复方丹参伍用强力宁治疗乙型慢性活动型肝炎疗效观察

复方丹参伍用强力宁治疗乙型慢性活动型肝炎疗效观察邱兴兰，朱琳，陈悦我们自１９９２年元月至１９９４年２月应用复方丹参联合强力宁治疗乙型慢活肝（ＣＡＨＢ）４８例，收到较好效果，现报道如下。对象与方法对象１８０例为我院同期住院ＨＢｓＡｇ、ＨＢｅＡｇ阳性的Ｃ...     

甘草甜素对肝硬化动物模型肝脏内NF一kB结合活性的抑制作用

从分子水平探讨强力宁生物活性的发生机理。方法大鼠随机分为正常对照组、模型对照组、强力宁组,后两组给子四氯化碳（ＣＣ１４）和乙醇造模处理以诱导慢性肝损伤,强力宁组在造模处理同时予强力宁治疗。各组大鼠在ＣＣ１４等处理后第９周处死,收集血清和肝脏标本,测定血清ＡＬＴ活性并进行组织学观察。部分肝组织提取细胞核蛋白进行凝胶迟滞实验以观察ＮＦ－ＫＢ活性。结果ＣＣ１４等处理后第９周模型对照组血清ＡＬＴ水平显著高于强力宁组。模型大鼠肝脏脂肪变性和纤维化程度较强力宁治疗组更为严重。模型对照组肝脏内ＮＦ－ＸＢ活性较正常对照组显著增加,而强力宁组大鼠肝脏内ＮＦ－ｋＢ结合活性与正常组相接近。结论强力宁能够抑制ＣＣ１４联会乙醇诱导的慢性肝损伤大鼠肝脏内ＮＦ－ｋＢ的结合活性的增加,可能是强力宁具有保护肝毒素性肝损伤和纤维化作用的分子机制之一。     

丹参注射液对实验性肝纤维化动物免疫功能的影响

本文用人血白蛋白（ＨＳＡ）制备大鼠免疫性肝纤维化模型，并观察丹参注射液对动物免疫功能的作用。结果表明ＨＳＡ攻击同时用丹参注射液治疗，动物血清免疫复合物（ＩＣ）阳性率和因过敏性休克死亡率明显低于肝纤维化对照组和秋水仙碱对照组。丹参组淋巴细胞转化功能，较后两组有显著性差异。丹参组和秋水仙碱组肝纤维化程度度均显著低于对照组。丹参组肝内炎细胞浸润程度明显减轻，提示丹参可减轻ＨＳＡ所致的免疫损伤，对免疫性肝     

丹参和白细胞介素2防治大鼠免疫性肝纤维化的实验研究

用人血清白蛋白（ＨＳＡ）制备大鼠免疫性肝纤维化模型，探讨丹参注射液和重组白细胞介素２（ＩＬ－２）的防治作用。结果显示：丹参和ＩＬ－２联合组及丹参组血清透明质酸水平和免疫复合物阳性率明显低于对照组和秋水仙硷组。对照组肝组织羟脯氨酸含量和肝纤维化程度均显著高于联合组、丹参组和秋水仙硷组。联合组肝胶原和网状纤维增生程度较另三组降低。提示丹参注射液与ＩＬ－２联合治疗，可减轻ＨＳＡ导致的兔疫损伤，防治免疫性肝纤维化的作用优于秋水仙硷和单独应用丹参注射液。     

川芎嗪与肝复肽联用对慢性乙型肝炎患者血清肝纤维化指标的影响

目的：观察川芎嗪与肝复肽（肝细胞生长与刺激因子，HSS）联用对慢性乙型肝炎（CHB）患者血清肝纤维化指标的影响。方法：169例血清肝纤维化指标异常的CHB患者，随机分为治疗组89例，对照组80例。治疗组采用川芎嗪与肝复肽；对照组采用丹参注射液。30天为1个疗程，两组患者均用药3个疗程。于治疗前后检测血清肝纤维化指标。结果：治疗组患者治疗后肝纤维化指标（PⅢP、LN、C-Ⅳ、HA）显著低于治疗前及对照组治疗后（P〈0．01）；治疗组总有效率为87．64％，对照组则为70．00％，治疗组疗效显著优于对照组（P〈0．05）。结论：川芎嗪与肝复肽两者联用具有纠正CHB患者血清肝纤维化指标异常的作用，两药联用可起到有效的抗肝纤维化作用。     

肝得健联合丹参注射液治疗慢性乙型肝炎肝纤维化疗效观察

目的观察肝得健联合丹参注射液治疗肝纤维化的疗效。方法选择慢性乙型肝炎肝纤维化患者68例。分为肝得健加丹参组、肝得健组、丹参组及对照组。治疗前后检测肝功能、肝纤维化血清学指标（HA、PCⅢ、LN、IV-C）。结果治疗后肝纤维化指标均有不同程度的好转。各组治疗前后及组间比较差异均有统计学意义。结论肝得健联用丹参治疗慢性乙型肝炎肝纤维化能增强抗肝纤维化效应。为临床治疗慢性肝炎和抗肝纤维化治疗提供依据。     

甘利欣和复方丹参注射液合用对慢乙肝肝纤维化的影响

寻找治疗慢性乙肝，抗肝纤维化的有效方法。用甘利欣和复方丹参注射液联合治疗慢乙肝６０例，并与单纯应用甘利欣组（５０例）比较，观察治疗前后血清Ⅲ型前胶原（ＰＣⅢ），层粘蛋白（ＬＮ），透明质酸（ＨＡ），肝功能等指标变化。结果：甘利欣联合复方丹参组血清肝纤维化指标、ＡＬＴ、ＳＢ下降明显，Ａ／Ｇ比值上升显著与治疗前和单用甘利欣组比较有显著性差异。甘利欣和复方丹参注射 用可有效改善肝功能，减轻和抑制纤维化发生     

软肝冲剂抗肝纤维化的临床研究

选择中度以上慢性肝炎和早期肝硬化患者１２０例，分为治疗组和对照组各６０例。治疗组采用软肝冲剂治疗，对照组以干扰素治疗，疗程均为３个月有乙昨观察血清质酸（ＨＡ）、Ⅲ型血清南酸（ＨＡ）、Ⅲ型前胶原肽（ＰⅢＰ）Ⅳ型胶原（Ｃ－Ⅳ）、板层素（ＬＮ）等肝纤维化指标，以及肝功能和病毒复制指标。结果治疗组ＨＡ、Ｃ－Ⅳ、ＬＮ、ＡＬＴ 和γ－Ｇｌｂ明显下降，与对照组比较有显著性差异。ＨＢｅＡｇ和ＨＢＶＤＮＡＢ有转率略     

维生素E抗大鼠四氯化碳所致肝纤维化的实验研究

目的为探讨维生素Ｅ（ＶＥ）对肝纤维化的治疗作用。方法观察了ＶＥ对四氯化碳（ＣＣＩ４）诱导的肝纤维化大鼠肝功能，脯氨酸肽酶（ＰＬＤ）、透明质酸（ＨＡ）、丙二醛（ＭＤＡ）、超氧化物歧化酶（ＳＯＤ）及肝脏组织学的影响。同时没有正常对照、溶剂对照及空白对照组。结果维生素Ｅ治疗１０周后，上述生化指标除ＨＡ（３８７．５７±１２９．３９ｎｇ／ｍｌ）仍示达正常外，其余各指标均恢复正常，其中ＡＬＴ于第２周后、ＰＬＤ和ＭＤＡ于第４周后恢复。溶剂对照及空白对照组在第１０周时各指标虽有下降，仍高于ＶＥ治疗组（Ｐ＜０．０１，Ｐ＜０．０５）；光镜观察治疗组大鼠肝内网状纤维由粗大变纤细并有缩短和断裂，经真彩色图像系统分析与对照组比较差异有显著性（Ｐ＜０．０１）。结论ＶＥ治疗有助于实验性四氯化碳肝纤维化的恢复。     

硫普罗宁联合复方丹参注射液治疗酒精性肝病22例

目的　观察硫普罗宁联合复方丹参注射液治疗酒精性肝病的临床疗效。方法　 42例酒精性肝病病人随机分为治疗组和对照组 ,两组病人均在戒酒基础上给予肝泰乐、复合维生素及强力宁治疗。治疗组加用硫普罗宁及复方丹参注射液 ,疗程为 1个月。结果　治疗组临床症状及体征改善 ,肝功能恢复程度及减轻肝纤维化指标方面均明显优于对照组 (P <0 .0 5 )。结论　硫普罗宁联合丹参治疗酒精性肝病有一定疗效     

Inhibitory effect of glycyrrhizin on NF-κB binding activity in CC14- plus ethanol-induced liver cirrhosis in rats

ABSTRACT— Aims/Background: Potenlini is an injectable compound whose active component is glycyrrhizin, which is extracted from licorice. Previous studies showed that it could reduce liver injury, improve alanine aminotransferase (ALT) levels and act as an antifibrotic agent. However, the mechanism of its action remains unclear. The aim of this study was to determine the molecular mechanism of its action by investigating the effects of potenlini on nuclear factor-κB(NF-κB) binding activity in an animal model of liver cirrhosis. Methods: Rats were randomly allocated into a normal control group, a model control group, and a potenlini group. Rats in the latter two groups were treated with CCl₄ and ethanol solution in order to induce chronic liver injury. Rats in the potenlini group were given potenlini treatment at the same time. Results: Serum ALT levels were significantly reduced in rats treated with potenlini compared with levels in rats of the model control group, which had dramatically increased ALT levels. Histologically, liver steatosis and fibrosis were severe in the rats of the model group, but were significantly improved in rats of the potenlini group. NF-κB binding activity was markedly increased in the liver specimens taken from the rats of the model control group in comparison with the binding of normal livers, but the binding levels were nearly normal in the livers of the potenlini group. Conclusions: The results suggest that potenlini can inhibit the NF-κB binding activity in CCl₄ and ethanol-induced chronic liver injury, and that effect may be a possible mechanism by which potenlini protects the liver from hepatotoxin-induced liver injury and cirrhosis.     

强力宁加门冬氨酸钾镁治疗急性黄疸型肝炎60例

目的 研究强力宁加门冬氯酸钾镁对急性黄疸型肝炎的治疗作用。 方法 选择急性黄疸型肝炎60例,分为人数相等、症状、体征、实验检查结果相似的两组。治疗组用强力宁、门冬氨酸钾镁,对照组用肝太乐、维生素C、复合维生素B、茵陈蒿汤,20 d为1疗程,复查症状、体征、血清ALT及AST。 结果 治疗组总有效率为93.4％(28/30),对照组总有效率为66.7％(20/30),差异显著(P<0.05)。 结论 强力宁、门冬氨酸钾镁配伍治疗急性黄疸型肝炎疗效显著。     

Clinical study and immunological observation on potenlini treatment of epidemic hemorrhage fever

439 cases of epidemic hemorrhagic fever (EHF) in the febrile stage of the disease were randomly divided into two groups. 226 cases in therapeutic group were treated with daily intravenous drip of 60-100 ml potenlini for 3 days. Other measures of treatment in this group was just the same as those in the control group. The results showed that the duration of both the febrile stage and the hypotensive shock stage were shorter and the rate of recovering from hypotensive shock stage and oliguric stage in the therapeutic group (P less than 0.01) was higher as compared with the control group. BUN, ALT, urinary protein, white blood cells and platelets returned to normal level earlier than expected (P less than 0.01). The occurrence rate of complication and case fatality rate in therapeutic group were lower. The research showed that potenlini in the treatment of EHF has effects. But it has not remarkable effects on immune adjustment.     

Systolic ejection murmurs in the elderly: aortic valve and carotid arteries echo-Doppler findings

Two-dimensional echographic and color Doppler studies of the heart and carotid arteries (CA) were performed in 45 patients greater than sixty-five years old without aortic stenosis, 23 with (Group 1) and 22 without (group 2) precordial ejection systolic murmur (SM). Aortic cusps thickening was found in 11 Group 1 (48%) and 2 Group 2 (9%) patients (p less than 0.001). Aortic root and aortic arch size were similar in the two groups. Maximum aortic flow velocity was significantly greater in Group 1 (200 60 cm/sec) than in Group 2 (120 20 cm/sec) (p less than 0.001). Left ventricular outflow systolic maximum velocity was similar in the two groups. A bilateral neck murmur was heard in 10/23 Group 1 patients (43%); in this group, patients with cervical SM had a greater maximum aortic flow velocity than those without cervical SM (230 + 60 cm/sec vs 172 + 32 cm/sec, p less than 0.001). In Group 1, 3 patients had a cervical SM louder on one neck side; only in these 3 patients were ipsilateral obstructive CA plaques found. A unilateral neck SM was heard in 4/22 Group 2 patients (18%); in these 4, ipsilateral obstructive CA were found. Conclusions: (1) in the elderly, precordial ejection SM is related to mild increase in maximum aortic flow velocity and thickening of aortic cusps; (2) in patients with precordial SM radiated to both neck sides, maximum aortic flow velocity tends to be more markedly increased; (3) in patients with precordial SM, a cervical SM louder on one neck side should suggest coexistent ipsilateral CA stenosis.     

The clinical study on efficacy of clarithromycin, levofloxacin, and streptomycin for pulmonary Mycobacterium avium-intracellulare complex infection

OBJECTIVE: The purpose of this study was to elucidate retrospectively the clinical effects of using RFP, EB, CAM, LVFX, and SM for pulmonary Mycobacterium avium-intracellulare complex infection. MATERIALS AND METHODS: During 9-year (1995-2003) period, 72 patients diagnosed according to the criteria of the Japanese Society for Tuberculosis Guidelines and treated for at least 6 months were available for this study. RESULTS: The age averaged 68 (range, 32-92) years. The male to female ratio was approximately 2 : 3. The follow-up period averaged 344 (190-365) days. 59 of 72 patients were treated for the first time. 58 of 72 patients were diagnosed as primary infection type. Among them, 20, 38, and 14 patients were treated by RFP, EB, and CAM (REC group), RFP, EB, CAM and LVFX (LVFX group), and RFP, EB, CAM, and SM (SM group), respectively. Comparing the baseline patient characteristics among three groups, we found significant difference (measured by ANOVA) in gender (male/female, REC group: 8/12, LVFX group: 20/18, and SM group: 2/12, p < 0.05), age (REC group: 75.2 +/- 9.1, LVFX group : 66.5 +/- 12.5, and SM group: 63.9 +/- 11.9, p < 0.01) and body mass index (REC group: 17.2 +/- 2.9, LVFX group: 18.9 +/- 2.8, and SM group: 19.7 +/- 2.4, p < 0.05). However, we did not find any significant difference in the clinical outcomes (improving rate of the symptoms, change of the erythrocyte sedimentation rate, improving rate of the chest X-ray, and the results of follow-up on bacteriological effect). In the 60 of 72 patients treated for 1 year, the results were superior to those of some previous reports (1-year improving rate of the symptoms, 1-year improving rate of the chest X-ray, 1-year improving rate of the sputum conversion, and 1-year rate of the relapse were 54.3%, 65.0%, 60.0%, and 15.3%, respectively). CONCLUSION: Further study was warranted that no advantage was shown by an additional use of LVFX or SM on REC from the point of view of the clinical effects for pulmonary Mycobacterium avium-intracellulare complex infection, in spite of the higher age and deteriorated nutritional status of REC group.     

Feasibility and importance of self-monitoring in patients over 75 years old]

The feasibility of self-measurement (SM) of the blood pressure (BP) is well demonstrated in hypertensive patients (pts) but, in elderly pts physical and intellectual limitations can restrict the use of SM. The aim was to evaluate the feasibility of SM as a function of autonomic psychomotricity in pts aged more than 75 years and to estimate the reproducibility of SM in comparison with office's measurements (OM). We initially proposed the use of SM devices of BP to 53 pts aged > 75 years. One-third of pts refused to participate in the study. In 32 pts we did a mini-mental-state score (MMS) and an evaluation of autonomic functions (IADL). Two patients with a MMS < 20 were excluded. The OM of BP was done in sitting position with a mercury sphygmomanometer (4 measures) and the SM by a Omron device during 5 consecutive days (3 measures morning and night). Eighteen (60%) pts did more or equal to 15 measures (good measurer) and 12 less than 15 (bad measurer). The pts of the group "good measurer" were significantly younger, were all hypertensive treated patients and had a higher MMS and a lower IADL than those of the group "bad measurer". Considering the differences (OM-SM), 55% of patients showed values superior to 10 mmHg for systolic blood pressure, and 64% of subjects had values superior to 5 mmHg for diastolic blood pressure. We conclude that the SM is acceptable by patients older than 75 years and that feasibility is optimal in those patients where the autonomic and cognitive functions are preserved and when the patient is hypertensive. Also, as the concordance between OM and SM of patients older than 75 years is below 50%, diagnostic and therapeutic decisions based on OM is hazardous in these patients.     

A double-blind randomized study of aminoglycoside infusion with combined therapy for pulmonary Mycobacterium avium complex disease

A prospective study of the clinical efficacy of an aminoglycoside antibiotic (streptomycin, SM) for the treatment of pulmonary Mycobacterium avium complex (MAC) disease was carried out. In a multicenter trial, patients with pulmonary MAC disease received protocol-guided combined chemotherapy with or without SM. SM was given to the patients intramuscularly 15 mg/kg three times per week for the initial 3 months and three other antibiotics (rifampicin, ethambutol, and clarithromycin) were added and administered for over 24 months after the conversion of MAC strains. From April 1998 to December 2004, 160 HIV-negative patients were enrolled in this trial. Fourteen patients were found to be ineligible because they could not continue the treatment, and they were excluded from the analysis after randomization. Seventy-three patients were assigned to receive combined chemotherapy with SM (group A) and 73 were assigned to receive combined chemotherapy without SM (group B). The median durations of treatment were 27.6 months in group A and 28.4 months in group B. The difference in the backgrounds of the groups was not statistically significant. There were no differences in microbiological and radiological findings between the groups, but the sputum conversion rate for pulmonary MAC disease at the completion of treatment was significantly higher in group A than that in group B. Although, there were no significant differences in the sputum relapse rate and clinical improvement including both clinical symptoms and radiological findings, group A showed better initial microbiological response than group B. As for adverse reactions and abnormal laboratory findings, there were no significant differences between the groups. Based on the results of this double-blind randomized study, we support treatment including SM according to both the American Thoracic Society (ATS) and the Japanese Society for Tuberculosis (JST) guidelines for patients with pulmonary MAC disease without HIV infection.     

Long-term outcomes of combined endoscopic resection and chemoradiotherapy for esophageal squamous cell carcinoma with submucosal invasion

BackgroundFor esophageal squamous cell carcinoma (ESCC) with submucosal (SM) invasion, surgery is the standard treatment. Definitive chemoradiotherapy (D-CRT) is a less invasive alternative option, but sometimes results in locoregional failure.AimTo examine whether endoscopic resection for primary lesion removal combined with chemoradiotherapy (ER-CRT) reduces locoregional failure rates in cases of ESCC with SM invasion.MethodsWe retrospectively compared clinical outcomes between ER-CRT and D-CRT in patients diagnosed with ESCC with SM invasion between 2003 and 2014. Twenty-one patients underwent ER-CRT based on a pathological diagnosis, and 43 patients underwent D-CRT based on a clinical diagnosis.ResultsLocoregional failure developed in 26% of patients in the D-CRT group, and in no patients in the ER-CRT group (p < 0.01). Thus, the 5-year relapse-free survival in the ER-CRT group was significantly more favorable than that in the D-CRT group (85.1% vs 59.2%; p < 0.05), although there was no difference in overall survival (85.1% vs 79.1%) nor in cause-specific survival (90.5% vs 87.2%) between the groups. There were no instances of perforation or hemorrhage associated with ER.ConclusionER-CRT is a safe and effective treatment strategy and can be considered as a new minimally invasive treatment option for patients with ESCC with SM invasion.     

丹参对大鼠乙酸性溃疡性结肠炎粘膜保护作用的研究

目的研究丹参(SM)对大鼠乙酸性溃疡性结肠炎(UC)粘膜保护作用.方法预防性静脉给予丹参注射液后评价大鼠乙酸性UC肠粘膜损伤指数,检测肠组织中的超氧化物歧化酶(SOD)、丙二醛(MDA)含量,并与生理盐水(NS)组对照.结果SM组和NS组肠粘膜损伤指数分别为5.75士1.04,14.70士3.15;肠组织中SOD含量分别为(80.8士2.4)U/g、(57.3士3.6)U/g;MDA含量分别为(19.7士1.2)nmol/g、(40.2士2.1)nmol/g.结论丹参对大鼠乙酸性UC肠粘膜具有保护作用,其机制可能与丹参清除氧自由基有关.     

Comparative effects of 5% ethanolamine oleate versus 5% sodium morrhuate for sclerotherapy of oesphageal varices

Forty-five cirrhotic patients with oesophageal varices were randomized to receive endoscopic injection sclerotherapy with either 5% ethanolamine oleate (EO), or 5% sodium morrhuate (SM). In the EO group, there was a statistically significant higher rate of disappearance of red colour signs on the varices a week after the initial session of sclerotherapy than in the SM group (91.3% vs 45.5%, P less than 0.05). A jet-like bleeding from injection sites at the second session of sclerotherapy occurred in three patients in the SM group and they experienced blurred vision. There was no such occurrence in the EO group. Oesophageal bleeding requiring blood transfusion during the course of repeated sclerotherapy occurred only in the SM group (five patients): bleeding was from a partly thrombosed varix and in four was from oesophageal ulcers. We found that EO administered intravariceally is more efficacious than SM for sclerotherapy of oesophageal varices.