散血明目片对非缺血型视网膜静脉阻塞患者血液流变学的影响

目的探讨散血明目片对非缺血型视网膜静脉阻塞患者血液流变学及血清相关生化指标的影响及作用机制。方法将34例非缺血型视网膜静脉阻塞患者随机分为治疗组（17例17眼）与对照组（17例18眼）,治疗组口服散血明目片,对照组口服血栓通片,两组均同时配合其他中西医常规治疗方法。治疗2个月后比较两组临床疗效、血液流变学及血清相关生化指标的差异。结果治疗组总显效率与对照组比较,差异有显著统计学意义（P〈0.01）;治疗组治疗前后低切和高切全血比黏度、红细胞电泳、血浆黏度、红细胞聚集指数、AT-Ⅲ、lp（a）、NO、A-CL IgG阳性率、ACL IgM阳性率、LA阳性率差异有显著统计学意义（P〈0.01）;ET-1、ACL IgA阳性率差异有统计学意义（P〈0.05）。结论散血明目片是治疗非缺血型视网膜静脉阻塞的有效药物,其作用机制可能与升高AT-Ⅲ、降低lp（a）、APL在血浆中的含量、稳定ET-1/NO比值有关,在外可反映于血液流变学指标的变化。     

促黄体激素释放激素与小剂量人绝经期促性腺激素诱导排卵

３例下丘脑闭经（ＨＡ）妇女及２例多囊卵巢综合征（ＰＣＯＳ）妇女采用脉冲式静脉注射促黄体激素释放激素（ＬＨ—ＲＨ）诱导排卵，在ＬＨ—ＲＨ治疗后１０天左右加用小剂量人绝经期促性腺激素。３例ＨＡ病人的３个治疗周期均排卵，其中１例妊娠并足月分娩一男孩。另一周期未加ｈＭＧ亦排卵。２例ＰＣＯＳ病人经４个周期治疗均失败。无卵巢过度刺激综合征发生。ＬＨ—ＲＨ与小剂量ｈＭＧ联合疗法对恢复下丘脑闭经妇女的生殖功能是一种安全、有效的方法。     

促进脑静脉回流对患者脑功能及炎症因子的影响

目的:探讨促进脑静脉回流对急性动脉硬化性脑梗死患者脑功能及炎症因子的影响,为临床治疗提供参考。方法:急性动脉硬化性脑梗死40例作为观察组,健康体检者40例作为观察组,观察组患者采用基于溶栓的促进脑静脉回流治疗措施,观察两组治疗前后的sICAM-1、sVCAM-1和hs-CRP炎性标志物变化水平。结果:观察组患者治疗前sICAM-1、sVCAM-1和hs-CRP炎性标志物明显高于对照组,差异有统计学意义(P<0.05)。经过促进脑静脉回流措施治疗后,治疗脑功能好转28例,无脑功能好转12例,Logistic回归分析提示hs-CRP活性是临床转归的独立炎性标志物(P<0.05)。结论:促进脑静脉回流对急性动脉硬化性脑梗死治疗能改善脑功能,同时使相关炎症因子发生变化,其中hs-CRP活性从某种程度对脑梗死预后有提示作用。     

Acupuncture for Infertility： Is It An Effective Therapy？

Acupuncture has been used to treat infertility extensively,including ovulatory dysfunction,in vitro fertilization and embryo transfer(IVF-ET),and male infertility.This review summarizes the recent studies which investigated the role of acupuncture in infertility.In conclusion,most of the existing studies suggest a positive effect of acupuncture in infertility treatment.Firstly,acupuncture may improve ovulation by modulating the central and peripheral nervous systems,the neuroendocrine and endocrine systems,the ovarian blood flow,and metabolism.Secondly,acupuncture can improve the outcome of IVF-ET,and the mechanisms may be related to the increased uterine blood flow,inhibited uterine motility,and the anesis of depression,anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET.Finally, the studies suggest that acupuncture plays a positive role in male infertility,the mechanism of which is not yet clear.Even though a positive effect of acupuncture in infertility has been found,well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore,it is urgent and necessary to clarify the mechanism of acupuncture for infertility.     

德生丹治疗排卵障碍性不孕症肾虚肝郁证患者临床研究

目的?观察中原门氏验方德生丹对排卵障碍性不孕症肾虚肝郁证患者的临床疗效。方法?将120例排卵障碍性不孕症肾虚肝郁证患者随机分为中药组（采用中药德生丹）、联合组（采用中药德生丹+克罗米芬）、西药组（单纯使用克罗米芬）。治疗12周后观察3组患者优势卵泡直径、子宫内膜厚度、宫颈黏液（Insler）评分及排卵率、妊娠率及血清雌二醇（E₂）、孕酮（P）水平的变化等。结果?治疗后3组优势卵泡直径与治疗前比较均显著增长（P<0.05~0.01）,联合组与西药组优于中药组（P<0.01）;3组中医证候积分均显著下降（P<0.01）,联合组与中药组优于西药组（P<0.01）;中药组、联合组子宫内膜厚度、Insle评分均有所增加（P<0.01）,优于西药组（P<0.05~0.01）;排卵日3组血清E₂水平均有所增长（P<0.01）,联合组与中药组优于西药组（P<0.05）;中药组、联合组黄体期血清P水平增长明显（P<0.01）,优于西药组（P<0.05~0.01）;3组排卵率比较,联合组与西药组均优于纯中药组（P<0.05~0.01）;3组妊娠率比较,联合组优于中药组、西药组（P<0.05~0.01）,中药组优于西药组（P<0.05）。结论?德生丹能改善排卵障碍性不孕症肾虚肝郁证患者临床症状,减少单纯克罗米芬抑制子宫内膜的不良作用,提高临床排卵及妊娠率。      

补肾助孕汤对雄激素致不孕大鼠的促排卵及卵巢IGF-1表达的影响

目的 探讨补肾助孕汤对雄激素致不孕大鼠(ASR)促排卵的作用机制.方法 选择9日龄SD龄雌性大鼠随机分为4组,正常对照组:皮下注射中性茶油;ASR模型组:皮下注射丙酸睾丸酮;中药组及西药组:ASR模型自81 d龄起,每天灌胃给药;连续28 d.采用阴道涂片测定大鼠动情周期及排卵率,采用ELISA法测定促卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)及孕酮(P)水平;采用免疫组织化学sp检测卵巢细胞胰岛素样生长因子(IGF-1)表达.结果 补肾助孕汤可明显增加大鼠卵巢组织各级卵泡及黄体数目,恢复排卵功能;提高血清中FSH、LH及P水平,并且降低卵巢细胞中IGF-1的表达.结论 补肾助孕汤可通过调节卵巢局部因子IGF-1及相应激素,促进卵泡生长发育及排出.     

中医综合治疗排卵障碍性不孕症中促排卵效应的临床疗效研究

目的:观察中医综合治疗排卵障碍性不孕症中促排卵效应的临床疗效。方法:95例排卵障碍性不孕症患者随机分成中医综合组、中西医结合组及西医组,中医综合组采用中药人工周期、针灸及耳穴压豆促排卵,中西医结合组用中药人工周期及氯米芬促排卵,西医组用氯米芬促排卵。结果:中医综合组33例中,排卵29例,占87.88%,妊娠25例,占75.76%;中西医结合组30例中,排卵24例,占80.00%,妊娠15例,占50.00%;西医组32例中,排卵18例,占56.25%,妊娠8例,占25.00%;3组比较妊娠率有显著差异(P0.05);中医综合组、中西医结合组与西医组比较排卵率有显著差异(P0.05)。结论:中医综合治疗促排卵疗效好,可明显提高受孕率。     

针刺联合补肾活血汤治疗排卵障碍性不孕临床研究

目的:观察针刺联合补肾活血汤治疗排卵障碍性不孕的临床疗效。方法:将门诊收集的排卵障碍性不孕患者60例随机分为治疗组和对照组,每组30例。治疗组给予口服补肾活血汤联合针刺治疗;对照组给予口服枸橼酸氯米芬联合绒毛膜促性腺激素(human choionic gonadotophin,HCG)治疗。治疗后观察两组的卵泡发育情况、排卵率、子宫内膜厚度、宫颈黏液评分、受孕率等指标。结果:1两组患者排卵率与妊娠率的比较,治疗组排卵59个周期,排卵率为65.56%,妊娠21例,妊娠率为70%;对照组排卵43个周期,排卵率为47.78%,妊娠11例,妊娠率为36.67%。两组比较,差异有统计学意义(P0.05)。2两组患者宫颈黏液评分比较,治疗组59个排卵周期,宫颈黏液评分大于8分者个51个;对照组43个排卵周期,宫颈粘液评分大于8分者21个。两组比较,差异有统计学意义(P0.05)。3两组患者临床疗效比较,治疗组有效8例,显效20例,无效2例,有效率为93.33%;对照组中有效13例,显效11例,无效6例,有效率为80.00%。两组比较,差异无统计学意义(P0.05)。4两组患者子宫内膜厚度、最大卵泡直径比较,治疗组子宫内膜厚度为(11.24±0.51)mm;对照组子宫内膜厚度为(7.69±0.63)mm,差异有统计学意义(P0.05)。治疗组最大卵泡直径为(21.16±1.58)mm;对照组最大卵泡直径(18.06±1.32)mm,差异有统计学意义(P0.05)。结论:针刺联合补肾活血汤不仅可提高排卵率,还能通过增加子宫内膜厚度、改善宫颈黏液评分,提高受孕率。     

Effect of chronic thyroid hormone treatment on cycling, ovulation, serum reproductive hormones and ovarian LH and prolactin receptors in rats

We studied the effect on cycling, ovulation and hormone secretion of a chronic thyroxine treatment (HT, 1 mg/kg,S.C., daily, initiated at oestrus) on female rats. HT rats showed normal 4-day vaginal cycles on the first three cycles after initiation of the treatment, but on the fourth cycle had a prolonged oestrus and subsequently entered in constant di-oestrus. In spite of the normal vaginal cycles only 66%, 50%, 33% and 10% of the HT rats ovulated on cycles 1 to 4 respectively. In contrast, during cycles 2 and 3, ovulating HT rats shed a significantly greater number of ova than controls. Hormones were measured at 12.00 and 18.00 h (pre-ovulatory) on prooestrus and at 11.00 h on oestrus. HT ovulating rats had normal LH levels on the first two cycles, but low levels on the third one, while non-ovulating HT rats had low preovulatory LH levels. Serum FSH concentrations were elevated in all the HT rats on cycles 1 and 2 and on pro-oestrus morning in cycle 3 and may have been responsible for the increase in ovulation rate. On oestrus, ovulating HT rats had higher FSH values than nonovulating ones. Serum prolactin levels were similar to controls in all the HT rats on cycle 1, but on the subsequent cycles pre-ovulatory levels were lower than controls in all the HT rats, while values were increased in the non-ovulating HT rats on the third and fourth oestrus mornings. Pro-oestrous serum oestradiol concentrations in all the HT rats were not different from controls on cycles 1 and 2 and diminished on 3 and 4. Oestrous levels were significantly lower on the cycle 1 and only on the nonovulating HT rats on cycle 2. Serum progesterone levels had values similar to those of FSH, with increased values in the first two cycles. Serum corticosterone levels were increased in the mornings of cycles 2 and 3, but values were normal on the fourth one. Ovarian prolactin and LH receptor mRNAs, measured on HT rats on the third prooestrus by Northern blotting, showed significant increases in all the majoritary molecular forms (2.5 and 7 kb for LH receptor and 0.9, 2.9–3, 5 and 10 kb for the prolactin receptor) with respect to control pro-oestrous rats. These results show a progressive disruption of cycling, ovulation and hormonal secretion after the initiation of a chronic thyroid hormone treatment in rats, which eventually lead to an anovulatory state. These results may be of importance for the interpretation of the reproductive disfunctions provoked by hyperthyroidism in women.