补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量影响的实验研究

为探讨补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量的影响,取10月龄SD雌性大鼠40只,随机分为模型组、正常对照组、E3阳性对照组、中药组,每组10只,正常对照组行假手术,其余3组行完整双侧卵巢除术。术后第3天开始灌胃给药,连续用药满12周后处死,分离L3腰椎体及左侧股骨,进行骨矿密度、骨矿含量、表观骨密度测定。结果显示补肾健脾方药能明显维持切除卵巢大鼠椎体及股骨的骨矿密度、骨矿含量和表观密度。     

肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮的疗效观察

[目的] 探讨解毒消痈饮治疗肛周坏死性筋膜炎术后热毒炽盛期的临床效果。[方法] 将60例肛周坏死性筋膜炎患者随机分为对照组和观察组,各30例。对照组采用术后对症支持的常规治疗+痛痒消洗剂坐浴,观察组在对照组的基础上,术后口服解毒消痈饮治疗。[结果] 观察组治疗后第3、7、14天视觉模拟评分量表（VAS）评分均低于对照组,差异具有统计学意义（P<0.05）;两组治疗14 d后白细胞（WBC）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）较治疗前显著减低,且观察组明显低于对照组（P<0.05）,而血红蛋白（Hb）较治疗前明显升高,且观察组优于对照组（P<0.05）;两组治疗14 d后坏死性筋膜炎实验室风险指数评分（LRINEC）、Fournier坏疽严重程度指数（FGSI）均较治疗前显著减低,且观察组明显低于对照组（P<0.05）;观察组治疗后第7、14天创面渗液和创面水肿情况评分均低于对照组,差异具有统计学意义（P<0.05）;观察组创面愈合时间较对照组短（P<0.05）;观察组的总有效率优于对照组（P<0.05）。[结论] 肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮疗效确切,能够有效缓解术后疼痛,降低炎症反应,提高血红蛋白含量,有利于评估患者术后病情及预后,减轻术后创面渗液和创面水肿,加速创面愈合。     

基于熵权法评价干燥方法对经典名方华盖散基准样品质量属性的影响

目的 优选经典名方华盖散基准样品的干燥方法。方法 采用真空干燥、真空带式干燥、喷雾干燥、冷冻干燥方法制备华盖散基准样品,应用扫描电子显微镜、差式扫描量热分析、HPLC等方法测定基准样品的质量属性,以得粉率、玻璃化转变温度及成分含量转移率等为评价指标,运用熵权法对各指标赋予权重进行综合评价。结果 喷雾干燥基准样品粒子呈类球形、粒径最小,冷冻干燥基准样品不规则、蓬松、溶化性好。指标成分盐酸麻黄总碱、苦杏仁苷、橙皮苷、甘草苷、甘草酸转移率分别为85.66%～104.78%、90.81%～104.16%、91.42%～94.86%、83.98%～94.69%、87.85%～94.45%,指纹图谱相似度均大于0.9。结论 经综合评价得出冷冻干燥方法最佳,3批验证工艺重复性、可行性较好,为经典名方基准样品质量属性研究提供了理论依据和实践价值。     

大黄-黄芪组分自微乳的制备及在体肠吸收特性研究

目的 研究大黄-黄芪多组分自微乳的处方与制备工艺,评价制剂质量,并考察其大鼠肠吸收特性。方法 通过溶解度实验、油相与乳化剂和助乳化剂配伍实验及伪三元相图的绘制,筛选出最优处方组成;并从自微乳的外观、形态、粒径、稳定性等方面对自微乳进行评价。通过大鼠在体单向肠灌流实验考察自微乳的肠吸收特性。结果 自微乳处方中油相为辛酸癸酸单双甘油酯、乳化剂为聚氧乙烯蓖麻油35、助乳化剂为乙二醇。在微乳形成区选择各辅料用量,采用适宜方法加入大黄总蒽醌及黄芪总皂苷制得的组分自微乳,外观均一透明,加水分散后形成黄色乳光的微乳液,透射电镜显微镜（transmission electron microscopy,TEM）下观察到微乳分散均匀,无黏连,呈大小均一圆球形乳滴;平均粒径为（33.01±0.12）nm、多分散指数（polydispersion index,PDI）为0.10±0.02、电位为（-10.10±1.00）m V;自微乳中大黄总蒽醌和黄芪总皂苷质量分数分别为6.29、8.80 mg/g。自微乳中大黄总蒽醌在十二指肠、空肠段的吸收速率常数（Ka）及表观吸收系数（Papp）较回肠段均有显著提高;黄芪...     

通腑解毒方联合六合丹辅助西医治疗急性胰腺炎临床研究

目的:观察通腑解毒方联合六合丹辅助西医治疗急性胰腺炎的临床疗效及对患者肠功能屏障、肝功能、炎症反应的影响。方法:将157例急性胰腺炎患者采用简单随机法分为西医组(n=78)和辨证组(n=79)。西医组给予西医治疗,辨证组在西医组治疗基础上给予通腑解毒方灌肠联合六合丹外敷治疗。比较两组临床相关指标、中医症候积分、疗效、28 d病死率、血清学指标。结果:辨证组总有效率高于西医组,腹痛、腹胀缓解时间及首次排便时间、进食时间均短于西医组(均P<0.05)。治疗后,两组各项中医症候积分较治疗前下降,且辨证组低于西医组(均P<0.05)。治疗后,两组血、尿淀粉酶及二胺氧化酶(DAO)、D-乳酸、谷草转氨酶(AST)、C反应蛋白(CRP)、单核细胞趋化因子-1(MCP-1)、谷丙转氨酶(ALT)水平均较治疗前下降,且辨证组低于西医组(均P<0.05)。两组28 d病死率比较,差异无统计学意义(P>0.05)。结论:通腑解毒方联合六合丹辅助西医治疗急性胰腺炎可促进腹痛、腹胀的缓解,保护肠功能屏障,抑制炎症反应,提高疗效。     

《伤寒杂病论》合方运用探讨

重点阐述了《伤寒杂病论》所创合方的这一方剂变化的特殊形式及其运用。并对合方的源流,涵义,组方原则,作用及意义进行了探讨。认为合方虽源于《内经》,但成形于《伤寒杂病论》。合方具有单方所不具备的优势和疗效,如治疗面广,作用性强,产生新疗效,调整作用功能等。     

由复方中单一组分微小效应引发的对中西医结合理论的思考

“霰弹理论”认为中药作用机制和途径表现为多向性、多层面、多靶点的药理学特点 ,这些特点决定了中药复方中任何一种单一组分均可具有微小的生物学效应。在药物组分之间的相互作用中 ,除了少数已证明具有受体效应的组分外 ,多数组分是微效组分 ,即 :中药药效 =A B C …N个微小效应的累加作用。对某一组分不能忽略其生物学的微小效应 ,也不能采用简单的检测手段和数学统计方法分析微小效应。采用细胞培养的方法结合数学概率论将组分的微小生物学效应合并成机体的整体的生物学效应 ,可以解决实验医学与中医结合中遇到的理论与实际相脱节、实验研究结果与临床效果相背离等问题。     

川芎嗪及其配伍对犬肺动脉高压血流动力学的影响

目的 探讨川芎嗪等药物对动力性肺动脉高压犬血流动力学影响。方法 利用幼犬肺动脉高压模型,经ＳｗａｎＧａｎｚ导管输入川芎嗪及其配伍观察其对体、肺循环血流动力学影响。结果 单用川芎嗪可降低肺动脉压,但作 弱,川芎嗪与黄芪,参麦等配伍后,降低肺动脉压作用增强,且降低体动脉压作用不及肺动脉压显。结论 川芎嗪与黄芪、参麦合用,对肺循环有较好选择性。     

Engagement with arts and culture activities in the Danish general population: Longitudinal associations with new onset or persistent depression and mental wellbeing

Objectives

International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population.

Design

Observational prospective study.

Methods

Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values.

Result

In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of .43 (95%CI .23–.80), while 8 times or more was associated with an OR of .53 (.29–.97). In terms of persistent depression, quarterly engagement was associated with an OR of .30 (.10–.90), while 8 times per year or more was associated with an OR of .26 (.07–.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds for high mental wellbeing but did not reach statistical significance.

Conclusions

The results support the involvement of the cultural and creative sectors in health strategies. Mental health promotion initiatives as well as arts and culture sectors may encourage the general public to engage in arts and culture activities with frequencies of at least once per quarter.