菝葜山药白术汤治疗糖尿病腹泻32例

糖尿病腹泻是糖尿病患者因植物神经功能病变导致肠道功能紊乱所致的一种症状,是糖尿病并发症之一.笔者于1998年起,自拟菝葜山药白术汤治疗该病32例,与西药治疗对照观察.报告如下.     

糖尿病腹泻的临床特点及治疗

特发性腹泻是糖尿病的常见并发症之一,常发生于Ⅰ型糖尿病伴周围神经和植物神经病变、血糖控制不良的病人。其发病可能与内脏植物神经病变、细菌过度繁殖、胆汁酸吸收不良、胰腺外分泌不足、电解质失衡及肠道激素生成异常等因素有关。1.临床特点:糖尿病腹泻多见于男性。大多数病人有周围神经病变和内脏植物神经功能紊乱,表     

糖尿病腹泻的发病机制及中西医结合治疗

糖尿病腹泻是中、晚期糖尿病患者胃肠道功能紊乱的一种临床表现,给糖尿病患者造成极大的痛苦,文献报道其患病率约4%~22%~[1]。近年的临床研究认为其发病机理非常复杂,与多种因素有关,如胃肠道自主神经病变、肠道菌群失调、胰腺外分泌不足、胆汁酸代谢障碍、胃肠道激素分泌异常和直肠肛门括约肌功能障碍等诸因素。糖尿病腹泻多为间歇性,大便呈棕黄色糊状或水样便且量较大,偶可伴有腹痛和里急后重,一般每日10余次,有     

小儿腹泻的肠道菌群变化

小儿腹泻是小儿的常见病、多发病,也是在某些疾病的治疗过程中常伴发的病症之一。病因虽较复杂,但肠道菌群的紊乱是其重要因素,我们对34例腹泻小儿进行了临床和肠道菌群的调查,并与30例正常小儿肠道菌值进行对比分析,其结果报告如下。     

小儿腹泻的肠道菌群变化

小儿腹泻是小儿的常见病、多发病，也是在某些疾病的治疗过程中常伴发的病症之一．病因虽较复杂，但肠道菌群的紊乱是其重要因素．我们对34例腹泻小儿进行了临床和肠道菌群的调查，井与30例正常小儿肠道菌值进行对比分析，其结果报告如下。     

腹泻与肠道离子转运关系的研究进展

腹泻作为全球性发病率和致死率较高的疾病之一,全世界每年有几百万的人因腹泻而死,其中绝大部分是婴幼儿童.腹泻按病程的长短可分为急性腹泻和慢性腹泻两类,而根据病因学又可分为感染性腹泻和非感染性腹泻,其本质上是肠道中水、电解质吸收和分泌功能的紊乱,这其中就与肠道离子的异常转运密切相关.本文从腹泻的发病原因,腹泻症状的产生与肠道不同离子转运的关系以及不同类型腹泻中的各种离子的转运过程进行了综述,以期为更全面地了解不同类型腹泻的相关发生发病机制,并为腹泻的病理生理学研究及相关肠道病症的治疗提供一定的依据.     

氯压定治疗糖尿病性腹泻

腹泻是糖尿病胃肠道并发症之一。控制不良的胰岛素依赖性糖尿病(IDDM)人,当伴发进行性神经病变及其他并发症时常有典型糖尿病性腹泻。间歇性大量水样便,夜间便失禁为其特点,常规治疗难于控制。 糖尿病性腹泻的发病机理尚不十分清楚。有人认为与胃肠运动紊乱有关,但无确切证据。最近,     

2型糖尿病合并腹泻的临床特征及相关因素分析

[目的]研究2型糖尿病(DM)合并腹泻患者肠道菌群及胃肠动力变化,探讨2型DM腹泻的发病机制.[方法]通过大便特检、消化道钡餐及纤维结肠镜检查研究60例2型DM合并腹泻患者的肠道菌群、胃肠动力及肠黏膜变化,并与40例无腹泻的2型DM患者对照.[结果]与对照组比较,2型DM腹泻患者血糖水平更高(P＜0.01),无明显肠道菌群失调,但有脂肪吸收不良(P＜0.01),且胃肠动力明显紊乱.[结论]2型DM腹泻患者存在胃肠动力紊乱,可能与高血糖、糖尿病植物神经病变有关.     

糖尿病胃肠功能紊乱发病机制及其治疗进展

糖尿病胃肠功能紊乱是糖尿病的常见并发症之一 ,糖尿病病人出现胃肠道症状者高达 75 % ,主要症状为呕吐、便秘、腹泻、大便失禁。该并发症不仅影响糖尿病患者的生活质量 ,而且影响糖尿病的有效控制 ,故对其进行有效治疗具有重要的意义。本文就糖尿病胃肠功能紊乱的发病机制及其治疗进展作一综述。一、糖尿病胃肠功能紊乱的功能变化特点1.胃转运及胃排空　糖尿病患者胃转运时间均延长。糖尿病病人ＭＭＣⅢ相出现率显著降低 ,Ⅰ相时程显著缩短 ,十二指肠和空肠Ⅱ相收缩的频率增加。餐后消化期缩短。2 .肠功能紊乱　糖尿病腹泻患者小肠可有蠕动…     

腹泻与肠道乳糖酶活性的关系研究进展

乳糖酶作为肠道重要的功能酶之一,其活性的表达与腹泻密切相关.中药治疗腹泻性疾病具有独特优势,中药治疗腹泻的疗效机制至今尚不明确.本文探究不同因素诱导下的腹泻与肠道乳糖酶活性的关系,中药治疗腹泻与肠道乳糖酶活性的关系,发现不同因素诱导的腹泻会降低肠道乳糖酶活性,中药治疗后提高肠道乳糖酶活性水平.肠道乳糖酶活性的提高与中药作用于肠道黏膜与肠道菌群,帮助修复肠道黏膜、调整肠道菌群有关,中药或许能调控乳糖酶细菌基因的表达提高肠道乳糖酶活性,具体机制值得进一步研究.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.