多索茶碱与氨茶碱改善支气管哮喘患者肺通气指标的临床观察Meta分析

目的采用Meta分析方法系统评价多索茶碱与氨茶碱改善支气管哮喘患者肺通气指标的临床疗效。方法通过检索CNKI、VIP、CBM、万方及Pub Med数据库,收集多索茶碱与氨茶碱治疗支气管哮喘的随机对照试验,采用Rev Man 5.3软件进行Meta分析。结果共纳入文献15篇,累计1378例患者。Meta分析结果显示,多索茶碱改善支气管哮喘患者的一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量(FEV1/FVC)、最大呼气流量(PEF)等肺通气指标的疗效显著优于氨茶碱(P0.01);而在总有效人数方面,也同样显示多索茶碱对于支气管哮喘患者的总体疗效优于氨茶碱(P0.01)。结论多索茶碱改善支气管哮喘患者肺通气指标的临床疗效优于氨茶碱。     

清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘随机平行对照研究

[目的]观察清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘疗效。[方法]使用随机平行对照方法,将78例住院及门诊患者按随机数字表法分为两组。对照组39例氨茶碱,4~6mg/kg,3次/d;沙美特罗替卡松粉吸入剂,50/250ug,1吸/次,2次/d。治疗组39例清热涤痰定喘汤(荆芥、麻黄、黄芩各12g,炙百部、炙冬花、炙金沸草、射干各6g,石膏、法夏各10g,葶苈子、苏子、神曲、山楂、橘红各15g,芦根30g);1剂/d,水煎至300mL,3次/d。痰涎壅盛、苔白腻加复方蛇胆陈皮末;腑气不通加胖大海10g,瓜壳15g;口渴加天花粉15g;舌苔黄腻加滑石15g,木通12g,郁金10g,黄连3g。穴位敷帖:在患者大椎、气海、肺俞等穴位贴敷冬病夏治消喘贴膏,白芥子、细辛各21g,甘遂、元胡各12g,皂角20g,研细末生姜汁调膏敷贴;0.5~2h/次,如皮肤异常,将贴敷时间缩短。每年夏季入伏日期,1次/10d,共贴3次。连续治疗30d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈25例,显效12例,无效2例,总有效率94.87%。对照组痊愈12例,显效16例,无效11例,总有效率71.79%。治疗组疗效优于对照组(P0.05)。[结论]清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘效果显著,值得推广。     

HPLC测定氨茶碱片中的无水茶碱

目的 采用HPLC法测定氨茶碱片中茶碱的含量.方法 采用Shim-pack VP-ODS C_(18)柱(150 mm×4.6 mm,5 μm),流动相为甲醇-0.05 mol·L~(-1)磷酸二氢钾溶液-三乙胺(25:75:0.2),流速1 mL·min~(-1),检测波长271 nm,柱温30 ℃.结果 无水茶碱7.935～79.35 mg·L~(1-)与峰面积的线性关系良好(r=0.9999,n=6),平均回收率为99.2%,RSD=0.5%(n=6).结论 该方法简便、准确、重复性好,可用于氨茶碱片的质量控制.     

纳洛酮与氨茶碱联合治疗早产儿呼吸暂停疗效观察

目的观察纳洛酮与氨茶碱联合应用治疗早产儿呼吸暂停的临床效果。方法22例患儿随机分为两组,治疗组12例在应用纳洛酮的基础上加用氨茶碱,对照组10例单用氨茶碱,两组各用3-5d,观察两组的临床效果。结果纳洛酬与氨茶碱治疗组：显效7例,显效率58％（7／12）;有效4例,有效率33％（4／12）;总有效率92％（11／12）。氨茶碱对照组：显效4例,显效率40％（4／10）;有效3例,有效率30％（3／10）;总有效率70％（7／10）。纳洛酮与氨茶碱治疗组的总有效率显著高于氨茶碱对照组（P〈0．01）。结论氨茶碱和纳洛酮联合应用治疗早产儿呼吸暂停比单用氨茶碱效果好,值得临床推广。     

Propofol and Aminophylline Antagonize Each Other During the Mobilization of Intracellular Calcium in Human Umbilical Vein Endothelial Cells

This study examined whether propofol and aminophylline affect the mobilization of intracellular calcium in human umbilical vein endothelial cells. Intracellular calcium was measured using laser scanning confocal microscopy. Cultured and serum-starved cells on round coverslips were incubated with propofol or aminophylline for 30 min, and then stimulated with lysophosphatidic acid, propofol and aminophylline. The results were expressed as relative fluorescence intensity and fold stimulation. Propofol decreased the concentration of intracellular calcium, whereas aminophylline caused increased mobilization of intracellular calcium in a concentration-dependent manner. Propofol suppressed the lysophosphatidic acid-induced mobilization of intracellular calcium in a concentration-dependent manner. Propofol further prevented the aminophylline-induced increase of intracellular calcium at clinically relevant concentrations. However, aminophylline reversed the inhibitory effect of propofol on the elevation of intracellular calcium by lysophosphatidic acid. Our results suggest that propofol and aminophylline antagonize each other on the mobilization of intracellular calcium in human umbilical vein endothelial cells at clinically relevant concentrations. Serious consideration should be given to how this interaction affects mobilization of intracellular calcium when these two drugs are used together.     

影响魔芋胶骨架片释药体外释放因素的研究

目的 以魔芋胶为骨架材料,考察药物从魔芋胶骨架片中释放的体外释放因素.方法 以氨茶碱为模型药物,采取湿法制粒压片法制备了氨茶碱魔芋胶骨架片,通过对释放度实验研究了释放介质的离子强度,搅拌转速,不同测定方法,释放介质pH值对骨架片释药的影响.结果 桨法测得的平均释放时间(MDT值)和篮法无明显差别;在不同pH值释放介质中,药物的释放以在pH6.8 PBS中最快,蒸馏水中次之,0.1mol/L盐酸液中最慢;药物释放随释放介质离子强度增加而减慢;药物释放随搅拌转速增加而加快,药物释放机制为扩散和溶蚀机制协同作用.结论 魔芋胶能有效的控制骨架片中药物释放,是一种优良的亲水骨架材料.     

氨茶碱血药浓度监测及个体化给药方案设计

目的测定氨茶碱血药浓度，并设计个体化给药方案。方法先用双波长紫外分光光度法测定血药浓度，再根据血药浓度调整用药剂量。结果当血药浓度在有效浓度范围内时，可用稳态时一点法设计给药方案。结论此方法可为临床调整剂量提供依据。     

氨茶碱针与二羟丙茶碱针治疗支气管哮喘疗效比较

目的观察氨茶碱针与二羟丙茶碱针对照治疗支气管哮喘的效果。方法对100例中老年哮喘患者分别使用氨茶碱针与二羟丙茶碱针治疗1h后疗效及3d后疗效、不良反应进行了观察、比较和统计。结果氨茶碱针对哮喘患者的显效时间比二羟丙茶碱针快,不良反应前者比后者多。结论氨茶碱针治疗支气管哮喘优于二羟丙茶碱针,但不良反应较多。临床应用应权衡利弊。     

Toluene exposure increases aminophylline-induced seizure susceptibility in mice

The effects of toluene on the sensitivity to seizures induced by aminophylline were investigated. Mice were pretreated with an ip injection of corn oil or toluene (100-500 mg/kg) followed by a timed intravenous infusion of aminophylline at various time intervals to assess the seizure thresholds and lethal doses. Toluene increased seizure susceptibility to aminophylline in a dose- and time-dependent manner. Toluene-induced enhancement of seizure susceptibility to aminophylline occurred as early as 30 min and persisted for at least 3 days after a single administration of toluene (500 mg/kg). Treatment of benzaldehyde, one of toluene's metabolites, also showed an increase in the susceptibility to aminophylline. The enhancing effect was also observed in caffeine-induced seizures 1 h, but not 1 day after toluene treatment. These results suggest that individuals with toluene exposure may increase the risk for convulsive and even lethal complications associated with the therapeutic use of aminophylline.     

小剂量罗红霉素联合氨茶碱治疗支扩疗效观察

目的 观察长期联合口服小剂量罗红霉素及小剂量氨茶碱对稳定期支气管扩张症患者的临床疗效。方法 41例稳定期支气管扩张症患者随机分为治疗组20例，口服罗红霉素75mg，2次／d，氨茶碱0.1g，2次／d，疗程26周；对照组21例，口服罗红霉素75mg，2次／d，疗程26周。治疗前后行血常规、肝肾功能、细菌培养、肺功能、CT检查，比较2组咯痰量及治疗期间病情加重次数。结果 治疗组与对照组相比较，26周内急性发作次数显著低于对照组（P〈0.05）；24h痰液减少量高于对照组（P〈0．05），第1秒用力肺容积（FEV1）改善绝对值、FEV1／用力肺活量（FVC）及FVC％（FVC占预计值的百分率）的改善差值均高于对照组（P均〈0．05）。结论 长期联合口服小剂量罗红霉素及小剂量氨茶碱治疗稳定期支气管扩张症较单纯口服小剂量罗红霉素效果更佳，