雷公藤多甙联合异甘草酸镁治疗儿童自身免疫性肝炎疗效及其对血清IL-17和CXCL10水平的影响

目的 探讨应用雷公藤多甙联合异甘草酸镁治疗自身免疫性肝炎(AIH)儿童的疗效及对血清白介素-17(IL-17)和趋化因子10(CXCL10)水平的影响。方法 2018年1月~2019年3月我院儿科收治的AIH患儿57例,随机分为观察组29例和对照组28例。给予对照组异甘草酸镁注射液静脉滴注治疗,观察组在对照组治疗的基础上加用雷公藤多苷片口服治疗,两组均持续治疗8周。采用ELISA法检测血清IL-17、趋化因子8(CXCL8)和CXCL10水平。结果 治疗后,观察组和对照组血清谷草转氨酶(AST)水平分别为(48.4±9.3)U/L和(61.2±12.5) U/L (P＜0.05)、丙氨酸氨基转移酶(ALT)水平分别为[(59.3±7.6)U/L和(66.4±9.7)U/L (P＜0.05)、碱性磷酸酶(ALP)水平分别为(60.2±5.1)U/L和(75.7±6.4)U/L(P＜0.05);两组血清免疫球蛋白G(IgG)水平分别为(13.8±2.9)mg/L和(16.3±3.4)mg/L(P＜0.05)、IgA水平分别为(2.4±0.3)mg/L和(2.9±0.5)mg/L(P＜0.05)、IgM水平分别为(2.6±0.3)mg/L和(3.1±0.4)mg/L (P＜0.05);血清IL-17水平分别为(6.8±0.7)ng/ml和(7.3±0.9)ng/ml (P＜0.05)、CXCL8水平分别为(10.4±1.2)pg/ml和(13.8±1.6) pg/ml (P＜0.05)、CXCL10水平分别为(16.3±2.5) pg/ml和(22.6±3.7)pg/m (P＜0.05);治疗后,观察组患儿不良反应发生率为12.5%,与对照组的7.5%比,差异无统计学意义(P＞0.05)。结论 在异甘草酸镁治疗的基础上加用雷公藤多甙治疗儿童AIH疗效较好,安全性高,可有效改善肝功能和免疫功能,降低机体炎症反应,值得临床进一步验证。     

雷公藤多苷联合来氟米特治疗类风湿性关节炎疗效观察

目的:观察雷公藤多苷联合来氟米特治疗类风湿关节炎的效果和安全性。方法:60例随机分为对照组和研究组各30例,两组均给予来氟米特治疗,研究组加用雷公藤多苷治疗。比较两组疗效及安全性。结果:临床疗效、实验室指标改善研究组均优于对照组(P<0.05)。结论:雷公藤多苷联合来氟米特治疗类风湿性关节炎能提高疗效,用药安全。     

加压溶剂法提取雷公藤多苷及其条件优化

目的:对卫矛科药用植物雷公藤提取方法进行研究。方法:利用加压溶剂提取方法进行提取分离,根据理化性质用显色-比色法进行定量分析,并在单因素试验基础上,根据中心组合试验设计原理采用3因素3水平的响应面分析法进行工艺优化。结果:经过响应面分析法得出优化的工艺条件为料液比1∶9.5,提取温度115℃,提取时间80 m in,在此条件下雷公藤多苷的浸膏得率可达0.21%,纯度为0.52%。结论:加压溶剂提取方法与常规提取法相比优势明显,是一种有效的提取分离方法。     

雷公藤多甙的抗炎和免疫抑制作用

目的探讨雷公藤多甙(T     

雷公藤多甙对大鼠胶原免疫性关节炎及佐剂性关节炎黏膜免疫功能影响的对比研究

目的观察雷公藤多甙对大鼠胶原免疫性关节炎（collagen-Ⅱ induced arthritis,CIA）及佐剂性关节炎（adjuvant arthritis,AA）黏膜免疫功能的影响。方法分别以Ⅱ型胶原加完全弗氏佐剂和完全弗氏佐剂单独致炎免疫大鼠造成CIA和AA模型,以雷公藤多甙治疗,观察大鼠黏膜、全身免疫指标（外周血T细胞亚群）以及关节局部炎症因子（IL-6、TNF—α、COX-2和NF-κB等）的变化。结果CIA模型组派伊尔结（Peyer’s patch,PP）CD4^＋、血中CD4^＋、CD8^＋均升高;AA模型组PPCD4^＋降低,CD8^＋升高,血中的CD4^＋,CD8^＋均升高。雷公藤对两模型组的PP和血中T细胞亚群存在不同影响。两种模型大鼠关节可见高水平IL-6、TNF—α、COX-2和NF—κB表达,雷公藤多甙可以抑制这些炎症介质的表达。结论两种关节炎模型在黏膜免疫反应方面及雷公藤多甙对这两种模型的影响存在异同。     

Characterization of Mixtures of Alkyl Polyglycosides (Plantacare) by Liquid Chromatography-Electrospray Ionization Quadrupole Time-of-Flight Mass Spectrometry

No HeadingPurpose. Industrial products of alkyl polyglycosides (APGs) are widely used as well tolerated surfactants in washing and cleaning agents. APGs belong to the class of nonionic surfactants and are mixtures of molecules consisting of a hydrocarbon chain with Y carbon atoms linked to X sugar residues. Physicochemical properties of APG products strongly depend on the molecular composition. Therefore, a detailed analytical investigation of technical-grade APGs is presented.Methods. Complex mixtures of alkyl/alkenyl polyglycosides (APGs, Plantacare) and mixtures of APGs with other surfactants were analyzed by reversed-phase liquid chromatography-electrospray ionization quadrupole time-of-flight mass spectrometry (LC/ESI-QTOF-MS) using methanol-water as mobile phase and gradient elution.Results. Analytes were separated according to the chain length of the alkyl homologs. Under the soft ionization of the ESI technique, mainly [M+Na]⁺ ions were observed, which proved to be very stable. Additionally [M+H]⁺ ions were detected. The QTOF mass spectrometer allows to identify even high molecular mass components in the mixtures, and APGs up to eight sugar residues were found. From these data, the alkyl/alkenyl chain lengths and the degree of oligomerization of the sugar moiety for different technical-grade APGs were calculated. Using MS/MS experiments, additional structural and chemical information was obtained.Conclusions. The presented LC/ESI-QTOF-MS approach allows to analyze and characterize various APG products, such as Plantacare. The ability of this LC/ESI-QTOF-MS approach to analyze mixtures of APGs with other surfactants is demonstrated.     

雷公藤治疗子痫前期孕鼠蛋白尿实验研究

目的研究雷公藤多甙对于子痫前期孕鼠蛋白尿的治疗作用。方法采用皮下注射亚硝酸左旋精氨酸甲酯(LNAME)125mg·(kg·d)-1建立大鼠子痫前期模型。将造模后的大鼠随机分为3组:即大、小剂量治疗组和对照组。2个治疗组分别给予6mg·(kg·d)-1或3mg·(kg·d)-1灌胃,对照组给予0.9%氯化钠注射液灌胃。另设一健康大鼠对照组即D组。测量孕鼠尾动脉收缩压、蛋白尿浓度、肾功能、胎盘质量、仔鼠体长、体质量及肝、脑质量。结果与对照组相比,雷公藤多甙治疗组的尿蛋白明显降低,胎盘质量、仔鼠体长及体质量增加,仔鼠死亡率明显降低。3组之间畸形率无显著性差异。结论雷公藤多甙可以显著降低子痫前期孕鼠的蛋白尿水平,增加胎盘质量、仔鼠体长及体质量,降低死胎率,而未增加仔鼠的畸形率。     

雷公藤多苷对IgAN大鼠血清IgA水平及γδT细胞表达的影响

目的研究雷公藤多苷对IgA肾病大鼠外周血γδT细胞表达影响。方法尾静脉注射葡萄球菌肠毒素诱导IgA肾病大鼠模型,并予雷公藤多苷干预治疗,同时给予强的松对照,运用流式细胞仪检测IgAN大鼠用药前后外周血γδT细胞比率;放射免疫法检测血清IgA水平。结果雷公藤多苷能抑制血清IgAN外周血γδT细胞表达从而抑制血清IgA的升高。结论通过抑制血清IgAN外周血γδT细胞表达,从而降低血清IgA水平,是雷公藤多苷治疗IgAN的作用机制之一。     

雷公藤多苷对系膜增生性肾炎患者肿瘤坏死因子水平的影响

目的　观察系膜增生性肾炎 (MsPGN)患者应用雷公藤多苷前后血、尿TNFα变化。方法　检测了 80例MsPGN患者雷公藤多苷治疗前及用雷公藤多苷后 3,6 ,10周血、尿TNFα变化 ,并与 2 0例正常人血、尿TNFα进行比较。结果　MsPGN患者 80例治疗前血、尿TNFα明显增高 [血正常 (6 7± 2 1)kU/L ,MsPGN(4 4 2± 35 2 )kU/L ,尿正常 0MsPGN (2 18± 136 )kU/L ,P <0 .0 1],雷公藤多苷治疗后 6 0例患者显效 ,2 0例无效 ,显效率为 75 %。显效者血、尿TNFα早期即开始下降 [血治疗前 (4 4 2± 35 2 )kU/L ,治疗后 (2 89± 176 )kU/L ,尿治疗前 (2 18± 136 )kU/L ,治疗后 (10 6± 70 )kU/L ,P <0 .0 1],而雷公藤多苷治疗无效者血、尿TNFα无明显变化。结论　TNFα参与系膜增生性肾炎发病及疾病进展 ;雷公藤多苷治疗MsPGN有效 ,其作用机制可能与其抑制TNFα产生有关 ;血、尿TNFα可作为判断雷公藤多苷疗效与预后的参考指标     

Clinical Observation on Treatment of Senile Rheumatoid Arthritis by Tripterygium Polyglycosides Combined with Small Dose of Methotrexate

Objective: To observe the effect and adverse reaction of tripterygium polyglycosides (TP) combined with small dose of methotrexate (MTX) in treating senile rheumatoid arthritis (RA). Methods: Sixty old patients with RA were equally divided into two groups, the treated group was treated with oral intake of TP (10 mg three times per day) plus MTX (7.5 mg, once per week), and the control group was treated with MTX (15 mg per week) respectively for 3 months. The changes from before to after treatment in resting pain, morning rigidity, bilateral grip strength, local tenderness index, arthroncus index, patient's evaluation, doctor's evaluation, erythrocyte sedimentation rate (ESR), C-reaction protein (CRP) and rheumatoid factor(RF) titre were observed and the clinical therapeutic effect assessed. Results: The total effective rate in the treated group was 86.67% and that in the control group 83.33% , showing insignificant difference between them (P>0.05). But the improvement in local tenderness index, arthroncu