参苓白术散加减治疗脾虚型小儿腹泻58例疗效观察

目的 观察参苓白术散减治疗脾虚型小儿腹泻的临床疗效.方法 将58例脾虚型小儿腹泻患者采用以参苓白术散加减治疗为主,配合口服或静脉补液,药用莲子肉8g,薏苡仁8g,砂仁3g,桔梗3g,炒扁豆8g,白茯苓8g,党参10g,炙甘革3g,炒白术8g,山药8g,陈皮3g. 结果在改善脾虚型腹泻惠儿粪便,性状,次数及全身症状等方面达到95%的有效率.结论 参苓白术散加减对辟虚型小儿腹泻有明显的治疗作用.     

曹吉勋教授治疗慢性肠炎的中医处方用药规律分析

目的:分析四川省名中医曹吉勋教授治疗慢性肠炎的中医处方规律。方法:以2014年10月~2015年9月期间曹吉勋教授门诊病历及中医处方作为数据源,采用用药频次分析,Apriori关联规则分析方法进行数据挖掘,确定核心药物配对方法、各味中药的四性五味等属性及证型与中医处方用药之间的关联性。结果:按诊断标准和纳入排除标准筛选后共纳入慢性肠炎的患者396例,共开具处方1025份。处方中使用频次最高的中药为:茯苓、山药、白术、甘草、党参、薏苡仁、莲子、白芍和白扁豆。最长使用的药物配对是:茯苓和山药、茯苓和白术、茯苓和党参、茯苓和薏苡仁、茯苓和甘草、山药和党参、山药和白术、山药和薏苡仁、党参和白术及党参和甘草。结论:曹吉勋教授治疗慢性肠炎的核心思想是健脾,以参苓白术散为主要方剂。     

山药及其麸炒品水提液不同极性部位对脾虚小鼠胃肠功能的影响

目的比较生山药及麸炒山药水提液不同极性部位对提高脾虚小鼠胃肠功能作用的差异。方法采用胃排空法及肠推进试验法,比较了生山药及其麸炒品水提液的不同极性部位对脾虚小鼠胃肠功能的影响。结果山药经麸炒后水提液二氯甲烷部位在抑制脾虚小鼠胃排空及肠推进作用较生品强。结论山药经麸炒后水提液二氯甲烷部位较生品有更强的抑制脾虚小鼠胃排空及肠推进作用,提示麸炒山药对脾虚小鼠胃肠功能作用的有效成份有可能存在与水提液的低级性部位,该实验为进一步阐明麸炒山药的炮制机理奠定了理论基础。      

山药及不同炮制品多糖含量分析

目的 :考查山药炮制与其有效成分多糖含量的关系。方法 :紫外分光光度法。结果 :山药及不同炮制品中多糖含量按以下顺序减少 ;生品 ,蜜麸炒山药 ,炒山药 ,米炒山药 ,土炒山药 ,焦山药 ,炭山药 ,麸炒山药。测定结果 :经统计检验说明各炮制品中多糖含量均较生品有显著降低 (p<0 0 1或p <0 0 0 1 )。     

参苓白术散对脾虚证小鼠小肠上皮细胞差异蛋白质组分影响的初步研究

目的研究参苓白术散对脾虚证小鼠小肠上皮细胞差异蛋白质组分的影响,并探讨参苓白术散治疗脾虚证的机制。方法将小鼠随机分为4组：空白对照组、模型组、参苓白术散低剂量组、参苓白术散高剂量组。观察各组小鼠的体征改变,通过SDS-PAGE技术检测各组小鼠小肠上皮细胞蛋白质的表达,利用Quest one分析软件对各组图谱进行对比分析,观察其改变。结果参苓白术散能够显著改善模型小鼠的体征,使小肠上皮细胞蛋白质组分的表达接近于正常。结论参苓白术散可以通过影响小肠上皮细胞蛋白质组分的表达起到治疗脾虚证的作用。     

常见症状的辨治(十六)

<正>腹泻(二)四、脾虚泄泻体质衰弱,或患有其他慢性疾病者,由于脾气虚弱,运化失常,所致的腹泻称为"脾泻"。临床表现为大便溏(半流动)薄或如水样,进食油腻则便次明显增加,或夹有不消食物,腹不痛或有隐痛,食欲不振,食后脘闷不舒,神疲乏力,面色萎黄,舌淡,苔薄白,脉细弱。本证的治疗宜用健脾益气之法,可选参苓白术散(党参、茯苓、白术、炒扁豆、炒山药、薏苡仁、莲子肉、广陈皮、炒砂仁、桔梗、炙甘草)     

期刊文摘

中医辨证施治自细胞减少症180例／兰克／／湖北中医杂志，－1998，20（3）．－29本组180例，年龄18～60岁。气血亏虚型87例用当归、白芍、党参、茯苓、阿胶各109，黄芪189，大枣5枚，甘草6g，肉桂末2g。肝肾阴盛20例用熟地、龟板各12g，枸杞、麦冬、山茱萸、当归、知母、黄柏、菊花、黄精、菟丝子各10g，山药15g。脾胃虚弱型15例用炙党参12g，云苓、白术、扁豆、法半夏各10g，山药、薏苡仁、炙黄芪各15g，陈皮、甘草各6g，肉桂末2g，大枣5枚，砂仁3g。肝郁脾虚型15例用柴胡、当归、白芍、茯苓白术、栀子、防风各10g，薄荷4g，丹皮、枳壳、甘…     

参苓白术散治疗消化系疾病概述

参苓白术散出自《太平惠民和剂局方》,作为培补脾胃的经典方剂,经久不衰,其方由人参、茯苓、白术、山药、白扁豆、莲子、薏苡仁、砂仁、桔梗及甘草组成。其中人参、白术、茯苓、甘草补气健脾,加扁豆、山药、薏苡仁、莲子有加强补脾渗湿的作用,加陈皮以和胃,加砂仁以醒脾,加桔梗以宣肺,全方具有健脾渗湿,行气和胃的作用。主治脾胃虚弱所致饮食不消,食少便溏,肌倦乏力,气短咳嗽,或恶心呕吐,胸脘满闷,形体消瘦,或身面浮肿,面色萎黄或胱白。长久以来,屡见文献报道参苓白术散治疗消化系疾病的临床观察,现综述如下。     

参苓白术散在儿科临床中的应用

参苓白术散是广泛用于内、儿科的一张方剂,出自《和剂局方》一书,由人参(党参)、白术、茯苓、甘草、山药、莲米、白扁豆、桔梗、薏苡仁、砂仁、陈皮组成。其功用是补气健脾,和胃渗湿,常用来治疗脾胃虚弱引起的纳呆不化,或吐或泻,形体虚赢,四肢无力等消化系统功能减弱之病证,在中医儿科临床中应用,更有独到之处,现简介如下。     

本刊投稿信箱sqys@sqys.com

参苓白术散出自《太平惠民和剂局方》，由人参、白术、白茯苓、桔梗、莲米、薏苡仁、淮山药、扁豆、甘草组成。功用；益气健脾、渗湿止泻。主治：饮食不化，胸脘痞闷，肠鸣泄泻，四肢无力，形体消瘦，面色萎黄，舌淡苔白腻，脉虚缓等脾虚夹湿之证。笔者临床应用此方化裁，人参改用党参，变散为汤，治疗多种内科病证，屡获满意疗效。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.