Histamine antagonists in the treatment of shock hyperglycemia in the rat

The present study was undertaken to determine the effect of exogenous histamine and histamine blockers on blood glucose and hepatic glycogen in the rat. Forty-one nonfasted male Sprague-Dawley rats that had been anesthetized with intraperitoneal injections of urethane were injected intravenously (femoral) with histamine (10 mg/kg) five minutes after pretreatment with Ringer's solution (control), diphenhydramine (1 mg/kg) (H-1 blocker); metiamide (1 mg/kg) (H-2 blocker); or a combination of these blockers. Mean arterial pressure (carotid), blood glucose, and hepatic glycogen were measured. Within 30 minutes, histamine evoked a significant increase in blood glucose, and a decrease in hepatic glycogen, and a reduction in blood pressure. However, rats treated with the H-2 blocker metiamide or with a combination of H-1 and H-2 blockers did not show as significant a hypotensive response as rats treated with the H-1 blocker diphenhydramine alone. The hyperglycemic-glycogenolytic response to histamine was modified by diphenhydramine as well as by a combination of blockers, but not by metiamide alone. These results suggest that a) the hypotension did not initiate the hyperglycemic and glycogenolytic response; b) the H-2 blocker metiamide has little effect on the hyperglycemic response to exogenous histamine; and c) the H-1 blocker diphenhydramine may have antihyperglycemic properties.     

手术创伤后红细胞丙酮酸激酶活性改变与外科性糖代谢障碍的关系

探讨手术创伤后围术期红细胞丙酮酸激酶活性改变与糖代谢障碍 (或称“外科性糖尿病”)的关系。随机选择中等度手术创伤如上腹部胆囊切除或胃大部切除手术病人 17例 ,ASAⅠ～Ⅱ级 ,观察普鲁卡因静脉复合麻醉 (IPBA)下上腹部手术对围麻醉手术期红细胞(RBC)丙酮酸激酶 (PK)活性及其相关重要调理因子 ,如RBC内ATP、ADP、Pi、Mg2 + ,以及血浆葡萄糖、血清胰岛素的影响。结果显示 ,PK在手术结束后 10min较麻醉前明显下降 (P<0 0 1) ,术后 2 4h仍无回升趋势。RBC Pi的变化与PK无相关性 (r=- 0 0 4 1,P >0 0 5 ) ,ATP/ADP比值的变化与PK呈正相关趋势(r=0 6 80 ,P <0 0 1) ,RBC Mg2 + 的变化与PK呈明显负相关 (r=- 0 817,P <0 0 5 ) ,Glu/Ins的变化与PK呈负相关趋势 (r=- 0 6 97,P <0 1)。研究表明 ,IPBA和上腹部手术创伤可直接或(和 )间接引起细胞内PK活性下降和糖酵解通路的障碍 ,导致细胞对葡萄糖、Pi的利用和ATP的合成障碍 ;围术期糖酵解反应的抑制可能是应激性糖代谢障碍的重要机制之一 ,在手术后期和术后表现尤为明显     

围术期应激性高血糖的研究进展

背景 应激性高血糖是机体在严重创伤、危重病、重大手术等应激状态下所产生的一种代谢反应.目前很多研究已经证实围手术期应激性高血糖与临床不良预后有关,是术后并发症和病死率增加的独立危险因素.目的 强调积极干预应激性高血糖的必要性和重要性,以及临床医师对于术中发生应激性高血糖患者的处理需要注意的一些问题.内容 阐述有关应激性高血糖的最新进展知识包括其发生机制和病理生理改变.趋向 临床上对于应激性高血糖患者的治疗逐渐个体化,控制血糖在合理水平以减少术后并发症,改善患者预后.     

疏肝健脾法治疗腹泻型肠易激综合征1例

肠易激综合征（IBS）是一种常见的功能性疾病，中医病名为"肠郁"。郭朋教授根据IBS生理、病理特点，以疏肝健脾法调和肝脾，辨证施治，取得良好疗效。文章从病因病机、辨证论治及经典案例介绍等几个方面对郭教授治疗IBS经验进行系统阐述，以期为中医药治疗IBS提供理论和方法学参考。     

中药序贯疗法治疗腹泻型肠易激综合征43例

目的 评价中药序贯治疗方案对腹泻型肠易激综合征的临床疗效。方法 将90例肠易激综合征患者分成试验组与对照组（共脱落6例,最终试验组43例,对照组41例）。试验组患者分阶段先后口服疏肝健脾利湿汤剂、参术益肠丸,对照组患者口服单剂马来酸曲美布汀片,两组疗程均为6周。记录并比较两组治疗前及治疗2周末和6周末的症状总积分,评价两组临床疗效。结果 治疗6周末,试验组临床疗效明显优于对照组（P<0.05）。与治疗前比较,治疗6周后两组腹痛或腹部不适、大便次数、大便性状、腹胀、排便紧迫感和黏液便积分均显著降低（P<0.05）,其中试验组大便性状和黏液便积分降低值显著大于对照组（P<0.05）。治疗2周末和治疗6周末,试验组症状总积分显著低于对照组（P<0.05）,且两组症状总积分均较前一时点显著降低（P<0.05）。结论 中药序贯治疗方案对腹泻型肠易激综合征患者的症状有明显改善作用,且起效快、作用持久。     

比较电针"合谷""足三里"穴对IBS模型大鼠结肠动力及结肠M3受体表达的影响

目的观察并比较电针"合谷""足三里"穴对肠易激综合征(IBS)模型大鼠结肠动力及结肠M_3受体免疫反应物阳性表达的影响,初步探讨电针不同穴性及不同神经节段支配的穴位对IBS的效应差异及结肠动力改变的相关机制。方法选取新生wistar大鼠40只,随机分为空白对照组、模型对照组、合谷组和足三里组。除空白对照组外,均采用新生期母婴分离、醋酸灌肠及结直肠扩张刺激(CRD)的方法联合制备IBS大鼠模型。大鼠9周龄时,合谷组和足三里组分别给予电针(EA)干预,隔日1次,共5次。空白对照组及模型对照组不予干预。治疗结束后,按照Bristol大便分类法观察电针前后IBS大鼠的便型,采用腹部回撤反射(AWR)对大鼠进行肠道敏感性及平滑肌收缩强度评估,观察潜伏期、收缩波个数、起始波压力值;采用免疫组织化学法检测结肠M_3受体的表达。结果与针前相比,针后合谷组及足三里组大鼠的大便评分显著降低(P0.01)。与空白对照组相比,模型对照组大鼠的大便评分显著增高(P0.01),潜伏期明显缩短(P0.01),收缩波个数明显增多(P0.01),起始波压力值明显降低(P0.01),结肠内M_3受体免疫反应物阳性表达水平明显增强(P0.01);合谷组结肠内M_3受体免疫反应物阳性表达水平增强(P0.05)。与模型对照组相比,合谷组和足三里组大鼠针后的大便评分均显著降低(P0.01),潜伏期均明显延长(P0.01),合谷组和足三里组收缩波个数明显减少(P0.01,P0.05),起始波压力值均明显增高(P0.01),结肠内M_3受体免疫反应物阳性表达水平明显下降(P0.01)。与合谷组相比,足三里组大鼠的大便评分降低(P0.05),起始波压力值显著降低(P0.01),结肠内M_3受体免疫反应物阳性表达水平下降(P0.05)。结论电针"合谷""足三里"穴均可抑制IBS模型大鼠肠道收缩,改善肠道敏感性,缓解IBS症状。但"合谷"穴缓解腹痛效果更佳,而"足三里"穴减轻腹泻作用更强。说明电针不同穴性及不同神经节段支配的穴位对IBS疗效具有经穴效应特异性。     

Selecting patients with faecal incontinence for anal sphincter surgery: the influence of irritable bowel syndrome

Aim This was a prospective study to determine the prevalence of irritable bowel syndrome (IBS) in patients with faecal incontinence and to investigate the association of IBS positivity with sphincter dysfunction. Method Patients with faecal incontinence were referred for physiological assessment and further management. Those with an acute obstetric injury, rectal prolapse or previous anorectal surgery were excluded. One hundred and seventy‐seven women were studied. Symptom questionnaires were used prospectively to identify IBS positivity using Rome 11 criteria and the Cleveland Clinic incontinence score. Results The prevalence of IBS was 44%. IBS patients had higher incontinence scores than non‐IBS patients (11.0 vs 9.0, P < 0.01). A normal or high maximum resting anal pressure in an incontinent woman increased the chance of her having IBS by a factor of 2.6. Conclusion The prevalence of IBS positivity in patients presenting with faecal incontinence was high. A normal or high anal resting pressure and a high incontinence score should raise the suspicion of IBS.     

Effect of Compound Laser Acupuncture-Moxibustion on Blood Glucose, Fasting Insulin and Blood Lipids Levels in Type 2 Diabetic Rats

Objective: To investigate the effect of compound laser acupuncture-moxibustion on blood glucose, fasting insulin and blood lipids levels in type 2 diabetes mellitus(T2DM) rats. Methods: Forty male Wistar rats were randomly divided into 4 groups, including the normal group, model control group, laser group and sham laser group(n=10 per group). The rats in the normal group were fed with a standard diet. Rats in other groups were fed with a high-sugar and high-fat diet for 4 weeks, then intraperitoneally injected with 1% streptozotocin to induce T2 DM model. The laser group was irradiated by 10.6 μm and 650 nm compound laser on bilateral Pishu(BL 20), Shenshu(BL 23) and Sanyinjiao(SP 6) for 5 min, 6 times a week for 5 weeks. The sham laser group received the same treatment as the laser group, but without laser output. The model control group and normal group were not treated. Blood glucose levels were measured before and after 1, 2, 3, 4 and 5 weeks of treatment. The serum levels of fasting insulin, total cholesterol(TC), triglyceride(TG), low-density lipoprotein(LDL), and high-density lipoprotein(HDL) were analyzed after the last treatment. Results: The blood glucose levels in the model control group increased during the 5 weeks of treatment compared with the normal group(P0.05), while those in the laser group were significantly lower than the model control group after weekly treatment(P0.01 or P0.05). After 1, 2 and 3 weeks of treatment, the blood glucose levels in the laser group decreased obviously compared with the sham laser group(P0.01 or P0.05). Compared with the normal group, the levels of fasting insulin, TC and LDL in the model control group notably increased(P0.01 or P0.05), while their levels in the laser group were significantly lower than the model control group after 5 weeks of treatment(P0.05 or P0.01). However, no statistically significant differences were observed in TG or HDL levels among the 4 groups(P0.05). Conclusion: The compound laser acupuncture-moxibustion of 10.6 μm and 650 nm had positive effects on the regulation of hyperglycemia and insulin resistance in T2 DM rats, which may be a potential treatment for T2 DM, and also provide an alternative to the traditional acupuncture and moxibustion therapy.