中药联合溴隐亭治疗女性高泌乳素血症的meta分析

目的系统评价中药联合溴隐亭治疗女性高泌乳素血症的疗效和安全性。方法检索VIP、WANFANG Data,CNKI. ,PubMe[J]. Sinomed Web of Science .Embase ,Coechrane Libranry SeneDiret数据库自建库以来至2020年11月5日公开发表的与中药联合溴隐亭治疗高泌乳素血症有关的临床随机对照试验。由两名研究者根据纳人及排除标准筛选文献,运用Cochnne协作网提供的RerMan 5.4版软件进行临床疗效和安全性评价。结果共纳人18箱文献，共计1934例惠者ometa分析结果显示,与对照組相比,试验组总有效率高(P<0.01),治疗后试验组血清泌乳素(PRL)水平、中医症状积分降低，血清雄二醇(E)水 平显著升高，试验组不良反应发生率和复发率低(P<0.01)。结论联合应用中药和澳隐亭治疗女性高铭乳素血症可提高临床疗效,降低PRL水平,改善Ea水平,且更加安全。     

溴隐亭治疗垂体泌乳素瘤对患者心脏瓣膜影响的研究

目的 研究长期使用溴隐亭治疗垂体泌乳素腺瘤是否会增加心脏瓣膜反流的危险。方法 于2012年1月-2013年2月间随访纳入26例使用溴隐亭治疗垂体泌乳素腺瘤至少6个月的患者（观察组）,并与101例健康人对照（对照组）,两组均行经胸心脏彩色多普勒超声检查,记录二维超声值及各瓣膜反流情况,比较两组上述心脏彩色多普勒超声数据。结果 观察组患者平均使用药物（27.53±2.77）个月,观察组三尖瓣微量反流比例（38.46%）较对照组（19.80%）高,差异有统计学意义（P=0.046）,余瓣膜反流与对照组差异无统计学意义;观察组室间膈厚度[（8.62±0.31）mm]较对照组[（8.57±0.12）mm]高,差异有统计学意义（P=0.042）。结论 使用溴隐亭治疗垂体泌乳素腺瘤未观察到引起有临床意义的心脏瓣膜反流,但长期的心脏彩色多普勒超声随访是必要的。     

中西医结合治疗高催乳素血症致不孕的临床疗效

目的：观察中西医结合治疗对高催乳素血症所致不孕的临床疗效。方法：将65例患者随机分中西医结合治疗组（35例）和单纯西药治疗对照组（30例）。结果：治疗组与对照组疗效情况比较,治疗组有效率远高于对照组（P〈0．05）,差异有统计学意义。结论：中西医结合治疗高催乳素血症所致不孕有较好的疗效,具有一定的临床推广价值。     

Impact of bromocriptine-QR therapy on cardiovascular outcomes in type 2 diabetes mellitus subjects on metformin

Objectives: Type 2 diabetes mellitus (T2DM) is associated with a substantially increased risk of cardiovascular disease (CVD). Bromocriptine-QR (B-QR), a quick release sympatholytic dopamine D₂ receptor agonist, is a FDA-approved therapy for T2DM which may provide CVD risk reduction. Metformin is considered to be an agent with a potential cardioprotective benefit. This large placebo controlled clinical study assessed the impact of B-QR addition to existing metformin therapy on CVD outcomes in T2DM subjects.

Methods: 1791 subjects (1208 B-QR; 583 placebo) on metformin ± another anti-diabetes therapy at baseline derived from the Cycloset Safety Trial, a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were included in this study. The primary CVD endpoint evaluated was treatment impact on CVD event rate, prespecified as a composite of time to first myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina/congestive heart failure. Impact on glycemic control was evaluated as a secondary analysis.

Results: The composite CVD end point occurred in 16/1208 B-QR treated (1.3%) and 18/583 placebo treated (3.1%) subjects resulting in a 55% CVD hazard risk reduction (intention-to-treat, Cox regression analysis; HR: 0.45 [0.23–0.88], p = 0.028). Kaplan-Meier curves demonstrated a significantly lower cumulative incidence rate of the CVD endpoint in the B-QR treatment group (Log-Rank p = 0.017). In subjects with poor glycemic control (HbA1c ≥ 7.5) at baseline, B-QR therapy relative to placebo resulted in a significant mean %HbA1c reduction of ?0.59 at week 12 and ?0.51 at week 52 respectively (p < 0.001 for both) and a 10 fold higher percent of subjects achieving HbA1c goal of ≤7% by week 52 (B-QR 30%, placebo 3%; p = 0.003).

Conclusion: These findings suggest that in T2DM subjects on metformin, BQR therapy may represent an effective strategy for reducing CVD risk.

Cycloset Safety Trial registration: ClinicalTrials.gov Identifier: NCT00377676.     

The effects of dopaminergic agonists on genital reflexes in paradoxical sleep-deprived male rats

Dopamine (DA) agonists provide evidence that different receptor subtypes in the central nervous system (CNS) have influence in sexual behavior. Sleep deprivation induces supersensibility of DA receptors and previous work has shown that the DA agonist apomorphine enhances spontaneous genital reflexes (penile erection-PE and ejaculation-EJ) in rats deprived of paradoxical sleep. The present study sought to extend the latter finding by assessing the effects of other DA agonists in paradoxical sleep-deprived (PSD) male rats. The DA drugs (bromocriptine and piribedil) were acutely administered to rats that had been deprived of sleep for 4 days and to normal controls. Sleep deprivation alone induced PE and this effect was potentiated by piribedil, with maximal effects occurring with the 8 mg/kg dose, whereas only one dose of bromocriptine (8 mg/kg) induced more PE in PSD rats than in non-deprived treated controls. EJs were increased in piribedil PSD groups but this response was absent after bromocriptine treatment in the dose range tested. Our data show the genital reflexes that occurred in PSD rats are potentialized by piribedil and not by bromocriptine. These DA agonists showed distinct effects in sexual response suggesting that these effects are probably due to PSD-induced DA receptor supersensitivity even though different mechanisms are involved.     

Bromocriptine prevents neuron damage following inhibition of superoxide dismutase in cultured ventral spinal cord neurons

Abstract

Rpsen et al. have reported point mutations in the cytosolic Cu/Zn superoxide dismutase (SOD 1) gene in some families with familial amyotrophic lateral sclerosis (ALS). To determine whether decreased SOD activity could contribute to neuronal damage, rat embryo ventral spinal cord neurons were incubated with diethyldithiocarbamate (DOC), an inhibitor of SOD. There was a marked increase in neuronal damage in cultures exposed to DOC and this phenomenon was dose-related. In this paradigm, these deteriorative changes were prevented by bromocriptine. DOC-treated ventral spinal cord neurons provide an in vitro model of free radical neurotoxicity secondary to decreased SOD activity. Simultaneous treatment with bromocriptine and DOC reduced neurotoxicity, indicating that bromocriptine has a neuroprotective effect against free radicals. [Neural Res 1997; 19: 389-392]     

Dissociable fronto-striatal effects of dopamine D2 receptor stimulation on cognitive versus motor flexibility

Genetic and pharmacological studies suggest an important role of the dopamine D2 receptor (DRD2) in flexible behavioral adaptation, mostly shown in reward-based learning paradigms. Recent evidence from imaging genetics indicates that also intentional cognitive flexibility, associated with lateral frontal cortex, is affected by variations in DRD2 signaling. In the present functional magnetic resonance imaging (MRI) study, we tested the effects of a direct pharmacological manipulation of DRD2 stimulation on intentional flexibility in a task-switching context, requiring switches between cognitive task rules and between response hands. In a double blind, counterbalanced design, participants received either a low dose of the DRD2 agonist bromocriptine or a placebo in two separate sessions. Bromocriptine modulated the blood-oxygen-level-dependent (BOLD) signal during rule switching: rule-switching-related activity in the left posterior lateral frontal cortex and in the striatum was increased compared to placebo, at comparable performance levels. Fronto-striatal connectivity under bromocriptine was slightly increased for rule switches compared to rule repetitions. Hand-switching-related activity, in contrast, was reduced under bromocriptine in sensorimotor regions. Our results provide converging evidence for an involvement of DRD2 signaling in fronto-striatal mechanisms underlying intentional flexibility, and indicate that the neural mechanisms underlying different types of flexibility (cognitive vs motor) are affected differently by increased dopaminergic stimulation.     

Pregnancy rate following bromocriptine treatment in infertile women with galactorrhea

Objective.?Infertility is one of the most common causes of women refer to gynecology clinics. Galactorrhea is defined as one of the causes of infertility caused by luteal phase defect and anovulatory cycles. The study aim was to investigate the effect of bromocriptine on pregnancy rate in infertile women with galactorrhea with or without high prolactin level.

Materials and methods.?In a prospective study, consecutive women with infertility and galactorrhea who referred to Afzalipour Hospital and a private clinic during 5 years from May 2001 to May 2006 were included. The study was conducted on 205 infertile women (18–39 years) with galactorrhea. They were treated with 2.5 mg bromocriptine BID for up to 6 months.

Results.?The mean duration of sterility was 43.1 ± 37.1 months (range, 12–16). 76.1% of patients showed positive signs for pregnancy. The pregnancy rate was 81.7% in the patients with high prolactin level (>20 ng/dl) and 74.3% in the patients with normal prolactin level (P = 0.26). There was a significant difference between mean duration of treatment with bromocriptine in women with and without pregnancy, 103.71 and 193.03 days, respectively (P < 0.001).

Conclusion.?Considering the efficacy of bromocriptine in the treatment of infertile women with galactorrhea, we suggest treatment with bromocriptine in these patients regardless of serum prolactin level.     

Haloperidol-induced hypoglycaemia in diabetic patients with organic brain disease: Normalization by bromocriptine

Spontaneous hypoglycaemia was related to treatment with a commonly used neuroleptic drug (haloperidol) in two diabetic patients with organic brain disease. Hypoglycaemia disappeared when the drug was replaced by a dopamine agonist (bromocriptine). Impaired secretion of growth hormone (GH) was demonstrated in both of the patients during haloperidol medication, or a short time thereafter, and a normalized GH response was found when the patients were treated with bromocriptine. Cerebral ventricular dilatation and subnormal cerebral perfusion were demonstrated in both and a partially empty sella in one of the patients. Organic brain disease and possibly additional endocrine abnormalities might have contributed to hypoglycaemia in our patients. The significance of dopamine-related neuroendocrine reactions and of GH in counteracting hypoglycaemic stimuli is discussed.     

The occurrence of macroscopical pituitary calcifications in prolactinomas

Summary Radiographs of the sella turcica from 73 hyperprolactinaemic women, were followed-up for 5 to 13 years. Six women (8%) were found to harbour granular calcific deposits in the anterior part of the sella turcica visible on the plain radiographs. In three women the calcification increased in size during follow-up. This was accompanied by signs of regression of other features of pituitary tumour on the radiographs in two women. Pituitary calcifications associated with hyperprolactinaemia seem to represent a benign and regressive process.