中药内外同治痛风性关节炎的临床研究

目的：观察四妙丸内服、痹痛膏外用治疗痛风性关节炎的临床疗效。方法：将60例痛风患者随机分为两组．对照组内服西药别嘌醇片、碳酸氢钠片,青鹏膏外用;治疗组内服四妙丸、外用痹痛膏治疗。结果：两组临床治疗结果及疗效比较．差异无统计学意义（P〉0．05）。两组均能明显降低血尿酸、血沉和超敏的C反应蛋白水平（P〈0．05）,但治疗组与对照组比较有显著性差异（P〈0．05）,两组均能改善患者主要关节症状,但治疗组与对照组比较有显著性性差异（P〈0．05）。结论：中药内外同治痛风性关节炎疗效显著。     

Women’s ability to self-screen for contraindications to combined oral contraceptive pills in Tanzanian drug shops

Objective

To estimate the accuracy of self-screening for contraindications to combined oral contraceptive pills (COCs) and to estimate the proportion of women with contraindications to hormonal methods among those using drug shops in Tanzania.

Methods

Trained nurses interviewed 1651 women aged 18–39 years who self-screened for contraindications to COCs with the help of a poster at drug shops in Tanzania. Nurse assessment of the women served as the gold standard for comparison with self-assessment. Blood pressure was also measured onsite.

Results

Nurses reported that 437 (26.5%) women were not eligible to use COCs, compared with 485 (29.4%) according to self-report. Overall, 133 (8.1%) women who said that they were eligible were deemed ineligible by nurses. The rate of ineligibility was artificially high owing to participant and nurse assessments that were incorrectly based on adverse effects of pill use and cultural reasons, and because of the sampling procedure, which intercepted women regardless of their reasons for visiting the drug shop. Adjusted rates of ineligibility were 8.6% and 12.7%, respectively, according to nurse and participant assessment. Both nurses and women underestimated the prevalence of hypertension in the present group.

Conclusion

Self-screening among women in rural and peri-urban Tanzania with regard to contraindications to COC use was comparable to assessment by trained nurses.     

Oral contraceptive pills for endometriosis after conservative surgery: a systematic review and meta-analysis

Abstract

To assess the effects of oral contraceptive pills (OCPs) for endometriosis in women after conservative surgery, we performed a search of PubMed, Embase, ISI Web of Science, Cochrane Library, Scidirect, Chinese VIP, CNKI and WANGFANG database. Randomized controlled trials (RCTs) of OCPs in postoperative medical therapy for endometriosis were collected. Articles published as of January 2013 with no language restriction were identified using defined keywords, and 15 studies comprising 1850 patients were included. There was a significantly higher rate of total endometriosis remission [OR?=?2.55, 95% CI (1.68, 3.86), p?<?0.00001] and a lower rate of recurrence [OR?=?0.31, 95% CI (0.22, 0.45), p?<?0.00001] in the OCPs group compared with surgery alone. There appears to be no statistical difference in pregnancy rates between the OCPs group as compared with surgery alone or other hormonal drug treatments in infertility patients. As for the rate of recurrence and complete remission, there were no statistical differences among OCPs and gestrinone, mifepristone or GnRH-a groups. However, OCPs users had less side effects that were more mild as compared with patients using other hormonal treatments.     

正交试验优选制萎扶胃浓缩丸的水提工艺*

目的：优选制萎扶胃浓缩丸最佳水提工艺条件。方法：以干浸膏、枸橼酸含量为评价指标,以煎煮次数、加水量、煎煮时间为考察因素,采用正交试验法对制萎扶胃浓缩丸的水提取工艺进行优选。结果：最佳水提取工艺为：煎煮2次,加水量为8倍量,煎煮时间为2.0、1.5 h。结论：该优选工艺合理可行,适用于工业大生产。     

丹参酮固体分散体滴丸的制备工艺优选

目的:优选丹参酮固体分散体滴丸的制备工艺。方法:选取药物与辅料的比例、熔融温度,聚乙二醇(PEG)4000-PEG6000比例,增溶剂种类为考察因素,以总丹参酮的溶出度为指标,采用正交设计优选丹参酮固体分散体的制备工艺;采用差示扫描量热分析(DSC),X-ray衍射、红外光谱分析固体分散体中药物的存在状态。同时对丹参酮固体分散体滴丸剂的制备工艺参数进行优化。结果:固体分散体制备工艺的最佳条件为药辅比1∶5,温度70℃,PEG4000-PEG6000 1∶1,增溶剂为泊洛沙姆;经DSC,X-ray和IR分析,证明药物以分子状态分散,形成的固体分散体为填充型固态溶液;滴丸制备工艺的最佳条件是冷凝剂为1 000 cs二甲基硅油,温度20℃,滴距4 cm,滴速30～40 d.min-1,制备的丹参酮滴丸平均累积溶出度85%。结论:制备的丹参酮固体分散体可显著提高丹参酮的体外溶出度,制备的丹参酮滴丸能够达到速释的要求。     

鹿茸健骨滴丸对骨质疏松症大鼠肾组织TRPV5表达的影响

目的: 通过观察鹿茸健骨滴丸对糖皮质激素性骨质疏松症(GIO)大鼠股骨骨密度(BMD)及肾组织钙转运通路蛋白(TRPV5) mRNA和蛋白表达的影响,探讨GIO的病理机制及鹿茸健骨滴丸的疗效。 方法: 将82只Wistar大鼠随机分为正常对照组(A组)、模型组(B组)、鹿茸健骨滴丸组(C组) 及骨疏康组(D组)。采用后肢肌注地塞米松(2.5 mg·kg^-1,每周2次)造模,造模同时,C,D 组分别按0.88, 2.1 g·kg^-1·d^-1 剂量ig给药,造模及给药9周后,应用XR-26型双能X射线骨密度仪测定BMD,采用实时定量PCR法及Western blot法测定肾组织TRPV5 mRNA和蛋白表达。 结果: 与正常组比较,模型组大鼠BMD明显降低(P<0.01),肾组织TRPV5 mRNA与蛋白表达均明显下降(P<0.01);与模型组比较,鹿茸健骨滴丸组BMD明显升高(P<0.01),TRPV5 mRNA与蛋白表达亦明显上调(P<0.01)。 结论: 地塞米松对肾钙转运过程产生抑制作用,是其诱发GIO的重要病理机制之一,鹿茸健骨滴丸通过上调肾组织TRPV5 mRNA与蛋白表达而促进肾钙重吸收,达到治疗GIO的作用。     

养心安神丸的质量标准

目的: 建立养心安神丸的质量标准。 方法: 采用TLC对养心安神丸中的五味子、丹参、首乌藤进行定性鉴别;采用HPLC测定五味子甲素和五味子乙素的含量。 结果: 养心安神丸中五味子、丹参、首乌藤的的薄层色谱鉴别斑点清晰,分离较好。五味子甲素在0.242~4.84 μg呈良好的线性关系(r=0.999 2),平均回收率为98.48% (RSD 1.03%);五味子乙素在0.110~2.21 μg呈良好的线性关系(r=0.999 4),平均回收率为97.10% (RSD 1.03%)。 结论: 建立的质量标准简便可行,可用于养心安神丸的质量控制。     

中药滴丸剂研究概况

利用固体分散技术新原理制备的中药滴丸剂现已成为一种有发展前途的中药新剂型。该剂型以中医、中药学为理论基础,辅以现代剂型新技术,并与其他制剂技术相结合,经过精制、富集有效成分或有效部位制备而成,其成分明确,质量易于控制、提高药物生物利用度。随着近年来滴丸相关辅料和制备工艺研究的不断深入和发展,在临床应用中逐渐显示出其优势,并表现出其他传统中药剂型所不具备的一些优点。与传统中药制剂相比避免了传统中药生物利用度低、服用不方便、起效慢的缺点,同时发扬了传统中药毒副作用小、安全性好、不良反应少等优点。更接近中药现代化要求。中药滴丸剂这一优良剂型得到了更为广泛的应用。     

毛细管电泳法同时测定清肺抑火丸中盐酸小檗碱、盐酸黄柏碱、苦参碱含量

目的:建立同时测定清肺抑火丸中盐酸小檗碱、盐酸黄柏碱、苦参碱含量的毛细管电泳法.方法:以盐酸伪麻黄碱为内标,采用未涂层弹性融硅石英毛细管柱(75 μm×55 cm,有效长度47 cm),运行缓冲液100 mmol·L-1磷酸二氢钠溶液+40％乙醇(pH 5.75),分离电压23 kV,重力进样15 s(高度15 cm),检测波长208 nm.结果:盐酸小檗碱、盐酸黄柏碱、苦参碱分别在40.5～81.0,0.896～3.584,6.0～36.0 mg·L-1线性关系良好,回收率分别为96.0％,100.5％,97.8％,RSD均＜1.85％.结论:该方法专属性强、结果准确可靠、重复性好,可用于清肺抑火丸的质量控制.     

疏肝健脾丸治疗慢性乙型肝炎肝郁脾虚证的疗效观察

目的：观察应用自拟中药方“疏肝健脾丸”治疗慢性乙型肝炎肝郁脾虚证的临床疗效。方法：选取我院收治的50例慢性乙型肝炎患者作为研究对象,按照随机数字表法随机分为治疗组与对照组各25例,治疗组给予自拟中药方“疏肝健脾丸”治疗,对照组给予拉米夫定（LAM）治疗,以连续治疗6个月为1个疗程,疗程结束后随访3个月,比较两组患者的临床疗效。结果：治疗组总有效率、ALT、AST、胁痛、纳差及乏力均较对照组改善明显（P<0.01）,具有统计学意义。结论：应用自拟中药方“疏肝健脾丸”治疗慢性乙型肝炎肝郁脾虚证效果理想,值得推广应用。