Long-Term Clinical Effect of Tangyiping Granules(糖异平颗粒)on Patients with Impaired Glucose Tolerance

Objective: To evaluate the long-term clinical effect of Tangyiping Granules(糖异平颗粒, TYP) on patients with impaired glucose tolerance(IGT) to achieve normal glucose tolerance(NGT) and hence preventing them from conversion to diabetes mellitus(DM). Methods: In total, 127 participants with IGT were randomly assigned to the control(63 cases, 3 lost to follow-up) and treatment groups(64 cases, 4 lost to follow-up) according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose(FPG), 2-h postprandial plasma glucose(2h PG), glycosylated hemoglobin(Hb A1c), fasting insulin(FINS), 2-h insulin(2hI NS), homeostatic model assessment of insulin resistance(HOMA-IR), blood lipid and patients' complains of Chinese medicine(CM) symptoms before and after treatment. Results: A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up(75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P0.05). The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up(16.67% vs. 31.67%, P0.05). Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride(TG), total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups(P0.05). After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group(P0.05). CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group(P0.05). No severe adverse events occurred. Conclusion: TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.     

中西医结合治疗糖尿病肾病Ⅲ期临床研究

目的:观察益气养阴、清热活血中药联合西药对糖尿病肾病(Diabetic Nephropathy,DN)Ⅲ期的临床干预疗效,分析并探讨其作用机制。方法:采用随机、对照的方法,将80例患者随机分为2组,西药治疗组40例,中西医结合组40例,观察时间为8周,主要观察指标:临床症状,空腹血糖(Fasting Blood Glucose,FBG),糖化血红蛋白(Glycosylated Hemoglobin,Hb A1c),β2微球蛋白(β2-microglobulin,β2-MG),尿白蛋白排泄率(Urinary Albumin Excretion Rate,UAER),纤溶酶原激活物抑制物(Plasminogen Activator Inhibitor 1,PAI-1)。结果:中西医结合组干预后临床症状、FBG、Hb A1c、β2-MG、PAI-1均有明显改善,中西医结合组总有效率80.00%,西药组总有效率57.5%,2组比较有统计学意义。结论:益气养阴、清热活血中药联合西药能减低糖尿病肾病Ⅲ期患者的SBP、DBP、FBG、Hb A1c、β2-MG、PAI-1,具有良好的安全性。     

恩替卡韦初治及阿德福韦酯耐药慢性乙型肝炎患者治疗96周的临床研究

目的观察恩替卡韦（ETV）治疗慢性乙型肝炎的临床疗效。方法 36例慢性乙型肝炎患者包括初治治疗组（20例）和阿德福韦酯（ADV）耐药组（16例）,两组患者分别给予ETV 0.5 mg口服,1次/d,治疗96周。结果 ETV初治组和ADV耐药组患者治疗96周后,ALT复常率分别为100%和93.75%,差异无统计学意义（χ^2=4.553,P〉0.05）;HBV DNA低于检测下限的比率均为100%;HBe Ag阴转率分别为42.8%和40.0%,差异无统计学意义（χ^2=0.422,P〉0.05）;HBe Ag血清学转换率分别为21.4%和20.0%,差异无统计学意义（χ^2=0.059,P〉0.05）。两组患者耐受性均良好,无明显不良反应。结论 ETV治疗慢性乙型肝炎,对初治及阿德福韦耐药患者均能有效地控制病毒复制,改善肝功能,促使HBe Ag血清学转换,长期服药安全性好。     

浅谈岭南湿热咳嗽论治

<正>湿热咳嗽是感受湿热邪气,肺失宣肃引起的咳嗽,此类咳嗽其病程可缠绵数周至数月,常经用抗生素治疗无效。岭南地处南方,其特殊的气候环境,对湿热咳嗽的产生影响很大。笔者通过对岭南地区湿热咳嗽形成因素、辨证特点进行分析,进一步讨论岭南湿热咳嗽论治特点。1岭南湿热咳嗽的病因病机湿热咳嗽的发生,主要与外感湿邪和体质因素有关。岭南地处我国的南端,北以五岭为屏障,南濒临南海,属亚热带海洋性气候。又由于长年受偏东或偏南暖湿气流影响,气候炎热     

人工全膝关节置换术的手术护理体会

随着我国人民生活水平的提高,人工全膝关节置换术（totalknee arthroplasty,TKA）为越来越多的膝关节疼痛患者减轻了疼痛、改善膝关节的功能并提高了患者的生活质量。全膝关节置换术手术护理是手术成败与否的关键步骤,本文介绍我院62     

从肝论治Ⅱ型糖尿病胰岛素抵抗

Ⅱ型糖尿病胰岛素抵抗的病机关键为肝失疏泄、肝气郁结,胰岛素抵抗的发生、发展与肝的关系密切,胰岛素抵抗是大多数Ⅱ型糖尿病发生和发展的关键因素,从肝论治是治疗Ⅱ型糖尿病胰岛素抵抗的基本法则.     

补肾活血法中药（糖络通）防治糖尿病大鼠早期视网膜病变的实验研究

目的：研究补肾活血法中药（糖络通）对糖尿病大鼠早期视网膜病变的防治作用及其作用机制。方法：随机将33只正常雄性Wistar大鼠分为正常对照组（N）11只,糖尿病对照组（D）11只,糖络通治疗组（DT）11只,连续给药8周后观察大鼠体重、空腹血糖、FPG、糖化血红蛋白（HbA1c）及大鼠视网膜RAGE mRNA的表达水平。并通过光镜电镜观察大鼠视网膜组织病理形态学的变化。结果：实验研究表明,糖络通可降低糖尿病大鼠视网膜RAGE mRNA的表达水平,组间比较有差异性（P＜0.01）;ALT, AST,Cr,BUN等安全性指标未出现异常,组间比较无统计学差异（P＞0.05）。结论：光镜、电镜观察表明糖络通对糖尿病大鼠的视网膜具有保护作用,能抑制神经节细胞及内外核层细胞的减少,减轻毛细血管扩张及视网膜组织的水肿。说明糖络通能够在一定程度上减缓DM大鼠视网膜的病理变化,对早期DR具有良好防治作用。为中医临床防治糖尿病微血管病变的研究提供理论依据。     

糖络通对防治糖尿病大鼠早期肾损害的实验研究

目的 研究糖络通对糖尿病大鼠早期肾脏损害的防治作用及其作用机制.方法 随机将33只正常雄性Wistar大鼠分为正常对照组(N)11只,糖尿病对照组(D)11只,糖络通治疗组(DT)11只,连续给药8周后观察大鼠体重、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、24 h尿微量白蛋白(mAlb)、ALT、AST、肌酐(Cr)、尿素氮(BUN).并通过光镜电镜观察大鼠肾脏组织病变情况.结果 实验研究表明:糖络通在消除糖尿病大鼠蛋白尿方面有较好疗效,组间比较有差异性(P<0.01).ALT、AST、Cr、BUN未出现异常,组间比较无统计学差异(P>0.05).光镜电镜观察表明糖络通对糖尿病大鼠的肾脏具有保护作用,抑制或延缓肾小球系膜细胞和系膜基质弥漫性增生,肾小球足突规整,基底膜增厚减慢.结论 本研究证明糖络通对糖尿病大鼠早期即可保护其肾组织,减轻肾脏负担,延缓了糖尿病肾病的发展,为中医临床防治糖尿病微血管病变的研究提供理论依据.     

重用白术、草决明治疗帕金森病有良效

白术、草决明配伍且大剂量等量使用是广东省名中医沈英森教授的用药经验。笔者有幸随诊左右,亲睹其娴熟辨证施治于帕金森病患者,疗效显著。     

6种固定液短时间固定对冰冻切片制片效果影响

目的通过探讨6种不同固定液短时间固定对冰冻切片制片效果的影响,以便在快速冰冻切片制片中选择较好的固定液。方法收集新鲜活体组织,取材冷冻包埋后,经恒温式冰冻切片机切片,以6种不同固定液固定6s,进行HE染色。结果经乙醚酒精固定后冰冻切片质量较好,染色鲜艳,镜下组织结构细胞形态清晰,细胞核浆对比分明。结论乙醚酒精固定是一种较为理想的冰冻切片快速固定液。