利胆消石汤治疗胆石症68例

目的观察中药利胆消石汤对胆石症的治疗效果．方法胆石症患者68例，应用利胆消石汤（主要由鸡内金25g，虎杖20g，土大黄20g，海金沙草30g，威灵仙25g，寻骨风15g，黄药子10g，石见穿15g，白术10g，郁金10g，水牛角粉10g～30g，滑石粉10g～30g等12味中药组成．饭前吞服：水牛角粉、滑石粉各10g～30g，饭后服用煎剂．）进行治疗，其中胆囊结石29例，胆管结石39例，结石在0．3cm以上者52例，0．3cm以下者16例．男26例，女42例，年龄36岁～64岁，其中，41岁～50岁者48例（75．6％），51岁～60岁者10例（14．7％），疗程15d～30d，临床表现：上腹隐痛（针刺样疼痛）16例，胀痛（放散到右肩背部）46例，绞痛6例，疗程结束后，对患者的年龄、症状及治疗结果进行比较分析．结果经利胆消石汤治疗15d～30d后，治愈56例，显效5例，有效4例，无效3例，总有效率95．6％．临床验证，疗效多与治疗次数成正比，对青壮年患胆石症湿热蕴结型者疗效较佳结论利胆消石汤对胆石症有良好的治疗作用．     

消炎利胆胶囊利胆抗炎的实验研究

目的：通过动物实验验证消炎胆胶囊的利胆抗炎作用,方法：按生药３,６,１２ｇ／ｋｇ消炎利胆胶囊口服给药,观察大鼠胆汁分泌量以及二甲苯致小鼠耳肿胀,醋酸对小鼠血管通透性,蛋清致大鼠中肿胀和棉球法引起大鼠肉芽组织增生。结果：消炎利胆胶囊明显增加胆汁分泌量,且随剂量增加而增多,维持时间达４ｈ之久;抑制二甲苯致小鼠耳肿胀;对抗醋酸引起的血管通透性增加;对抗蛋清致大鼠中肿胀和棉球所致大鼠肉芽组织增生,与对照组     

消炎利胆胶囊利胆抗炎的实验研究

目的通过动物实验验证消炎利胆胶囊的利胆抗炎作用。方法按生药3、6、12g／kg消炎利胆胶囊口服给药,观察大鼠胆汁分泌量以及二甲苯致小鼠耳肿胀,醋酸对小鼠血管通透性,蛋清致大鼠足肿胀和棉球法引起大鼠肉芽组织增生。结果消炎利胆胶囊明显增加胆汁分泌量．且随剂量增加而增多,维持时间达4h之久;抑制二甲苯致小鼠耳肿胀;对抗醋酸引起的血管通透性增加;对抗蛋清致大鼠足肿胀和棉球所致大鼠肉芽组织增生,与对照组比较有显著性差异。结论消炎利胆胶囊有明显地利胆抗炎作用。     

胆石基质糖基在成石过程中的作用

作者以六种不同糖基特异性的凝集素为分子探讨，检测胆石基质中糖基的种类、含量与分布。结果表明，氨基己糖、β－半乳糖及岩藻糖为胆石基质的主要糖基。糖基选择性聚集于胆石基质的致密层，与胆红素不易分离，提示糖基可能参与胆石形成的重要环节－胆红素的聚合过程。     

胆石清片治疗胆石症的临床和实验研究

目的：通过临床和实验研究，观察胆石清片治疗胆石症的作用。方法：临床研究以酸甘利胆为主佐以清热通腑、溶石排石之胆石清片治疗胆石症，并与目前公认疗效较好的消溶肝胆结石及熊去氧胆酸片作为阳性对照组进行对照观察。动物实验动物造模采用皮下注射林可霉诱发豚鼠胆囊结石。研究胆石清的防石，排石功能。结果：经临床81例观察，胆石清片能有效地改善临床症状，溶石，排石，总有效率达92．6％，动物实验表明，皮下注射林可霉素可以诱发豚鼠胆囊结石，但当同时服用胆石清片时，其成石明显下降，胆汁中胆汁酸含量明显升高，而游离胆红素及钙离子含量则明显降低，结论：临床和动物实验表明胆石清片具有防石，排石功能。     

胆道排石胶囊的药效学研究——防治食饵性胆结石作用

胆道排石胶囊 １００、５００ｍ ｇ／ｋｇ 　ｐｏ 能显著降低豚鼠食饵性胆结石的发生率,降低胆汁中游离胆红素的百分含量;２００、５００ｍ ｇ／ｋｇ ｉｇ 可明显增加大鼠胆汁流量,抑制醋酸所致小鼠的扭体反应次数。提示该方具有预防食饵性胆结石的形成、利胆和镇痛等作用。     

国人胆石胆汁和血清中多种元素的分析与胆石成因的探讨

本实验利用电感耦合等离子发射光谱法(简称ICAP)。对国人胆石,胆汁和血清中26种微量金属和非金属元素进行了分析测定,以期探讨与胆石症的关系。     

利胆剂的进展及临床应用

近年来,胆石症的治疗方法已趋于多样化。非手术治疗越来越受到人们的重视。作为胆石症非手术治疗的一种方法,利胆剂较广泛地应用于临床。本文就利胆剂的进展及临床应用作一综述。去氢胆酸(Dehydrocholic acid) 本品为半合成产物,是最有力的利胆药。能明显增加胆汁分泌,具有清洗胆道的作用,适用于胆道炎、胆囊炎、胆结石,     

利胆化瘀片的利胆消炎作用

目的:通过动物实验观察利胆化瘀片的利胆消炎作用.方法:以熊去氧胆酸为对照药物,测定健康大鼠单位时间内胆汁流量,观察利胆化瘀片对胆汁分泌及胆汁总胆红素及胆汁酸含量的影响.以阿司匹林为对照药物,采用二甲苯及冰醋酸建立炎症模型,观察利胆化瘀片对小鼠耳廓肿胀及血管通透性的影响.结果:利胆化瘀片明显增加胆汁分泌量,且随剂量增加而利胆效应增强,可持续3h以上,提高泌出胆汁、胆汁酸及总胆红素含量.低、中和高剂量组抑制小鼠因二甲苯所致的耳廓肿胀和对抗小鼠因冰醋酸所致的腹腔毛细血管通透性增加,与模型组比较差异有显著性(34.9%,39.5%,52.3%vs 0;38.6%,52.6%,55.5% vs 0,P<0.01).高剂量利胆化瘀片组利胆,促总胆红素和胆汁酸排出作用,与熊去氧胆酸组比较差异有显著性,抗炎作用与ASP相似.中剂量利胆化瘀片组促总胆汁酸排出与熊去氧胆酸组比较差异有显著性,对抗小鼠因冰醋酸所致的腹腔毛细血管通透性增加的作用与ASP相似.结论:利胆化瘀片具有明显的利胆消炎及促总胆红素及胆汁酸排泄的作用.     

胆囊胆固醇结石形成相关的候选基因研究进展

胆囊胆固醇结石病是一种常见疾病。近年来研究证实它的形成涉及环境变化和多基因的相互作用,遗传因素涉及的候选基因可以分为六大类,此文对其主要候选基因的研究进展作一综述。     

小肠动力障碍对胆固醇结石形成影响的研究进展

小肠动力障碍及小肠移行性复合运动(migrating motor complex,MMC)减弱对胆固醇结石形成的影响作用日益受到重视。小肠动力障碍及MMC减弱间接地使胆汁中脱氧胆酸(deoxycholic acid,DCA)浓度增高:DCA本身可以使肠转运减慢,肠道吸收胆固醇增加,胆汁中DCA比例过高直接抑制胆囊运动;DCA增强胆汁中胆固醇分泌;DCA增加富含胆固醇的“泡”(vesicles)不稳定性,增强胆汁胆固醇结晶形成。胆汁中DCA浓度增高,胆汁酸减少,胆囊运动减弱,从而促进胆固醇结石的形成。     

Prevalence of gallstone disease in Iran

BACKGROUND: Prevalence of gallstone disease is different depending on the geographic region involved. Few studies, in Asia but not from Iran, about the frequency of gallstone disease have been published. The aim of this study is to examine the prevalence of gallstone disease in Iran. METHODS: Four hundred and seventy-seven nomads from southern Iran, 513 industrial laborers older than 34 years, and 421 laborers from a pharmaceutical company above 30 years of age, and 471 elderly persons from three nursing homes near Tehran underwent abdominal sonography. RESULTS: There were 1373 men and 509 women. Eighty-nine subjects had gallstone disease and 10.1% of them were cholecystectomized. While the prevalence in the men and women in the age group 31-40 years was very low (0.3% in men and 1.8% in women), it increases sharply in men older than 60 years and women older than 50 years to more than 10-fold (12.5 and 24.6% in male and female with an age 71-80 years, respectively). CONCLUSION: In Iran, gallstone disease is very uncommon in middle-aged people, but increases sharply in older people. However, this does not reach the high prevalence seen in Western countries. The intake of a high fiber-containing diet, a low number of overweight people, smoking habit and hyperlipidemia are probably the cause for this low prevalence.     

滋水涵木利胆方联合熊去氧胆酸胶囊治疗原发性胆汁性胆管炎临床研究

目的:观察滋水涵木利胆方联合熊去氧胆酸胶囊治疗原发性胆汁性胆管炎的临床疗效。方法:重庆市中医院肝病科门诊就医的原发性胆汁性胆管炎患者76例,随机分为试验组与对照组,试验组患者采用滋水涵木利胆方联合熊去氧胆酸胶囊治疗,对照组患者单用熊去氧胆酸胶囊,疗程24周,比较2组患者治疗前后中医证候评分、生化指标、肝纤维化、免疫球蛋白IgM、血清胆固醇水平。结果:治疗24周时,与对照组比较,试验组患者中医证候积分明显降低、生化指标(ALT、GGT、ALP)显著改善、肝纤维化指标(HA、CIV)明显下降、血清IgM和总胆固醇水平显著降低,差异均有统计学意义(P<0.05)。结论:滋水涵木利胆方联合熊去氧胆酸胶囊治疗原发性胆汁性胆管炎患者,其疗效优于单用熊去氧胆酸胶囊,可在临床推广应用。     

Risk factors for gallstone formation during rapid loss of weight

Risk factors for the development of gallstones during rapid weight loss were assessed in 457 subjects who entered a weight control program (520 kcal/day). Absence of gallstones in these subjects was documented by ultrasonography prior to entry into the study. Ultrasonography was performed again at 16 weeks on the subjects who remained in the study (N=248). The incidence of gallstones by 16 weeks of rapid weight loss was 10.9% (27/248). Most factors associated with gallstones in the general population, eg, older age, female gender, parity, positive family history, etc, were not associated with gallstones in this population. The risk factors for developing gallstones included increased initial body mass index [weight (kg)/height (m)²], amount of body mass index loss, and serum triglyceride levels. The positive predictive value of these risk factors was 75%, but the sensitivity was only 12%. These observations indicate that risk factors for the development of gallstones during rapid weight loss are probably different from those in the general population. The factors identified by this study are useful in predicting patients at high risk for gallstones. However, since only a minority of gallstones that form can be predicted, further study is needed to identify additional factors that will improve our ability to predict gallstone formation.This study was supported by grants from NIH-NIDDK R01 DK-37080, Ciba-Geigy, and the Stuart Foundations.     

Relative prevalence of gallstone diseases in Taiwan

For many years, it has been said that Taiwan has the highest relative prevalence of hepatolithiasis among the Asian countries. To confirm this, and to reevaluate the chronological changes regarding gallstone disease in Taiwan, a retrospective nationwide cooperative study was conducted in this country. A total of 17,182 patients from 28 medical centers are included in this survey. A gradual increase during the past 20 years in gallstone prevalence with a concomitant decrease of choledocholithiasis and hepatolithiasis are well demonstrated. Both nutritional and environmental factors are involved in these changes. With respect to hepatolithiasis, Taiwan continues to have the highest prevalence among Asian countries, and 20% may be the average figure for the whole country.The study was conducted with the cooperation of the following 28 institutions: Cathay Memorial Hospital, Chang-Hua Christian Hospital, Cheng Ching General Hospital, Chia-Yi Lin General Hospital, Chung Shan Medical & Dental College, Far Eastern Memorial Hospital, 802 Army General Hospital, 803 Army General Hospital, 804 Army General Hospital, Keelung Chang-Gung Memorial Hospital, Keelung Navy Hospital, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung Medical College, Kaohsiung Yuan's General Hospital, Kuang Tien General Hospital, Minshen General Hospital, National Cheng Kung University Medical College and Hospital, Provincial Hsinchu Hospital, Provincial Taichung Hospital, Provincial Taoyuan Hospital, Sha-Lu Tung's Memorial Hospital, Taipei Chang-Gung Memorial Hospital, Taipei Mackay Memorial Hospital, Taitung Mackay Memorial Hospital, Triservice General Hospital, Tzu-Chi Buddhist General Hospital, Veterans General Hospital-Taichung, and Veterans General Hospital-Taipei.     

三草护肝胶囊抗实验性肝纤维化药效学研究

目的:观察三草护肝胶囊对肝纤维化动物血清相关指标(ALT、AST、ALP、TP、Alb、Glb、A/G、LM、HA、PCⅢ)、肝脏羟脯氨酸(Hyp)和肝脏超微结构的影响。方法:以四氯化碳皮下注射复制大鼠化学性肝纤维化模型,与秋水仙碱作比较。结果:三草护肝胶囊能显著降低肝纤维化大鼠血清AST和ALP活性,降低血清HA、LM、PCⅢ及肝组织Hyp含量,超微结构观察亦显示给药组肝纤维化程度较模型组轻。结论:三草护肝胶囊具有较好的抗肝纤维化作用。     

九龙胃药胶囊药效学研究

目的观察九龙胃药胶囊治疗胃溃疡药效学作用。方法采用小鼠寒冷应激性胃溃疡、醋酸所致大鼠胃溃疡、豚鼠离体肠管运动、新斯的明所致小鼠肠蠕动亢进、醋酸所致小鼠疼痛、巴豆油所致小鼠耳肿胀等模型，观察九龙胃药胶囊治疗胃溃疡的药效学作用。结果九龙胃药胶囊对小鼠寒冷应激性胃溃疡和醋酸所致大鼠胃溃疡均有明显的治疗作用，还具有明显的解痉、镇痛、抗炎作用。结论九龙胃药胶囊具有抗胃溃疡、解痉、镇痛、抗炎作用。     

脉心康胶囊治疗血脂异常的疗效观察

目的观察脉心康胶囊对血脂异常病人的降脂疗效。方法将40例血脂异常病人随机分为脉心康组(治疗组)和血脂康组(对照组)各20例,连续给药50d。检测治疗前后临床症状变化以及血脂和载脂蛋白变化。结果治疗组治疗后血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、载脂蛋白(G)[Lp(a)]和ApoB100/ApoAI比值均较治疗前明显降低(P<0.01),且乏力和少寐症状临床症状的改善及降低三酰甘油(TG)的作用均明显优于对照组(P<0.05)。结论脉心康胶囊具有良好的降脂疗效。