利心丸治疗充血性心力衰竭的临床研究

目的：观察利心丸对充血性心力衰竭的治疗效果。方法：将９０例心功能Ⅲ～Ⅳ级的充血性心力衰竭患者随机分为Ａ、Ｂ、Ｃ３组，分别用利心丸、利心丸加小剂量地高辛及常规剂量地高辛治疗，疗程均为１个月；全部患者均常规服用利尿剂、砂酸酯类及血管紧张素转换酶抑制剂作为基础治疗。结果：Ａ、Ｂ、Ｃ３组患者心功能总有效率分别为８３．３％、９３．３％和９０．０％，Ｂ组与Ａ、Ｃ组比较均有显著性差异（Ｐ〈０．０５）。３组患者左     

栀子苷对ox-LDL诱导的RAW264.7来源泡沫细胞DNA异常甲基化的双向调节作用

目的观察栀子苷对ox-LDL诱导的RAW264.7来源泡沫细胞DNA甲基化的作用。方法以ox-LDL诱导RAW264.7细胞形成泡沫细胞模型;CCK-8法检测不同浓度栀子苷对泡沫细胞的增殖抑制情况;将细胞分为4组,分别为空白对照组(无处理)、模型组(80μg/mL ox-LDL处理)、栀子苷小剂量组(80μg/mL ox-LDL+30μg/mL栀子苷)、栀子苷大剂量组(80μg/mL ox-LDL+100μg/mL栀子苷),处理24 h后收集细胞,总胆固醇试剂盒检测栀子苷降脂效应;同时提取DNA,进行甲基化免疫共沉淀联合测序(Medip-seq)检测,并对差异甲基化基因进行GO与Pathway分析。结果红油O染色结果提示:以80μg/mL ox-LDL处理的RAW264.7细胞泡沫化最为明显;栀子苷对RAW264.7来源泡沫细胞无细胞毒作用;大剂量栀子苷(100μg/mL)能够降低细胞总胆固醇(P=0.04)。与空白组比较,模型组共有大量异常差异基因甲基化(包括异常的基因高甲基化与基因低甲基化)。涉及多个AS相关功能与通路,如蛋白激酶C活性,MAPK信号通路、PPAR信号通路、Wnt信号通路等;小剂量与大剂量栀子苷(30μg/mL与100μg/mL)均能改变泡沫细胞中异常的基因甲基化,涉及蛋白激酶C功能、Wnt信号通路、MAPK信号通路、PPAR信号通路等。栀子苷不仅能去甲基化,同时还能促甲基化。结论栀子苷可能通过对ox-LDL诱导的泡沫细胞异常基因甲基化进行双向调控实现抗AS效应。     

徐凤芹“以补药之体,作泻药之用”治疗老年功能性便秘经验撷英

老年功能性便秘(functional constipation,FC)是老年人常见的临床症状之一,亦是诱发急性心血管疾病的重要危险因素,严重影响患者的身心健康和生活质量。老年FC发病率逐年升高,随着我国人口老龄化的进展,对其治疗和管理仍需进一步研究。徐凤芹教授治疗老年FC特色鲜明、辨证严谨、疗效显著;认为本病多属本虚标实、虚中夹实,多以肺脾肾亏虚为本,肠燥津亏为标;在治疗上,强调以补药之体,作泻药之用;肺脾肾同补,复气机升降,谨慎运用攻下、滋腻之法;强调血结肠腑常作为病情进展、迁延不愈的重要病理因素,但老年患者多因虚致瘀,强调以补虚之法达到活血通便的效果;对于顽秘久秘,病机复杂者,自拟“加减通幽汤”治疗,全方药性平和、通补兼施、标本兼顾。本文总结徐凤芹诊治老年性FC经验,并整理相关临床案例,以期为中医药防治老年性FC提供借鉴。     

高危高血压病人中医证型与靶器官损害及心血管事件危险因素的关系研究

目的探讨原发性高血压高危病人不同证型心血管事件危险因素、靶器官损害的差异性,为高危高血压病人辨证分型标准化及防治提供客观依据。方法对中国中医科学院西苑医院259例住院原发性高危高血压病人的临床资料进行回顾分析,用相关检验对中医证型构成比及其与高血压靶器官损害和心血管病危险因素之间的关系进行统计分析。结果阴虚阳亢证在所调查病例中比例最高（34.4%）,肝火亢盛证病人吸烟量、饮酒量明显高于其他证型,阴阳两虚证病人合并冠心病比例最高（56.5%）,痰湿壅盛证病人合并脑血管病比例最高（37.7%）,肝火亢盛证病人合并左心室舒张功能受损比例最高。结论中医证型有可能预测高血压心、脑、肾、大血管等靶器官损害事件,特别是高血压心脏损害事件的发生。     

老年肺癌术后肺栓塞原因分析及护理

老年肺癌开胸术后极易发生血栓,栓子脱落容易诱发肺栓塞.2003年1月～2005年1月,我院行肺癌切除术106例,经采取有效护理,效果满意,现报告如下.     

阳虚与非阳虚型慢性心力衰竭与神经内分泌相关性研究

目的通过对阳虚与非阳虚型慢性心力衰竭与神经内分泌相关性研究,探讨阳气亏虚对慢性心力衰竭患者神经内分泌的影响,为慢性心力衰竭辨证施治提供客观依据。方法收集符合西医诊断标准的慢性心力衰竭患者55例,按照中医辨证标准分为阳虚组（29例）与非阳虚组（26例）,入院后检测血管紧张素Ⅰ（AngⅠ）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）、脑钠素（BNP）、甲状腺功能指标,分析阳虚型慢性心力衰竭与这些神经内分泌指标的相关性。结果阳虚组心功能明显比非阳虚组差（P〈0.05）;阳虚组患者EF值明显低于非阳虚组（P〈0.01）,BNP、游离甲状腺素（FT4）明显高于非阳虚组（P〈0.05）;AngⅠ、AngⅡ、醛固酮、血清游离三碘甲状腺原氨酸（FT3）、三碘甲状腺原氨酸（T3）、促甲状腺素（TSH）、甲状腺素（T4）两组间无统计学意义。在AngⅠ、AngⅡ、ALD、BNP、FT3、FT4、TSH、T3、T4中筛选出单因素有统计学意义的BNP、FT4进行回归分析,BNP与阳虚型慢性心力衰竭有明显相关性。结论在慢性心力衰竭的病程进展中存在BNP、FT4等神经内分泌的激活及损伤性作用,并且阳虚型心力衰竭较非阳虚型心力衰竭神经内分泌激活更加明显,损伤性作用更强。     

气滞血瘀证客观化研究进展

气滞血瘀证作为一种常见的中医临床病症,其病证实质仍属当前中西医结合研究的热点与创新点。兹将当前对气滞血瘀证客观化研究的进展综述如下。1血流动力学对气滞血瘀证患者面部、舌尖或甲襞血流图、脉图、心血管功能的观测表明,其微循环红细胞聚集、管袢顶部淤血的发生率较高,且管袢横径低、排列紊乱、迂曲畸形[1],血管张力和弹性下降[2-4],外周血管动脉顺应性减低[5];     

A Multicenter,Randomized,Double-blind Clinical Study on Wufuxinnaoqing Soft Capsule(五福心脑清胶囊) in Treatment of Chronic Stable Angina Patients with Blood Stasis Syndrome

Objective:To confirm the efficacy and safety of Wufuxinnaoqing Soft Capsule(五福心脑清胶囊,WSC)in the treatment of chronic stable angina(blood stasis syndrome).Methods:A multicenter,randomized,double-blind,placebo-controlled trial with superiority test was designed.A total of 240 patients with chronic stable angina(blood stasis syndrome)from multiple centers were randomly and equally assigned to the treatment group and the control group.Based on standard treatment of Westem medicine,the treatment group was given WSC,while the control group was given WSC mimetic,both for 12 weeks.Observed indicators included the efficacy in angina,the efficacy in Chinese medicine syndrome,the withdrawal or reduce rate of nitroglycerin and routine safety indices.Results:After 12-week treatment,the significant effective rate and total effective rate of the treatment group were significantly better than those of the control group(23.5%vs.9.2%,64.7%vs.30.8%),respectively,with statistically significant difference(P0.01).After 12-week treatment,the decreased points and the decreased rate of angina symptom score in the treatment group were better than in the control group(5.1±4.2 points vs.2.8±3.5 points,44.9%±37.2%vs.25.4%±30.7%)respectively,with significant difference(P0.01).After 12-week treatment,the significant effective rate and total effective rate of the treatment group were better than the control group(respectively,30.3%vs.15.0%,67.2%vs.45.0%,P0.01).After 8-or 12-week treatment,the decreased points and the decreased rate of Chinese medicine syndrome score in the treatment group were better than the control group(P0.05 or P0.01).After 12-week treatment,nitroglycerin withdrawal rate and the withdrawal or reduce rate in treatment group were better than the control group(P0.01).On safety evaluation,the incidence of adverse events(7.563%vs.7.500%)and the incidence of cardiovascular events(0.840%vs.0.000%)in the treatment group were similar with the control group,and the difference was not statistically significant(P0.05).Conclusion:In treatment of chronic stable angina(blood stasis syndrome),WSC can reduce angina attacks and consumption of nitroglycerin,decrease angina severity degree,effectively relieve the blood stasis syndromes,such as chest pain,chest tightness,palpitations,dark purple tongue and other symptoms.Besides,adverse events and cardiovascular adverse events in the treatment group and the control group showed no difference.All shows that the drug is safe and effective.[This study was registered in Chinese Clinical Trial Registry(ChiCTR),with registration number:ChiCTR-TRC-14005158.]     

单硝酸异山梨酯联合钙通道阻滞剂治疗单纯收缩期高血压的Meta分析

目的 系统评价单硝酸异山梨酯联合二氢吡啶类钙通道阻滞剂治疗老年单纯收缩期高血压的疗效和安全性.方法 检索中英文数据库,结合手工检索,应用Revman 5.3软件对符合纳入标准的随机对照研究进行质量评价及Meta分析.结果 共纳入9篇随机对照研究进行Meta分析,结果 显示联合单硝酸异山梨酯较单用二氢吡啶类钙通道阻滞剂可...     

栀子苷防治动脉粥样硬化的分子生物学分析

目的 基于网络药理学和分子对接分析栀子苷治疗动脉粥样硬化(Atherosclerosis,AS)的分子生物学机制.方法 利用TCMSP、BATMAN-TCM、STITCH、Swiss Target Prediction数据库筛选栀子苷的作用靶点,通过GeneCards、CTD、PALM-IST、Disgenet数据库筛...