芪苈强心胶囊对地高辛血药浓度影响的可能机制

芪苈强心胶囊是治疗慢性心力衰竭的中药复方制剂,临床发现有规范服用地高辛的心力衰竭病人联用芪苈强心胶囊后可出现地高辛血药浓度升高的现象,对用药安全性造成影响。通过检索相关文献,对出现此现象的可能机制进行综述,以期为临床安全用药提供参考。     

芪苈强心胶囊对慢性充血性心力衰竭病人生活质量的影响

目的观察芪苈强心胶囊治疗对慢性充血性心力衰竭病人生活质量的影响和临床疗效。方法将70例病人随机分为治疗组和对照组,每组35例。对照组单用西医常规治疗,治疗组在西医常规治疗的基础上加服芪苈强心胶囊,两组均以30d为1个疗程。观察两组治疗前后明尼苏达生活质量调查表(LiHFe)积分及心功能、射血分数(EF)、每搏量(SV)、每分钟输出量(CO)等指标变化情况。结果治疗组总有效率94.29%,对照组总有效率82.86%,两组比较差异有统计学意义(P<0.05)。治疗后两组明尼苏达生活质量调查积分和心功能等各项指标比较,差异均有统计学意义(P<0.05或P<0.01)。结论芪苈强心胶囊治疗慢性心力衰竭优于西医常规治疗。     

芪苈强心胶囊治疗心力衰竭机制的研究进展

芪苈强心胶囊属于通过中医理论研制而成的中成药,用于慢性充血性心力衰竭,增加心肌收缩力、心输出量和肾血流量,具有一定的临床疗效。但其治疗心力衰竭、抑制心脏重构的具体机制并不是十分清楚。本研究结合近年来国内外相关文献,就中药复方芪苈强心胶囊治疗心力衰竭的相关机制作一简单综述。     

芪苈强心胶囊对心力衰竭大鼠心肌线粒体蛋白质组影响的研究

目的采用蛋白质学方法研究芪苈强心（QLQX）胶囊对心力衰竭大鼠心肌细胞线粒体蛋白表达情况的影响,并探讨其治疗心力衰竭的机制。方法将心肌梗死心力衰竭大鼠模型分为心衰模型组、QLQX（1.0g/kg.d-1）胶囊组、假手术组。灌胃给药,每天一次,连续4周后,差速离心法提取心肌线粒体,双向电泳法分离差异表达的蛋白,凝胶银染后酶切差异蛋白点进行激光解析电离飞行时间（MALDI-TOF）质谱分析,通过Mascot软件在数据库检索。结果共鉴定出11种差异表达的蛋白质,表达上调的有NADH氧化还原酶、ATP合成酶、苹果酸脱氢酶、长链乙酰辅酶A脱氢酶、缩醛酶、肌酸激酶、58 kDa钙调蛋白;表达下调的蛋白有乳酸脱氢酶B、烯醇酶、αB2Crystallin和热休克蛋白27。结论 QLQX胶囊能够部分纠正衰竭心肌线粒体有关能量代谢、氧化应激相关酶的异常表达,可能是其治疗心力衰竭的机制之一。     

芪苈强心胶囊治疗高血压心力衰竭52例

目的观察芪苈强心胶囊治疗高血压心力衰竭的临床疗效。方法将104例高血压心力衰竭患者随机分为治疗组与对照组,各52例。两组均给予常规药物治疗,治疗组加服芪苈强心胶囊,每次4粒,每日3次。两组疗程均为3个月。结果治疗组总有效率90.4%,对照组为75.0%,两组比较差异有统计学意义(P0.05)。结论芪苈强心胶囊能有效控制心力衰竭,提高患者的生活质量,改善预后。     

基于网络药理学方法对芪归八味汤治疗病毒性心肌炎作用机制的分析

目的 基于网络药理学方法分析芪归八味汤治疗病毒性心肌炎(VMC)的作用机制.方法 在中药系统药理学数据库与分析平台、中药分子机制的生物信息学分析工具数据库中收集芪归八味汤的化学成分和作用靶点,通过UniProt数据库对得到的靶点进行基因注释.在OMIM和GeneCards数据库中查找VMC的疾病靶点,与药物靶点进行韦恩...     

芪苈强心胶囊对心力衰竭大鼠心室重构的作用及机制研究

目的 观察芪苈强心胶囊对慢性心力衰竭大鼠心室重构的作用,探讨其抗心力衰竭作用的相关机制.方法 将大鼠随机分为假手术组,模型组,芪苈强心胶囊高、中、低剂量组[1.2、0.6、0.3 g/(kg.d)],采用腹主动脉缩窄法制作慢性心力衰竭大鼠模型,术后4周开始灌胃给药,连续8周.检测血流动力学,心室指数,及血浆中内皮素-1(ET-1)、血管紧张素Ⅱ(Ang-Ⅱ)和肿瘤坏死因子-α(TNF-α)含量;RT-PCR法检测心肌组织基质金属蛋白酶-2(MMP-2)、MMP-9及基质金属蛋白酶抑制因子1(TIMP-1)表达;明胶酶谱法测定MMPs活性.结果 芪苈强心胶囊能显著改善血流动力学指标,芪苈强心胶囊组较模型组心室指数、ET-1、Ang-Ⅱ和TNF-α水平下降,MMP-2、MMP-9活性下降,TIMP-1表达升高.结论 芪苈强心胶囊可通过抑制MMPs活性、调节MMP/TIMP平衡改善慢性心力衰竭大鼠的心功能,抑制心室重构,延缓心力衰竭的发生.     

半夏泻心汤对大鼠肠外运动的影响

[目的]探讨经典方半夏泻心汤对大鼠肠外运动的影响。[方法]选取SD大鼠体外结肠、十二指肠各1段,保存于充有氧气的新鲜台氏液中,连接四导生理仪,记录曲线下面积及平均张力,予卡巴胆碱、盐酸肾上腺素拮抗剂,造成肠段偏亢或偏抑状态,再予半夏泻心汤不同剂量,观察其对体外肠段的作用。[结果]结肠:半夏泻心汤组与正常组相比,图像波动率降低,曲线下面积减少,平均值也减小(P<0.05);与加入卡巴胆碱组比较,卡巴胆碱对体外肠段呈促进作用,半夏泻心汤使曲线下面积减小,波动率降低,平均值减小(P<0.05);与加入盐酸肾上腺素组比较,盐酸肾上腺素对体外肠段呈抑制状态,半夏泻心汤使曲线下面积呈上升趋势,波动率增加,平均值上升(P<0.05)。十二指肠:半夏泻心汤组与正常组相比,图像波动率降低,曲线下面积减少,平均值也减小(P<0.05);与加入卡巴胆碱组比较,卡巴胆碱对体外肠段呈促进作用,半夏泻心汤使曲线下面积减小,波动率虽有升高趋势,但仍有降低,平均值减小(P<0.05);与加入盐酸肾上腺素组比较,盐酸肾上腺素对体外肠段呈抑制状态,半夏泻心汤使曲线下面积呈上升趋势,波动率增加,平均值上升(P<0.05)。[结论]半夏泻心汤对大鼠正常的肠运动功能呈轻微的抑制倾向,对偏抑或偏亢状态下的肠运动功能减慢或亢进起双向调节作用,这可能与肠道中胆碱能受体、肾上腺素能受体的功能有关。     

肠清胶囊对实验动物胃肠动力的影响

目的 :研究肠清胶囊对实验动物胃肠动力的影响。方法 :将 2 4只大白兔随机分为 0 .9% Na Cl溶液对照组、甘露醇组、番泻叶组和肠清液组 ,测定给药前后的胃肠电活动。结果 :4组实验动物中 ,肠清液组的胃肠电振幅最强 ,与对照组比较 P <0 .0 5。结论 :肠清胶囊具有增强胃肠动力 ,促进排空肠腔内粪便的作用     

芪参复肠方保留灌肠对腹腔镜直肠癌根治术后细胞免疫功能及肠黏膜损伤的影响

[目的]探讨中药芪参复肠方保留灌肠对腹腔镜直肠癌根治术后细胞免疫功能、肠黏膜损伤的影响。[方法]选择秦皇岛市海港医院2017年6月~2020年1月收治的84例直肠癌患者,按照随机数字表法分为2组,每组42例,2组均接受腹腔镜直肠癌根治术,对照组术后维持水、电解质酸碱平衡,并给予营养支持、抗生素等常规治疗及其他对症处理。中药组在对照组治疗基础上,于术后24 h应用中药芪参复肠方保留灌肠,2次/d,连续治疗7 d。比较2组术后肠鸣音恢复时间、首次排气时间、首次排便时间和腹胀发生率,并比较2组术后第1、4、7天血清胃动素、胃泌素水平;比较2组术后第1、7天外周血CD3^+、CD4^+、CD8^+、NK细胞含量及CD4^+/CD8^+,血清肠型脂肪酸结合蛋白、二胺氧化酶水平。[结果]中药组肠鸣音恢复时间、首次排气时间和首次排便时间均短于对照组(P<0.01),腹胀发生率低于对照组(P<0.05);术后第4天,中药组血清胃动素、胃泌素水平均高于对照组(P<0.01);术后第7天中药组外周血CD3^+、CD4^+、NK细胞含量及CD4^+/CD8^+高于对照组(P<0.01),血清肠型脂肪酸结合蛋白、二胺氧化酶水平均低于对照组,均差异有统计学意义(P<0.01)。[结论]腹腔镜直肠癌根治术后应用芪参复肠方保留灌肠可增强机体细胞免疫功能,减轻肠黏膜损伤,在早期提高胃肠激素水平,促进胃肠功能的恢复。     

大黄利胆胶囊联合水飞蓟宾治疗非酒精性脂肪性肝病的疗效及对肠道菌群的影响

目的:探讨大黄利胆胶囊联合水飞蓟宾治疗非酒精性脂肪性肝病的疗效以及对肠道菌群的影响。方法:选取2017年1月至2019年1月泰州市人民医院收治的80例非酒精性脂肪性肝病患者,按随机数字表法分为对照组和观察组,每组各40例。两组患者根据指南给予非药物康复措施;对照组患者口服水飞蓟宾,2~4片/次,3次/d。观察组患者在对照组患者治疗的基础上给予大黄利胆胶囊口服,2粒/次,2~3次/d,两组患者疗程均为3个月。比较两组患者治疗前后肝功能、血脂水平、肠道菌群的变化以及临床疗效。结果:治疗结束后,观察组患者的谷草转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转肽酶(GGT)以及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)低于对照组,差异有统计学意义(P<0.01);观察组患者的总有效率为92.50%,显著优于对照组(P<0.05);与对照组比较,观察组患者治疗后双歧杆菌、乳酸杆菌显著高于对照组,大肠杆菌明显低于对照组(P<0.01)。结论:大黄利胆胶囊联合水飞蓟宾治疗非酒精性脂肪性肝病,可改善患者的肝功能和血脂水平,提高临床疗效,调节肠道菌群可能是其疗效途径之一。     

Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: results of a prospective clinical trial

BACKGROUND AND AIM: The presence of a critical intestinal stricture is a contraindication for conventional capsule endoscopy for the risk of impaction. Prior assessment of intestinal patency can substantially minimize this risk. The aim of the present study was to assess the safety and efficacy of the M2A patency capsule (PC) for verification of intestinal strictures. METHODS: The M2A PC consists of a biodegradable body surrounding a small radiofrequency identification (RFID) tag. This capsule was administered to patients with known or suspected intestinal strictures. Patency was verified if the capsule was excreted intact. The capsule disintegrated into small fragments and only the RFID tag was excreted if retained at the stricture beyond a stipulated time. The patency scanner was used to detect the RFID tag externally. The M2A video capsule (VC) was administered to patients who excreted the intact capsule. RESULTS: Twenty-six patients with known or suspected intestinal strictures were administered the M2A PC. This included 16 (61%) patients with tuberculosis, eight (31%) with Crohn's disease, and one each of postoperative and malignant strictures. Eight capsules were excreted intact within 72 h and two at 109 and 110 h. Fifteen capsules disintegrated in the G(I) tract and one capsule was removed during surgery. No PC-related complications were noted. Six of the eight patients who tested positive for patency were tested with the regular M2A VC with normal excretion. CONCLUSION: The M2A PC is a reliable indicator of functional patency in suspected or even known cases of intestinal stricture. It could be used prior to conventional capsule endoscopy to predict and minimize the risk of impaction.     

心脉宁胶囊对血液流变学的影响

目的 :探讨心脉宁胶囊对血小板聚集、血液黏度和血栓形成的影响。方法 :家兔 7只 ,颈动脉放血 ,观察不同浓度的心脉宁及给药后不同时间点血小板聚集和聚集抑制百分率 ;SD大鼠 2 4只 ,用不同浓度的心脉宁灌胃 ,于颈动脉放血测量血液黏度 ;SD大鼠 30只 ,用不同浓度的心脉宁灌胃 ,于颈内静脉置丝线后对丝线上形成的血栓称重。结果 :不同浓度的心脉宁对家兔血小板聚集均有抑制作用。随心脉宁浓度的增加 ,对血小板聚集抑制作用也随之增加 （P<0 .0 5 ,P<0 .0 1）。每天喂养心脉宁 （6 g/kg）可使大鼠各项血液黏度指标明显降低 （P<0 .0 5或 P<0 .0 1）。不同浓度的心脉宁喂养组均与对照组血栓湿重有显著差异 （P<0 .0 1）。结论 :心脉宁可使血液黏度降低 ,对血小板聚集和血栓形成具有抑制作用。     

Effect of capsule placement with transnasal endoscopy

Aim: One of the prohibiting factors in achieving complete small bowel capsule endoscopy is slow gastric transit of the capsule. The present study retrospectively investigated the success rate of, and the time required for, transnasal endoscope‐assisted capsule placement to assess its clinical utility. Methods: In 24 of 27 patients who underwent capsule placement assisted by a transnasal endoscope, the capsule was successfully transported to and released in the duodenum (capsule placement group). For each patient in the capsule placement group, three age‐ and sex‐matched patients who underwent conventional capsule endoscopy were assigned as controls (n = 72). Gastric transit time, small bowel transit time, and rate of capsule arrival at the cecum within 8 h were compared between the two patient groups. Results: Among the 27 patients in whom capsule placement was carried out, the capsule was successfully placed in the duodenum in 24 patients (88.9% success rate). In the capsule placement group, gastric transit time was significantly shorter (10.5 vs 46.2 min, P = 0.0021), small bowel transit time was significantly longer (354.7 vs 301.3 min, P = 0.0134), and completion rate (capsule arrival at the cecum within 8 h) was significantly higher (83.3 vs 61.1%, P = 0.0455) than in the control group. There were no procedural accidents associated with capsule placement. Conclusion: Transnasal endoscope‐assisted capsule placement appears to be a safe and reliable procedure, achieving complete small bowel capsule endoscopy, and is considered clinically useful.     

Small intestinal bacterial overgrowth and intestinal permeability

Abstract

Objective. Capsule endoscopy (CE) is the gold standard to diagnose small bowel bleeding. The “suspected blood indicator” (SBI) offers an automated detection of active small bowel bleeding but validity of this technique is unknown. The objective was to analyze specificity and sensitivity of the SBI using the second small bowel capsule generation for the detection of active bleeding. Methods. This is a retrospective analysis of all patients (199) who attended our clinic for CE from June 2008 through March 2013. The second-generation PillCam SB 2 capsule was used for detection of (1) luminal blood content and (2) potentially responsible small bowel lesions. The findings of an independent investigator were correlated to SBI findings and a number of SBI markings were analyzed by a receiver operating characteristic (ROC). Results. In 157/199 cases, no sign of active bleeding or altered blood was detected. One hundred and thirty-seven of these 157 cases provided at least one SBI marking and a mean of 18.4 positive SBI markings per record were found. In 20 cases, neither SBI nor the human investigator detected abnormalities. Thirteen patients showed investigator-detected minor bleeding with mean SBI findings of 36 positive screenshots per record. When major bleeding was diagnosed by the investigator (n = 29), SBI detected a mean of 46.6 SBI-positive markings. SBI turned positive in 179 patients, whereas the investigator detected active bleeding in 42 cases. All patients with active bleeding were detected by SBI (sensitivity 100%, specificity 13%). ROC analysis revealed 51.0 SBI markings being the optimal cutoff for active versus no bleeding (sensitivity 79.1%, specificity 90.4%, misclassification of 15.3%). Conclusion. The new SBI software is a reliable tool to exclude active bleeding and/or major lesions but analysis of the CE video by a trained investigator is still important for the detection of lesions responsible for past bleeding.     

参松养心胶囊治疗室性早搏的效果

目的：观察参松养心胶囊不同治疗方法对室性早搏治疗的疗效。方法：98例室性早搏的入选病例均使用参松养心胶囊并美托洛尔联合治疗,治疗一周后,随机均分为两组：一组持续使用参松养心胶囊联合美托洛尔治疗3个月（持续治疗组）,另一组使用参松养心胶囊联合美托洛尔治疗1个月后停用参松养心胶囊1周,再继续原方案治疗（间断治疗组）,观察两组室性早搏发作的情况。结果：治疗1月时,两组效果无显著差异（P〉0.05）,停用参松养心胶囊1周内,间断治疗组早搏发生率（65.1%,28/43）明显高于持续治疗组（2.4%,1/41）（x2=36.47,P〈0.05）,两组在3个月后抗心律失常作用方面没有显著差别（P〉0.05）。结论：参松养心胶囊在治疗室性早搏过程中,需要持续给药,如果短期中断治疗可出现病情反弹,再加用参松养心胶囊治疗仍然有效,对长期室性早搏的控制无显著影响。     

Wireless capsule endoscopy for diagnosis of small intestinal lesions

Background: Capsule endoscopy represents a new and highly innovative method of visualizing the small intestine. The aim of the present study was to evaluate the practicality, usefulness and diagnostic yield of capsule endoscopy in a group of patients with suspected small intestinal disease. Methods: Eleven patients underwent capsule endoscopy using the M2A Capsule Endoscope? (Given Imaging, Yogneam, Israel). The indications for the procedure were: obscure gastrointestinal (GI) bleeding in seven patients, evaluation of Crohn's disease in three patients and unexplained abdominal pain and weight loss in one patient. Results: Abnormalities were detected in six of 11 patients overall. Detection of abnormalities was highest among patients with obscure GI bleeding where active bleeding and/or the source of bleeding was identified in five of the seven (71.4%) patients. One of the three patients with Crohn's disease had an ileal ulcer detected, while the remaining patient with unexplained weight loss and pain had a normal examination. Conclusion: We have found in our preliminary experience that capsule endoscopy is a useful and practical procedure to perform especially for evaluation of obscure GI bleeding.     

丁酸钠对DMH诱导大鼠肠道肿瘤的作用

目的:观察1,2-二甲基肼(1,2-dimethy lhydrazine,DMH)是否可以诱导出小肠肿瘤,并与大肠进行比较.并探讨丁酸钠(sodium butyrate,NaBt)对DMH诱导肠道肿瘤的作用.方法:实验动物用SPF级♂Wistar大鼠,大小为8-9周龄,共分4组:DMH组、DMH+NaBt组、NaBt组、对照组.实验30-32wk之后过量麻醉使大鼠安乐死,取出小肠和大肠,观察肿瘤部位、数量、大小等;然后用10%甲醛固定,制作病理切片,观察各部位组织学改变.结果:实验结束时DMH组大鼠死亡率60.00%(18/30),DMH+NaBt组死亡率48.00%(12/25).DMH组肠道肿瘤发生率66.67%(8/12),4只肿瘤单发,4只多发,荷瘤率1.33(16/12),小肠肿瘤4个,大肠肿瘤12个;DMH+NaBt组肠道肿瘤发生率84.62%(11/13),6只为单发肿瘤,5只多发,荷瘤率1.46(19/13),小肠肿瘤3个,大肠肿瘤16个.两组之间肿瘤发生率及荷瘤率均无统计学差异.无论是DMH组还是DMH+NaBt组,结肠肿瘤发生率都高于小肠肿瘤,统计学有显著性差异(75.00%vs25.00%,P<0.05;84.21%vs15.79%,P<0.01).DMH组中肿瘤平均体积>0.05cm3个数占37.5%;DMH+NaBt组中肿瘤平均体积>0.05cm3个数占73.68%,两组肿瘤大小有统计学差异(37.50%vs73.68%,P<0.05).与DMH+NaBt组相比,DMH组浸润深度多局限于黏膜层内,有统计学差异(43.75%vs10.53%,P<0.05).结论:DMH也可诱导大鼠小肠肿瘤的发生,但发生率明显低于大肠肿瘤;NaBt可能促进肿瘤生长,关于NaBt对DMH诱导的肠道肿瘤作用仍需做进一步的深入研究.