肠炎清治疗湿热内蕴型溃疡性结肠炎的临床研究

目的；探讨肠炎清治疗湿热内蕴型溃疡性结肠炎（ＵＣ）的临床疗效。方法：将１２８例患者随机分为肠炎清试验组及柳氮磺胺吡啶对照组各６４例，分别给予口服及直肠滴注，治疗６０ｅ，对试验数据进行统计处理。结果：试验组临床综合疗效、证候疗效、肠镜下粘膜疗效以及肠粘膜病理组织学疗效均明显优于对照组（均Ｐ〈０．０１）。结论：运用肠炎清口服与直肠滴注治疗湿热内蕴型溃疡性结肠炎是一种良好的综合疗法。     

当归拈痛汤联合美沙拉嗪治疗湿热内蕴型溃疡性结肠炎的随机对照研究

[目的]观察当归拈痛汤联合美沙拉嗪湿热内蕴型治疗溃疡性结肠炎的临床疗效及对炎症细胞因子的影响。[方法]选择符合纳入标准的溃疡性结肠炎患者96例,随机分为治疗组和对照组,每组48例。对照组给予美沙拉嗪肠溶片1g口服3次/d治疗,治疗组在口服美沙拉嗪肠溶片的基础上给予当归拈痛汤中草药口服。治疗10周后观察2组患者临床症状、实验室指标、大肠黏膜积分变化、并统计临床疗效。[结果]治疗组治疗后在中医症状积分、理化检测指标、大肠黏膜方面与对照组比较差异有统计学意义(P0.05);治疗组与对照组临床疗效总有效率分别为93.75%、79.17%,比较差异有统计学意义(P0.05)。[结论]当归拈痛汤联合美沙拉嗪能够有效地缓解湿热内蕴型溃疡性结肠炎患者临床症状及大肠黏膜病变,改善相关检测指标水平,值得进一步推广及应用。     

复方苦参结肠溶胶囊治疗溃疡性结肠炎24例

[目的]观察复方苦参结肠溶胶囊治疗溃疡性结肠炎(湿热内蕴证)患者的临床疗效及安全性.[方法]采用随机、双盲双模拟、对照的方法共入组溃疡性结肠炎(湿热内蕴证)患者43例,其中试验组24例,对照组19例,试验组给予以复方苦参结肠溶胶囊及美沙拉嗪肠溶片模拟剂,对照组予以美沙拉嗪肠溶片及复方苦参结肠溶胶囊模拟剂,8周后对患者的中医症候积分、肠镜下表现、肠黏膜病理组织学炎症程度及Sutherland疾病活动指数积分等指标进行评价,并观察不良反应发生情况.[结果]2组患者经治疗后均能明显改善中医症候、肠镜下表现、肠黏膜病理组织学炎症程度及降低Sutherland疾病活动指数积分;2组均未发生严重不良反应.[结论]复方苦参结肠溶胶囊治疗轻、中度溃疡性结肠炎(湿热内蕴证)具有较好的治疗效果,同时具有较好的安全性,可以作为该病治疗的一种选择.     

清热利湿法对湿热内蕴证溃疡性结肠炎疾病活动度及肠黏膜屏障的临床疗效研究

目的:探讨清热利湿法联合西药治疗湿热内蕴证溃疡性结肠炎的临床疗效。方法:选取2018年1月-2021年6月治疗的溃疡性结肠炎患者84例,按随机数字表法分为对照组和实验组,每组各42例。对照组给予美沙拉嗪及整肠生治疗;实验组在对照组的基础上,联合口服自拟清热利湿中药治疗。两个组的疗程均为8周。记录治疗前后患者的改良Mayo活动指数评分、Baron评分、Gebos指数、血清二胺氧化酶、D-乳酸、内毒素、中医辨证积分和疾病活动指数(DAI)评分。结果:两组患者治疗后,改良Mayo活动指数评分、Baron评分、Gebos指数、血清二胺氧化酶、D-乳酸、内毒素、中医辨证积分与DAI评分的改善均优于治疗前(P<0.05)。改良Mayo活动指数评分、Baron评分、Gebos指数、内毒素、中医辨证积分与DAI评分等评价指标,治疗后实验组的改善情况均优于对照组(P<0.05)。结论:清热利湿法联合西药治疗湿热内蕴证溃疡性结肠炎可以提高临床疗效,促进患者肠道黏膜屏障功能的恢复。     

肠炎清对湿热内蕴型肠黏膜受损时菌群失调的影响

[目的]研究肠炎清对湿热内蕴型肠黏膜受损时菌群失调的影响.[方法]将60例符合纳入标准的门诊及住院患者随机分为2组,各30例,其中2组菌群失调者各17例.治疗组口服中药肠炎清,50 ml/次,2次/d,并用肠炎清直肠滴注100ml,1次/d,连续治疗6周;对照组口服美沙拉嗪,0.5 g/次,3次/d,连续治疗6周.观察患者大便中细菌总数变化,革兰氏阳性、阴性杆菌及球菌的比率改变和大便培养情况,结肠镜下观察黏膜变化,并对治疗前后进行统计学分析.[结果]治疗组与对照组均有效修复肠黏膜,治疗组在改善菌群失调方面明显优于对照组(P＜0.05);当肠黏膜修复明显时,对应的菌群失调也明显改善;而肠黏膜无修复时,对应的菌群失调改善也不明显.[结论]通过口服及灌肠的方法,肠炎清能够抑制肠黏膜损伤,修复受损肠黏膜,明显改善肠道菌群失调.     

中西药合用及灌肠治疗溃疡性结肠炎40例

目的采用中西药合用及灌肠治疗溃疡性结肠炎的疗效观察．方法溃疡性结肠炎患者40例，男30例，女10例，年龄22岁～56岁，平均年龄39岁，病程3mo～6a，以溃疡性结肠炎的临床表现特征，乙状结肠镜及X光钡剂灌肠诊断溃疡性结肠炎．根据中医的传统理论及临床表现及辨证分型，分为湿热内蕴型8例，脾肾阴虚型17例，脾胃虚弱型6例，气滞血瘀型4例，肝郁脾虚型5例，我们采用黄苓、黄柏、地榆各12g，水煎100mL，将庆大霉素16万U，强的松10mg、甲硝唑0．4研末加入液体内保留灌肠，1次／d，2wk为1疗程，观察疗效．结果中西药合用保留灌肠治疗溃疡性结肠炎临床症状消失，大便镜检阴性，结肠镜检查肠粘膜恢复正常，基本治愈30例（75％），临床症状基本消失或减轻，大便镜检阴性，结肠镜检查肠粘膜病变有明显改善，好转6例（15％），治疗前后临床症状，大便常规及结肠镜检查均无改善，无效4例（10％），总有效率为90％．结论中西药合用及保留灌肠治疗溃疡性结肠炎，既治标又治本，标本相照，内外合治的综合疗法，故诸药合用疗效较好．     

珍珠固肠散保留灌肠治疗湿热内蕴型左半结肠溃疡性结肠炎临床疗效

目的:观察珍珠固肠散保留灌肠治疗溃疡性结肠炎的临床疗效及优势.方法:40例轻、中度初发或复发型左半结肠溃疡性结肠炎活动期湿热内蕴证患者随机分为治疗组和对照组各20例.治疗组给予中药珍珠固肠散保留灌肠,疗程为45 d;对照组给予口服美沙拉嗪肠溶片,疗程45 d.疗程结束后对主要临床症状、中医症候和生活质量的改善进行评估.结果:治疗组总体疗效评价其显效率为80%,临床症状缓解率、中医症候疗效、诱导缓解率分别为52.5%,85.0%,75.0%.对照组总体疗效评价其显效率为55%,临床症状缓解率、中医症候疗效、诱导缓解率分别为40.0%,60.0%,50.0%.治疗组均优于对照组(P0.05).结论:珍珠固肠散保留灌肠散在改善溃疡性结肠炎患者临床症状、中医症候、提高缓解率等方面具有良好疗效,安全性良好.     

健脾清肠方治疗脾虚湿热型溃疡性结肠炎的临床观察

[目的]观察健脾清肠方治疗轻、中度脾虚湿热型溃疡性结肠炎的临床疗效。[方法]选取溃疡性结肠炎患者80例,辨证属于脾虚湿热型,采用随机数字表法分为2组,分别是试验组和对照组,每组各40例。试验组口服健脾清肠方,对照组口服美沙拉嗪。疗程为8周。分别观察2组治疗前后肠道症状评分、中医证候积分以及2组中医证候疗效。[结果]2组治疗后腹泻、脓血便、腹痛及里急后重等肠道症状评分与治疗前比较均明显降低(P0.05),其中腹泻与脓血便症状评分试验组显著低于对照组(P0.05)。2组治疗后中医证候评分与治疗前比较均明显降低(P0.05),试验组显著低于对照组(P0.05)。试验组中医证候疗效总有效率为92.5%,对照组为85%。2组比较差异无统计学意义。[结论]与对照组比较,健脾清肠方治疗轻、中度脾虚湿热型溃疡性结肠炎患者具有明显疗效,可以有效减轻和缓解患者肠道症状,减少中医证候积分,具有良好的临床疗效。     

中药直肠滴注式灌肠法治疗溃疡性结肠炎30例

[目的]观察中药直肠滴注式灌肠法治疗溃疡性结肠炎（UC）的疗效优势。[方法]60例UC患者,随机分为2组,各30例,2组患者分别采用中药直肠滴注式灌肠法（观察组）和传统保留灌肠法（对照组）治疗。[结果]观察组中药在肠内存留时间、药物外溢情况、患者满意度、临床效果均优于对照组（P〈O．05）。[结论]UC病程长、易反复,采用中药直肠滴注式药物保留灌肠提高了临床疗效,增加了患者满意度,利于疾病恢复。     

生肌愈溃汤直肠点滴治疗溃疡性结肠炎48例

[目的]观察生肌愈溃汤经直肠点滴治疗溃疡性结肠炎的临床效果.[方法]治疗组48例,运用生肌愈溃汤经直肠点滴治疗溃疡性结肠炎;对照组36例,用柳氮磺胺吡啶加甲硝唑经直肠点滴,两组间进行疗效对照观察.[结果]治疗组近期治愈率及总有效率为66.67%及93.75%;对照组分别为38.89%及75.00%,两组间近期治愈率及总有效率比较差异均有统计学意义（均P＜0.01）.[结论]生肌愈溃汤经直肠点滴治疗溃疡性结肠炎疗效可靠且不良反应少.     

Role of the placenta in the control of the ante-partum surge of prolactin in the rat

A nocturnal surge of prolactin secretion occurs in the dark period preceding parturition in the rat. The aim of this study was to examine the role of the placenta in the control of this prolactin surge. Plasma prolactin and progesterone were measured by radioimmunoassay in serial blood samples collected after surgical removal of conceptuses during late pregnancy, and after intracerebroventricular (i.c.v.) injection of placental lactogen (PL) before the prolactin surge. In intact control animals, prolactin secretion remained low until a nocturnal surge of secretion occurred in the dark period preceding parturition, peaking at 269 +/- 51 (S.E.M.) micrograms/l at 03.00 h on day 21. Progesterone levels fell from greater than 200 nmol/l on day 19 to less than 40 nmol/l by 12.00 h on day 20 of pregnancy. PL levels during late pregnancy were modified by partial or complete removal of conceptuses at 10.00 h on day 19 of pregnancy. Removal of all but one or two conceptuses did not change the normal pattern of prolactin or progesterone secretion. Removal of all conceptuses, however, induced a large nocturnal surge of prolactin secretion, peaking at 211.7 +/- 78 micrograms/l at 03.00 h on day 20, 24 h earlier than the surge in intact animals. Progesterone levels after removal of all conceptuses fell to less than 40 nmol/l by 23.00 h on day 19, approximately 12 h before the decline in intact animals. Maintenance of increased progesterone levels after conceptus removal using silicone tubing implants significantly (P less than 0.05) reduced the peak of the premature prolactin surge to 79.7 +/- 18 micrograms/l at 05.00 h on day 20.(ABSTRACT TRUNCATED AT 250 WORDS)     

On the Role of the Septal Area in the Development of Doca-Salt Hypertension in the Rat

The extensive destruction of forebrain noradrenergic nerve terminals by the intraventricular injection of 250 μg of 6-hydroxy-dopamine prevents the subsequent development of DOCA-salt experimental hypertension in rats while the lesser destruction of noradrenergic nerve terminals produced by 90 μg of 6-hydroxydopa does not. The greatest difference in brain part noradrenaline levels between these two neurotoxins was in the septal area where noradrenaline was less than 15% of controls after 6-hydroxydopamine but was the same as controls after 6-hydroxydopa. The non-specific destruction of the lateral septal area by radiofrequency lesions prevented the subsequent development of DOCA-salt hypertension. The relatively selective destruction of catecholamine nerve terminals in the lateral septal area by the injection of 1 μg 6-hydroxydopamine in 1 μl vehicle also prevented the development of DOCA-salt hypertension. These data suggest that the lateral septal area may be the location of the forebrain catecholaminergic neural activity that is necessary for the development of DOCA-salt experimental hypertension in rats.     

Oxprenolol in the treatment of hypertension in the elderly

Controversy continues to surround the value of drug treatment of hypertension in the elderly. Epidemiologic evidence implicates hypertension as a major risk factor in the precocious development of stroke and coronary heart disease in the elderly subject as clearly as it is implicated in the younger person. The hemodynamic and neuroendocrine profiles of the older patient with essential hypertension are similar to those of younger patients in the stable phase of the disease. However, the arterial ravages induced by many years of sustained hypertension render the circulation of the elderly subject more sensitive to pharmacologic intervention. The benefit-risk ratio of most antihypertensive drugs appears to be inversely related to age. Diuretics reduce the blood pressure at rest but have no influence on the increases in systolic pressure during normal activity; in addition, they carry potentially serious metabolic hazards in the elderly hypertensive patient. Centrally acting drugs likewise lower the blood pressure at rest without influencing the high systolic pressures induced by exercise. They also enhance the tendency to endogenous depression. Adrenergic-neurone blocking drugs and alpha-adrenoceptor antagonists are contraindicated because of the frequency of impaired cardiovascular reflexes in the elderly. The beta-blocking drugs can reduce the risk of coronary and cerebrovascular disease in the older patient with hypertension. They appear to be well tolerated, but because of their impaired metabolic handling in many elderly patients they should probably be used in smaller doses than those prescribed in younger patients. The influence of antihypertensive treatment on cardiovascular morbidity and mortality in the elderly hypertensive patient is not known.     

Tissue Oxygen Demand in Regulation of the Behavior of the Cells in the Vasculature

The control of arteriolar diameters in microvasculature has been in the focus of studies on mechanisms matching oxygen demand and supply at the tissue level. Functionally, important vascular elements include EC, VSMC, and RBC. Integration of these different cell types into functional units aimed at matching tissue oxygen supply with tissue oxygen demand is only achieved when all these cells can respond to the signals of tissue oxygen demand. Many vasoactive agents that serve as signals of tissue oxygen demand have their receptors on all these types of cells (VSMC, EC, and RBC) implying that there can be a coordinated regulation of their behavior by the tissue oxygen demand. Such functions of RBC as oxygen carrying by Hb, rheology, and release of vasoactive agents are considered. Several common extra‐ and intracellular signaling pathways that link tissue oxygen demand with control of VSMC contractility, EC permeability, and RBC functioning are discussed.