脾脏原发性恶性肿瘤

报告原发性脾脏恶性肿瘤7例。临床以左上腹不适，左上腹肿块及体重下降、发热、贫血、白细胞减少及血小板减少为主要特点。病理以淋巴系统及血管源性恶性肿瘤多见。治疗以手术和化疗等手段为主。早期发现、早期手术对提高疗效是非常重要的。     

温针灸和电针治疗脾虚型单纯性肥胖症的对照研究

目的:比较温针灸与电针治疗脾虚型单纯性肥胖症的疗效.方法:将68例脾虚型单纯性肥胖症(包括脾虚湿阻、肺脾气虚、脾肾阳虚3型)患者随机分成温针灸组(36例)、电针组(32例).两组取穴均以中脘、水分、气海、中极、天枢、水道等为主,对其疗效及体重指标进行观察.结果:温针灸组总有效率为88.9%,电针组为71.9%,两组比较差异有显著性意义(P<0.05);温针灸组与电针组肥胖体重下降差异亦有显著性意义(P<0.05).结论:温针灸治疗脾虚单纯性肥胖疗效确切且持久,值得推广.     

Effect of Soothing Gan (Liver) and Invigorating Pi (Spleen) Recipes on TLR4-p38 MAPK Pathway in Kupffer Cells of Non-alcoholic Steatohepatitis Rats

Objective: To investigate the mechanism of inflammatory-mediated toll-like receptor 4(TLR4)-p38 mitogen-activated protein kinase(p38 MAPK) pathway in Kupffer cells(KCs) of non-alcoholic steatohepatitis(NASH) rats and the intervention effect of soothing Gan(Liver) and invigorating Pi(Spleen) recipes on this pathway. Methods: After 1 week of acclimatization, 120 Sprague-Dawley male rats were randomly divided into 8 groups using a random number table(n=15 per group): normal group, model group, low-dose Chaihu Shugan Powder(柴胡疏肝散, CHSG) group(3.2 g/kg), high-dose CHSG group(9.6 g/kg), low-dose Shenling Baizhu Powder(参苓白术散, SLBZ) group(10 g/kg), high-dose SLBZ(30 g/kg) group, and low-and highdose integrated recipe(L-IR, H-IR) groups. All rats in the model and treatment groups were fed with a high-fat diet(HFD). The treatments were administrated by gastrogavage once daily and lasted for 26 weeks. The liver tissues were detected with hematoxylin-eosin(HE) and oil red O staining. Levels of liver lipids, serum lipids and transaminases were measured. KCs were isolated from the livers of rats to evaluate the mRNA expressions of TLR4 and p38 MAPK by real-time fluorescence quantitative polymerase chain reaction, and proteins expressions of TLR4, p-p38 MAPK and p38 MAPK by Western blot. Levels of inflammatory cytokines including tumor necrosis factor α(TNF-α), interleukin(IL)-1 and IL-6 in KCs were measured by enzyme-linked immunosorbent assay. Results: After 26 weeks of HFD feeding, HE and oil red O staining showed that the NASH model rats successfully reproduced typical pathogenesis and histopathological features. Compared with the normal group, the model group exhibited significant increases in body weight, liver weight, liver index, serum levels of total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol, and aspartate aminotransferase as well as TC and TG levels in liver tissues, and significant decrease in serum level of high-density lipoprotein cholesterol(P0.05 or P0.01), while those indices were significantly ameliorated in the H-IR group(P0.05 or P0.01). Higher levels of TNF-α, IL-1 and IL-6 in KCs were observed in the model group compared with the normal group(P0.01). Significant decreases in TNF-α, IL-1 and IL-6 were observed in the H-SLBZ, H-IR and L-IR groups compared with the model group(P0.05 or P0.01). The m RNA expressions of TLR4 and p38 MAPK and protein expressions of TLR4, p38 MAPK and p-p38 MAPK in KCs in the model group were significantly higher than the normal group(P0.01), while those expression levels in the L-IR and H-IR groups were significantly lower than the model group(P0.05 or P0.01). Conclusions: Inflammation in KCs might play an important role in the pathogenesis of NASH in rats. The data demonstrated the importance of TLR4-p38 MAPK signaling pathway in KCs for the anti-inflammatory effect of soothing Gan and invigorating Pi recipes.     

原发性脾占位性病变

目的 探讨原发性脾脏占位性病变的流行病学、诊断、鉴别诊断和治疗方法。方法 回顾性分析1958年8月－1999年12月收治的31例原发性脾脏占位性病变患者的临床资料。结果 原发性脾脏占位性病变按其发病频率高低依次为：脾海绵状血管瘤（32.3%）、脾血管肉瘤（19.4%）、脾局限性充血（12.9%）、脾囊肿（9.7%）、脾结核（6.5%）、脾局限性纤维化（3.2%）、脾血肿（3.2%）、脾淋巴组织反应性增生（3.2%）、脾动脉瘤伴钙化（3.2%）、脾肉芽肿样病变（3.2%）;其中良性病变占80.6%,脾脏占位性病变的诊断以影像学诊断为主,单一影像诊断技术误诊率高（48.4%）,多种影像诊断技术 联合应用很重要;鉴别诊断主要是癌瘤患者承诊过程中发现的原发性脾占位性病变与脾转移瘤的区别。手术是治疗脾占位性病变的主要手段,术后并发症发生率为9.7%,其中以感染性并发症为主。结论 脾脏以良性占位病变多见,诊断采用多种影像技术的联合应用效果好,治疗以手术为主,并尽量保存脾脏组织和功能。     

黄芪四君汤对脾虚证大鼠甲状腺素及环核苷酸水平的影响

目的观察黄芪四君汤对脾虚证模型大鼠甲状腺激素及环核苷酸水平的影响,探讨该方防治脾虚证的作用机理。方法SD雄性大鼠随机分为3组:正常对照组,脾虚模型组,黄芪四君汤组。采用大黄复制脾虚证动物模型,观察各组动物血清甲状腺素(T4)、三碘甲腺原氨酸(T3)、促甲状腺素(TSH)及血浆环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)水平的变化。结果与正常对照组比较,脾虚模型组大鼠血清T3、T4含量下降(P<0.01),血浆cAMP含量及cAMP/cGMP比值均升高(P<0.01)。黄芪四君汤能提高实验性脾虚证大鼠T3、T4水平及脾脏指数、胸腺指数,降低cAMP含量及cAMP/cGMP比值。结论黄芪四君汤能改善脾虚证模型大鼠的脾虚症状,其作用机理与调节甲状腺激素及cAMP、cGMP水平有关。     

运用数据挖掘技术分析针灸治疗高脂血症患者的选穴规律

目的：运用数据挖掘技术分析针灸治疗高脂血症患者的选穴规律。方法：检索1990年1月1日至2020年12月31日国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、Pubmed针灸治疗高脂血症的相关文献,建立针灸处方数据库,运用SPSS 20.0、SPSS Modeler 18.0软件进行统计分析,探究腧穴选用规律。结果：共纳入134篇文献,涉及177个针灸处方、88个腧穴,腧穴使用总频次1 207次。使用频次前10位的腧穴依次是足三里、丰隆、三阴交、中脘、脾俞、天枢、阴陵泉、太溪、肾俞、太白。常选用经脉为胃经、脾经、膀胱经,下肢及胸腹部腧穴使用较多,特定穴方面,主要选取合穴、募穴和交会穴,关联分析获得强关联腧穴配伍8组,其中足三里-三阴交居首位;聚类分析获得4个腧穴聚类群。结论：针灸治疗高脂血症多从脾论治,以调理脾胃功能为核心,足三里、丰隆、三阴交为核心腧穴,以辨证取穴为主,表里经配穴、远近配穴、前后配穴多种配穴方式相结合。     

可视化仿真手术在脾脏手术中的应用

目的研究基于64排螺旋CT脾脏扫描数据的三维重建和脾切除的动态可视化仿真手术。方法采集脾脏64排螺旋CT的原始扫描数据,通过一种自适应的区域生长法对CT序列图像进行图像程序分割和自动提取,再采用自行研发的医学图像处理软件分割后的图像数据进行三维重建,然后利用Freeform Modeling System和PHANTOM软件系统进行脾切除的可视化仿真手术研究。结果利用自适应区域生长法进行脾脏图像程序分割速度快、效果好,可获得满意的脾脏分割数据。采用自行研发的图像处理软件对脾脏的分割数据进行三维重建图像结构清晰,可真实再现脾脏和周围的结构。利用Freeform Modeling System和PHANTOM软件系统可以有助于术前进行模拟的脾脏可视化仿真手术。结论利用脾脏CT扫描数据进行的可视化三维重建和脾切除仿真手术研究,对脾脏手术前的风险评估和临床教学等方面都有很大的应用价值。     

芳香药物治疗脾胃系统疾病探析

本文通过梳理芳香中药的定义、归经,探讨其在脾胃系统疾病中的应用.芳香中药辛温香燥,循脾之所喜,去脾之所恶,行中焦之正气,宣壅滞之湿浊,可健脾、理脾、醒脾、暖脾,临证脾胃有恙者均可灵活加减用之.现代药理研究发现,其具有抗溃疡及促进胃肠蠕动等药理活性.本文重点从原理、适应证、临床应用等方面介绍芳香中药化湿健脾、行气宽中、醒...     

从脾胃论治失眠探析

失眠病因病机复杂,皆与五脏六腑有关。《黄帝内经》言"胃不和则卧不安",概括了胃不和导致不寐的病理机制。内伤脾胃,百病始生。若忧思劳倦过度伤脾,脾胃亏虚,运化失调,精微化生无源,气血虚衰,意不入舍,心失所养或宿食痰火内停,胃失和降,浊邪上扰均可导致阴不涵阳,阳不入阴,心神不安,从而导致不寐。笔者通过探讨脾胃与失眠的关系,明晰从脾胃论治失眠的机制,进而更好地指导临床治疗用药。     

狼疮清颗粒对小鼠免疫功能的影响

目的研究狼疮清颗粒对正常小鼠免疫功能的影响。方法将小鼠随机分为两组,治疗组口服给予不同剂量的狼疮清颗粒(分别为11.4、22.8、45.6g/kg),对照组灌服生理盐水。观察狼疮清颗粒对小鼠刀豆蛋白(ConA)诱导的脾淋巴细胞转化、溶血空斑数的作用。结果小剂量狼疮清颗粒能够增加小鼠脾淋巴细胞和溶血空斑数,大剂量狼疮清颗粒能够抑制小鼠脾淋巴细胞和溶血空斑数。结论狼疮清颗粒具有调节机体免疫功能的作用,且与剂量相关。