二仙通关胶囊对前列腺肥大症患者血液流变及性激素水平的影响

目的：探讨二仙通关胶囊对前列腺肥大症(benign hypertrophic prostatitis，BHP)的影响及其作用机制。方法：辨证为肾阴阳两虚、湿瘀浊结型前列肥大症患者80例，随机数字表法单盲分为两组，分别用中药制剂二仙通关胶囊(治疗组45例)和癃闭舒胶囊(对照组35例)治疗，并观察BHP患者的临床疗效及中医证候疗效，测定血液流学指标、卵激素(FSH)、黄体生成素(LH)和血浆内皮素-1(ET-1)的变化。结果：临床治疗2个月后，治疗组和对照组的临床疗效总有效率分为88．89％和68．57％，两组比较，有显著性差异(u=217．P&;lt;0．05)；两组证候疗效治疗组与对照组的总有效率分别为95．56％、与77．14％，组间比较有显著性差异(u=2．059，P&;lt;0．05)。两组治疗后对血液黏度值均有所改善，治疗组对低切变率下的全血黏度值、血浆黏度值及红细胞聚集指数的改善程度较对照组更显著(P&;lt;0．01，P&;lt;005，t=5．13，2．64，3．38)。治疗组能降低BHP患者血清性激素FSH、LH水平，改善患者血浆ET-1，较用药前均有显著性差异(P&;lt;0．01，t=7．87，5．69，8．57)，其降低：FSH、ET-1程度优于对照组(P&;lt;0．05，t=2．23，2．06)。结论：中药制剂二仙通关胶囊对前列腺肥大症有较好的疗效，临床运用安全，无明显毒副作用，改善血液流变性的异常，调节性激素紊乱可能是其主要的作用机制。     

葛根素对糖尿病患者血液相关因子及血管内皮功能的影响

目的：通过观察葛根素对血内皮素、一氧化氮(NO)和一氧化氮合酶(NOS)水平的影响，初步探讨其对糖尿病患者血管内皮的保护作用。方法：将2002-01／2004-01抚顺市中医院内分泌科收治的76例单纯糖尿病患者随机分为单纯糖尿病葛根素治疗组(给予葛根素注射，39例)，丹参对照组(给予复方丹参注射液，37例)，同时选20名糖尿病并血管病变的患者作为糖尿病并血管病变葛根素治疗组(给予葛根素注射)，选20名健康成年人作为健康对照组。葛根素治疗30d，治疗前后检测内皮素、NO，NOS水平。结果：治疗后，单纯糖尿病葛根素治疗组和糖尿病并血管病变葛根素治疗组血内皮素浓度降低，治疗前后的值分别为(107．33&;#177;29．31)，(85．04&;#177;23．62)pg／L和(119．67&;#177;30．73)，(88．12&;#177;27．29)pg／L(P&;lt;0．05)，NO，NOS上升，NO为(50．49&;#177;20．31)，(59．51&;#177;21．19)μmol／L(P&;lt;0．05)；(50．67&;#177;21．19)，(56．88&;#177;22．11)μmol／L(P&;gt;0．05)；NOS为(109．02&;#177;21．84)，(116．86&;#177;16．34)nkat／L和(118．86&;#177;23．34)，(137．19&;#177;22．84)nkat／L(P&;lt;0．05)，以糖尿病并血管病变葛根素治疗组为明显；丹参对照组与治疗前比较，血内皮素略下降(P&;gt;0．05)，血NO，NOS水平稍升高(P&;gt;0．05)。结论：葛根素通过降低内皮素浓度，升高NO，NOS水平而发挥保护糖尿病患者血管内皮的作用。     

血液治疗机治疗对高血压患者血压及内皮素水平的影响

采用ZE-100血液治疗机治疗高血压患者26例,同时观察治疗前后患者血压、内皮素及肝肾功能的变化。发现该治疗方法可短期内显著降低患者血压水平和内皮素水平,而且对患者肝肾功能无明显副作用。     

血液滤过对重症中暑休克犬内皮素和一氧化氮的影响

目的探讨血液滤过(hemofiltration,HF)对重症中暑休克犬内皮素(endothelin,ET)和一氧化氮(nitricoxide,NO)的影响。方法 16只健康雄性杂种犬,随机分为中暑对照组(HS组)和血液滤过组(HF组)各8只。采用整体高温来诱导犬重症中暑休克,模型成功后立即出舱,HS组置于常温下观察,HF组立即行HF治疗,观察两组犬各时间点血浆ET和血清NO含量及NO/ET值的变化。结果两组犬中暑前ET和NO含量及NO/ET值比较无统计学差异(P>0.05)。中暑休克时ET和NO含量及NO/ET值较中暑前明显升高(P<0.01),且两组之间比较无统计学差异(P>0.05)。休克后1h:HS组ET值上升,HF组ET值下降,与休克时比较均无统计学意义(P>0.05),但HF组ET明显低于HS组(P<0.05);HS组NO值升高,但无统计学意义,HF组NO值下降,低于休克时(P<0.05),HF组NO明显低于HS组(P<0.01);HS组NO/ET值略降低,HF组NO/ET值亦下降,但均无统计学意义(P>0.05),两组之间NO/ET比较亦无统计学意义(P>0.05);休克后2h和3h:HS组ET值继续上升明显高于休克时(P<0.01),HF组ET值逐渐下降明显低于休克时(P<0.01),HF组ET值明显低于HS组(P<0.01);HS组NO值继续上升,但与休克时比较无统计学意义(P>0.05),HF组NO逐渐下降,明显低于休克时(P<0.01),HF组NO明显低于HS组(P<0.01);HS组NO/ET略低于休克时,但无统计学意义(P>0.05),HF组NO/ET值明显低于休克时(P<0.01),HF组NO/ET值明显低于HS组(P<0.01)。结论重症中暑休克犬会出现血浆ET和血清NO的升高及NO/ET值的失调,HF可清除血中异常升高的ET和NO,并恢复NO/ET值,而清除NO和ET可能是HF治疗重症中暑时稳定其血压和改善微循环灌注的重要机制之一。     

吸烟对健康人和脑梗死患者血浆内皮素的影响

目的:探讨吸烟在急性脑梗死发病中的可能机制。方法:在发病72h内和发病后3周应用放射免疫方法测定脑梗死患者(年龄38～80岁,32例吸烟,28例不吸烟;37例轻型,18例中型,5例重型)的血浆内皮素(ET-1)含量。并检测22例健康吸烟者与18例健康不吸烟者血浆ET-1的含量。结果:①患者组发病72h内的血浆ET-1含量与健康人组血浆ET-1含量犤(75±19)ng/L与(66±13)ng/L犦比较差异有显著性意义(t=2.69,P<0.01)。②发病72h内脑梗死组中重症患者血浆ET-1含量犤(83±19)ng/L犦高于轻症患者犤(71±18)ng/L,t=2.03,P<0.05犦。③吸烟患者72h内及3周时的血浆ET-1含量为(84±19)ng/L和(77±16)ng/L,均高于不吸烟患者(66±14)ng/L和(61±13)ng/L(P<0.01)。④健康人组中吸烟者血浆ET-1含量犤(71±14)ng/L犦亦明显高于不吸烟者犤(60±9)ng/L,P<0.01犦。⑤患者组及健康人组中,吸烟人群吸烟时间达20年以上者的血浆ET-1值为(87±17)ng/L,10～20年ET-1值为(67±12)ng/L,两者之间比较差异有显著性意义(P<0.01);每日吸烟量达20支以上ET-1值为(96±15)ng/L,10～20支ET-1值为(69±12)ng/L,两者之间比较差异有显著性意义(P<0.01)。结论:吸烟可使健康人和脑梗死患者血浆ET-1水平明显升高,ET-1的升高可能是吸烟引起脑梗死的重要因素之一。     

葛根素对糖尿病患者血液相关因子及血管内皮功能的影响

目的:通过观察葛根素对血内皮素、一氧化氮(NO)和一氧化氮合酶(NOS)水平的影响,初步探讨其对糖尿病患者血管内皮的保护作用。方法:将2002-01/2004-01抚顺市中医院内分泌科收治的76例单纯糖尿病患者随机分为单纯糖尿病葛根素治疗组(给予葛根素注射,39例),丹参对照组(给予复方丹参注射液,37例),同时选20名糖尿病并血管病变的患者作为糖尿病并血管病变葛根素治疗组(给予葛根素注射),选20名健康成年人作为健康对照组。葛根素治疗30d,治疗前后检测内皮素、NO,NOS水平。结果:治疗后,单纯糖尿病葛根素治疗组和糖尿病并血管病变葛根素治疗组血内皮素浓度降低,治疗前后的值分别为(107.33±29.31),(85.04±23.62)pg/L和119.67±30.73),(88.12±27.29)pg/LP((<0.05),NO,NOS上升,NO为50.49±20.31),(59.51±21.19)μmol/L((P<0.05);(50.67±21.19),(56.88±22.11)μmol/L(P>0.05);NOS为(109.02±21.84),(116.86±16.34)nkat/L和(118.86±23.34),(137.19±22.84)nkat/L(P<0.05),以糖尿病并血管病变葛根素治疗组为明显;丹参对照组与治疗前比较,血内皮素略下降(P>0.05),血NO,NOS水平稍升高(P>0.05)。结论:葛根素通过降低内皮素浓度,升高NO,NOS水平而发挥保护糖尿病患者血管内皮的作用。     

高血压患者血浆内皮素水平测定的临床意义

近年来,内皮素、加压素等肽类物质致高血压的作用已引起人们的注意.为了解高血压患者血浆内皮素(ET)水平变化的临床意义,本文用特异性放射免疫分析法测定了93例高血压患者和16例健康体检者血浆内皮素浓度.其结果报道如下.     

糖尿病患者血浆内皮素含量测定的临床意义

【目的】研究糖尿病肾病患者血浆内皮素（ET）的含量变化及临床意义。【方法】采用放射免疫分析法（RIA）对51名健康对照者，56名糖尿病肾病患者，57名糖尿病无肾病患者的血浆进行ET测定。【结果】糖尿病无肾病组、糖尿病肾病组ET浓度明显高于对照组（P〈0．01）；糖尿病肾病组与糖尿病无肾病组相比，血浆ET含量亦明显升高（P〈0．01）。【结论】血浆ET的检测对糖尿病肾病患者的早期诊断和合理治疗具有一定的意义。     

复方肾炎片对慢性肾炎患者血浆内皮素水平的影响

目的:探讨复方肾炎片对慢性肾炎患者血浆及尿液内皮素(ET-1)水平及24 h尿蛋白的影响。方法:将80例慢性肾炎患者随机分为对照组和复方肾炎片治疗组,观察两组治疗前后血浆及尿液ET-1水平、24 h尿蛋白定量的变化。结果:与对照组比较,复方肾炎片治疗组慢性肾炎患者血浆及尿液ET-1水平降低,24 h尿蛋白定量减少。结论:复方肾炎片治疗慢性肾炎可明显降低患者血浆及尿液ET-1水平,减少24 h尿蛋白定量,有助于延缓慢性肾病的进展。     

心血通对充血性心力衰竭患者血浆内皮素的影响

内皮素 (ＥＴ)与心血管疾病密切相关 ,充血性心力衰竭(ＣＨＦ)患者血浆ＥＴ升高 ,ＥＴ又加重ＣＨＦ ,因此治疗ＣＨＦ时降低ＥＴ十分重要[1] 。我们用心血通注射液对 33例ＣＨＦ患者进行治疗 ,同时测定了治疗前后血浆ＥＴ浓度 ,以探讨心血通对ＣＨＦ患者血浆ＥＴ的影响。1　资料与方法1.1　研究对象　我院 1998年 10月至 2 0 0 0年 5月期间住院治疗的ＣＨＦ患者 6 5例 ,随机分为研究组和治疗组。研究组33例 ,男 2 1例 ,女 12例 ;年龄 2 3～ 70岁 ,平均年龄 (5 4 .7±12 .3)岁 ;其中风湿性心脏病 12例 ,扩张性心肌病 7例 ,冠心病 12例 ,高血压…     

盐酸维拉帕米治疗肥厚性瘢痕作用机制的实验研究

目的寻找治疗肥厚性瘢痕的有效的药物.方法人类肥厚性瘢痕移植裸鼠18例,其中盐酸维拉帕米治疗9例,生理盐水对照9例.移植物内注射3H-脯氨酸,于7、10、14d后取标本.结果(1)肥厚性瘢痕组织经盐酸维拉帕米治疗后,胶原合成量无明显变化,胶原降解量明显下降.(2)3H-脯氨酸注射后7、10、14d瘢痕组织的胶原合成、降解量无明显变化.结论盐酸维拉帕米治疗肥厚性瘢痕的作用机制主要是增加瘢痕组织的胶原降解.     

中药单体治疗血脂异常的机制研究进展

血脂异常是动脉粥样硬化性疾病的独立危险因素,临床常用他汀类降脂药物治疗。中医药可明显改善血脂异常,其中中药单体的研究逐年增多,机制逐渐明确,揭示了治疗血脂异常的中药治疗具有多靶点、多途径的特点。     

Preventive effect of ginsenoid on chronic bacterial prostatitis

Empirical antibiotic therapy is the preferred primary treatment modality for chronic bacterial prostatitis (CBP). However, this method of treatment has a low success rate and long-term therapy may result in complications and the appearance of resistant strains. Therefore a new alternative method for the prevention of CBP is necessary. There are several reports that ginsenoid has a preventive effect on urinary tract infection (UTI). To evaluate the preventive effect of ginsenoid on CBP compared to conventional antibiotics, we carried out an experiment in a rat model of the disease. Four groups of adult male Wistar rats were treated with the following medications: (1) control (no medication), (2) ciprofloxacin, (3) ginsenoid, and (4) ciprofloxacin/ginsenoid. All medications were given for 4 weeks, and then we created a CBP model in the animals by injecting an Escherichia coli Z17 (O2:K1;H^?) suspension into the prostatic urethra. After 4 weeks, results of microbiological cultures of prostate and urine samples, as well as histological findings of the prostate in each group were analyzed. The microbiological cultures of the prostate samples demonstrated reduced bacterial growth in all experimental groups compared with the control group. Histopathological examination showed a significantly decreased rate of infiltration of inflammatory cells into prostatic tissue and decreased interstitial fibrosis in the ginsenoid group compared with the control group. Inhibition of prostate infection was greater in the group receiving both ginsenoid and antibiotic than in the single-medication groups. Although the findings of this study suggest a preventive effect of ginsenoid, preventive methods for CBP are still controversial.     

Preventive effect of selenium on chronic bacterial prostatitis

The antibiotic treatment rate of chronic bacterial prostatitis (CBP) is low, and long-term administration can result in adverse events and bacterial resistance. For these reasons, a new preventive modality, which can replace traditional antibiotic therapy, is required. To evaluate the preventive effect of selenium on CBP, the pre-treatments were divided into four groups, administered for 4 weeks, as follows: (1) control, (2) ciprofloxacin, (3) selenium, and (4) ciprofloxacin and selenium. Then, drip infusion of a bacterial suspension (Escherichia coli Z17, O2:K1; H–) into the prostatic urethra of Wistar rats was conducted to induce CBP. In 4 weeks, the results of microbiological culture of prostate and urine samples as well as histological findings of the prostate in each group were analyzed. Selenium decreased bacterial infection significantly; the decrease in infiltration rate of inflammatory cells into prostate tissues in the selenium group was similar to that in the control group. The effect of hindering bacterial infection on prostate tissue was greater in the group administered both selenium and an antibiotic than in other groups given only one of the agents. Although the findings of this study suggest that selenium can have a preventive effect against the occurrence of CBP, methods to prevent CBP are still controversial.     

瘢痕的中药治疗

我国的中医药在瘢痕的预防和治疗方面有着独到之处。现从中医角度出发,对中药治疗瘢痕的方法及相关基础研究做一综述,并提出自己的观点。     

中医药在口腔护理中的应用及展望

本文简要介绍了口腔护理现状、中药及中医手段在口腔护理中的应用现状,并对未来中药在口腔护理中的应用进行了展望。     

丹参酮对肥厚心肌中电生理异常的干预

目的 通过研究丹参酮对肥大心肌细胞中的电生理异常的干预作用,来阐明丹参酮预防心脏肥厚中发生心律失常可能的电生理基础. 方法 将SD大鼠随机分为4组,每组8只,其中三组通过"一肾一夹"手术制作肾动脉缩窄模型,另外一组进行假手术(正常组).待血压升高后,再根据是否进行药物干预,将手术组分成丹参酮组、卡托普利组和肥厚组.最终,通过膜片钳和胞内钙测定技术,观察比较丹参酮和卡托普利对肥大心肌细胞膜上动作电位时间、L-型钙通道电流和瞬问外向钾电流密度的影响. 结果 各手术组的血压较假手术组明显升高(P<0.01),而各手术间差异无统计学意义(P>0.05).肥厚组的心室/体重比率(the ratio of ventricle weight to bocly weight,VW/BW)明显高于正常组(P<0.01),而经卡托普利和丹参酮干预后,较肥厚组显著性降低(P<0.01).和卡托普利干预的结果相似,丹参酮可以显著地缩短肥大心肌细胞中存在的动作电位时间(action potential duration,APD)延长(P<0.01)、降低膜电容和L型钙电流(L-type calcium current,ICa,L,)峰值幅度(P<0.01),但不影响ICa,L密度.丹参酮还使肥大心肌细胞中的瞬间外向钾电流(transient outward potassium current,ITO)密度和最大电流幅度明显的升高,和肥厚组之间差异具有统计学意义(P<0.05). 结论 丹参酮能够在抗心肌肥厚的同时通过减少钙内流和恢复Ito钾通道活性,使复极1期和平台期的时间缩短,缩短动作电位时间,起到预防心律失常的作用.     

调制中频电刺激与超短波治疗前列腺炎Ⅲa的疗效评价

目的:探讨调制中频电刺激与超短波对前列腺炎Ⅲa的治疗作用。方法: 将62例前列腺炎Ⅲa患者分为观察组32例和对照组30例。两组均采用超短波电疗，观察组在此基础上加用调制中频电刺激治疗；治疗前及治疗后观察分析尿频、排尿不尽感、尿痛、会阴胀痛、前列腺压痛等症状、体征变化以及尿流率检测数据。结果:经20次治疗，两组患者的尿频、排尿不尽感、尿痛、会阴胀痛、前列腺压痛等症状、体征变化及尿流率检测数据均有明显改善；观察组临床治愈16例，对照组临床治愈8例（P<0.01）；总有效率分别为87.5%和63.3%（P<0.05）, 两组对比差异有非常显著性意义。结论:调制中频电刺激与超短波电场综合治疗前列腺炎Ⅲa疗效显著，且明显优于对照组。     

循证医学与中药上市后的再评价

目前,我国已逐渐开展对上市后药物的不良反应监测,并开始重视其对患者生存质量、患者死亡率等指标的影响.已获上市批准的中药中,有很多在不良反应的发现和管理上存在时滞现象,且在临床有效性和安全性方面存在一定问题.对中药上市后的再评价,需要有效、规范的评价体系.循证药物评价运用循证医学的理念,结合临床流行病学、系统评价、卫生技术评估等手段,评价新药和上市后药物的临床有效性、安全性、经济性和适用性,对我国中药的现代化与国际化进程具有重要作用.     

The effect of silicone gel sheets on perfusion of hypertrophic burn scars

The mechanism of action of topical silicone gel sheets on hypertrophic scars is not well understood and their effect on the blood flow within hypertrophic scars has not been investigated. The purpose of this study was to examine whether application of silicone gel sheets produced any acute effects on blood flow in hypertrophic burn scars. Perfusion of hypertrophic scars and adjacent normal skin was measured using a laser Doppler with and without application of silicone gel sheets. Continuous measurements were made for 5 minutes before gel application, for 30 minutes during gel application and for 5 minutes following gel removal. Surface temperature of the scar was continuously monitored. An occupational therapist, blinded to the perfusion level, rated each scar using the Vancouver Scar Scale. Eighteen scars and adjacent control sites in sixteen adult burn patients (11 male, 5 female; mean age: 42 +/- 14 years) were evaluated. The mean scar age was 5.4 +/- 3.7 months. The mean Vancouver Scar Scale was 5.5 +/- 2.4. Hypertrophic scars demonstrated higher perfusion measurements at baseline compared to control areas (58.5 +/- 19.3 flux units vs 25.0 +/- 8.4 flux units; P < 0.001). Application of silicone sheeting gel did not significantly alter perfusion in either the hypertrophic scar or normal tissue from the baseline measurements. However, application of silicone gel sheeting did significantly increase the mean baseline surface temperature of the hypertrophic scar from 29 +/- 0.8 degrees C to 30.7 +/- 0.6 degrees C (P < 0.001). The mechanism of action of silicone gel sheeting probably does not involve an acute alteration in blood flow within the scar. However, surface temperature of the scar increased significantly following gel application, raising the possibility that temperature alteration is involved in the mechanism of action.