山莨菪碱治疗麻醉剂依赖性

阿片成瘾者２５０例（男性２２２例，女性２８例，年龄３０±ｓ５ａ）应用山莨菪碱０．５－２ｍｇ／（ｋｇ·ｄ），分２－３次加入１０％葡萄糖２５０ｍＬ或５％葡萄糖生理盐水５００ｍＬ静脉滴注；东莨菪碱０．０２－０．０３ｍｇ／ｋｇ加入１０％葡萄糖２５０ｍＬ静脉滴注１次，必要时对重患者追加１次，疗程５－７ｄ。结果戒断症状均有改善（Ｐ＜０．０１），２７例需加用羟丁酸钠。不良反应轻，可作为阿片瘾者的脱瘾药物。＊Ｐ＜０．０１。碱确能解除阿片药物戒断症状。其对阿片戒断症状缓解时间在治疗４－５ｄ后，强烈觅药渴求也随之逐渐消失。１５０例（６０％）要求进食，１７５例（７０％）仍需借助安眠药睡眠。另６５例（２６％）戒断症状阵发性发作，每次持续０．５－１ｈ，症状轻重不一，轻者流泪、全身弥漫性疼痛，重者焦躁不安、心中猫抓虫咬样难受，甚至想自残，可配合艾司唑仑３－４ｍｇ／ｄ，ｐｏ或氯硝西泮６－１０ｍｇ／ｄ，ｐｏ；也可用氯硝西泮１－２ｍｇ／次，ｉｍ，每日２－３次；针刺胃俞、脾俞、中脘、足三里、印堂、太阳、百会、内关、合谷、命门、夹脊和肾俞穴位，根据临床症状任选其中３－５个穴位进行治疗或心理治疗能快速减轻患者戒断症状。治程中２７例（１０．８％）重?     

山莨菪碱抗脂质过氧化的研究

以红细胞为对象，研究了山莨菪碱对外加Ｈ２Ｏ２及氧自由基发生系统的抗氧化作用，结果山莨菪碱可防止Ｈ２Ｏ２诱导的溶血；抑制氧自由基发生系统引起的脂质过氧化物增加，增加红细胞膜的流动性。提示山莨菪碱抗氧化作用是在膜水平上抗氧自由基引发的膜脂质过氧化，保护细胞膜。     

山莨菪碱对肾移植术后并发症的治疗

目的：研究山莨菪碱对移植肾术后并发症的治疗作用。方法：肾移植术后３２人。术后１４人未发生少尿时ｉｖ山莨菪碱４７±ｓ１２（３０～６０）ｍｇ／ｄ，连续给药７．１±２．９ｄ（４～１０ｄ）（预防组）。术后１８人出现少尿时ｉｖ山莨菪碱９１±２７（６０～１２０）ｍｇ／ｄ、呋塞米与免疫抑制剂（治疗组）。结果：预防组多尿期缩短１～３ｄ，２４ｈ尿量明显少于治疗组，血肌酐达正常值较治疗组提前１．５ｄ，无继发少尿或无尿。治疗组亦全部恢复正常，肾功能达显效所需时间为２．５±１．０ｄ（１～４ｄ）。结论：山莨菪碱具有改善和保护移植肾功能，预防和治疗移植肾术后出现的少尿或无尿的作用。     

Effect of anisodamine on changes of blood-brain barrier permeability following brain injury in rabbits

The changes of blood-brain barrier(BBB)permeability following brain injury werestudied quantitatively by using colloidal gold(CG)particles of various sizes as tracers in 57 rab-bits.In addition,water content in brain tissues was determined.The brain-injured rabbits re-ceived intravenous injection of anisodamine in a dose of 0.3 mg/kg BW at 5rain or 3h after braininjury,and the effect of anisodamine on aherations of BBB permeability and water content of thebrain tissue after brain injury was investigated.The results indicated that an increase of BBBpermeability began at 30min after injury with only a few of 5nm CG tracers present in the endo-cytic pits and endothelial microvilli,and there were 10nm CG tracers passing through the BBB at3 h after brain injury.The increase of BBB permeability reached its peak at 6 h after brain in-jury.More 15nm CG tracers penetrated the BBB by way of pinocytotic vesicule transportationand opening of tight junctions between endothelial cells.The water content in the brain tissueincreased,which was closely correlated to the above-mentioned EBB permeability and giving ad-vantages to the treatment of traumatic brain edema in the present study.     

胸腺移植和654—2治疗难治性癫痫的研究

采用胸腺移植和654—2治疗小儿难治性癫痫45例,总有效率达91.1％,明显高于对照组45.2％(P<0.01)。癫痫患儿T细胞亚群测定与对照组比较显示CD_3、CD_4、CD_4/CD_8明显降低(P<0.01),表明癫痫患儿存在细胞免疫功能异常。胸腺移植和654—2治疗后与治疗前比较CD_3、CD_4、CD_4/CD_8明显升高(P<0.01)可达正常水平,表明其能明显改善癫痫患儿的免疫功能。抗癫痫药物治疗前后各免疫学指标无明显改变,甚至降低,表明抗癫痫药物对患儿T细胞亚群变化无明显影响。     

胎儿宫内发育迟缓模型孕鼠血浆TXA_2／PGI_2的比值及青心酮、山莨菪碱的效

健康Ｓｐｒａｇｕｅ－Ｄａｗｌｅｙ种妊娠大鼠１０２只，均于妊娠第４天～第２０天仿Ｙｏｕｎｏｓｚａｉ法制备胎儿宫内发育迟缓模型．随机分成对照组、模型组、氨基酸组、青心酮组和山莨菪碱组，各组按规定给药，观察有关指标．结果表明：模型组胎仔发育明显迟缓，血红蛋白和红细胞压积水平升高，血栓素Ｂ_２／６－酮基－ＰＧＦ_（１α）（ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α））比值明显高于对照组．以上指标在青心酮组和山莨菪碱组得到明显改善，收到一定疗效．     

Effect of intracoronary administration of anisodamine on slow reflow phenomenon following primary percutaneous coronary intervention in patients with acute myocardial infarction

Background Many basic and clinical studies have proved that anisodamine can produce significant effect on relieving microvascular spasm, improving and dredging the coronary microcirculation. It may be beneficial to the improvement of slow-reflow phenomenon (SRP) following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). So we investigated the effect of intracoronary administration of anisodamine on SRP of infarct related artery (IRA) following primary PCI in patients with ST segment elevated acute myocardial infarction (STEAMI). Methods Twenty-one patients with SRP from a total of 148 STEAMI patients accepted primary PCI were enrolled into this study from September 2004 to December 2005. When SRP happened, nitroglycerin (200 &micro;g) was “bolus” injected firstly into IRA to exclude the spasm of epicardial artery and identify SRP as well as a baseline and self-control agent following PCI. Ten minutes later, 1000 &micro;g of anisodamine was injected into IRA with SRP at 200 &micro;g/s, while the coronary angiography (CAG) was taken before and at 1st, 3rd and 10th minute after administration of nitroglycerin or anisodamine, respectively. The corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG) and the diameter of IRA were calculated and analyzed by Gibson’s TIMI frame count method using quantitative computer angiography (QCA) system to evaluate the influence of anisodamine on coronary flow and vessel lumen. In the meantime the invasive hemodynamic parameters of intracoronary and systemic artery (systolic, diastolic and mean pressure) and electrocardiogram (ECG) were measured and monitored. The changes of ventricular performance parameters and the adverse reaction were evaluated and followed-up at 1 month post-PCI. Results No significant changes in cTFCs and TMPGs were found at 1st, 3rd and 10th minute after intracoronary administration of nitroglycerin as compared with the baseline control (P＞0.05). cTFCs were decreased by 58.3%, 56.2%, and 54.6%, respectively (P&lt;0.001), and TMPGs were increased from 1.13±0.21 grade to 2.03±0.32, 2.65±0.45 and 2.51±0.57 grades (P&lt;0.05) at 1st, 3rd and 10th minute after intracoronary administration of anisodamine as compared with those after intracoronary administration of nitroglycerine, respectively. The average coronary blood flow of TIMI grade was improved from 1.76±0.43 to 2.71±0.46 (P&lt;0.05) while the diameter of middle segment in re-patented coronary artery was slightly increased from (3.20±0.40) mm to (3.40±0.50) mm at the 3rd minute after intracoronary administration of anisodamine (P＞0.05) as compared with those of nitroglycerine control. The systolic, diastolic and mean pressures of intracoronary artery after intracoronary administration of anisodamine increased from 115 to 123, 75 to 84, 88 to 95 mmHg (P&lt;0.05), respectively, along with the rise of heart rate from 68 to 84 beats per minute (P&lt;0.05). There were no significant changes in intervals of PR, QT and QRS (P＞0.05) and no any severe fast arrhythmia after intracoronary administration of anisodamine. The ventricular performance parameters were significantly improved and no major adverse cardiovascular events (MACE) were found during follow-up at 1 month post-PCI. Conclusions Intracoronary administration of 1000 &micro;g anisodamine is effictive in reversing SRP following PCI in STEAMI patients, especially it is suitable for SRP patients with bradycardia or hypotension.     

灯盏花素联合山莨菪碱治疗椎-基底动脉供血不足的疗效分析

目的观察灯盏花素联合山莨菪碱治疗椎-基底动脉供血不足所引起的发作性眩晕等症状的缓解情况。方法治疗组51例给予灯盏花素联合山莨菪碱，对照组38例给予灯盏花素。结果治疗组在用药3d后总有效率为76．5％，对照组总有效率为55．3％，有显著性差异（P〈0．05）。结论灯盏花素联合山莨菪碱治疗椎一基底动脉供血不足时，在起效时间上显著优于单用灯盏花素，且副作用少，该方法值得推广。     

山莨菪碱对耳蜗辐射防护作用的动物实验研究

目的研究山莨菪碱对耳蜗辐射损伤的防护作用。方法健康豚鼠25只随机分成三组：对照组、单纯放射组和山莨菪碱防护组，每组观察10耳。放疗前30分钟，按每公斤体重20mg于山莨菪碱防护组豚鼠的股部肌肉注射山莨菪碱，对照组和单放组在上述部位注射等量生理盐水。用直线加速器所产生的6Mev电子线对山莨菪碱防护组和单纯放射组豚鼠的耳颞部予以分次照射，总剂量达到60Gy后作耳蜗毛细胞的光镜及扫描电镜观察。结果耳蜗基底膜铺片表明对照组照射耳耳蜗内外毛细胞排列整齐无缺如，单纯放疗组照射耳耳蜗外毛细胞有大量缺如，内毛细胞有少许缺如，山莨菪碱防护组照射耳耳蜗外毛细胞少许缺如，内毛细胞无缺如；扫描电镜表明对照组照射耳耳蜗外毛细胞的纤毛排列整齐无倒伏、缺失，单纯放疗组照射耳耳蜗外毛细胞的纤毛明显倒伏、缺失、排列紊乱，山莨菪碱防护组照射耳耳蜗外毛细胞的纤毛排列基本整齐，偶见倒伏现象。结论①分割剂量60Gy对豚鼠耳颞部照射可造成耳蜗毛细胞损害，②山莨菪碱对耳蜗辐射损伤具有保护作用。     

中西医结合治疗肺痨咯血72例临床观察

目的观察中西医结合治疗肺痨咯血的疗效.方法将肺痨咯血患者属肺阴亏损证者138例随机分成两组.治疗组72例用抗痨 中药(月华化血丹) 山莨菪碱治疗;对照组66例用抗痨 止血药(对羧基苄胺、安特诺新)治疗,观察比较其疗效.结果止血疗效治疗组总有效率为95.83%,对照组为75.76%,治疗组优于对照组(P＜0.001).肺痨治愈率中初治涂阳治愈率治疗组为98.1%,对照组为83.3%,治疗组优于对照组(P＜0.01).结论中西医结合治疗肺痨咯血见效快、疗效确切.