清痰化瘀饮对新西兰大白兔动脉粥样硬化炎性因子的影响

目的通过实验证实清痰化瘀饮联合阿托伐他汀可以改善兔动脉粥样硬化的炎症反应。方法24只新西兰大白兔随机分为4组：空白对照组,模型对照组,阿托伐他汀治疗组,清痰化瘀饮联合阿托伐他汀治疗组。空白组予普通兔饲料,其余3组予高脂饲料。12周后各组取外颈静脉血8ml。继续高脂饲料喂养后三组,模型对照组每日给予等量生理盐水,阿托伐他汀治疗组和清痰化瘀饮联合阿托伐他汀治疗组每日一次灌胃给药8周。再次取血8ml。测定Fg、Hs-CRP、IL-18三个炎性因子指标,与治疗前进行对比分析。结果治疗前与空白组比较,其余三组Fg、Hs-CRP、IL-18均有显著升高（P〈0．01）;治疗后组内比较,两治疗组3种炎性因子指标均显著降低（P〈0．05）;治疗后组间比较,与模型对照组比较,两个治疗组的3种炎性因子指标均显著降低（P〈0．01）;两个治疗组比较,清痰化瘀饮联合阿托伐他汀治疗组在降低3种炎性因子指标方面,疗效优于阿托伐他汀治疗组（P〈0．05）。结论清痰化瘀饮联合阿托伐他汀能显著降低动脉粥样硬化新西兰大白兔Fg、Hs-CRP、IL-18三种炎性因子水平,且疗效优于单纯使用西药。     

百裕银杏内酯注射液抑制家兔血小板聚集作用的实验研究

目的观察不同低剂量的百裕银杏内酯注射液对家兔血小板聚集功能、超微结构及PF-4和B—TG的影响。方法将日本大耳兔分为百裕银杏内酯高、中、低剂量组及生理盐水组,分别予相应药物静注1周．采用体内实验法,观察各组对血小板活化因子（PAF）诱导的家兔血小板聚集作用的影响,以及血小板超微结构和PF-4和B—TG水平的变化。结果百裕银杏内酯各剂量组较生理盐水组均能抑制PAF诱导的家兔血小板聚集,减少聚集型血小板数量并使树突型血小板突起变少变短,降低PF-4和8-TG的表达（P〈0．01）。结论百裕银杏内酯注射液能够抑制PAF诱导的血小板聚集,抑制血小板的活化。     

玉泉颗粒治疗2型糖尿病84例疗效分析

目的观察玉泉颗粒治疗2型糖尿病的疗效及安全性。方法将84例2型糖尿病患者随机分为2组,所有患者均保持原降糖治疗方案不变,治疗组加用玉泉颗粒5 g,每日4次冲服。治疗期间不加用与本病有关的其他药物和治疗方法。2个月后观察两组疗效。结果治疗组同对照组相比,玉泉颗粒能显著降低空腹及餐后血糖,降低血脂作用显著,组间比较差异具有统计学意义(P<0.05),且对肝肾功能无明显影响。结论玉泉颗粒是安全有效的降糖药物。     

从痰瘀论治动脉粥样硬化的研究进展

动脉粥样硬化(Atherosclerosis,AS)一种常见的、慢性、进行性、全身性疾病,往往同时累及多处血管,导致严重后果。近年来随着中医治疗动脉粥样硬化的实验和临床研究逐步深入,从痰瘀论治动脉粥样硬化性疾病取得了显著的进展,值得我们深入研究。本文对动脉粥样硬化性疾病的病因病机、证候要素分布,以及从痰瘀角度防治本病进行了归纳总结。     

化瘀明目合剂治疗阴虚血瘀型非增殖性糖尿病视网膜病变临床研究

目的:观察化瘀明目合剂治疗非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的临床疗效。方法:60例(119眼)NPDR患者随机分为对照组和观察组。对照组30例(60眼)给予羟苯磺酸钙胶囊(昊畅)口服,观察组30例(59眼)给予化瘀明目合剂口服,两组疗程均为12周。治疗后比较两组视力和眼底病变的疗效、治疗前后两组患者空腹血糖、糖化血红蛋白、血脂、血液流变学水平。结果:治疗后,对照组视力显效2眼,有效36眼,无效16眼,恶化6眼;观察组视力显效6眼,有效48眼,无效4眼,恶化1眼;两组疗效等级分布比较,差异有统计学意义(P0.05)。对照组眼底改变显效2眼,有效36眼,无效18眼,恶化4眼;观察组眼底改变显效6眼,有效48眼,无效4眼,恶化4眼;两组疗效等级分布,差异有统计学意义(P0.05)。观察组患者治疗后血清总胆固醇、三酰甘油水平均较治疗前显著降低(P0.01)。治疗后观察组全血黏度低切与治疗前比较,差异有统计学意义(P=0.042,P0.05);治疗后观察组血浆黏度值与治疗前比较,差异有统计学意义(P=0.035,P0.05)。结论:化瘀明目合剂对NPDR患者提高视力、改善眼底具有明显疗效,并且可降低该类患者血脂、血浆黏度。     

Reduction of Slit Diaphragm-associated Molecules by Sirolimus: Is it Enough to Induce Proteinuria?

Sirolimus (SRL), a mammalian target of rapamycin inhibitor, is widely used in transplantation, but the mechanisms whereby it induces adverse effects, such as proteinuria and edema, remain unclear. To determine whether isolated SRL induces proteinuria or not, the authors intraperitoneally injected C57BL/6 mice with different doses of SRL (0 mg/[kg·d], 3 mg/[kg·d], 10 mg/[kg·d], or 30 mg/[kg·d]) for 24 days. Urinary albumin excretion was then quantified using a double-sandwich enzyme-linked immunosorbent assay, and serum creatinine levels were measured using a single dry-film chemistry auto-analyzer. The mRNA expression levels of various genes were also measured by polymerase chain reaction. Urinary albumin was not detected in the SRL-treated mice, but serum creatinine levels were found to increase dose-dependently and were significantly higher in the animals treated with 30 mg/kg of SRL than in untreated controls. Glomerular mRNA expression profiling showed down-regulations of podocyte-related genes (Wilms tumor 1, synaptopodin, nephrin, CD2-associated protein, and podocin) and of transforming growth factor-beta (a marker of fibrosis) in sirolimus-treated mice. In addition, expressions of the antiapoptotic genes Bcl-2 and Bcl-xL were also down-regulated. Furthermore, the protein levels of these genes in mice kidney were also decreased by sirolimus. Although sirolimus treatment reduced the expressions of slit diaphragm–associated molecules and increased serum creatinine levels, it failed to induce proteinuria. Our findings indicate that proteinuria is not induced by isolated SRL treatment. Further studies are required to identify conditions in which sirolimus induces proteinuria.     

俞根初对《伤寒论》攻下剂的发挥

绍派伤寒创始人俞根初先生法崇仲景,下及温病,其所著《通俗伤寒论》载攻下剂十七方,名承气者十方,暗用承气而另易方名者七方,理法完备,方药翔实。文章对上述十七方作了分类整理,介绍了每一个方的源头与发展以及其背后反映的机体病理生理状态,以期全面呈现俞氏在阳明腑实证治疗方面的丰富经验和临证思路。     

张昱教授运用药对治疗慢性肾炎经验总结

[目的]总结分析张昱教授运用药对治疗慢性肾炎的经验。[方法]通过跟师临证,收集整理临证医案,查阅相关文献资料,总结张师治疗慢性肾炎的常用药对组成、配伍特色以及常用剂量,探讨药对的临床药理机制,并附验案一则加以佐证。[结果]张师认为“虚-风(内风、外风)-瘀-毒”为慢性肾炎的病因病机,临证时以扶正与祛邪为纲,在辨证论治的基础上灵活运用药对组合治疗。对于正气不足者,常用益气固表、健脾益肾等药对扶助正气;属于邪实者,针对风、瘀、毒不同致病因素,分别采用祛风、活血、解毒等药对以祛除邪气。所举医案,患者辨证为气虚血瘀兼风邪热毒,张师治以益气活血、搜风通络、祛风解毒等常用药对,收效甚佳。[结论]张师运用药对组合治疗慢性肾炎,其方药精简,配伍合理,疗效显著,可为临床用药提供新思路。