阿霉素肾病大鼠药理应用实验研究进展

Wistar或SD大鼠静脉注射阿霉素造成的急性模型类似微小病变性肾病综合征 (NS) :光镜下病变甚微 ;电镜下肾小球上皮细胞足突肿胀、融合。处理鼠一般于用药后 4～6d出现蛋白尿 ,13～ 15d出现大量蛋白尿 ,30d左右出现显著低蛋白血症、高脂血症和明显水肿[1] ,目前已广泛应用于NS的各种实验研究。本文就阿霉素肾病 (AN)大鼠在国内NS药理应用研究方面的进展作一概述。　　 1　抗氧化剂AN鼠的发病机理与氧自由基 (OFR)产生、脂质过氧化物 (LPO)形成 ,对肾小球和肾小球上皮细胞产生毒性 ,造成肾小球滤过膜电荷屏障缺损和对分子控制的缺乏 ,…     

1型与2型糖尿病大鼠周围神经病变的比较

目的观察链脲佐菌素(STZ)诱导的1型与2型糖尿病大鼠周围神经病变的区别。方法 SD大鼠分组,每组各10只,腹腔注射STZ建立1型糖尿病(T1DM)模型;高脂高糖饲养6周后按体质量35 mg/kg单次腹腔注射STZ建立2型糖尿病(T2DM)模型;设立正常对照(Con)组。检测不同时间点大鼠的体质量、血糖水平。成模8周后,电子Von Frey仪检测机械痛阈值,热水甩尾试验检测甩尾潜伏期,并取坐骨神经进行病理形态学检查。结果成模后第1、8周,与对照组及T2DM组相比,T1DM组大鼠的体质量显著下降(P0. 01); T1DM组与T2DM组的血糖均显著高于对照组(P0. 01); DM组的甩尾潜伏期均较对照组延长(P0. 01),T2DM组较T1DM组延长更显著(P0. 05)。DM组的机械痛阈值均较对照组显著降低(P0. 01),T2DM组较T1DM组降低更明显(P0. 01); DM组大鼠的坐骨神经有髓神经纤维排列紊乱,轴索肿胀或皱缩,髓鞘密度不均匀,空泡变性,部分神经纤维髓鞘脱失; T2DM组的神经损害程度较T1DM严重。结论 STZ诱导的2型糖尿病大鼠的周围神经病变程度严重于1型糖尿病大鼠。     

儿童频复发性肾病中医证型与病理类型的相关性分析

目的:探讨儿童频复发性肾病(FRNS)的中医证型与病理类型的相关性.方法:选择50例FRNS患儿,采用中医辨证分型和肾穿刺活检病理诊断,比较治疗前后血、尿常规,血生化、24h尿蛋白定量、肾功能检查、免疫指标的变化.结果:①中医证型以肝肾阴虚、脾肾阳虚为主,其次为湿热内蕴、肾虚血瘀,气阴两虚较少见.②西医分型肾炎型中气阴两虚型与其它证型比较差异显著(P<0.05);单纯型中肝肾阴虚与其它证型间有显著性差异(P<0.05).③病理类型以弥漫系膜增生性肾小球肾炎(MsPGN)、系膜增生性肾炎 局灶节段性肾小球硬化(MsPGN FSGS)和IgA肾病(IgAN)为主,少数为IgM肾病(IgMN)、膜性肾病(MN)、膜增生性肾小球肾炎(MPGN)和局灶性肾炎(FGN).MsPGN中以肝肾阴虚多见,二者之间呈显著正相关;IgAN中湿热内蕴多见,二者呈显著正相关;MsPGN FSGS主要见于肝肾阴虚、脾肾阳虚和肾虚血瘀,二者之间无显著差异.结论:MsPGN、IgAN可以作为肝肾阴虚型和湿热内蕴型的客观指标和辨证依据,中药肾康灵对治疗肾虚血瘀型FRNS疗效显著,能显著降低复发率,减轻副作用.     

筋脉通胶囊通过增强背根神经节Nrf2和HO-1的表达改善糖尿病大鼠的周围神经痛简

 目的观察中药筋脉通胶囊对链尿佐菌素（STZ）诱导的糖尿病（DM）大鼠背根神经节（DRG）的核因子E2相关因子2（Nrf2）和血红素加氧酶-1（HO-1）的表达以及血浆一氧化碳（CO）含量的影响。 方法腹腔内注射STZ诱导建立DM大鼠模型,随机分为模型组、筋脉通小、中和大剂量组及硫辛酸组,并设对照组。成模后每天1次灌胃给药,持续12周。电子Von Frey仪检测机械痛阈值,免疫组化法及Rt-PCR检测DRG的Nrf2和HO-1蛋白及mRNA表达,并检测血浆一氧化碳血红蛋白（COHb）含量。 结果与对照组相比,糖尿病大鼠的机械痛阈值、血浆COHb含量以及DRG的Nrf2和HO-1蛋白及mRNA表达水平均明显下降（P＜0.01）;各治疗组的上述指标均显著回升（P＜0.01或P＜0.05）。在提高DRG的HO-1蛋白表达上,筋脉通中剂量组疗效显著优于硫辛酸组（P＜0.05）。 结论筋脉通胶囊可通过增强DRG的Nrf2、HO-1和CO表达来改善糖尿病大鼠的周围神经痛。     

REVIEWS——Survey of Current Experimental Studies of Effects of Traditional Chinese Medicine on Peripheral Nerve Regeneration

The repairing and regeneration of peripheral nerves is a very complex biological and cytological process, its mechanism is unclear so far, and thus results in the lack of specific and effectual therapy and medicament. Chinese herbs and their effective components have their own inimitable predominance in promoting peripheral nerve regeneration, such as their multi-factorial, multi-target and multi-functional ac- tion. abundant source, inexpensive, etc. In this paper, the experimental studies reported in recent 5 years concerning the effects of Chinese herbs or their active components on peripheral nerve repairing and regeneration are reviewed in respects of the integral level, cellular level, molecular level and qene level.     

172例糖尿病周围神经病变患者中医证候特点与神经传导速度的关系

目的探讨糖尿病周围神经病变（DPN）患者中医证候特点与神经传导速度的关系。方法对172例DPN患者按气虚、阴虚、阳虚、血瘀、痰湿进行中医证候归类，5级记分法量化评分，并进行常规神经传导速度（NCV）检测。结果中医证候出现频率阴虚、血瘀〉50％；高龄组阳虚证候比重及积分高于低龄组（P〈0．05）；血瘀、阳虚证候积分随着病程的延长明显增高（P〈0．01）。神经系统症状、体征评分与阴虚、阳虚、血瘀积分呈正相关；空腹血糖（FBG）与气虚积分、脂蛋白a与阴虚积分、同型半胱氨酸（Hcy）与阳虚积分呈正相关；NCV异常组中的阴虚、血瘀证候比例高于各自正常组，而气虚、痰湿证候反之，但无统计学意义（P〉0．05）；阳虚、血瘀积分越高，NCV异常越明显。病程、FBG、收缩压（SBP）、同时并发糖尿病肾病（DN）和糖尿病视网膜病变（DR）、神经系统体征评分是NCV异常的独立危险因素。结论DPN临床证候以阴虚、血瘀为主，阳虚、血瘀越明显，神经传导速度越慢；病程延长、FBG和SBP升高、合并DN和DR及神经系统体征评分增加是NCV异常的独立危险因素。     

小儿“纯阳之体”之我见

“纯阳之体”理论源于道家阴阳学说,“谓其未曾破身耳”。其正式运用于医学则始见于《颅囟经》“凡三岁以下,呼为纯阳,元气未散”。后世医家据此对“纯阳”的含义各有阐释:有作“阳盛阴微”者;有作“独阳无阴”者;有作“生机蓬勃而阴精相对不足”者等。吾以为,上述见解虽各有偏执,但显而易见;“纯阳之体”学说确切反映了小儿生机蓬勃、发育迅速的生理特点及其体质患病倾向,对小儿日常预防保健和疾病辨证施治都具有十分重要的指导意义。1“纯阳”并非无阴或盛阳,乃生机旺盛之意张介宾《类经》云:“阳不独立,必得阴而后成;阴不自长,必得阳而后…     

Effects of Jinmaitong Capsule (筋脉通胶囊) on Ciliary Neurotrophic Factor in Sciatic Nerves of Diabetes Mellitus Rats

Objective:To study the effects of the Chinese medicine Jinmaitong Capsule(筋脉通胶囊,JMT) on the pathomorphology of sciatic nerves,ciliary neurotrophic factor(CNTF),and the mRNA expressions of CNTF in rats with streptozotocin-induced diabetes mellitus(STZ-DM).Methods:The animal model was established by one time intraperitoneal injection of streptozotocin.The rats were simply divided by random into 5 groups including model group,low-dose JMT group(JL),medium-dose JMT group(JM),high-dose JMT group(JH) and neurotropin group.For each of the above 5 groups,a group of 10 normal Wistar rats matched in body weight,age and gender were set as normal group.Intragastric administrations were started after the animal model established.The JL group were administered with five times the JMT dose recommended for a human adult;the JM group were administered with ten times the JMT dose recommended for a human adult;the JH group were administered with twenty times the JMT dose recommended for a human adult.The neurotropin group was administered with ten times the neurotropin dose recommended for a human adult.All rats were given intragastric administration for 16 weeks and then killed.In the 4th,8th,12th,16th week,body weight and blood glucose level were detected before and after the intervention.The morphologic changes of the sciatic nerves were observed by optical microscope and transmission electron microscope.The CNTFmRNA expressions were detected by real-time fluorescent quantitative polymerase chain protein,and the CNTF protein expressions were detected by immunohistochemical method.Results:The blood glucose levels of the STZ-DM rats were much higher than normal group(P<0.01),and there was no apparent difference between any treatment groups and the model group(P>0.05).Before and after the intervention in the 4th, 8th,12th,16th week,there were no significant differences in the body weight among all the groups(P>0.05). The sciatic nerves of STZ-DM rats might have pathomorphological changes in axons,myelin sheaths,and interstitium.The levels of CNTF and CNTF-mRNA expressions in the STZ-DM rats were both significantly decreased(P<0.01).The sciatic nerves of STZ-DM rats might have pathomorphological changes in axons, myelin sheaths,and interstitium.Conclusion:JMT could improve the pathomorphology of sciatic nerves by increasing CNTF’s and CNTF-mRNA expressions in sciatic nerve tissues,and promote the repair and regeneration of damaged nerve fibers.     

梁晓春从肝论治失眠经验

梁晓春教授认为,失眠症虽然病因复杂,但精神心理因素最关键;在脏腑功能失调中,以肝居主导地位,主张从肝论治失眠;肝气郁结是脏腑功能失调的始动因素,肝血亏虚是阴阳气血失和的病理基础,而病程中产生的郁火、痰阻和血瘀可加重失眠。初期以肝气郁结为主;中期可出现肝郁化火、痰热上扰、肝血亏虚、肝肾阴虚;后期可出现肝阳上亢及肝郁血瘀。治疗时依据失眠的病程长短和病情轻重,辨别脏腑之阴阳和气血之虚实的不同,采用疏肝、清肝、养肝、柔肝及平肝五法,根据兼证灵活配伍安神药,或酌情配合化痰和活血之品,使肝之气血调和,肝之阴阳平秘,失眠得以治愈。     

糖尿病周围神经病变合并脂代谢异常的中药干预研究进展

糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的病理机制复杂,迄今尚未完全阐明。研究证实,脂代谢异常与DPN的发生、发展密切相关,脂质调节可能是除了降血糖外DPN治疗的关键靶点之一。本文从游离脂肪酸、线粒体功能障碍、氧化脂质与非典型鞘脂4个方面,对脂代谢异常与DPN之间的病理机制联系以及近5年中药对其的干预作用进行综述。