补肾活血法改善165例长期维持性血液透析肾性骨病患者生存质量的临床疗效评价

目的采用健康调查问卷(SF-36)生存质量量表评价补肾活血法对长期维持性血液透析(MHD)肾性骨病患者生存质量的改善作用。方法随机将165例行MHD的慢性肾衰性骨病患者分为对照组81例和中药组84例。对照组采用对症治疗方案,中药组加用补肾活血颗粒剂。分别于治疗前后采用国际通用的生存质量评测工具———SF-36量表对MHD患者生存质量进行评估。结果中药组和对照组生存质量综合评分在治疗后均有提高,而中药组更为显著,中药组生存质量综合评分疗后显著提高,优于对照组。结论补肾活血中药能够提高慢性肾衰肾性骨病患者总体生存质量。     

骨癌通泰方配合MP方案治疗多发性骨髓瘤24例

目的:观察补肾益气活血中药配伍辅助MP化疗方案治疗多发性骨髓瘤(MM)的临床疗效。方法:将24例MM骨病患者随机分为2组。对照组10例,给予MP方案化疗治疗;治疗组14例,在对照组治疗基础上加服骨癌通泰方(由党参、黄芪、白术、当归、丹参、莪术、骨碎补、补骨脂、薏苡仁等组成)。主要观察治疗前后骨痛症状视觉模拟量表(VAS)评分、血钙水平、血红蛋白(Hb)及TNFa和β2-MG水平等指标的变化。结果:治疗组治疗后骨痛症状VAS评分、血钙水平、及TNFa和β2-MG水平均明显下降,血红蛋白(Hb)明显升高,与治疗前比较,差异均有非常显著性意义(P<0.01);治疗组与对照组治疗后比较,差异均有显著性意义(P<0.05)。结论:中药补肾益气活血法能有效辅助化疗减轻MM患者骨痛症状,降低血钙浓度,减少骨髓破骨细胞的数量。     

中药结合博宁治疗肿瘤性骨溶解性骨破坏疗效研究

观察博宁配合中药补肾活血方对肿瘤性骨溶解性骨破坏骨痛及骨质修复的疗效。临床确诊为肿瘤性骨溶解性骨破坏伴骨痛患者63例,随机分为博宁加补肾活血方组(治疗组)及单纯博宁组(对照组)。结果:治疗组骨痛缓解率76.67%,优于对照组的60.61%,P<0.05。8周后骨质修复,治疗组为26.67%,对照组为6.06%,P<0.05。提示:补肾活血方对博宁有增效作用,博宁配合中药补肾活血方对肿瘤性骨溶解性骨破坏骨痛有较好的缓解作用,并能促进骨骼修复。     

崔玉衡祛风汤治疗维持性血液透析患者皮肤瘙痒症临床研究

目的:观察崔玉衡祛风汤对维持性血透患者皮肤瘙痒症的作用机制,为维持性血液透析患者皮肤瘙痒的治疗提供新途径。方法:选取本院肾病风湿科血液净化中心收治的维持性血液透析皮肤瘙痒症患者120例,随机分为崔玉衡祛风汤组与乌蛇祛风汤组各60例。2组均进行西医常规治疗,崔玉衡祛风汤组加予崔玉衡祛风汤治疗,乌蛇祛风汤组加予乌蛇祛风汤治疗。采用视觉模拟评分(VAS)、行为评分(BRS)、瘙痒情绪评分和皮肤干燥程度评分评价临床疗效,检测患者外周血相关实验指标、白细胞介素-12 (IL-12)含量以及IL-12 mRNA相对表达量。结果:治疗后,VAS评分、BRS评分、瘙痒情绪评分和干燥程度评分分值显著下降(P<0.01);血红蛋白(Hb)升高(P<0.05),甲状腺旁激素(PTH)、血钙和血磷下降(P<0.05);IL-12mRNA和IL-12表达水平显著上升(P<0.01)。与乌蛇祛风汤组比较,崔玉衡祛风汤组的VAS评分、BRS评分、瘙痒情绪评分和干燥程度评分分值较低(P<0.05),IL-12 mRNA和IL-12表达水平显著上升(P<0.01)。VAS评分、BRS...     

中药内服外敷治疗老年性骨质疏松症疼痛临床观察

目的:观察中药内服外敷治疗老年性骨质疏松症疼痛的疗效。方法:将60例患者随机分成2组各30例,治疗组予中药内服结合湿热外敷治疗,对照组予密钙息肌注治疗。观察比较2组治疗前疼痛评分及骨密度(BMD)变化。结果:治疗后1、2、3月2组腰背痛疼痛视觉模拟(VAS)评分均较治疗前有不同程度下降(P<0.01)。治疗后2组腰椎L2~L4BMD值均较治疗前显著升高(P<0.01)。治疗组血钙、血磷治疗前后变化不大(P>0.05);对照组血磷治疗前后变化不大(P>0.05),血钙治疗后较治疗前明显下降(P<0.05)。结论:中药内服外敷治疗老年性骨质疏松症疼痛疗效肯定,且对血钙无影响。     

加味补肾活血汤对肾虚血瘀型骨质疏松早期骨量减少患者的干预作用研究——附45例临床资料

目的：观察加味补肾活血汤对肾虚血瘀型骨质疏松早期骨量减少患者骨代谢指标及中医证候、生存质量等的干预作用。方法：将纳入本研究的90例肾虚血瘀型骨质疏松早期骨量减少患者随机分为治疗组与对照组,每组45例。对照组予碳酸钙D3片口服治疗,配合健康宣教;治疗组在对照组治疗的基础上加用中药汤剂加味补肾活血汤口服。2组患者均连续治疗3个月。比较2组患者治疗前后血清总Ⅰ型前胶原氨基末端肽（t PⅠNP）、β-Ⅰ型胶原交联C-末端肽（β-CTX）、25-羟基维生素D[25-(OH)D]、骨钙素（BGP）、血钙、血磷等骨代谢指标以及中国人骨质疏松症专用生存质量量表（COQOL）评分、中医证候评分改变情况,治疗前后检测患者肝肾功能指标以评价药物安全性,治疗后比较2组患者临床疗效。结果：治疗后治疗组血清t PⅠNP、25-(OH)D、BGP及血钙含量均较本组治疗前明显升高（P<0.05）,β-CTX含量较本组治疗前明显降低（P<0.05）,其中β-CTX含量明显低于同期对照组（P<0.05）,BGP含量明显高于同期对照组（P<0.05）。治疗后2组患者COQOL评分均较本组治疗前明显降...     

补肾活血汤加味对股骨近端骨折术后疼痛和睡眠效率的影响

目的：观察补肾活血汤加味对股骨近端骨折术后疼痛和睡眠效率的影响。方法：将120例股骨近端骨折术后患者随机分为结合组与对照组各60例。2组均行手术治疗,结合组术后服用补肾活血汤加味治疗。比较2组临床疗效、疼痛程度、睡眠质量及血清中碱性磷酸酶（ALP）、骨形态发生蛋白-2 (BMP-2)、骨钙素（BGP）含量。结果：结合组总有效率96.67%,高于对照组83.33%(P<0.05)。与同组治疗前比较,治疗后1个月、3个月2组疼痛视觉模拟评分法（VAS）评分、睡眠质量均下降（P<0.05）,血清ALP、BMP-2、BGP含量均升高（P<0.05）;治疗后1个月、3个月,结合组VAS评分、睡眠质量均低于对照组（P<0.05）,血清ALP、BMP-2、BGP含量均高于对照组（P<0.05）。结论：补肾活血汤加味治疗股骨近端骨折术后患者疗效显著,可降低疼痛程度,提高睡眠质量及血清中成骨生物活性指标的含量。     

补肾壮骨汤对尿毒症维持性血液透析患者不安腿综合征及骨代谢影响的临床观察

目的观察补肾壮骨汤联合常规疗法治疗尿毒症维持性血液透析患者不安腿综合征的临床疗效,并探讨其可能的机制。方法将64例尿毒症维持性血液透析不安腿综合征患者随机分为治疗组和对照组,每组32例。两组均维持原有稳定饮食习惯并对血液透析治疗方案进行改进、治疗基础疾病,对照组加服骨化三醇胶丸及碳酸钙片,治疗组在对照组治疗措施基础上加服补肾壮骨汤治疗。两组疗程均为6个月,观察临床疗效,比较血钙、血磷、ALP、iPTH水平及国际不安腿综合征研究组(IRLSSG)问卷调查表评分(IRLSSG评分)的变化情况。结果 (1)治疗组、对照组临床总有效率分别为81.3%、37.5%;组间临床疗效比较,治疗组明显优于对照组(P0.05)。(2)组间治疗后比较,血钙、血磷、ALP、iPTH水平及IRLSSG评分治疗组改善明显优于对照组(P0.05)。结论补肾壮骨汤联合常规疗法治疗尿毒症维持性血液透析患者不安腿综合征的疗效满意,其机制可能与改善患者的骨代谢、钙磷代谢紊乱有关。     

补肾活血化痰法治疗血管性痴呆41例

目的:观察补肾、活血、化痰类中药治疗血管性痴呆的疗效。方法:61例患者随机分为治疗组41例,采用补肾、活血、化痰类(何首乌、黄精、益智仁、葛根、赤芍、地龙、菖蒲等)中药汤剂;对照组20例,采用肠溶阿斯匹林片和胞二磷胆碱针治疗。结果:治疗组疗效明显高于对照组(P<0.01),治疗后长谷川痴呆量表评分亦显著高于治疗前(P<0.01),治疗后长谷川痴呆量表评分差值亦显著高于对照组(P<0.01)。结论:说明本方法对血管性痴呆具有补肾益智,活血化痰的功效。     

益肾强骨方治疗肾虚浊瘀型维持性血液透析并发肾性骨病临床观察

目的 益肾强骨方对肾虚浊瘀型维持性血液透析（MHD）并发肾性骨病患者临床症状及实验指标的影响。方法 选取肾虚浊瘀型MHD并发肾性骨病患者52例,依据曾经是否服用益肾强骨方分为治疗组和对照组各26例。对照组患者给予常规治疗,治疗组患者在常规治疗基础上口服益肾强骨方,2组疗程均为8周。评估2组治疗前后中医症状评分,检测治疗前后血浆全段甲状旁腺激素（i PTH）、骨碱性磷酸酶（BAP）、血钙、尿素、肌酐水平。结果 治疗组骨痛、皮肤瘙痒、纳差腹胀、倦怠乏力4项症状评分均降低（P <0.05）,与对照组比较,4项评分降低更明显（P <0.05）。治疗组i PTH、BAP、血磷、血肌酐指标均明显降低（P <0.05）,与对照组比较,治疗组降低更明显（P <0.05）。结论 益肾强骨方可能在一定程度上改善肾虚浊瘀型MHD并发肾性骨病患者的相关实验指标,从而改善患者的临床症状、生活质量及远期生存率。     

Influence of Scalp Point-through-point Acupuncture on 200 kDa Neurofilament Protein in Rats with Acute Cerebral Infarction

目的研究头穴透刺对急性脑梗死大鼠神经丝蛋白-200(NF-200)的影响,探讨针刺对脑梗死大鼠神经可塑性影响的机制.方法将健康雄性Wistar大鼠随机分为假手术组(A组)、模型组(B组)、针刺组(C组).通过建立大鼠局灶性脑缺血模型(MCAO),用逆转录-聚合酶链反应(RT-PCR)法,测定以上各组在7 d、14 d、28 d不同时间点NF200 mRNA变化情况.结果头穴透刺组脑组织NF-200的表达与假手术组、造模组相比差异有统计学意义(P＜0.05);而在不同时间窗内头穴透刺组,模型组与假手术组比较差异有统计学意义(P＜0.01).表明头穴透刺可以促进脑组织神经丝蛋白-200的表达.结论头穴透刺能够提高脑缺血后神经功能,促进肢体功能恢复,增加神经丝蛋白-200的表达,发挥对脑组织神经细胞可塑性的调节作用.     

Acupuncture treatment for Subacute Non-specific Low Back Pain-A Retrospective Cohort Study in the Role of the Back Exercise in Acupuncture Services for Low Back Pain Sufferers

目的研究腰部的锻炼方法与针刺疗效的内在关系,以揭示部分腰痛病人针灸治疗恢复较慢的原因.方法采用回顾性调查研究方法.70例被诊断为腰痛的患者按顺序性抽样方法分为两组.观察组44例采用针刺治疗加锻炼的方法,对照组26例仅针刺治疗.根据针刺治疗后1年内的复发率比较两组间的差异.结果与结论背部锻炼是一个危险因素,它和腰痛的频繁发作有关.而针刺治疗是一种对亚急性非特异性腰痛的有效治疗方案.     

The effect of Nigella sativa alone, and in combination with dexamethasone, on tracheal muscle responsiveness and lung inflammation in sulfur mustard exposed guinea pigs

Ethnomedical relevance

The anti-inflammatory activity of both systemic and local administrations of essential oil from Nigella sativa L. has been shown.

Aim of the study

Therefore, the effect of Nigella sativa on tracheal responsiveness (TR) and lung inflammation of sulfur mustard (SM) exposed guinea pigs was examined.

Materials and methods

Guinea pigs were exposed to diluent solution (control group), inhaled SM (SME group), SME treated with Nigella sativa (SME + N), SME treated with dexamethasone (SME + D) and SME treated with both drugs (SME + N + D), (n = 7 for each group). TR to methacholine, total white blood cell (WBC) and differential WBC count of lung lavage, and serum cytokines were measured 14 days post-exposure.

Results

The values of TR, eosinophil, monocyte, lymphocyte, interleukine-4 (IL-4) and interferon gamma (IFN-γ) of SME group were significantly higher than those of controls (p < 0.05 to p < 0.001). The TR in SME + N, SME + D and SME + N + D was significantly lower compared to that of SME group (p < 0.01 for all cases). The percentage of eosinophil in SME + D, and the percentage of monocyte in SME + N + D (p < 0.05 to p < 0.01) were significantly lower than those in SME group. The neutrophil number was decreased in SME + N and SME + N + D groups compared to SME animals (p < 0.05 to p < 0.01). IL-4 levels in serum of SME + N (p < 0.01), SME + D (p < 0.05), SME + N + D (p < 0.01) and IFN-γ in SME + N (p < 0.05) were greater than those in SME animals.

Conclusions

These results showed a preventive effect of Nigella sativa on TR and lung inflammation of SM exposed guinea pigs.     

川芎嗪、阿魏酸和延胡索乙素在模型与正常大鼠体内药动学比较研究

目的探讨川芎、延胡索中主要活性成分在模型与正常大鼠体内药动学规律与差异。方法 SD大鼠分为对照组和子宫内膜异位症模型组,每组8只,各组均按川芎嗪50mg/kg、阿魏酸30mg/kg、延胡索乙素20mg/kg ig给药,采用高效液相色谱法测定各组大鼠血浆中川芎嗪、阿魏酸和延胡索乙素的质量浓度,DAS2.0程序计算药动学参数。结果模型组川芎嗪药时曲线下面积(AUC_(0~t))、达峰浓度(C_(max))、达峰时间(t_(max))、半衰期(t_(1/2))和平均驻留时间(MRT_(0~t))与对照组相比差异均不显著(P0.05);模型组阿魏酸AUC_(0~t)、C_(max)、t_(max)都小于对照组,但差异没有显著性(P0.05),t_(1/2)、MRT_(0~t)显著小于对照组(P0.05);模型组延胡索乙素AUC_(0~t)、t_(max)、MRT_(0~t)均显著大于对照组(P0.05)。结论川芎、延胡索主要活性成分在正常大鼠和模型大鼠的体内过程有所不同。阿魏酸在模型大鼠体内消除更快,延胡索乙素在模型大鼠体内吸收浓度更高、消除更慢,川芎嗪在正常及模型大鼠的体内过程无显著性差异。     

Bacopa monnieri and its constituents is hypotensive in anaesthetized rats and vasodilator in various artery types

Ethnopharmacological relevance

Bacopa monnieri (Brahmi) provides traditional cognitive treatments possibly reflecting improved cerebral hemodynamics. Little is known about the cardiovascular actions of Brahmi. We sought to assess its effects on blood pressure and on isolated arteries, thus providing insights to clinical applications.

Materials and methods

Intravenous Brahmi (20-60 mg/kg) was tested on arterial blood pressure and heart rate of anaesthetized rats. In vitro vasorelaxation was assessed in arteries, with and without blockers of nitric oxide synthase (L-NAME), cyclooxygenase (indomethacin), and mechanical de-endothelialisation. The effects of Brahmi on Ca²⁺ influx and release from stores were investigated.

Results

Intravenous Brahmi extract (20-60 mg/kg) decreased systolic and diastolic pressures without affecting heart rate. Brahmi evoked relaxation in isolated arteries in order of potency: basilar (IC50 = 102 ± 16 μg/ml) > mesenteric (171 ± 31) > aortae (213 ± 68) > renal (IC50 = 375 ± 51) > tail artery (494 ± 93) > femoral arteries (>1000 μg/ml). Two saponins, bacoside A3 and bacopaside II, had similar vasodilator actions (IC50 = 8.3 ± 1.7 and 19.5 ± 6.3 μM). In aortae, without endothelium or in L-NAME (10-4 M), Brahmi was less potent (IC50 = 213 ± 68 to 2170 ± 664 and 1192 ± 167 μg/ml, respectively); indomethacin (10-5 M) was ineffective. In tail artery, Brahmi inhibited K⁺-depolarization induced Ca²⁺ influx and Ca²⁺ release from the sarcoplasmic reticulum by phenylephrine (10-5 M) or caffeine (20 mM).

Conclusions

Brahmi reduces blood pressure partly via releasing nitric oxide from the endothelium, with additional actions on vascular smooth muscle Ca²⁺ homeostasis. Some Brahmi ingredients could be efficacious antihypertensives and the vasodilation could account for some medicinal actions.     

小儿清瘟解热颗粒的解热抗炎镇痛作用

目的:研究小儿清瘟解热颗粒的解热、抗炎及镇痛作用。方法:选取Wistar大鼠,日本大耳白兔,分别采用ih酵母致大鼠发热模型,采用内毒素致家兔发热模型,观察小儿清瘟解热颗粒的解热作用;选取KM小鼠,采用醋酸致小鼠扭体及热板刺激观察小儿清瘟镇痛反应;ICR小鼠,SD大鼠通过小儿清瘟解热颗粒对二甲苯所致耳肿胀,小鼠毛细血管通透性,大鼠后肢足跖炎症性肿胀的影响观察其抗炎作用。结果:小儿清瘟解热颗粒3.92 g·kg-1及15.68 g·kg-1于给药3 h能显著降低家兔肛温差值(P0.05,P0.01),3.78~30.24 g·kg-1于给药4 h能显著降低大鼠肛温(P0.05,P0.01)。小儿清瘟颗粒43.68 g·kg-1显著减少小鼠扭体次数(P0.05),10.92,21.84 g·kg-1于给药2 h能显著提高小鼠痛阈值(P0.05)。小儿清瘟解热颗粒5.46~43.68 g·kg-1连续给药3 d显著减轻二甲苯所致小鼠右耳肿胀度(P0.01),7.56 g·kg-1组于给药1 h显著降低足肿胀度(P0.05),15.12 g·kg-1组于给药0.5,2,4 h显著降低足肿胀度(P0.05,P0.01),30.24 g·kg-1组于给药0.5~4 h显著降低足肿胀度(P0.05,P0.01),小儿清瘟解热颗粒43.68 g·kg-1组腹腔冲洗液吸光度值显著低于模型组(P0.05)。结论:小儿清瘟解热颗粒具有解热、抗炎及镇痛作用。     

基于单向灌流法的葛根素羧甲基壳聚糖微球肠吸收特性研究

目的考察葛根素羧甲基壳聚糖微球的在体肠吸收特性。方法采用大鼠在体单向灌流法,以HPLC法测定葛根素的量,分别考察不同灌流体积流量、药物质量浓度、肠段对药物吸收的影响,并对比了葛根素原料药及载药微球的吸收特性。结果灌流体积流量对葛根素的吸收速率常数(Ka)和表观渗透系数(Papp)有显著性影响(P0.05);葛根素的质量浓度对Ka和Papp无显著性影响(P0.05);葛根素在空肠和回肠的Ka和Papp无显著性差异,但均显著大于在十二指肠处的值(P0.05);载药微球在空肠的Ka和Papp值显著高于葛根素原料药(P0.05)。结论葛根素羧甲基微球中葛根素的吸收机制为被动扩散,其在空肠和回肠段吸收较好,羧甲基壳聚糖作为载体能显著提高葛根素的吸收。     

Endothelium-independent relaxation and contraction of rat aorta induced by ethyl acetate extract from leaves of Morus alba (L.)

Aim of the study

Based on screening for vasoactive traditional Chinese medicinal herbs, the present study was performed to investigate the vasoactive effects of an ethyl acetate extract from leaves of Morus alba (L.) (ELM) on rat thoracic aorta and the mechanisms underlying these effects.

Materials and methods

Isolated rat thoracic rings were mounted in an organ bath system and the effects of ELM on their responses were evaluated.

Results

ELM (0.125–32.000 g/l) induced a concentration-dependent relaxation (P < 0.01 vs. control) both in endothelium-intact and -denuded aortas precontracted by high K⁺ (6 × 10⁻² M) or 10⁻⁶ M phenylephrine (PE). In endothelium-denuded aortas, ELM at the EC₅₀ concentration reduced Ca²⁺-induced contraction (P < 0.01 vs. control) after PE or KCl had generated a stable contraction in Ca²⁺-free solution. And after incubation with verapamil, ELM induced contraction in endothelium-denuded aortas precontracted by PE (P < 0.01 vs. control); this was abolished by ruthenium red (P < 0.01 vs. ELM-treated endothelium-denuded group; P > 0.05 vs. control), but not by heparin (P > 0.01 vs. ELM-treated endothelium-denuded group; P < 0.01 vs. control).

Conclusions

The results showed that ELM had dual vasoactive effects, and the relaxation was greater than the contraction. The relaxation was mediated by inhibition of voltage- and receptor-dependent Ca²⁺ channels in vascular smooth muscle cells, while the contraction occurred via activation of ryanodine receptors in the sarcoplasmic reticulum.     

5种黄连生物碱大鼠体外肝代谢特征比较

目的 探讨黄连中5种结构相似异喹啉生物碱大鼠体外肝代谢的选择性。方法 采用大鼠体外肝微粒体温孵方法,通过考察温孵时间、微粒体蛋白浓度以及底物浓度对小檗碱、巴马汀、黄连碱、表小檗碱和药根碱代谢的影响,求得代谢反应动力学参数K_m、V_max和CL_int。结果 5种黄连生物碱成分的体外肝代谢动力学参数K_m和CL_int间差异明显（P＜0.05）。结论 黄连中5种异喹啉生物碱大鼠体外肝代谢存在显著选择性。