胃宁煎对功能性消化不良的治疗作用

目的观察胃宁煎对功能性消化不良(FD)的临床疗效和促进胃排空的作用.方法把符合诊断标准的70例患者随机分两组,胃宁煎组(W)38例,西沙比利组(C)32例,治疗4wk后评定疗效.对38例W组FD患者用钡餐法测定用药前后的胃排空时间,并进行比较分析.结果两组临床疗效观察结果为W组总有效率为92.1%,C组总有效率为87.2%,两组疗效无显著的差异(P>0.05).不良反应发生率分别为10.5%和37.5%,W组明显低于C组(P<0.05).随访已治愈患者,6mo后复发率分别为7.1%和34.8%,W组明显低于C组(P<0.05).服用胃宁煎前后测定胃排空时间的结果由用药前的(87.2±36.5)min,缩短到(53.2±22.8)min,用药前后有显著性差异(P<0.05).结论胃宁煎组对FD患者具有促进胃排空的作用,其临床总有效率与西沙比利可比,同时又具有不良反应少,疗效持久的优点.     

胃祺Ⅱ号方治疗功能性消化不良疗效观察及对大鼠胃排空的影响

目的观察胃棋I号方治疗功能性消化不良(FD)的临床疗效及对大鼠胃排空的影响.方法收集FD患者68例,随机分为胃祺I号方治疗组(中药组37例)和西沙比利对照组(西药组31例),观察其临床疗效;同时观察该方对大鼠酚红胃排空的影响.结果胃祺I号方和西沙比利的总有效率分别为89.19%和83.87%,无统计学差异(P＞0.05);该方能改善FD各主要临床症状,且无不良反应;随访无一例复发,显著优于西药组(33.33%,P＜0.05).该方能促进大鼠胃酚红排空,较模型组差异有显著性意义(P＜0.05).结论胃祺Ⅱ号方能有效改善FD各主要症状,近期疗效显著,远期疗效可靠,且无不良反应.该方能显著促进大鼠胃排空,改善胃运动功能.     

胃祺Ⅱ号方治疗功能性消化不良疗效观察及大鼠胃排空的影响

目的观察胃祺Ⅱ号方治疗功能性消化不良(FD)的临床疗效和对大鼠胃排空的影响.方法收集FD患者68例,随机分为治疗组(37例)和西沙比利对照组(31例),观察其临床疗效;同时观察该方对大鼠酚红胃排空的影响.结果胃祺Ⅱ号方和西沙必利的总有效率分别为89.19%和83.87%,无统计学差异(P＜0.05);本方能改善FD各主要临床症状,且无不良反应;随访中药组无一例复发,显著优于西药组(复发率33.33%)(p＜0.05).该方能促进大鼠胃酚红排空,较对照组有显著差异(P＜0.05).结论胃祺Ⅱ号方能有效改善FD各主要症状,近期疗效显著,远期疗效可靠,且无不良反应.该方能显著促进胃排空,改善胃运动功能.     

胃祺Ⅱ号方治疗功能性消化不良疗效观察及对大鼠胃排空的影响

目的：观察胃祺Ⅱ号方治疗功能性消化不良（FD）的临床疗效和对大鼠胃排空的影响。方法：收集FD患68例，随机分为治疗组（37例）和西沙比利对照组（31例），观察其临床疗效；同时观察该方对大鼠酚红胃排空的影响。结果：胃祺Ⅱ号方和西沙必利的总有效率分别为89．19％和83．87％，无统计学差异（P＜0．05）；本方能改善FD各主要临床症状，且无不良反应；随访中药组无一例复发，显优于西药组（复发率33．33％）（P＜0．05）。该方能促进大鼠胃酚红排空，较对照组有显差异（P＜0．05）。结论：胃祺Ⅱ号方能有效改善FD各主要症状，近期疗效显，远期疗效可靠。该方能显促进胃排空，改善胃运动功能。     

胃祺号方治疗功能性消化不良疗效观察及对大鼠胃排空的影响

目的 :观察胃祺 号方治疗功能性消化不良 (FD)的临床疗效及对大鼠胃排空的影响。方法 :收集 FD患者 6 8例 ,随机分为胃祺 号方治疗组 (中药组 37例 )和西沙比利对照组 (西药组 31例 ) ,观察其临床疗效 ;同时观察该方对大鼠酚红胃排空的影响。结果 :胃祺 号方和西沙比利的总有效率分别为 89.19%和 83.87% ,无统计学差异 (P >0 .0 5 ) ;该方能改善 FD各主要临床症状 ,且无不良反应 ;随访无一例复发 ,显著优于西药组 (33.33% ,P<0 .0 5 )。该方能促进大鼠胃酚红排空 ,较模型组差异有显著性意义 (P <0 .0 5 )。结论 :胃祺 号方能有效改善 FD各主要症状 ,近期疗效显著 ,远期疗效可靠 ,且无不良反应。该方能显著促进大鼠胃排空 ,改善胃运动功能。     

参芪健胃颗粒联合复合凝乳酶胶囊对功能性消化不良儿童胃排空及胃肠激素水平的影响

[目的]探讨参芪健胃颗粒联合复合凝乳酶胶囊治疗功能性消化不良(FD)儿童临床疗效及对患儿胃排空、胃肠激素水平的影响。[方法]收集112例FD儿童作为研究对象,随机分为对照组和观察组,每组各56例。常规治疗基础上,对照组给予复合凝乳酶胶囊治疗,观察组在对照组基础上联合参芪健胃颗粒治疗。4周后,比较2组FD儿童临床疗效、症状积分、胃排空指标、胃肠激素水平及不良反应。[结果]4周后,观察组FD患儿治疗总有效率高于对照组,组间比较差异有统计学意义(94.6%:80.4%,P0.05)。治疗后,与对照组比较,观察组患儿饱腹感、恶心、嗳气、反酸及上腹部疼痛等症状积分降低,组间比较差异有统计学意义(均P0.05)。胃排空指标显示,与对照组比较,观察组FD患儿治疗后胃半排空时间缩短,胃窦收缩频率及胃窦收缩幅度增加,组间比较差异有统计学意义(均P0.05)。与对照组比较,观察组FD患儿治疗后胃动素(MOT)、胃泌素(GAS)、神经肽Y(NPY)等胃肠激素水平均升高,组间比较差异有统计学意义(均P0.05)。治疗过程中,2组FD患儿均未出现严重不良反应,2组不良反应发生率组间比较差异无统计学意义(8.9%:14.3%,P0.05)。[结论]参芪健胃颗粒联合复合凝乳酶胶囊在FD儿童中应用效果良好,能够有效缓解临床症状,促进胃排空,调节胃肠激素水平,且不增加不良反应发生率,临床上值得应用。     

糖尿病胃轻瘫患者胃黏膜Ghrelin表达与血糖水平、胃排空的关系

目的 研究糖尿病胃轻瘫(DGP)患者胃黏膜Ghrelin的表达与血糖水平、胃排空的关系.方法 收集30例DGP患者并按近1周空腹血糖控制水平分为A组(＜9 mmol)和B组(≥9 mmol);收集20例功能性消化不良(FD)患者作为对照组(FD组),分别采用核素法与免疫组化法检测三组患者的胃液体排空功能及胃黏膜Ghrelin表达.结果 A组平均胃半排空时间为24.57 min,明显快于FD组的32.86 min(q=6.32,P＜0.01);B组平均胃半排空时间为41.92 min,较A组与FD组明显减慢(q=14.58,P＜0.01;q=9.22,P＜0.01).A、B两组胃黏膜腺体内Ghrelin阳性染色均较FD组明显变淡,部分腺体呈空泡状,其积分吸光度较FD组显著降低(q=8.80,P＜0.01;q=10.25,P＜0.01).其中B组胃黏膜大部分腺体呈空泡状,肉眼观其腺体内Ghrelin含量较A组减少,积分吸光度也低于A组,但差异无统计学意义(q=2.03,P＞0.05).A、B两组患者血糖水平与Ghrelin积分吸光度均呈负相关(r=-0.378,P＜0.01;r=-0.155,P＜0.05).结论 DGP患者胃黏膜Ghrelin表达主要与血糖水平有关,而与胃排空异常无关.     

胃必欢颗粒治疗功能性消化不良的临床研究

[目的]观察胃必欢颗粒治疗功能性消化不良(FD)患者的疗效。[方法]将142例FD患者随机分为胃必欢颗粒治疗组(72例),多潘立酮对照组(70例),观察两组治疗前后临床症状、胃排空、胃电图的变化。[结果]治疗组和对照组总有效率分别为90.27%和85.71%(P<0.05)。胃必欢颗粒能有效改善症状,促进胃排空,改善胃电节律紊乱,与对照组比较P<0.05。[结论]胃必欢颗粒具有多途径改善FD患者的胃动力作用。     

中西医结合治疗功能性消化不良的临床研究

目的探索中西医结合治疗功能性消化不良(Functional Dyspepsia,FD)疗效机理,评估中西医结合治疗FD疗效。方法通过多中心对798例FD患者,随机分成3组,分别用吗丁啉(A组),中药复方(B组)及吗丁啉加中药复方(C组)对其进行治疗,同时检测胃排空率、胃半排空时间、胃电参数、血浆胃动素及胃泌素水平,并观察各组疗效情况。结果 A组治愈46例,显效89例,进步49例,治愈率20.35％,总有效率81.42％;B组治愈58例,显效71例,进步50例,治愈率27.5％,总有效率84.83％;C组治愈187例,显效122例,进步40例,治愈率51.8％,总有效率96.68％,C组治愈率及总有效率都明显高于A、B组,具有统计学意义,胃排空率、胃半排空时间、胃电活动及胃电参数均较治疗前明显改善(P<0.05),胃动素水平较治疗前明显提高(P<0.05),而血浆胃泌素水平治疗前后无明显变化(P>0.05)结论中西医结合组治疗FD无论是总有效率还是治愈率均明显高于单一中约组或吗丁啉组,为日前治疗FD较为理想的方法,其机制主要是通过各个环节改善胃电活动,增加胃动力,从而达到治疗FD目的。     

运脾散治疗儿童运动障碍样型功能性消化不良30例

[目的]观察运脾散敷脐治疗运动障碍样型功能性消化不良(FD)患儿的疗效.[方法]将60例患儿,分为运脾散治疗组和西药(多潘立酮)对照组各30例,比较2组治疗前后临床症状及胃动力学指标改善情况,判定疗效.[结果]2组治疗前后胃排空率及胃电节律得到显著改善,但2组间差异无统计意义.2组治疗后,均有显著的症状疗效,治疗组痊愈率优于对照组(P＜0.05),而总有效率和对照组大致相当(P＞0.05).[结论]运脾散敷脐治疗运动障碍样型FD有显著的症状疗效,能有效调节胃排空率及胃电节律.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.