陈可冀治疗充血性心力衰竭经验

陈可冀参照传统中医思辨特点，以“虚”“瘀”“水”统领充血性心力衰竭中医病机，病证结合。将充血性心力衰竭分为3型。以传统古方为基础，结合中药现代药理学研究成果进行辨证施治，取得理想疗效。     

史载祥中西医结合治疗高血压的临床思路和经验

中西医学对高血压的发病机制，从不同的理论体系出发有各自的认识，治疗理念上也有较大的差异。①中药调整体质，增强机体对降压药的敏感性；②中药与西药需配伍应用，才能取得最佳疗效；③对高血压痛的靶器官损害。采取中西医结合防治；④重视高血压病的非药物治疗。对治疗高血压病的临证经验：①早期实证多见。治以清肝潜阳：以羚羊钩藤汤为主；②中期虚实夹杂，兼顾滋阴补肾，祛痰化瘀通络：以镇肝熄风汤为主：③后期以虚为主，调整阴阳平衡：辨证治疗心力衰竭、脑出血等危重症。     

554例并发高血压全麻病人的围术期临床资料分析

目的探讨并发高血压的全身麻醉下择期手术病人围术期风险.方法选择并发高血压的全身麻醉择期手术病人554例,监测围术期血压和心率,并追踪术后恢复情况.结果围术期血压有明显波动,插管后及术毕拔管时的收缩压、舒张压、心率以及探查时舒张压和心率与麻醉前比较均有升高,比较有统计学意义（P＜0.05）.术中196例及术后74例使用降压药物处理,术后其他并发症发生率为7.6%.结论采取相应的处理可以使围术期风险减少,但并发症及潜在隐患依然存在,提供有效预防措施非常重要.     

珍菊降压片与卡托普利对高血压左心室肥厚逆转作用的比较

目的：观察珍菊降压片和卡托普利逆转左室肥厚的作用。　方法：分别对 ３０ 名用珍菊降压片的高血压病人及 ３５ 名用卡托普利的病人行１２ 个月的治疗。观测血压及心脏超声指标。比较治疗前后指标的变化。　结果：两组经治疗后均有血压的下降及左心室重量指数（ Ｌ Ｖ Ｍ Ｉ）的改善。　结论：二药均有逆转左室肥厚的作用。     

Improvement of Vascular Remodeling in Spontaneous Hypertensive Rats with Traditional Chinese Medicine

Qin-Dan-Jiang-Ya-Tang (QDJYT) is a traditional Chinese herbal medicine for the treatment of hypertension. The effect of QDJYT on blood pressure (BP) and vascular remodeling in hypertension was investigated in the model of spontaneous hypertensive rats (SHR). Sixteen SHRs were divided into two groups: the SHR group and the SHR+ QDJYT group. Eight Wistar-Kyoto (WKY) rats were in the normal control group. QDJYT (750mg/kg) was orally administered daily for 12 weeks to the SHR+QDJYT group. After 12 weeks, thoracic aortas were segregated. The media thickness (MT) and the lumen diameter (LD) of the aortic wall, the ratios of MT to LD, the expression of basic fibroblast growth factor (bFGF) mRNA, and the level of its proteinic production were examined by histology, real-time PCR, and Western blot analysis, respectively. It was observed in our study that MT, MT/LD, the expression of bFGF mRNA, and the level of its proteinic production in aortic walls were higher in SHRs than in WKY rats. However, in the SHRs treated with QDJYT, we found MT, MT/LD, the expression of bFGF mRNA and the level of its proteinic production were lower than SHRs. These results suggest that QDJYT can improve the vascular remodeling in SHRs, and the mechanisms may be related to the suppressive effect of QDJYT on bFGF mRNA and its proteic productions in the aortic walls of SHRs.     

高血压患者血压变异性的临床研究

目的探讨高血压病人血压变异性的特点。方法对４８例血压正常人和４２例高血压病人进行动态血压监测。结果无论是高血压组还是正常对照组血压变异性与血压均值一样白天增高，夜间下降，而且收缩压变异大于舒张压变异。但高血压组血压变异性各项指标均显著大于正常对照组（Ｐ＜０．０５）。结论高血压患者血压变异性明显高于血压正常者。     

中西医结合治疗高血压性脑出血51例疗效观察

目的探讨中西医结合治疗高血压脑出血的疗效和机制。方法将100例高血压性脑出血病人随机分成两组,对照组49例予常规西医治疗,治疗组51例采用由手术、中药、针刺、西医和高压氧5大措施为主的中西医结合治疗,两组病人于治疗后观察相关指标。结果治疗组病人治疗10d和大于20d的清醒率分别为37.25%和92.16%,均优于对照组(P<0.01);治疗30d和90d神经功能缺损程度评分及90d日常生活能力均明显改善(P<0.01)。结论中西医结合治疗可提高病人的生存率和清醒率,改善神经功能和生活质量,降低严重致残和病死率。     

美托洛尔治疗高血压120例临床分析

单用美托洛尔0．05g，2／d治疗高血压患者120例．4周后有效率为68.3％，收缩压及舒张压显著下降。对疗效不显者增加剂量0．1g，2／d，疗效无明显改善。加用硝苯地平10mg，3／d，血压显著下降，总有效率达90．9％。     

Relationship Between Serum Leptin Levels and Clinical Outcomes of Hypertensive Intracerebral Hemorrhage

Circulating leptin is associated with cardiovascular events but the relationship between leptin and the clinical outcomes of intracerebral hemorrhage (ICH) is unclear. This study was to investigate the relationship between circulating leptin and the short-term clinical outcomes of ICH. Fifty-seven patients with hypertensive ICH (stroke group), 50 patients with hypertension (hypertension group), and 41 healthy subjects (control group) were recruited to this study. Serum levels of leptin were measured by radioimmunoassay. The serum level of leptin in the stroke group (14.6 ± 3.3 ng/L) was significantly higher than in the hypertension (10.2 ± 2.9 ng/L, P < 0.05) and control group (4.7 ± 3.3 ng/L, P < 0.01). Nine patients (15.8%) in the stroke group died during hospitalization. The mean National Institute of Health Stroke Scale (NIHSS) score of the surviving patients at admission and before discharge was 16 ± 6 and 9 ± 5, respectively (P < 0.01). There was a significant correlation between the serum leptin level and predischarge NIHSS scores (r = 0.62, P < 0.01). After adjusting age, sex, ICH volume and location, fasting blood glucose, fasting insulin levels, and systolic blood pressure (SBP) multivariate analysis showed that a high leptin level (>10 ng/L) was an independent predictor for in hospital mortality (adjusted risk ratio (RR), 3.6; 95% confidence interval (CI): 1.22–17.62; P = 0.02). In conclusion, serum leptin levels were increased in patients with hypertensive ICH. High leptin levels were associated with a poor functional recovery following ICH.