿病患者的抑郁状态发生率较高,临床实践中应重视对抑郁的筛查。医护人员应针对危险因素,积极进行早期心理干预。     

疏肝无忧汤治疗糖尿病合并抑郁症临床观察

目的:观察自拟疏肝无忧汤治疗糖尿病合并抑郁症的疗效。方法:将61例2型糖尿病合并抑郁症患者随机分为治疗组和对照组。在糖尿病常规治疗基础上,治疗组给予疏肝无忧汤水煎剂口服,对照组给予盐酸氟西汀口服。观察并对比2组患者治疗前后汉密尔顿抑郁量表(HAMD)评分、血糖水平变化以及药物不良反应等情况。结果:2组治疗后HAMD评分均较治疗前显著降低(P0.05),且治疗组的下降优于对照组(P0.05)。2组治疗后空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)均较治疗前明显降低(P0.05,P0.01);治疗组P2hBG的下降优于对照组(P0.05)。结论:疏肝无忧汤是治疗糖尿病合并抑郁症的有效方法之一。     

卒中后抑郁合并糖尿病的临床特点及氧化应激机理研究

[目的]探讨卒中后抑郁合并2型糖尿病患者的临床特点及氧化应激在其发病机制中的可能作用.[方法]将65例卒中后抑郁患者分为卒中后抑郁合并2型糖尿病组(A组)和单纯卒中后抑郁组(B组),均行汉密尔顿抑郁量表(HAMD)评分并分级.比较两组的抑郁分级情况及相关实验室指标(HbA1c,SOD,MDA,P-LPO,P-VitC,...     

中医分时辨治糖尿病合并抑郁症56例临床观察

目的:观察中医分时辨治糖尿病合并抑郁症的临床疗效。方法:将157例糖尿病合并抑郁症患者随机分为3组。中药组56例寅时服用调气降糖丸,巳时服用益脾降糖丸,酉时服用糖肾康;西药组51例予盐酸氟西汀胶囊口服治疗;基础治疗组50例仅维持原糖尿病基础及降糖药物治疗不变。3组均治疗12周,分别评定3组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、中医症状改善情况,检测血糖[空腹血糖(FPG)、餐后2 h血糖(2h PG)]、糖化血红蛋白(HbA1c)。结果:中药组、西药组治疗后HAMD、HAMA量表积分均较本组治疗前下降(P0.05);中药组、西药组治疗后HAMD、HA-MA量表积分均较基础治疗组下降(P0.05,P0.01);中药组治疗后HAMD、HAMA量表积分较西药组下降明显(P0.01)。中药组、西药组FPG、2h PG、HbA1c均较本组治疗前降低(P0.05,P0.01),基础治疗组治疗后FPG、2h PG、HbA1c均较本组治疗前升高(P0.05)。中药组、西药组FPG、2h PG、HbA1c均较基础治疗组降低(P0.05,P0.01)。中药组治疗后FPG较西药组降低(P0.05)。中药组除焦虑抑郁、不寐外,其他中医症状均较西药组改善明显(P0.05,P0.01);中药组、西药组中医症状均较基础治疗组改善(P0.01)。结论:中医分时辨治糖尿病合并抑郁症可有效改善患者的血糖,降低HAMD、HAMA量表积分,除焦虑抑郁、不寐外,其他中医症状均亦较西药组改善明显。     

非糖尿病人群中糖化血红蛋白与心血管疾病危险因素的相关性研究

目的探讨非糖尿病人群中糖化血红蛋白(HbA1c)与心血管危险因素的关系,明确HbA1c对非糖尿病人群心血管危险因素的预测意义。方法采用横断面研究方法,选择古城社区自愿参加糖尿病筛查的资料完整并符合入选条件的2 007例(男650例,女1 357例)。以HbA1c 6.5%为糖尿病诊断界值,每0.5为级差,以高血压、血脂紊乱、超重或肥胖、年龄(男45岁、女55岁)、HbA1c≥6.0%及空腹血糖(FBG)≥6.1 mmol/L为心血管危险因素,对不同HbA1c组中的个体所拥有的危险因素进行个数统计分析。同时将受检者按照所拥有的危险因素个数分组为0,1,2,3及4个以上组,比较不同组的危险因素的均值。通过Logistic回归分析HbA1c与心血管危险因素的相关性。结果①随着HbA1c的升高,有3个以上危险因素的频数逐渐增多。②HbA1c在不同危险因素个数组的均值随危险因素个数的增加而增加,并且组间比较有显著性差异(P0.001)。③Logistic回归分析显示HbA1c与FBG受损及糖耐量减低相关性最强,年龄次之。结论6.0%HbA1c6.5%是非糖尿病人群心血管危险因素高发人群;HbA1c水平与FBG受损及糖耐量减低高度相关,可能是独立于其他心血管危险因素以外的非糖尿病人群的心血管危险因素预测指标。     

网膜素-1与老年2型糖尿病合并大面积脑梗死患者预后的相关性分析

目的探讨网膜素-1与老年2型糖尿病合并大面积脑梗死患者预后的相关性。方法选取老年2型糖尿病合并大面积脑梗死患者112例,分为生存组88例和死亡组24例。分析2组患者临床资料,采用ELISA法测定血浆网膜素-1、脂联素水平及代谢参数,并对各变量行相关分析、多元逐步回归分析及Logistic回归分析。结果生存组血浆网膜素-1和脂联素水平均明显高于死亡组(P均0. 05)。血浆网膜素-1水平与APACHEⅡ评分、HbA1c、hs-CRP、HOMA-IR呈负相关(P均0. 05),与脂联素呈正相关(P 0. 05)。多元逐步回归分析显示,APACHEⅡ评分、HbA1c、脂联素是血清网膜素-1的独立影响因素。Logistic回归分析结果显示,HbA1c、APACHEⅡ评分、网膜素-1、hs-CRP是老年2型糖尿病合并大面积脑梗死患者死亡的影响因素。结论血清网膜素-1与老年2型糖尿病合并脑梗死患者的死亡密切相关。网膜素-1的表达可能受到糖脂代谢和疾病预后的影响。     

2型糖尿病心身相关的临床特点及代谢内分泌功能的变化

[目的]探讨2型糖尿病心理因素相关的中医证候学特征以及神经内分泌功能与心理健康状况的变化。[方法]调查192例2型糖尿病患者,根据四诊资料进行心身相关辨证,结果分为单纯糖尿病组和糖尿病并心身相关组,对两组患者进行一般资料、状态特质焦虑问卷(STAI)、简明心境量表(BPOMS)和代谢内分泌相关指标进行比较,采用logisitic回归分析探讨糖尿病并心身相关的危险因素。[结果]192例2型糖尿病患者合并心身相关证候的暴露水平为81/192(42.19%)。糖尿病心身相关组的焦虑状态、焦虑习性因子评分高于糖尿病组和正常对照组,反映心境状态的BPOMS各纬度因子得分高于单纯糖尿病组和正常对照组,差异具有统计学意义(P<0.05或P<0.01),心身相关组糖尿病患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗(IR)、皮质醇(COR)、促肾上腺皮质激素(ACTH)、胰高血糖素(GLU)均高于单纯糖尿病组(P<0.05或P<0.01),logisitic回归分析显示、FPG、GLU、HbA1c、COR是2型糖尿病心身相关的主要危险因素。[结论]糖尿病患者情绪障碍患病率较高,对血糖控制不佳HbA1c高水平的患者应重视心身并重的综合治疗。     

2型糖尿病患者合并非酒精性脂肪肝与血脂异常及中医辨证分型的关系

目的 探讨2型糖尿病患者合并非酒精性脂肪肝(NAFLD)与血脂异常及中医辨证分型的关系。方法 选取符合纳入标准的147例确诊为2型糖尿病患者进行研究,根据B超检测有无脂肪肝影像将糖尿病患者分为NAFLD组和无NAFLD组,统计2组患者的性别、年龄、病程、体质量指数(BMI)、中医辨证分型,测定糖化血红蛋白(HbA1c)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。运用t检验、卡方检验和Logistic回归分析,分析脂肪肝和血脂异常及中医辨证分型的关系。结果 NAFLD组BMI、HbA1c明显高于无NAFLD组(P均0.05),糖尿病病程明显短于无NAFLD组(P0.05),年龄明显小于无NAFLD组,TG、TC、LDL-C和HDL-C均明显低于无NAFLD组(P均0.05)。回归分析显示,BMI、TG、HDL-C是导致NAFLD的主要危险因素。肝肾阴虚型和气阴两虚兼瘀型相关因素的回归分析分别显示,BMI、TG和TG分别是其主要危险因素。结论 2型糖尿病患者NAFLD的发生与血脂异常及中医辨证分型有一定关联,有助于进一步评估糖尿病及其并发症的状态。     

调肝健脾补肾法治疗糖尿病合并抑郁症临床观察

目的:观察调肝健脾补肾法治疗糖尿病合并抑郁症的临床疗效。方法:将108例糖尿病合并抑郁症患者随机分成2组。治疗组56例在西药治疗糖尿病的同时,给予清消解郁汤治疗;对照组52例在西药治疗糖尿病同时给予抗抑郁药舍曲林治疗。疗程4周。观察治疗前后空腹血糖(FBG)、餐后2h血糖(P2hBG)、糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、汉密尔顿抑郁量表(HAMD)评分等。结果:治疗组显效16例,有效29例,无效11例,总有效率80.36%。对照组显效14例,有效25例,无效13例,总有效率75.00%。2组总有效率比较,差异无显著性意义(P>0.05)。2组治疗后FBG、P2hBG、HbA1c、TC、TG、HDL-C、LDL-C均有所改善,但与治疗前比较,差异均无显著性意义(P>0.05);2组治疗后各指标比较,差异均无显著性意义(P>0.05)。2组HAMD评分治疗后均有所下降,与治疗前比较,差异均有显著性意义(P<0.05);治疗组较对照组分值下降更明显,但差异无显著性意义(P>0.05)。结论:调肝健脾补肾法治疗糖尿病合并抑郁症的总体疗效与舍曲林相当。     

2型糖尿病合并心脑血管病的临床内科观察及治疗

目的:探讨2型糖尿病合并心脑血管病变的相关危险因素及临床治疗要点。方法:分析179例2型糖尿病患者病情,将其分为合并心脑血管病变组97例(A组),无大血管病变组82例(B组),进行对照研究。结果:①A组患者嗜甜食、嗜荤食、吸烟、低血糖发作次数和发生频率显著高于B组,而运动频率及时间显著低于B组;②Logistic回归分析显示,2型糖尿病合并心脑血管病变与饮食控制程度、吸烟、经常低血糖发作有关。结论:饮食控制差、有吸烟史、经常低血糖发作是2型糖尿病合并心脑血管病变的危险因素,应当积极采取防治措施。     

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。