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1.
目的 观察清胰利胆颗粒联合注射用亚胺培南西司他丁钠治疗重症急性胰腺炎的临床疗效。方法 选取2019年4月—2021年1月商丘市第一人民医院收治的120例重症急性胰腺炎患者,根据随机数字表法将患者分为对照组和治疗组,每组各60例。对照组患者静脉滴注注射用亚胺培南西司他丁钠,将1.0 g/次配伍0.9%氯化钠注射液100 mL,8 h/次。治疗组在对照组的基础上温水冲服清胰利胆颗粒,1袋/次,3次/d。两组均治疗14 d。观察两组临床疗效,比较两组临床症状改善情况、血清炎症因子、生化指标、肠道黏膜屏障功能指标水平。结果 治疗后,对照组的总有效率为68.33%,治疗组的总有效率为88.33%,治疗组高于对照组(P<0.05)。治疗后,治疗组的肠鸣音恢复时间、血清淀粉酶恢复时间、腹膜刺激征消失时间、腹痛腹胀消失时间、胃肠减压时间均比对照组更短(P<0.05)。治疗后,两组患者的血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、白细胞计数(WBC)水平均显著下降,血清白细胞介素-35(IL-35)水平均升高(P<0.05),且治疗组血清IL-6、IL-8、CRP、WBC水平明显低于对照组,血清IL-35水平高于对照组(P<0.05)。治疗后,两组患者的血清淀粉酶、脂肪酶、尿淀粉酶水平均显著下降(P<0.05),且治疗组血清淀粉酶、脂肪酶、尿淀粉酶水平均明显低于对照组(P<0.05)。治疗后,两组的血清内霉素(PE)、D-乳酸、二胺氧化酶(DAO)水平均显著下降(P<0.05),且治疗组血清PE、D-乳酸、DAO水平低于对照组(P<0.05)。结论 清胰利胆颗粒联合注射用亚胺培南西司他丁钠治疗重症急性胰腺炎患者具有确切的临床疗效,能够促进临床症状恢复,降低炎症因子和生化指标水平,改善患者的肠道黏膜屏障功能,安全性较好。  相似文献   

2.
目的 分析清胰利胆丸联合丙氨酰谷氨酰胺注射液治疗老年重症急性胰腺炎患者的临床效果。方法 选取2019年5月—2022年5月宁国市人民医院收治的82例老年重症急性胰腺炎患者,按照随机数字表法分为对照组和治疗组,每组各41例。对照组静脉滴注丙氨酰谷氨酰胺注射液,20 g/次加入以500 mL葡萄糖溶液,1次/d。治疗组在对照组基础上口服清胰利胆丸,1袋/次,3次/d。两组均连续治疗10 d。观察两组患者临床疗效,比较治疗前后两组患者腹痛消失和血清淀粉酶恢复正常时间,中医证候积分,及血清热休克蛋白70(HSP70)、高迁移率族蛋白1(HMGB1)、内毒素、二胺氧化酶(DAO)和D-乳酸水平。结果 治疗后,治疗组总有效率(92.68%)显著高于对照组(75.61%,P<0.05)。治疗后,治疗组腹痛消失时间、血清淀粉酶恢复正常时间明显较对照组短(P<0.05)。治疗后,两组中医证候积分均明显低于治疗前(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,两组血清HSP70、HMGB1、内毒素、DAO和D-乳酸水平均明显低于治疗前,且治疗组明显低于对照组(P<0.05)。结论 清胰利胆丸联合丙氨酰谷氨酰胺注射液治疗老年重症急性胰腺炎患者效果确切,可抑制炎症反应,调节免疫状态,促进肠道屏障功能恢复,加快临床症状缓解。  相似文献   

3.
目的 探讨丹参注射液联合生长抑素治疗急性胰腺炎的临床疗效。方法 选取2018年1月—2021年2月阜阳市人民医院收治的94例急性胰腺炎患者作为研究对象,根据治疗方法患者分为对照组和观察组,每组各47例。对照组静脉滴注注射用生长抑素,0.25 mg加入500 mL的生理盐水充分稀释,以250 μg/h速度进行滴注,1次/d。观察组在对照组基础上静脉滴注丹参注射液,20 mL加入250 mL的生理盐水充分稀释后静脉滴注,1次/d。两组均连续治疗7 d。观察两组患者的临床疗效、症状和体征恢复时间,同时比较两组治疗前后的血清C反应蛋白(CRP)、人巨噬细胞趋化蛋白-1(MCP-1)、中性粒细胞/淋巴细胞比值(NLR)和淀粉酶的水平及血液流变学指标水平。结果 治疗后,观察组患者总有效率为95.74%,明显高于对照组的82.98%,差异有统计学意义(P<0.05)。治疗后,观察组淀粉酶、电解质恢复时间、腹痛消失时间、腹胀消失时间均较对照组短,差异有统计学意义(P<0.05)。治疗后,两组的CRP、MCP-1、NLR、血清淀粉酶水平均显著降低(P<0.05);治疗后,观察组的CRP、MCP-1、NLR、淀粉酶水平显著低于对照组(P<0.05)。治疗后,两组的全血高切黏度、血浆比黏度、血小板聚集率显著下降(P<0.05);且观察组各项血液流变学指标均低于对照组,差异有统计学意义(P<0.05)。结论 丹参注射液联合生长抑素治疗急性胰腺炎的疗效确切,能进一步减轻临床症状,减轻炎症反应和改善血液流变学,安全性良好。  相似文献   

4.
目的 探讨血府逐瘀口服液联合生长抑素治疗急性胰腺炎的临床疗效。方法 选取2012年10月-2014年4月内蒙古医科大学附属医院收治的急性胰腺炎患者98例,随机分成治疗组(49例)和对照组(49例),对照组在常规治疗的基础上给予注射用生长抑素0.25 mg/h,经微泵持续静脉泵注;治疗组在对照组治疗的基础上口服血府逐瘀口服液,10 mL/次,3次/d。两组均连续治疗7 d。观察两组患者的临床疗效,同时比较两组腹痛缓解时间、胃肠功能恢复时间、血尿淀粉酶正常时间、白细胞计数恢复时间、并发症发生率等临床指标以及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、血浆内皮素(ET)、血栓素B2(TXB2)及6-酮前列腺素-F1α(6-keto-F1α)的水平变化。结果 治疗组和对照组的总有效率分别为95.92%、85.71%,两组比较差异有统计学意义(P<0.05)。治疗组患者在腹痛缓解时间、胃肠功能恢复时间、血尿淀粉酶恢复时间、白细胞计数恢复时间、并发症发生率方面均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的TNF-α、IL-1β、ET、TXB2、6-keto-PGF1α均较治疗前有显著降低,同组治疗前后差异有统计学意义(P<0.05、0.01)。治疗后,治疗组这些指标明显低于对照组,两组比较差异有统计学意义(P<0.05、0.01)。结论 血府逐瘀口服液联合生长抑素对急性胰腺炎有较好的临床疗效,可能与减轻患者的炎症反应,改善微循环有关。  相似文献   

5.
目的 探析康复新液联合注射用生长抑素治疗急性十二指肠溃疡出血的临床效果。方法 选取2020年1月—2022年1月中国人民解放军南部战区总医院诊治的106例急性十二指肠溃疡出血患者,以随机数字表法将所有患者分为对照组和治疗组,各53例。对照组首先缓慢静脉注射0.25 mg注射用生长抑素作为负荷剂量,而后立即静脉点滴0.25 mg/h。如果两次输液给药间隔大于3~5 min,采取重新静脉注射0.25 mg注射用生长抑素以确保给药的连续性。治疗组在对照组治疗的基础上口服康复新液,10 mL/次,3次/d。两组连续治疗7 d。比较两组的临床疗效、临床指标、血清炎性因子水平。结果 治疗后,治疗组总有效率为98.11%,显著高于对照组的总有效率83.02%(P<0.05)。治疗后,治疗组大便隐血转阴时间、禁食时间均短于对照组(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)水平均较治疗前下降(P<0.05);且治疗组的血清IL-6水平均低于对照组(P<0.05)。结论 康复新液联合注射用生长抑素治疗急性十二指肠溃疡出血的效果更显著,可有效改善临床症状、降低血清IL-6水平。  相似文献   

6.
目的 研究谷氨酰胺联合生长抑素对急性胰腺炎患者肝功能的影响。方法 选择2015年1月-2017年12月安徽省第二人民医院急诊医学科收治的50例急性胰腺炎患者,随机分为对照组(n=25)和观察组(n=25)。对照组将6 mg生长抑素加入至500 mL生理盐水中进行静脉滴注,每天1次。观察组在对照组基础上联合静脉滴注谷氨酰胺,每次20 g,每天1次。两组均给药7 d。记录两组的机械通气时间、APACHE Ⅱ评分及住院时间,比较两组肝功能和血清炎性细胞因子水平。结果 观察组的有效率为92.00%,明显高于对照组的76.00%,差异有统计学意义(P<0.05)。观察组机械通气时间、APACHE Ⅱ评分及住院时间均明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和丙氨酸氨基转移酶(ALT)均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组以上指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组以上指标明显低于对照组,差异有统计学意义(P<0.05)。结论 谷氨酰胺联合生长抑素可以有效改善急性胰腺炎患者的肝功能,抑制炎症反应,效果明显优于单用生长抑素。  相似文献   

7.
目的 探究谷氨酰胺联合异甘草酸镁治疗重症急性胰腺炎(severe acute pancreatitis,SAP)疗效及对炎症因子、肠黏膜屏障功能的影响。方法 选取2014年2月—2017年2月收治的SAP患者80例,随机分为对照组和联合组,各40例。2组均给予常规治疗,对照组在肠内营养基础上加用谷氨酰胺0.3 g·kg-1·d-1,联合组在对照组基础上静脉滴注含150 mg异甘草酸镁的5%葡萄糖注射液250 mL,每天1次。2组均连续治疗14 d。比较2组临床疗效,治疗前,治疗3,7,14 d后急性生理及慢性健康评分Ⅱ(APACHE Ⅱ),IL-6、IL-8、IL-10、TNF-α等炎症因子水平,二胺氧化酶(diamine oxidase,DAO)、D-乳酸、内毒素(endotoxin,ET)等肠黏膜屏障功能指标。结果 联合组总有效率为92.50%,明显高于对照组的75.00%(P<0.05)。治疗3,7,14 d后,联合组APACHEⅡ评分均明显低于同期对照组(P<0.05);联合组血清TNF-α、IL-6、IL-8水平均明显低于同期对照组(P<0.05),血清IL-10水平明显高于同期对照组(P<0.05);联合组血清DAO、D-乳酸、ET水平均明显低于同期对照组(P<0.05)。结论 谷氨酰胺联合异甘草酸镁治疗SAP患者能有效缓解炎症反应,改善肠黏膜屏障功能,提高临床疗效。  相似文献   

8.
目的 探讨头孢曲松联合利福平对儿童大叶性肺炎的疗效及安全性。方法 入组西安市中心医院收治的患者78例,随机分为观察组(n=39)和对照组(n=39)。对照组静脉给予注射用头孢曲松钠,每次80 mg/kg,每日1次。观察组在对照组基础上口服利福平胶囊,每次10~20 mg/kg,每日1次。两组疗程均为7~14 d。比较两组患者(研究药物自初次给药时间的8~15 d)的临床治愈率,炎症因子白介素-6(IL-6)、白介素-10(IL-10)、C反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)水平及不良反应。结果 观察组和对照组临床有效率分别为87.2%、66.7%,两组疗效有统计学差异(P<0.05)。与治疗前比较,两组患儿治疗后血清IL-6、IL-10、CRP、HMGB1均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且观察组显著低于对照组,差异有统计学意义(P<0.05)。两组不良事件发生率,没有统计学差异。结论 利福平联合头孢曲松治疗儿童大叶性肺炎疗效确切,安全性好,值得临床应用推广。  相似文献   

9.
王世刚  纪放  李萍  林浩  吴泽 《现代药物与临床》2023,38(12):3066-3070
目的 考察热毒宁注射液联合注射用亚胺培南西司他丁钠治疗重症肺炎的临床疗效。方法 选择2020年7月—2023年2月在南京市中西医结合医院就诊的94例重症肺炎患者作为研究对象,参考随机数字表法将94例患者分为对照组(n=47)和治疗组(n=47)。对照组静脉滴注注射用亚胺培南西司他丁钠,1.0 g加入100 mL生理盐水中,1次/12 h。治疗组在对照组治疗的基础上静脉滴注热毒宁注射液,20 mL热毒宁注射液加入250 mL葡萄糖溶液中,滴速30~60滴/min,1次/d。两组连续治疗10 d。对比两组患者临床疗效、病情严重程度、症状消失时间、肺通气功能、血清指标。结果 治疗后,治疗组总有效率与对照组的总有效率组间比较差异显著(P<0.05)。治疗后,两组的序贯性脏器功能衰竭(SOFA)评分显著减少(P<0.05),治疗组的SOFA评分小于对照组(P<0.05)。治疗后,治疗组高热、咳嗽、喘息、肺啰音消失时间明显短于对照组(P<0.05)。治疗后,两组的气道阻力、吸气峰压、平均气道压显著降低(P<0.05),治疗组气道阻力、吸气峰压、平均气道压明显低于对照组(P<0.05)。治疗后,两组的血清高迁移率族蛋白B1(HMGB1)、白细胞介素-18(IL-18)、可溶性髓系细胞触发受体-1(sTREM-1)水平均显著降低(P<0.05),治疗组的血清HMGB1、IL-18、sTREM-1水平明显低于对照组(P<0.05)。结论 热毒宁注射液联合注射用亚胺培南西司他丁钠可显著提高重症肺炎的临床疗效,缓解患者的临床症状和病情严重程度,改善肺通气功能,显著减轻炎症反应。  相似文献   

10.
目的 探讨己酮可可碱联合胰激肽原酶治疗糖尿病足的临床疗效。方法 选择2018年5月—2022年2月在漯河市中心医院治疗的86例糖尿病足患者为研究对象,根据住院号的奇偶性分为治疗组和对照组,每组各43例。对照组患者肌肉注射注射用胰激肽原酶,40 U/次,1.5 mL灭菌注射用水溶解,1次/d;在此基础上,治疗组患者静脉滴注注射用己酮可可碱,0.4 g加入250 mL生理盐水,1次/d。两组患者连续治疗4周。观察两组患者临床疗效,比较治疗前后两组患者糖尿病自护行为量表(SDSCA)、自我感受负担量表(SPBS)评分和食物多样化评分(DDS),血清胰岛素样生长因子-1(IGF-1)、同型半胱氨酸(Hcy)、瘦素、转化生长因子-β(TGF-β)和白细胞介素-13(IL-13)水平,足部溃疡面积和深度,足背动脉血管内径、血流流速、搏动指数(PI)、阻力指数(RI)。结果 治疗后,对照组有效率为81.40%,明显低于治疗组(97.67%,P<0.05)。治疗后,两组SDSCA评分明显升高,而SPBS评分和DDS评分明显下降(P<0.05);两组患者血清IGF-1和TGF-β水平明显升高,而Hcy、瘦素和IL-13水平均明显降低(P<0.05);两组足部溃疡面积、溃疡深度均明显减小(P<0.05);两组患者足背动脉血管内径、血流流速、PI、RI均明显增加(P<0.05);上述指标以治疗组改善更为明显(P<0.05)。结论 注射用己酮可可碱联合注射用胰激肽原酶治疗糖尿病足可有效促进溃疡愈合,减轻患者疼痛,提高自我管理能力。  相似文献   

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We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.  相似文献   

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Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.
Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.
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This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.  相似文献   

18.
Lung disease and PKCs   总被引:1,自引:0,他引:1  
The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.  相似文献   

19.
This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.  相似文献   

20.
In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.  相似文献   

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