耐多药肺结核患者中医证候与胸部CT特征的研究

目的:分析耐多药肺结核患者中医临床证候分布特点与胸部CT表现之间的关系。方法:对60例耐多药肺结核患者的中医证候分布、胸部CT表现二者之间的关系进行回顾性分析。结果:耐多药肺结核患者中医分为肺阴亏虚、气阴两虚、阴虚火旺、气虚血瘀4个证型,主要以气阴两虚型最为多见(51.67%),且随着胸部CT病变程度的加重,气阴两虚证愈发突显。结论:耐多药肺结核患者的病机以阴虚为主,证型分布与胸部CT的病变程度具有一定的相关性。     

耐多药肺结核中医证候与肺部影像相关性研究

目的:通过分析耐多药肺结核中医证候一般分布特征、中医证候与肺部病变范围和空洞情况相关性,初步明确耐多药肺结核中医证候分布规律。方法:采用临床流行病学方法研究120例耐多药肺结核患者的证候分布及与影像学的关系,具体为设计统计分类表,标注证候、性别、年龄、病程、肺部病变范围、空洞情况、耐药基因突变位点等条目,建立Excel数据库,提取中医证候分布信息,确定数量、出现频率等,进行统计学比较。结果:120例耐多药肺结核患者中医证候分布排序依次为阴虚火旺证(40.83%)、气阴两虚证(38.33%)、阴阳两虚证(11.67%)、肺阴亏虚证(9.17%)。肺阴亏虚证与阴虚火旺证、气阴两虚证比较,其肺部病变范围相对较小;阴虚火旺证、气阴两虚证、阴阳两虚证三型肺部病变范围无明显差异。阴虚火旺证出现肺部空洞的表现与肺阴亏虚证、气阴两虚证、阴阳两虚证比较相对较多;肺阴亏虚证、气阴两虚证、阴阳两虚证三型出现肺部空洞表现的情况无明显差异。结论:耐多药肺结核中医证候分布排序为阴虚火旺证、气阴两虚证、阴阳两虚证、肺阴亏虚证。肺阴亏虚证与阴虚火旺证、气阴两虚证、阴阳两虚证等比较,肺部病变范围较轻。阴虚火旺证与肺阴亏虚证、气阴两虚证、阴阳两虚证等比较,肺部空洞病变最为严重。     

耐多药与药物敏感肺结核的CT影像表现比较

目的对比耐多药肺结核与药物敏感肺结核的CT影像表现,提高对耐多药肺结核的认识。方法选取2013年3月—2014年3月我院收治的80例耐多药肺结核患者作为观察组,另选取同期我院收治的80例药物敏感肺结核患者作为对照组。所有患者于治疗前后进行胸部CT扫描,比较2组患者CT影像学表现上的病变范围和病变形态,并对比治疗前后患者病变部位的变化情况。结果观察组患者肺内病灶形态多样,分布广泛,且全肺叶受侵的患者例数明显多于对照组(P<0.05);与对照组比较,观察组患者的病变形态中出现肺内实变、广泛播散灶、多发空洞、胸膜增厚、合并毁损、支扩以及气胸的患者例数明显增多(P均<0.05);与对照组比较,观察组患者经治疗后病灶明显吸收的例数明显较少,而病变进展的例数相对较多,差异有统计学意义(P均<0.05)。结论耐多药肺结核病灶形态多样,分布广泛,易发生广泛播散、多发空洞及其他严重并发症,治疗效果及预后均相对较差。     

肺结核中医辨证证型与X线影像及痰菌关系的研究

目的探讨肺结核中医辨证证型与X线影像及痰菌检查的关系。方法将688例肺结核患者进行中医辨证,分为肺阴亏虚型、阴虚火旺型、气阴两虚型和阴阳两虚型,分析各证型与胸部X线征象和痰中抗酸杆菌的关系。结果688例患者中肺阴亏虚型404例(58.7%),X线影像以小范围的增殖、渗出灶为主;阴虚火旺型204例(29.7%),X线影像见病灶扩大,干酪样病灶和空洞性病灶较其他类型多见;气阴两虚型67例(9.7%),X线示广泛纤维化样病灶发生率较高(47.3%);阴阳两虚型13例(1.9%),见于疾病晚期,肺组织损伤严重者。4型的痰涂片抗酸杆菌阳性率依次是(19.2%,63.1%,13.5%,3.9%),各证型间比较有显著性差异(P<0.01)。结论肺结核中医辨证证型与X线影像及痰中抗酸杆菌存在一定的关系,X线胸片和痰菌检查对肺结核中医辨证分型诊断客观化有一定的参考价值。     

继发性肺结核初治患者的中医证候分布规律探讨

目的观察继发性肺结核初治患者的中医证候分布规律。方法选择本院自2015年1月—2016年1月收治的110例继发性肺结核初治患者的流行病学情况进行统计分析,同时对与之相对应的中医证候进行初步的整理、总结,以探讨中医证候与客观指标的相互关系。结果初治继发性肺结核以肺阴虚、阴虚火旺、气阴两虚为主要证型;肺阴虚型患者在肺部影像学变化及痰菌阳性率与其他两种类型比较,出现空洞、合并胸膜病变、痰菌阳性率的发生率低、病变单纯。结论继发性肺结核初治患者的中医证候规律与肺部影像学变化及痰菌阳性率有相关性。     

抗痨方联合西药治疗阴虚火旺型初治继发性肺结核41例临床评价

目的观察中药抗痨方联合西药治疗阴虚火旺型初治继发性肺结核的临床疗效。方法将符合入组标准的阴虚火旺型初治继发性肺结核患者随机分为两组。对照组采用2HREZ/4HR化疗方案,治疗组在化疗基础上加用抗痨方治疗。动态检测患者的肝功能、痰菌、肺部结核病灶的吸收情况与空洞直径,以及临床证候改善情况。结果两组均在治疗3个月末痰涂片阳性率明显低于治疗前(P0.01),但组间比较差异无统计学意义。治疗组在3个月末的病灶吸收率明显高于1个月末(P0.01),且病灶吸收较对照组快;在空洞吸收率方面,治疗组略高于对照组,但组间无明显差异。治疗组中医证候改善明显优于对照组,且肝损率低于对照组(P0.05)。结论中药抗痨方联合西药治疗阴虚火旺型初治继发性肺结核能提高结核病灶吸收速度及吸收率,较快改善中医证候,减少肝损发生率、减轻肝损严重程度。     

75例新型冠状病毒肺炎患者中医证候与肺部CT影像相关性分析

[目的]对新型冠状病毒肺炎(简称新冠肺炎,COVID-19)患者中医证候与肺部计算机断层扫描(CT)影像的相关性进行分析,为中医药治疗提供参考.[方法]对武汉市中医院2019年12月20日—2020年1月31日,收治的75例COVID-19患者信息进行整理,采用预先设置的数据提取表收集中医证型与肺部CT影像等信息,根据...     

经皮肺穿刺注药结合利肺片治疗耐多药空洞型肺结核疗效分析

目的：探讨CT引导经皮肺穿刺注药结合利肺片治疗耐多药空洞型肺结核的疗效。方法：将84例耐多药空洞型肺结核患者随机分为2组,介入治疗组采用经皮肺穿刺、空洞注入含抗结核药物凝胶配合全身化疗和利肺片治疗,对照组单用抗结核药物治疗。结果：介入治疗组痰茵阴转率73．3％、病灶吸收率71．1％、空洞闭合率47．4％,明显高于对照组,2组比较差异有统计学意义。结论：CT引导经皮肺穿刺注药配合全身化疗和利肺片治疗治疗耐多药空洞型肺结核,疗效优于单纯全身化疗,操作安全,不良反应少。     

CT对肺结核与肺癌空洞的鉴别诊断价值

目的:探讨计算机断层扫描(CT)在肺结核空洞与肺癌空洞鉴别诊断中的应用。方法:抽取2012年5月-2014年5月本院25例肺结核空洞患者(A组)及25例肺癌空洞患者(B组),均经病理手术证实为肺结核空洞与肺癌空洞,对其CT检查的影像学资料进行回顾性分析。结果:观察组卫星灶(80.0%)、钙化(28.0%)、厚壁空洞(64.0%)为主要特点,分叶(8%)、毛刺(12.0%)、胸膜凹陷(16.0%)等现象少见,两组患者征象比较,除薄壁空洞外,差异均具有统计学意义(P0.05)。结论:肺结核空洞主要CT征象为厚壁空洞、周围卫星灶以及钙化,而肺癌空洞主要征象为分叶、厚壁空洞、胸膜凹陷、毛刺以及壁结节,在临床鉴别诊断中具有重要参考价值。     

96例空洞型肺结核X线与螺旋CT对照分析报告

目的:通过对空洞型肺结核普通X线与CT影像表现的差异,进一步提高对二者在肺结核诊断价值方面的认识.方法:回顾性分析本院收治的资料完整且经证实的96例空洞型肺结核病人的X线与CT影像表现,并相互对比.结果:本组96例肺结核病例中,X线发现62例中有空洞78个,其中有5例为多发性空洞.CT检出该组96例均发现有空洞共146个,其中19例为多发性空洞.另外,CT发现支气管播散灶及少量胸水较X线明显增多.结论:通过对本组病例的X线与CT影像表现对照分析,发现CT对肺结核空洞的有无、数目、大小、位置、空洞壁及壁内外特征、支气管播散灶等方面明显优于普通X线.     

Influence of Scalp Point-through-point Acupuncture on 200 kDa Neurofilament Protein in Rats with Acute Cerebral Infarction

目的研究头穴透刺对急性脑梗死大鼠神经丝蛋白-200(NF-200)的影响,探讨针刺对脑梗死大鼠神经可塑性影响的机制.方法将健康雄性Wistar大鼠随机分为假手术组(A组)、模型组(B组)、针刺组(C组).通过建立大鼠局灶性脑缺血模型(MCAO),用逆转录-聚合酶链反应(RT-PCR)法,测定以上各组在7 d、14 d、28 d不同时间点NF200 mRNA变化情况.结果头穴透刺组脑组织NF-200的表达与假手术组、造模组相比差异有统计学意义(P＜0.05);而在不同时间窗内头穴透刺组,模型组与假手术组比较差异有统计学意义(P＜0.01).表明头穴透刺可以促进脑组织神经丝蛋白-200的表达.结论头穴透刺能够提高脑缺血后神经功能,促进肢体功能恢复,增加神经丝蛋白-200的表达,发挥对脑组织神经细胞可塑性的调节作用.     

Acupuncture treatment for Subacute Non-specific Low Back Pain-A Retrospective Cohort Study in the Role of the Back Exercise in Acupuncture Services for Low Back Pain Sufferers

目的研究腰部的锻炼方法与针刺疗效的内在关系,以揭示部分腰痛病人针灸治疗恢复较慢的原因.方法采用回顾性调查研究方法.70例被诊断为腰痛的患者按顺序性抽样方法分为两组.观察组44例采用针刺治疗加锻炼的方法,对照组26例仅针刺治疗.根据针刺治疗后1年内的复发率比较两组间的差异.结果与结论背部锻炼是一个危险因素,它和腰痛的频繁发作有关.而针刺治疗是一种对亚急性非特异性腰痛的有效治疗方案.     

The effect of Nigella sativa alone, and in combination with dexamethasone, on tracheal muscle responsiveness and lung inflammation in sulfur mustard exposed guinea pigs

Ethnomedical relevance

The anti-inflammatory activity of both systemic and local administrations of essential oil from Nigella sativa L. has been shown.

Aim of the study

Therefore, the effect of Nigella sativa on tracheal responsiveness (TR) and lung inflammation of sulfur mustard (SM) exposed guinea pigs was examined.

Materials and methods

Guinea pigs were exposed to diluent solution (control group), inhaled SM (SME group), SME treated with Nigella sativa (SME + N), SME treated with dexamethasone (SME + D) and SME treated with both drugs (SME + N + D), (n = 7 for each group). TR to methacholine, total white blood cell (WBC) and differential WBC count of lung lavage, and serum cytokines were measured 14 days post-exposure.

Results

The values of TR, eosinophil, monocyte, lymphocyte, interleukine-4 (IL-4) and interferon gamma (IFN-γ) of SME group were significantly higher than those of controls (p < 0.05 to p < 0.001). The TR in SME + N, SME + D and SME + N + D was significantly lower compared to that of SME group (p < 0.01 for all cases). The percentage of eosinophil in SME + D, and the percentage of monocyte in SME + N + D (p < 0.05 to p < 0.01) were significantly lower than those in SME group. The neutrophil number was decreased in SME + N and SME + N + D groups compared to SME animals (p < 0.05 to p < 0.01). IL-4 levels in serum of SME + N (p < 0.01), SME + D (p < 0.05), SME + N + D (p < 0.01) and IFN-γ in SME + N (p < 0.05) were greater than those in SME animals.

Conclusions

These results showed a preventive effect of Nigella sativa on TR and lung inflammation of SM exposed guinea pigs.     

川芎嗪、阿魏酸和延胡索乙素在模型与正常大鼠体内药动学比较研究

目的探讨川芎、延胡索中主要活性成分在模型与正常大鼠体内药动学规律与差异。方法 SD大鼠分为对照组和子宫内膜异位症模型组,每组8只,各组均按川芎嗪50mg/kg、阿魏酸30mg/kg、延胡索乙素20mg/kg ig给药,采用高效液相色谱法测定各组大鼠血浆中川芎嗪、阿魏酸和延胡索乙素的质量浓度,DAS2.0程序计算药动学参数。结果模型组川芎嗪药时曲线下面积(AUC_(0~t))、达峰浓度(C_(max))、达峰时间(t_(max))、半衰期(t_(1/2))和平均驻留时间(MRT_(0~t))与对照组相比差异均不显著(P0.05);模型组阿魏酸AUC_(0~t)、C_(max)、t_(max)都小于对照组,但差异没有显著性(P0.05),t_(1/2)、MRT_(0~t)显著小于对照组(P0.05);模型组延胡索乙素AUC_(0~t)、t_(max)、MRT_(0~t)均显著大于对照组(P0.05)。结论川芎、延胡索主要活性成分在正常大鼠和模型大鼠的体内过程有所不同。阿魏酸在模型大鼠体内消除更快,延胡索乙素在模型大鼠体内吸收浓度更高、消除更慢,川芎嗪在正常及模型大鼠的体内过程无显著性差异。     

Bacopa monnieri and its constituents is hypotensive in anaesthetized rats and vasodilator in various artery types

Ethnopharmacological relevance

Bacopa monnieri (Brahmi) provides traditional cognitive treatments possibly reflecting improved cerebral hemodynamics. Little is known about the cardiovascular actions of Brahmi. We sought to assess its effects on blood pressure and on isolated arteries, thus providing insights to clinical applications.

Materials and methods

Intravenous Brahmi (20-60 mg/kg) was tested on arterial blood pressure and heart rate of anaesthetized rats. In vitro vasorelaxation was assessed in arteries, with and without blockers of nitric oxide synthase (L-NAME), cyclooxygenase (indomethacin), and mechanical de-endothelialisation. The effects of Brahmi on Ca²⁺ influx and release from stores were investigated.

Results

Intravenous Brahmi extract (20-60 mg/kg) decreased systolic and diastolic pressures without affecting heart rate. Brahmi evoked relaxation in isolated arteries in order of potency: basilar (IC50 = 102 ± 16 μg/ml) > mesenteric (171 ± 31) > aortae (213 ± 68) > renal (IC50 = 375 ± 51) > tail artery (494 ± 93) > femoral arteries (>1000 μg/ml). Two saponins, bacoside A3 and bacopaside II, had similar vasodilator actions (IC50 = 8.3 ± 1.7 and 19.5 ± 6.3 μM). In aortae, without endothelium or in L-NAME (10-4 M), Brahmi was less potent (IC50 = 213 ± 68 to 2170 ± 664 and 1192 ± 167 μg/ml, respectively); indomethacin (10-5 M) was ineffective. In tail artery, Brahmi inhibited K⁺-depolarization induced Ca²⁺ influx and Ca²⁺ release from the sarcoplasmic reticulum by phenylephrine (10-5 M) or caffeine (20 mM).

Conclusions

Brahmi reduces blood pressure partly via releasing nitric oxide from the endothelium, with additional actions on vascular smooth muscle Ca²⁺ homeostasis. Some Brahmi ingredients could be efficacious antihypertensives and the vasodilation could account for some medicinal actions.     

小儿清瘟解热颗粒的解热抗炎镇痛作用

目的:研究小儿清瘟解热颗粒的解热、抗炎及镇痛作用。方法:选取Wistar大鼠,日本大耳白兔,分别采用ih酵母致大鼠发热模型,采用内毒素致家兔发热模型,观察小儿清瘟解热颗粒的解热作用;选取KM小鼠,采用醋酸致小鼠扭体及热板刺激观察小儿清瘟镇痛反应;ICR小鼠,SD大鼠通过小儿清瘟解热颗粒对二甲苯所致耳肿胀,小鼠毛细血管通透性,大鼠后肢足跖炎症性肿胀的影响观察其抗炎作用。结果:小儿清瘟解热颗粒3.92 g·kg-1及15.68 g·kg-1于给药3 h能显著降低家兔肛温差值(P0.05,P0.01),3.78~30.24 g·kg-1于给药4 h能显著降低大鼠肛温(P0.05,P0.01)。小儿清瘟颗粒43.68 g·kg-1显著减少小鼠扭体次数(P0.05),10.92,21.84 g·kg-1于给药2 h能显著提高小鼠痛阈值(P0.05)。小儿清瘟解热颗粒5.46~43.68 g·kg-1连续给药3 d显著减轻二甲苯所致小鼠右耳肿胀度(P0.01),7.56 g·kg-1组于给药1 h显著降低足肿胀度(P0.05),15.12 g·kg-1组于给药0.5,2,4 h显著降低足肿胀度(P0.05,P0.01),30.24 g·kg-1组于给药0.5~4 h显著降低足肿胀度(P0.05,P0.01),小儿清瘟解热颗粒43.68 g·kg-1组腹腔冲洗液吸光度值显著低于模型组(P0.05)。结论:小儿清瘟解热颗粒具有解热、抗炎及镇痛作用。     

基于单向灌流法的葛根素羧甲基壳聚糖微球肠吸收特性研究

目的考察葛根素羧甲基壳聚糖微球的在体肠吸收特性。方法采用大鼠在体单向灌流法,以HPLC法测定葛根素的量,分别考察不同灌流体积流量、药物质量浓度、肠段对药物吸收的影响,并对比了葛根素原料药及载药微球的吸收特性。结果灌流体积流量对葛根素的吸收速率常数(Ka)和表观渗透系数(Papp)有显著性影响(P0.05);葛根素的质量浓度对Ka和Papp无显著性影响(P0.05);葛根素在空肠和回肠的Ka和Papp无显著性差异,但均显著大于在十二指肠处的值(P0.05);载药微球在空肠的Ka和Papp值显著高于葛根素原料药(P0.05)。结论葛根素羧甲基微球中葛根素的吸收机制为被动扩散,其在空肠和回肠段吸收较好,羧甲基壳聚糖作为载体能显著提高葛根素的吸收。     

Endothelium-independent relaxation and contraction of rat aorta induced by ethyl acetate extract from leaves of Morus alba (L.)

Aim of the study

Based on screening for vasoactive traditional Chinese medicinal herbs, the present study was performed to investigate the vasoactive effects of an ethyl acetate extract from leaves of Morus alba (L.) (ELM) on rat thoracic aorta and the mechanisms underlying these effects.

Materials and methods

Isolated rat thoracic rings were mounted in an organ bath system and the effects of ELM on their responses were evaluated.

Results

ELM (0.125–32.000 g/l) induced a concentration-dependent relaxation (P < 0.01 vs. control) both in endothelium-intact and -denuded aortas precontracted by high K⁺ (6 × 10⁻² M) or 10⁻⁶ M phenylephrine (PE). In endothelium-denuded aortas, ELM at the EC₅₀ concentration reduced Ca²⁺-induced contraction (P < 0.01 vs. control) after PE or KCl had generated a stable contraction in Ca²⁺-free solution. And after incubation with verapamil, ELM induced contraction in endothelium-denuded aortas precontracted by PE (P < 0.01 vs. control); this was abolished by ruthenium red (P < 0.01 vs. ELM-treated endothelium-denuded group; P > 0.05 vs. control), but not by heparin (P > 0.01 vs. ELM-treated endothelium-denuded group; P < 0.01 vs. control).

Conclusions

The results showed that ELM had dual vasoactive effects, and the relaxation was greater than the contraction. The relaxation was mediated by inhibition of voltage- and receptor-dependent Ca²⁺ channels in vascular smooth muscle cells, while the contraction occurred via activation of ryanodine receptors in the sarcoplasmic reticulum.     

5种黄连生物碱大鼠体外肝代谢特征比较

目的 探讨黄连中5种结构相似异喹啉生物碱大鼠体外肝代谢的选择性。方法 采用大鼠体外肝微粒体温孵方法,通过考察温孵时间、微粒体蛋白浓度以及底物浓度对小檗碱、巴马汀、黄连碱、表小檗碱和药根碱代谢的影响,求得代谢反应动力学参数K_m、V_max和CL_int。结果 5种黄连生物碱成分的体外肝代谢动力学参数K_m和CL_int间差异明显（P＜0.05）。结论 黄连中5种异喹啉生物碱大鼠体外肝代谢存在显著选择性。