芳竭丸活血化瘀作用的实验研究

目的对中药新药芳竭丸的活血化瘀作用进行研究。方法采用在冰水中游泳和SC注射肾上腺素方法制造大鼠急性血瘀模型,观察芳竭丸对血液流变性的影响;用肾上腺素制造大鼠肠系膜急性微循环障碍模型,观察芳竭丸对微循环障碍的改善作用;采用体外法,用PT和KPTT试剂盒测定血液凝固时间,观察芳竭丸对凝血酶原时间（PT）及活化部分凝血活酶时间（KPTT）的影响。结果芳竭丸能明显降低大鼠的全血黏度、血浆黏度、血纤维蛋白原含量、血沉及血小板黏附率,减轻血瘀大鼠血液的黏、凝状态,防止血栓形成;可抑制肾上腺素引起的大鼠肠系膜微循环细动脉管径缩小、流速减慢、毛细血管开放量减少、流态改变,并改善这些现象;可显著延长家兔的PT、KPTT。结论芳竭丸有改善血液流变性及微循环障碍的作用,有抑制内源性及外源性凝血系统的作用,提示有活血化瘀作用。     

雷公藤多甙及雌孕激素治疗对大鼠卵巢Bcl-2和Bax表达的实验研究

目的探讨雷公藤多甙（TWP）致雌性大鼠生殖系统损害机制及防治方法。方法取50只SD雌性大鼠随机分为对照组,雌孕激素干预组（干预组）,雌孕激素治疗组（治疗组）,恢复组和雷公藤组。运用放免法测定血清性激素水平的变化,HE染色观察卵巢组织变化,免疫组化染色法检测卵巢组织颗粒细胞凋亡蛋白Bcl-2和Bax的表达水平。结果与对照组相比,雷公藤组和恢复组大鼠血清黄体生成素（LH）和卵泡刺激素（FSH）水平明显升高,雌激素（E2）的分泌明显下降,且差异有统计学意义（P值均〈0．05）;卵巢组织明显受损,各级卵泡明显减少,卵泡闭锁较多,干预组各指标则无明显改变;大鼠颗粒细胞凋亡蛋白Bcb2的表达在雷公藤组明显低于对照组,而干预组及治疗组均高于雷公藤组;Bax蛋白在各组的表达则相反（P〈0．01）,其中干预组与对照组无明显差异（P〉0．05）。结论TWP可致雌性大鼠生殖系统的损害,雌孕激素替代治疗对卵巢功能有较好的保护作用,其机制可能与Bcl-2蛋白表达上调以及Bax表达下凋有关。     

Synovitis,acne, pustulosis,hyperostosis, osteitis syndrome with invisible organizing pneumonia: A case report

We report the case of a 59-year-old female patient, presenting with pustular rash on both hands and pain in the lumbosacral part and left lower limb. A magnetic resonance imaging examination of the left leg was undertaken and the result showed that a malignant lesion with bone destruction of the left femoral shaft could not be excluded. Subsequently, bone tumor was excluded by pathological examination. Lung computed tomography scan showed patchy consolidation and cord shadow in the middle left lung. Subsequently, lung cancer was excluded by pathological examination, and the histopathological changes of lung were consistent with those of organized pneumonia. Blood tests revealed elevated C-reactive protein and erythrocyte sedimentation rate. Antinuclear antibody, rheumatoid factor, and human leukocyte antigen-B27 were unremarkable. Whole body bone scintigraphy via technetium 99m-methyl diphosphonate showed increased radionuclide uptake in the left middle femur. Based on her clinical manifestations, imaging results and bone scintigraphy, the patient was diagnosed as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome. Loxoprofen and Tripterygium wilfordii Hook F led to impressive clinical and radiologic improvement.     

昆明山海棠在治疗原发性肾小球疾病中的应用

本文对56例原发性肾小球疾病患者,随机分为昆明山海棠(山海棠)加小剂量激素治疗组及常规剂量激素、免疫抑制剂对照组两组进行观察。结果示两组疗效相近(P>0.05),而复发及药物副作用,治疗组较对照组明显减少(P<0.05,P<0.005)。初步提示山海棠对治疗原发性肾小球疾病是一有希望的药物。     

矿泉浴与雷公藤多甙治疗类风湿性关节炎对比观察

采用矿泉浸浴与雷公藤多甙治疗类风湿性关节炎８６例，观察疼痛及压痛关节数、肿胀关节数、握力、１５米步行时间、晨僵时间、血沉及类风湿因子等。经统计学处理，两组患者治疗前后的变化差异均有显著性或非常显著性，但两组疗效差异无显著性。矿泉浸浴组症状开始改善的平均时间早于雷公藤多甙组，且副作用明显少而轻微。     

雷公藤多苷联合醋酸泼尼松治疗中度活动型系统性红斑狼疮的疗效观察

目的探讨雷公藤多苷治疗中度活动型系统性红斑狼疮的疗效和安全性。方法 79例中度活动型系统性红斑狼疮患者随机分为观察组40例和对照组39例,在应用醋酸泼尼松基础上,观察组给予雷公藤多苷20mg/次,3次/d,口服;对照组给予甲氨蝶呤10mg/次,1次/周,口服。治疗6个月后评定2组疗效及不良反应发生情况,并比较2组治疗前、后24h尿蛋白、补体C3、系统性红斑狼疮疾病活动度（systemic lupus erythematosus disease activity index,SLEDAI）评分。结果观察组总有效率（87.5%）高于对照组（66.7%）（P〈0.05）;观察组治疗后24h尿蛋白、补体C3、SLEDAI评分分别为（0.65±0.12）g、（0.81±0.55）g/L、4.87±1.92,对照组分别为（0.97±0.39）g、（0.79±0.22）g/L、5.29±2.10,与治疗前（（2.16±0.36）g,（0.48±0.37）g/L,12.8±4.15;（2.08±0.21）g,（0.49±0.26）g/L,12.6±5.01）比较差异均有统计学意义（P〈0.05）;观察组治疗后24h尿蛋白水平低于对照组（P〈0.05）;观察组月经紊乱发生率（20.00%）高于对照组（2.56%）（P〈0.05）,恶心呕吐、上呼吸道感染等不良反应发生率比较差异均无统计学意义（P〉0.05）。结论醋酸泼尼松联合雷公藤多苷治疗中度活动型系统性红斑狼疮疗效优于联合甲氨蝶呤,且不良反应轻。     

正交试验优选雷公藤药材生物碱的提取工艺

目的：建立雷公藤药材生物碱的最佳提取工艺.方法：以雷公藤总生物碱、雷公藤吉碱、雷公藤次碱和浸膏得率为指标,采用正交设计优选提取工艺参数.结果：最佳工艺条件：药材提取前浸泡1h,分别用12、10倍量的80％乙醇回流提取2次,每次1h,调pH为4.结论：此工艺合理可行,适用于雷公藤药材生物碱的提取.     

雷公藤多苷片治疗临床蛋白尿期糖尿病肾病的疗效与安全性

目的：观察分析雷公藤多苷片治疗临床蛋白尿期糖尿病肾病的疗效与安全性。方法对江西省泰和县人民医院收治的76例处于临床蛋白尿期糖尿病肾病患者,按照治疗方法的不同划分为2组,对照组42例接受科素亚治疗,观察组34例接受雷公藤多苷片治疗,对比观察2组治疗效果。结果76例患者中,观察组治疗总有效率为94.1%,对照组治疗总有效率为76.2%,差异有统计学意义（P〈0.05）,2组均无明显不良反应,观察组患者的复发率（2.9%）显著低于对照组（21.4%）,差异有统计学意义（P〈0.05）。结论采用雷公藤多苷片治疗临床蛋白尿期糖尿病肾病,疗效显著,安全可靠,值得应用推广于临床治疗中。     

Molecular mechanism of reproductive toxicity induced by Tripterygium Wilfordii based on network pharmacology

To explore the possible molecular mechanism of reproductive toxicity of Tripterygium wilfordii from the perspective of network pharmacology and bioinformatics.The compounds of T wilfordii were obtained by querying the relevant Chinese medicine database, the effective compounds were screened and the corresponding targets were obtained, and then compared with the reproductive toxicities related to disease targets obtained from the disease gene database to infer the potential toxic targets of reproductive toxicity of T wilfordii. Then, the key targets of reproductive toxicity of T wilfordii were screened using Search Tool for the Retrieval of Interacting Genes/Protein and Cytoscape. The gene ontology function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as module analysis, were performed on the key targets using Database for Annotation, Visualization, and Integrated Discovery and Cytoscape, respectively. Finally, the network between effective compounds-toxic targets was conducted to see how the compounds interacted.A total of 48 effective compounds and 482 potential toxic targets related to the reproductive toxicity of T wilfordii were screened. The enrichment analysis results showed that the key targets were mainly enriched in biological processes such as response to drug, ionotropic glutamate receptor signaling pathway, and KEGG pathways such as neuroactive ligand-receptor interaction, cAMP signaling pathway. In the protein-protein interaction network of potential toxic targets, there were 78 key targets such as TP53, INS, IL6, AGT, ADCY3, and so on. Enrichment analysis of the top module with 19 genes from module analysis indicated that T wilfordii might cause reproductive toxicity by gene ontology terms and KEGG pathways such as regulation of vasoconstriction, G-protein coupled receptor signaling pathway, inflammatory response, cAMP signaling pathway, and so on. In the network between effective compounds of T wilfordii and key targets, there were 5 compounds with high degree including Tingenone, Wilfordic Acid, Abruslactone A, Nobilin, and Wilforlide B.The complex molecular mechanism of reproductive toxicity of T wilfordii can be preliminarily elucidated with the help of the network pharmacology method, and the analysis results can provide some reference for the further mechanism research of reproductive toxicity of T wilfordii.     

血塞通联合雷公藤多苷治疗糖尿病肾病的疗效观察

目的探讨血塞通联合雷公藤多苷治疗糖尿病肾病（DN）的疗效及安全性。方法选择早期DN（Ⅲ期以前DN）患者80例,按确诊先后顺序分为治疗组和对照组各加例。对照组常规予积极调控血糖、血压、血脂、体重,同时121服雷公藤多苷治疗。治疗组在上述基础上加用血塞通注射剂治疗。观察两组患者治疗前后尿白蛋白排泄率（UAE）、血清胱抑素C（CysC）、肾小球滤过率（GFR）等变化。结果两组治疗后组间比较,治疗组UAE低于对照组,差异有统计学意义（P〈0．05）;治疗组CysC高于对照组,Cys—eGFR（Mac）低于对照组,但差异元统计学意义（P〉0．05）;两组UAE及CysC均呈下降趋势,但治疗组下降幅度较对照组明显,差异有统计学意义（P〈0．05）;两组Cys—eGFR（Mac）均升高,但增高幅度差异无统计学意义（P〉0．05）。结论在常规使用雷公藤多苷治疗的基础上,加用血塞通治疗早期DN疗效更佳。治疗中未见不良反应,安全性好,适合临床应用。