中西医结合治疗肥胖型2型糖尿病的疗效观察

目的观察中西医结合治疗肥胖型2型糖尿病的临床疗效。方法将150例2型肥胖型糖尿病患者随机分成治疗组与对照组各75例,2组均采用相同的西医综合治疗,治疗组在西医综合治疗的基础上结合中医治疗,观察2组的临床疗效。结果治疗组降糖总有效率为82.7%明显优于对照组的53.3%;治疗组体质量下降总有效率为72.0%明显优于对照组的40.0%。2组比较差异有统计学意义（P〈0.05）。结论在西医综合治疗的基础上结合中医治疗肥胖型2型糖尿病,疗效确切,可明显改善患者血糖及体质量指数水平,值得临床推广。     

社区中西医结合糖尿病防治管理探索

社区糖尿病管理可有效改善患者自我管理行为,本文以糖尿病的中西医结合防治为切入点,综合分析中西医结合的手段防治糖尿病的优势,社区中西医结合糖尿病管理团队的建立,加强健康教育,提高患者的治疗依从性;以八纲辨证为纲、脏腑辨证为目,系统地辨证探讨社区中西医结合糖尿病防治管理体系的实践和进展,为更全面、系统、有效地开展中西医结合社区糖尿病防治工作奠定基础。     

聚类法分析糖尿病的药物治疗状况

目的探讨糖尿病的药物治疗的研究热点。方法检索2014-2016年Pub Med数据库中收录的有关糖尿病药物治疗的文献,并通过书目共现分析系统(BICOMB),提取分析文献的主要主题词+副主题词,建立高频主要主题词+副主题词的词篇矩阵,最终导入SPSS 19.0中进行聚类分析。结果共检索文献7 505篇,共抽取主要主题词+副主题词6 580个,截取高频主要主题词+副主题词共37个,最后聚类分析为5类。结论糖尿病药物治疗的研究热点主要集中在5个方面:11型糖尿病投药剂量以及血糖监测研究;22型糖尿病药物疗法与新的特效药的治疗应用;32型糖尿病并发症的药物治疗;4实验性糖尿病神经病变的药物治疗;5糖尿病眼部病变的药物疗法。     

An integrated metabonomic and proteomic study on Kidney-Yin Deficiency Syndrome patients with diabetes mellitus in China

Aim:

To investigate specific changes in metabolites and proteins of Kidney-Yin Deficiency Syndrome (KYDS) patients with diabetes mellitus (DM) in China.

Methods:

KYDS (n=29) and non-KYDS (n=23) patients with DM were recruited for this study. The KYDS was diagnosed by two senior TCM clinicians separately. The metabonomic and proteomic profiles of the patients were assessed using a metabonomic strategy based on NMR with multivariate analysis and a proteomic strategy based on MALDI-TOF-MS, respectively.

Results:

Eighteen upregulated peptides and thirty downregulated peptides were observed in the plasma of the KYDS patients. Comparing the proteomic profiles of the KYDS and non-KYDS groups, however, no significantly differentially expressed peptides were found. At the same time, major metabolic alterations were found to distinguish the two groups, including eight significantly changed metabolites (creatinine, citrate, TMAO, phenylalanine, tyrosine, alanine, glycine and taurine). The levels of creatinine, citrate, TMAO, phenylalanine and tyrosine were decreased, whereas the levels of alanine, glycine and taurine were increased in the KYDS patients. These biochemical changes were found to be associated with alterations in amino acid metabolism, energy metabolism and gut microflora.

Conclusion:

The identification of distinct expression profiles of metabolites and signaling pathways in KYDS patients with DM suggests that there are indeed molecular signatures underlying the principles of ''Syndrome Differentiation'' in traditional Chinese medicine.     

Current strategies for drug discovery through natural products

Importance to the field: Natural products are the most consistently successful source of drug leads, both historically and currently. Despite this, the use of natural products in industrial drug discovery has fallen out of favour. Natural products are likely to continue to be sources of new commercially viable drug leads because the chemical novelty associated with natural products is higher than that of any other source: this is particularly important when searching for lead molecules against newly discovered targets for which there are no known small molecule leads.

Areas to be covered: Current drug discovery strategies involving natural products are described in three sections: developments from traditionally used medicines, random testing of natural compounds on biological assays and use of virtual screening techniques with structures of natural products.

What the reader will gain: The reader will gain an insight into the potential for natural products in current drug discovery paradigms, particularly in the value of using natural products in virtual screening approaches.

Take home message: Drug discovery would be enriched if fuller use was made of the chemistry of natural products.     

从中医药降糖的进步谈新药研发中几个值得关注的问题

中医药降糖疗效不佳始终是一个无法回避的问题，尽管近年来中药降糖取得了较大进步，但仍然存在着种种问题，既影响了中医在治疗重大疾病方面发挥主流作用，也影响了中药新药的研发。文中对糖尿病的古今认识差异、治法差异、药理成果的回归、中药治疗剂量等临床中存在的主要问题进行了探讨，以期对中医药治疗糖尿病及中药新药研发有所启示。     

糖尿病治疗药的现况和今后发展方向

将治疗糖尿病的药物分类为胰岛素类 ,胰岛素分泌促进剂 ,胰岛素增敏剂 ,一氧化氮合酶抑制剂 ,糖原异生抑制剂 ,影响碳水化合物吸收的药物 ,中药类等类别分别进行综述 ,并指出今后发展方向。对今后中药的发展提出了看法。     

中药复方在欧盟注册的对策探析

在前人研究的基础上,明晰了中药复方在欧盟注册的障碍,并从奠定认同基础、实现文化融合、渗透法律理念、优化注册方案等角度全方位地对中药复方在欧盟顺利注册提出对策,以期为我国中药复方在欧盟成功注册提供参考.     

经方是中药开发的源泉

目的:探讨将经方作为中药新药开发的必要性。方法:从经方的定义、为何开发经方以及如何开发经方3个方面分析经方作为中药开发源泉的优势,指明新药研发的方向和方法。结果与结论:经方作为临床实践验证的确有疗效的中医药方剂,应加强以其为基础的中药新药的开发。     

中医医院小包装中药饮片推广使用情况分析

基于2010年全国中医基本现状调查数据,分析了全国2845所中医医院小包装中药饮片推广使用情况,结论是推广使用的比例为34.09%,并对使用与未使用小包装中药饮片的三级中医医院,从中药饮片支出、收入、收支结余等方面进行了统计对比分析研究,结果表明使用小包装会增加中药饮片收入和支出,但不影响收支结余。     

Active ingredients of traditional Chinese medicine in the treatment of diabetes and diabetic complications

Introduction: Diabetes mellitus (DM) is a chronic progressive systemic disease caused by metabolic disorder. In recent years, significant amounts of studies have shown that traditional Chinese medicine (TCM) and its active ingredients have obvious hypoglycemic effect.

Areas covered: This paper summarizes single herbs and their active ingredients from TCM with the role of treating DM, and relevant literatures published in the past decades are reviewed. The active ingredients are divided into polysaccharides, saponins, alkaloids, flavonoids, terpenoids and others, which are described in this article from the aspects of active ingredients, sources, models, efficacy, and mechanisms.

Expert opinion: Mechanisms of TCM in treating DM are concluded: i) to promote insulin secretion and increase serum insulin levels; ii) to increase the sensitivity of insulin and improve its resistance; iii) to inhibit glucose absorption; iv) to affect glucose metabolism of insulin receptor; and v) to scavenge radicals and prevent lipid peroxidation. The separation and extraction of effective monomer from TCM is an important direction of anti-diabetic drug discovery currently. Future research about hypoglycemic mechanism of TCM based on the clinical should combine with modern scientific methods and regulatory approach to strive for more meaningful discovery and innovation.     

2型糖尿病中西医结合诊治研究

目的探讨中西医结合治疗2型糖尿病(T2DM)临床疗效。方法将184例T2DM患者随机分为中西医结合治疗组和对照组各92例。对照组予二甲双胍联合格列齐特治疗,中西医结合治疗组在对照组的基础上辨证论治加用中药治疗。结果中西医结合治疗组的总有效率91.3%;对照组的总有效率79.34%(P<0.05)。结论二甲双胍联合格列齐特加中医方剂治疗T2DM的效果优于单纯西药治疗。     

天然产物的结构改造

药理活性和成药性是新药创制的两大要素, 药理活性自不待言, 成药性是由分子的物理化学性质、生物化学性质、药代动力学性质和安全性所支撑。天然产物作为动物、植物、微生物和海洋生物的次级代谢产物, 具有维持生理、自身防御和种群繁衍的功能, 许多药物来自天然产物。天然产物具有多样性和复杂性结构, 多含立体化学中心, 氮和卤素含量低。天然活性物质是良好的先导物, 但未必能满足成药性要求, 需要进行结构修饰和优化。结构改造的要旨是: 根据天然产物的分子大小和复杂程度, 采取不同的化学处置方式, 复杂和较大的分子作结构剖裂, 去除冗余原子; 研究构效关系, 提取药效团, 实现骨架迁越, 获得新结构类型分子; 消除不必要的手性中心, 保留与靶标结合的必须的构型与构象; 全合成实现工业化, 保护环境与资源。天然产物结构改造的方略是: 提高活性强度和选择性作用; 改善物理化学性质; 提高化学和代谢稳定性; 改善生物化学性质; 改善药代动力学性质; 消除或降低毒副作用和不良反应; 获得知识产权。本文以成功的实例解析以天然活性物质为先导物研制新药的内涵。     

Screening of natural products for drug discovery

The discovery of new biologically active compounds derived from natural products seems to be the main objective of many scientific researchers and pharmaceutical companies. Screening of natural products for this objective with the greatest possibility of success is always needed. Using plants in this area, especially, has a huge advantage owing to their long-term use in health care. In this review, the place of natural products in the therapeutic arsenal is rigorously analysed. The authors also describe and discuss several approaches (essentially biological approaches, including pharmacological and clinical) in selecting and screening natural products as candidates for drug discovery and for drug development. Furthermore, the steps leading from plants to drug discovery are given. In addition, approaches to select plants for biological and/or phytochemical investigation in the laboratory are discussed. Finally, the authors list some of the known drugs and their plant sources.     

染色增重中药材及饮片科学监管技术方法探究

目的探索科学监管染色增重中药材、中药饮片的技术依据。方法以2010-2012年亳州市食品药品检验所检验出的易染色增重中药材、中药饮片的检验数据为基础,进行比较和研究,分析染色增重中药材、中药饮片的现状和危害。结果与结论通过研究,发现了染色加重中药材、中药饮片的常见品种和常用的染色加重方法,找到严控措施,为科学监管提供了技术依据。     

中药降糖复方与二甲双胍对照治疗2型糖尿病的临床研究

目的观察中药降糖复方(降血糖中药方剂)对2型糖尿病患者的血糖、血脂、体质量的影响。方法采用随机、平行对照多中心前瞻性研究方法,选择超重及肥胖的初发2型糖尿病患者250例,随机分为试验组(口服降糖复方)与对照组(口服二甲双胍片),服药12周,分析降糖复方对2型糖尿病患者的影响。结果2组糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2 h血糖(P2BG)均较服药前下降。其中HbAlc,试验组下降(1.68±1.43)%,对照组下降(1.77±1.48)%;FBG,试验组下降(1.28±2.39)mmol·L~(-1),对照组下降(1.09±1.78)mmol·L~(-1););P2BG,试验组下降(4.73±4.23)mmol·L~(-1),对照组下降(3.99±3.67)mmol·L~(-1)),与服药前比较,差异有统计学意义(P<0.05)。2组间比较,差异无统计学意义(P>0.05)。2组胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)较服药前下降;而高密度脂蛋白(HDL)较服药前上升,与服药前比较,差异有统计学意义(P<0.05);2组间比较,TG差异有统计学意义(P<0.05),TC、HDL、LDL差异无统计学意义(P>0.05)。2组体质量指数(BMI)、腰围(WC)较服药前下降,与服药前比较,差异有统计学意义(P<0.05);而2组间比较,差异无统计学意义(P>0.05)。结论降糖复方可改善2型糖尿病患者的高糖脂状况,其疗效与普通二甲双胍片相似。     

英国人用传统草药药品政策分析

英国是欧盟中第一个启动对传统医药进行立法管理的国家.根据《欧盟传统草药指令》,英国制订了《英国人用传统草药产品法规2005》、《英国传统草药登记方案》等一系列有关传统草药管理的法规、指南等,从传统草药药品的申报、零售、批发、进口及生产各个环节进行管理,以保证安全、有效和质量可控.以英国传统草药登记程序、豁免条件等内容为...     

自乳化制剂的研究进展

本文综述了近年来自微乳化给药系统(SMEDDS)的研究进展,对自微乳化给药系统的处方优化、质量评价和新型表面活性剂的使用进行了探讨,并对自乳化制剂(SEDDS)在中药新制剂的形成与实际应用进行了展望。