IgA肾病血瘀证与临床病理的相关性研究

目的探讨IgA肾病血瘀证与临床病理指标之间的相关性。方法分析94例IgA肾病血瘀证患者的临床与病理资料：、结果94例IgA肾病患者中,血瘀证占61．70％,非血瘀证占38．30％。血瘀证组中医宏观辨证以舌质紫暗最常见;临床多表现为蛋白尿伴血尿,常伴高血压和肾功能不全;血肌酐、甘油三酯、血纤维蛋白原水平明显高于非血瘀证组,活化部分凝血活酶时间、尿型纤溶酶原激活物水平明显低于非血瘀证组;Lee’s分级多见于Ⅲ～Ⅴ级者;肾小球球性硬化、肾小管间质总积分、间质炎细胞浸润、间质纤维化、肾小管萎缩和血管积分均显著高于非血瘀证组。结论IgA肾病血瘀证与临床指标及肾组织病变程度有关,中医宏观辨证与现代医学微观辨证相结合更有利于揭示IgA肾病血瘀证的实质。     

中西医结合治疗早期糖尿病肾病的临床研究

目的：观察中西医结合治疗早期糖尿病肾病患者的临床疗效。方法：观察30例早期糖尿病肾病患者服用麦地消渴汤联合降糖药3个月后，血糖、糖化血红蛋白、血脂、尿微量白蛋白的变化。结果：中药麦地消渴汤具有较好的降低血糖、稳定糖化血红蛋白、调节血脂、降低尿微量白蛋白的作用。结论：中药麦地消渴汤具有保护肾功能，延缓早期糖尿病肾病进展的作用。     

中药外洗联合前列腺素E1治疗糖尿病下肢动脉硬化闭塞症48例

目的观察中药外洗联合前列腺素E。（PGE。）治疗糖尿病下肢动脉硬化闭塞症的疗效。方法选择48例糖尿病合并下肢动脉硬化闭塞症的住院患者为治疗组，用中药汤剂外洗联合前列腺素E。静点治疗2个疗程。另选40例为对照组，单纯前列腺素E1（PGE，）治疗2个疗程。观察两组治疗前后症状和下肢动脉超声多普勒血流动力学指标。结果治疗组有效率91、67％。对照组有效率77．5％。（X^2=5．005，P〈0．05），下肢动脉超声多普勒血流动力学指标明显改善（P〈0.01或P〈0.05）。下肢超声强回声团短径与收缩压呈正相关，狭窄口血流速度与血红蛋白值呈正相关。结论中药外洗联合PGE1较单纯PGE1疗效好，能改善糖尿病合并下肢动脉硬化闭塞症症状和下肢动脉超声多普勒血流动力学指标。     

麦地消渴汤治疗早期糖尿病肾病的临床研究

目的:麦地消渴汤联合降糖药对早期糖尿病肾病的疗效观察:方法:观察15例早期糖尿病肾病患者服用麦地消渴汤联合降糖药3个月后,血糖、糖化血红蛋白、血脂、尿微量白蛋白的变化;结果:麦地消渴汤具有较好的降低血糖、稳定糖化血红蛋白、调节血脂、降低尿微量白蛋白的作用;结论:麦地消渴汤具有保护肾功能、延缓早期糖尿病肾病进展的作用.     

脂多糖对人类风湿性关节炎滑膜细胞基质金属蛋白酶-9表达的影响

目的 研究脂多糖（LPS）对人类风湿性关节炎（RA）成纤维状滑膜细胞(FLS)基质金属蛋白酶-9（MMP-9）表达的影响。方法 明胶酶谱法测定MMP-9酶活性；Western blot法测定MMP-9蛋白的表达；RT-PCR法测定MMP-9 mRNA的表达。结果 LPS处理对FLS中MMP-9表达无显著影响；LPS刺激的U937细胞培养上清液可明显增强FLS 中MMP-9酶活性、蛋白分泌及mRNA表达；地塞米松可显著抑制上述变化，且其抑制作用随浓度的增加而增强。结论 LPS对FLS中MMP-9表达无直接影响，LPS刺激的U937细胞上清液使FLS中MMP-9表达增加，而地塞米松能抑制MMP-9的变化。     

Assessment of the clinical effect of Chinese medicine therapy combined with psychological intervention for treatment of patients of peri-menopausal syndrome complicated with hyperlipidemia

<正>Objective:To observe the effect of Chinese medicine therapy combined with psychological intervention(combined therapy) on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia.Methods:With the use of a randomizing digital table method,185 patients that fit the registration standard were randomly assigned to three groups.The 59 cases in Group A were treated with two Chinese patents,Kunbao Pill(坤宝丸) and Modified Xiaoyao Pill(加味逍遥丸);the 63 in Group B received psychological intervention alone;and the 63 in Group C were treated with both(the combined therapy),with the treatment course for all six months.The items of observation included: (1) scoring by SCL-90 on eight factors and seven symptoms;(2) scoring on Chinese medicine symptoms by Kupermann scale,including anxiety and bad temper,scorching sense ation with sweating,dizziness,tinnitus, soreness and weakness of the loin and knees,palpitation,insomnia,lassitude,weakness,and hyposexuality; (3) blood contents of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C),apoprotein Al(ApoAl) and B(ApoB);(4) levels of sex hormones, including estradiol(E_2),progesterone(P),pituitary prolactin(PRL),follicular stimulating hormone(FSH),and luteinzing hormone(LH) in some randomly selected patients;(5) adverse reaction;and(6) one-year follow-up study on long-term effect.Results:A total of 21 patients(6,8,and 7 cases in Groups A,B,and C,respectively) dropped out;the drop-out rate was insignificant among groups.(1) The markedly effective rates in Group A, B,and C were 26.42%(14/53),18.18%(10/55),and 53.57%(30/56),respectively,and the total effective rates in them were 64.15%(34/53),50.91%(28/55),and 87.50%(49/56),respectively,suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B(P0.01).(2) SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C(P0.01),but remained unchanged in Groups A and B(P0.05).(3) Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms,except that menstrual disorder and amenorrhea were unchanged in all three groups(P0.05).(4) Levels of HDL-C,ApoAl,and E_2 increased and those of TG,TC,LDL-C,ApoB,FSH,and LH decreased after treatment in Group C,reaching near normal levels;similar trends of blood lipids were shown in Group A,but the level of sex hormones was unchanged.In Group B all the above-mentioned indices were unchanged(P0.05).(5) A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively(P0.01).(6) No adverse reaction was found.Conclusion:Chinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms,but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.     

二甲双胍对糖尿病前期患者生长分化因子15及体脂分布影响的研究

目的探讨二甲双胍对DM前期患者生长分化因子15(GDF-15)及体脂分布的影响。方法选取DM前期患者112例,随机分为标准生活方式干预+二甲双胍的试验组(Exp)和仅标准生活方式干预的对照组(Con),每组各56例。干预1年后比较两组体重、BMI、WC、体脂分布、血糖、Ins、GDF-15等指标变化。再以BMI≥24 kg/m²为标准分为超重/肥胖组和体重正常组,多元线性回归分析GDF-15的影响因素。结果干预1年后Exp组FPG、2 h PG低于Con组(P<0.05),定量IS指数(QUICKI)、GDF-15高于Con组(P<0.05);超重/肥胖组TC、TG、HbA₁c、2 h Ins、WC、内脏脂肪面积、四肢、A区及G区脂肪质量较前降低(P<0.05),GDF-15较前升高(P<0.05)。Spearman相关分析显示,GDF-15与年龄、QUICKI呈正相关(r=0.362、0.375,P<0.05),与FIns呈负相关(r=-0.353,P<0.05)。多元线性回归分析显示,应用二甲双胍是GDF-15的影响因素,应用二甲双胍是A区脂肪质量的影响因素。结论二甲双胍干预可减少DM前期患者腹部脂肪,升高GDF-15,且在超重/肥胖人群更显著。     

杨倩中西医结合诊治烧心经验

杨倩教授通过中西医结合理论诊治烧心,将"浊毒"理论引入烧心诊治过程中,认为其病机关键为肝郁脾虚,浊毒内蕴,并重视胃镜等现代检查手段于该病中的应用,四诊合参,辩证论治,灵活运用中药、针灸等特色、经典疗法,并配合西药提高疗效。     

面向隐结构模型和网络药理学探讨“调肝守恒”治疗慢性胃炎的潜在生物学机制＊

目的 通过隐结构模型方法诠释名老中医“调肝守恒”治疗慢性胃炎经验，运用网络药理学探讨“调肝守恒”核心组方治疗慢性胃炎的潜在靶标及作用机制。方法 利用TCMSP数据库筛选组方具有成药可能性较大以及口服吸收较佳的候选活性成分；通过GeneCards数据库筛选获得慢性胃炎相关预测靶点，并与潜在活性成分的作用靶点进行交集分析，获得组方治疗慢性胃炎的靶点；采用Cytoscape软件，构建“药物-活性成分-作用靶点”网络图；借助String数据库平台构建蛋白质相互作用网络，筛选核心靶点；利用Cytoscape软件中的ClueGO插件对共同作用靶蛋白进行GO生物功能注释与KEGG富集分析。结果 发现组方中包含的59个候选成分可能作用于疾病的101个靶点，候选成分中槲皮素、木犀草素、山柰酚可能是组方发挥作用的关键成分，生物学功能涉及凋亡、增殖、炎症反应等多方面，交集基因富集于MAPK信号通路、PI3K/AKT信号通路等经典炎症-肿瘤信号通路。结论 隐结构模型方法诠释名老中医遣方用药以“调肝守恒”为路法，提供临床实践用药范式与借鉴。组方治疗慢性胃炎是多靶点、多成分、多通路的复杂过程，其可能是通过调节以上关键蛋白表达及信号通路，来发挥改善慢性胃炎相关症状，延缓、阻断炎-癌转化的作用。     

中药复方鹿角胶丸防治绝经后骨质疏松症的机制研究

目的探索中药复方鹿角胶丸防治绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)的潜在研究。方法动物分A组:正常组(Sham组); B组:模型空白组(OVX组); C组:中药复方组:高、中、低3个剂量组(鹿角胶丸组,C1:LJJW-H、C2:LJJW-M、C3:LJJW-L组); D组:中药对照组(仙灵骨葆组,XLGB组); E组:西药对照组(福善美组,FSM组)。双能X线(DEXA)、micro-CT检测大鼠OVX模型骨密度及微结构的改变; HE染色检测骨小梁结构改变; ELISA法检测骨代谢相关指标的改变; Western blot及免疫组化检测成骨及破骨相关蛋白改变。结果 DEXA显示,与OVX组相比,LJJW-M能够明显恢复大鼠的骨密度(P=0.0370.05)。HE染色显示,与OVX组相比,LJJW-M能够明显恢复大鼠的骨小梁百分比(P=0.0310.05),ELISA显示LJJW-M能够提高血清中PINP的含量(P=0.0180.05),同时降低β-CTX的含量(P=0.0260.05)。micro-CT显示LJJW-M能够明显改善骨的微结构(P=0.0160.05),免疫组化及免疫印迹结果显示,LJJW-M能够促进调节骨形成的关键蛋白Runx 2(P=0.0230.05)和促进骨吸收的关键蛋白Cathepsin K(P=0.0130.05)。结论中药复方鹿角胶丸通过促进成骨和抑制破骨的双重作用防治PMOP。