非酒精性脂肪性肝病患者血清TNF-α、IL-6水平与胰岛素抵抗相关性研究

目的检测非酒精性脂肪性肝病(NAFLD)患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)表达水平,并探讨其与胰岛素抵抗的相关性。方法测定106例NAFLD患者血清TNF-α、IL-6、空腹血糖(FBG)、空腹胰岛素(FINS)水平,采用稳态模式评估胰岛素抵抗指数(HOMA-IR),根据患者身高、体质量结果计算体质量指数(BMI),并以同期不嗜酒的30名健康人为对照组进行比较。结果 NAFLD组患者血清TNF-α、IL-6、FBG、FINS水平及BMI、HOMA-IR均明显高于健康对照组(P均0.01)。NAFLD组患者血清TNF-α、IL-6水平与BMI、FINS及HOMA-IR呈正相关性(P均0.01)。结论 NAFLD患者存在炎症反应,血清TNF-α、IL-6水平升高与肥胖及以高胰岛素血症为主的胰岛素抵抗密切相关。     

利拉鲁肽对2型糖尿病患者血清炎症因子的影响

目的观察利拉鲁肽对2型糖尿病患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)的影响。方法选择住院的2型糖尿病患者40例为糖尿病组,同时期健康体检者40例作为对照组。糖尿病组给予利拉鲁肽治疗24周。测对照组及糖尿病组治疗前、治疗第12周、第24周空腹血糖(FBG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、hs-CRP、IL-6及TNF-α,计算胰岛素抵抗指数(HOMA-IR)。结果治疗前,糖尿病组FBG、2hPG、HbA1c、HOMA-IR、IL-6、TNF-α、hs-CRP均显著高于对照组(P<0.01),FINS显著低于对照组(P<0.01)。治疗后,FBG、2hPG、HOMA-IR、IL-6、TNF-α、hs-CRP均显著降低(P均<0.01),HbA1c逐步降低(P均<0.05),FINS显著升高(P<0.01)。结论利拉鲁肽可通过抑制2型糖尿病患者体内炎症反应,预防糖尿病及其并发症发展。     

夏仙逍遥饮对围绝经期失眠症患者胰岛素抵抗及炎症因子的影响

目的观察夏仙逍遥饮对围绝经期失眠症患者的糖代谢和胰岛素抵抗的影响。方法将60例肝郁化火型围绝经期失眠症患者随机分为对照组和观察组,每组各30例。对照组采用克龄蒙联合右佐匹克隆治疗,观察组采用中药夏仙逍遥饮。比较2组患者治疗前后的空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)和肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)等。结果治疗后,2组患者FPG、2h PG、Hb A1C水平均明显降低(P 0.05),且治疗组降低程度优于对照组(P 0.05)。2组患者FINS和HOMA-IR水平明显降低(P 0.05),且治疗组降低程度优于对照组(P 0.05)。2组患者TNF-α和IL-6水平明显降低(P 0.05),且治疗组降低程度优于对照组(P 0.05)。结论夏仙逍遥饮能够能明显降低围绝经期失眠症患者的FPG、2h PG和Hb A1C水平,还能显著抑制患者FINS和HOMA-IR水平,并能显著恢复异常升高的TNF-α和IL-6,恢复失衡的糖代谢、改善胰岛素抵抗和抑制因子的作用,其具体作用机制值得进一步探究。     

清血解毒合剂对2型糖尿病患者胰岛素抵抗及相关促炎因子的影响

目的:观察清血解毒合剂对2型糖尿病患者(阴虚热盛兼血瘀证)空腹血糖(FBG)、餐后2小时血糖(P2h PG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、血清白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(IRI)等指标的影响,分析清血解毒合剂对2型糖尿病促炎因子及胰岛素抵抗的调节作用。方法:60例符合本次研究标准的2型糖尿病患者,按照随机原则分为常规治疗组及联合治疗组,每组30例。常规治疗组给予常规降糖方案治疗,联合治疗组在常规降糖方案的基础上联合应用清血解毒合剂治疗,两组疗程均为8周。治疗前后分别检测两组患者的FBG、P2h PG、Hb A1c、FINS、IL-6、IL-8、TNF-α、hsCRP及IRI水平。结果:两组患者治疗后在FBG、P2h BG、Hb A1C、FINS、IRI方面均较均治疗前显著降低(P0.01),联合治疗组FINS、IRI治疗后显著低于常规治疗组(P0.05);两组患者治疗后IL-6、IL-8、TNF-α、hs-CRP水平在体内的浓度均较治疗前下降明显,且联合治疗组优于常规治疗组(P0.05),且联合治疗组IL-6、TNF-α、hs-CRP治疗后显著低于常规治疗组(P0.05)。结论:清血解毒合剂能有效降低2型糖尿病患者体内促炎症因子表达浓度,同时可改善其胰岛素抵抗程度,且对患者血糖波动无不良影响,安全有效。     

靳三针疗法干预对T2DM大鼠模型胰岛素抵抗的影响

目的:通过观察靳三针疗法干预2型糖尿病(T2DM)大鼠模型,探讨靳三针疗法对T2DM大鼠IR的影响机制。方法:Wistar大鼠随机分为靳三针疗法组(A组)、模型对照组(B组)、健康对照组(C组)三组,观察各组大鼠治疗干预前后血FPG、2hPG、HbA1c、FINS、TNF-α、ADPN,HOMA-IR及HOMA-β等指标变化。结果:A组的针灸干预对降低FPG、2hPG、HbA1c、TNF-α、HOMA-IR及改善FINS、ADPN、HOMA-β均有效(均P0.05)。干预前A组、B组与C组比较,血清FPG、2hPG、HbA1c、TNF-α、HOMA-IR水平较高,而ADPN、HOMA-β水平较低(均P0.05)。结论:实验证明糖尿病模型组大鼠出现胰岛素抵抗;细胞因子TNF-α、ADPN与T2DM大鼠的胰岛素抵抗密切相关,胰岛素抵抗程度与TNF-α水平呈正相关,与ADPN水平呈负相关;靳三针疗法对改善T2DM大鼠模型IR具有较好的疗效。     

清肺泻肝汤对2型糖尿病患者炎症指标和肠道菌群的调节作用

目的:观察清肺泻肝汤治疗太阴人2型糖尿病(T2DM)的疗效及对炎症指标和肠道菌群的调节作用。方法:将122例患者随机分为对照组(65例)和观察组(67例)。对照组给予盐酸二甲双胍片,0. 25 g/次,2～3次/d,根据血糖控制情况调整剂量。观察组在对照组的基础上给予清肺泻肝汤加减治疗,1剂/d。疗程2个月。检测治疗前后空腹血糖(FPG),餐后2 h血糖(2 h PG),糖化血红蛋白(Hb A1c)和空腹胰岛素(FINS),并计算胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMAIR);检测治疗前后三酰甘油(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HLD)和低密度脂蛋白(LDL-C)水平;检测治疗前后白细胞介素-6(IL-6),IL-8,肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平;进行治疗前后肠道菌群检测和治疗前后朝鲜族医学证候评分。结果:经秩和检验,观察组疾病疗效优于对照组(P 0. 01);治疗后观察组血清FPG,2 h PG,Hb A1c,FINS水平低于对照组(P 0. 01),HOMA-IR低于对照组(P 0. 01),ISI高于对照组(P 0. 01);观察组患者血浆TC,TG和LDL-C水平较对照组降低(P 0. 01),HDL-C较对照组升高(P 0. 01);观察组血清IL-6,IL-8,TNF-α和CRP水平低于对照组(P 0. 01);观察组肠道需氧菌群(肠杆菌、肠球菌、酵母菌)数量低于对照组(P 0. 05),肠道厌氧菌群(拟杆菌、双歧杆菌、乳杆菌)数量高于对照组(P 0. 05)。结论:清肺泻肝汤可进一步改善太阴人T2DM患者胰岛素抵抗(IR),调节血糖和血脂水平,减轻临床症状,抑制炎症反应,调节肠道菌群,临床疗效优于单纯的西医治疗。     

穴位埋线对单纯性肥胖症患者肿瘤坏死因子-α和胰岛素抵抗的影响

目的:探讨穴位埋线治疗单纯性肥胖症的临床机理,为治疗效果的客观化评价提供依据。方法:80例单纯性肥胖患者随机分为埋线和针刺治疗组,主穴为梁丘、中脘、天枢、水分、丰隆、局部阿是穴,并辨证配以阴陵泉、内庭、太冲、气海、太溪穴。埋线1周进行1次,共4次;针刺治疗前5d为每日1次,以后隔日1次,共1个月。观察治疗前后患者的体重、体重指数(BMI)、空腹血清胰岛素(FINS)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、肿瘤坏死因子-α(TNF-α)的变化,并与正常人对照。结果:单纯性肥胖患者不同程度地存在胰岛素抵抗,体重、BMI、FINS、HOMA-IR、TNF-α明显高于正常对照组(P<0.01),治疗后两组体重、BMI、FINS、HOMA-IR、TNF-α明显低于治疗前,有非常显著性统计学差异(P<0.01),穴位埋线组FBG较治疗前有显著性降低(P<0.05),针刺组FBG治疗前后比较无显著性统计学意义(P>0.05);两组治疗后指标比较差异无显著性统计学意义(P>0.05),仍高于正常对照组(P<0.01)。结论:穴位埋线疗效可靠,是治疗单纯性肥胖症的一种有效方法。     

心脑舒通胶囊对冠心病患者胰岛素抵抗及炎症因子的干预作用

目的探讨心脑舒通胶囊对冠心病患者胰岛素抵抗及炎症因子的干预作用。方法共观察冠心病患者86例,随机分为治疗组（43例）和对照组（43例）。同时选取健康体检者30名作为正常组。治疗组和对照组均予西药常规基础治疗,治疗组再给予心脑舒通胶囊口服,疗程共8周。检测干预前治疗组、对照组、正常组及干预后治疗组、对照组空腹血糖（FBG）、空腹胰岛素（FINS）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、高敏C反应蛋白（hs-CRP）等指标,计算胰岛素抵抗指数（HOMA-IR）。结果治疗前两组冠心病患者FINS、HOMA-IR及TNF-α、IL-6、hs-CRP较正常组显著增加（P〈0.05）,治疗后治疗组FINS、HOMA-IR及TNF-α、IL-6、hs-CRP较治疗前均有显著降低（P〈0.05或P〈0.01）;对照组TNF-α较治疗前有所下降（P〈0.05）,FBG、FINS、HOMA-IR及IL-6、hs-CRP较治疗前均无统计学意义。结论冠心病患者存在明显的胰岛素抵抗及亚临床炎症,心脑舒通胶囊可以改善冠心病患者的胰岛素抵抗,抑制炎症反应,这可能是其治疗冠心病的机制之一。     

黄地安消胶囊对改善2型糖尿病GK大鼠胰岛素抵抗的影响

目的观察黄地安消胶囊(葛根、枇杷叶、三七,等)对2型糖尿病(T2DM)模型GK大鼠的血糖和胰岛素抵抗的影响及可能的效应机制。方法选取符合T2DM模型的GK大鼠纳入实验,随机分为模型组,罗格列酮(1.44 mg/kg)组,参芪降糖颗粒(1.08 g/kg)组,黄地安消胶囊高、中、低(12、6、3 g/kg)组以及Wistar大鼠正常组。各组连续给药6周后,测定各组大鼠的空腹血糖(FBG)、血清胰岛素(FINS)含有量、空腹血清血糖(FPG),并计算胰岛素抵抗指数(HOMA-IR)。对血清生化指标(TG、TC、HDL-C、LDL-C)、糖化血红蛋白(Hb A1c)、胰高血糖素样肽-1(GLP-1)及胰岛素样生长因子(IGF-1)进行测定。取胰腺组织,常规石蜡包埋并进行HE染色,观察其病理形态的改变。结果与正常组比较,模型组FBG、FPG、FINS、HOMA-IR、TG、TC、HDL-C、LDL-C、Hb A1c均显著升高(P0.01),GLP-1、IGF-1表达量显著降低(P0.01)。与模型组比较,黄地安消高、中、低剂量组FBG、FPG、FINS、HOMA-IR、TG、TC、HDL-C、LDL-C、Hb A1c均明显降低(P0.05,P0.01);GLP-1、IGF-1表达量显著增加(P0.05,P0.01),黄地安消高、中、低剂量组胰腺组织结构改变明显减轻。结论黄地安消胶囊能够降低GK大鼠空腹血糖,改善胰岛素抵抗,其机制可能与促进胰岛细胞的产生与增殖,改善胰岛细胞的功能,增加胰岛素的分泌有关。     

酸甘化阴法治疗2型糖尿病患者临床疗效及机制研究

目的:研究酸甘化阴法对2型糖尿病气阴两虚证患者血糖的影响,从调节胰岛素抵抗角度探讨其作用机制。方法:采用随机、对照的方法,将60例患者分成治疗组和对照组,每组30例。在饮食、运动治疗的基础上,分别加用芪贞降糖方和安慰剂,疗程3个月。观察治疗前后患者体重指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)的变化,评定所有入组患者服用芪贞降糖方3个月后的中医证候疗效,探讨芪贞降糖方酸甘化阴法对胰岛素抵抗(IR)作用的可能机制。结果:中医证候疗效比较治疗组的疗效优于对照组(P<0.05);治疗组改善FBG、Hb A1c、HOMA-IR优于对照组(P<0.05);两组2 h PG、FINS治疗前后无显著性差异(P>0.05);两组治疗后BMI值均较前下降(P<0.05),但两组的组间比较差异无统计学意义(P>0.05)。结论:芪贞降糖方酸甘化阴法可显著改善气阴两虚型2型糖尿病患者中医临床证候,降低FPG、Hb A1C、HOMA-IR,证实酸甘化阴法可通过改善胰岛素抵抗从而改善患者血糖水平。     

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。