参芪消渴汤治疗糖尿病周围血管病变.80例疗效分析

目的 观察自拟参芪消渴汤治疗糖尿病周围血管病变的临床疗效.方法 将160例糖尿病周围血管病变患者随机分为两组各80例,对照组口服西洛他唑片治疗;治疗组在对照组治疗基础上加服参芪消渴汤,3个月为1个疗程,观察两组治疗前后综合疗效、临床症状和体征、血糖、血脂、血液流变学变化及不良反应情况.结果 治疗组总有效率为96.25%;对照组总有效率为86.25%,两组总有效率比较差异有统计学意义(P<0.01).结论 参芪消渴汤治疗糖尿病周围血管病变有效.     

益气养阴活血对中国小型猪心肌梗死后早期心肌组织Na^＋-K^＋ATP酶、Ca^2＋-Mg^2＋ATP酶活性及抗氧化的作用

目的采用结扎中国小型猪冠状动脉造成急性前壁心肌梗死（AMI）模型,应用益气养阴活血中药（复方芪丹液）干预动物AMI后早期心室重构（VR）的影响,并研究其对动物心肌钙、镁离子和氧自由基的作用。方法中国小型猪28只,采取结扎冠状动脉左前降支中下1/3部,造成AMI模型。手术成功存活动物随机分为复方芪丹液大、小剂量组及卡托普利（开搏通）组、模型组、假手术组共5组,均予灌胃给药或自来水4周。4周后测定猪的血流动力学指标、心肌Na＋-K＋ATP酶、Ca2＋-Mg2＋ATP酶活性、心肌超氧化物歧化酶（SOD）、丙二醛（MDA）含量等。结果与模型组比较,复方芪丹液大剂量组的左室内压（LVP）、血压（BP）、-dp/dtmax值明显升高（P〈0.01）,复方芪丹液小剂量组及开博通组LVP显著升高（P〈0.05）,开博通组-dp/dtmax值显著升高（P〈0.05）。复方芪丹液大剂量组Na^＋-K＋ATP酶、Ca^2＋-Mg^2＋ATP含量较模型组显著升高（P〈0.05）,复方芪丹液小剂量组、开博通组与模型组相比Ca^2＋-Mg^2＋ATP酶仅有升高的趋势,未有统计学意义（P〉0.05）;复方芪丹液大剂量组、复方芪丹液小剂量组、开博通组SOD活力较模型组均显著升高（P〈0.05）。复方芪丹液大剂量组的MDA含量与模型组比较显著降低（P〈0.05）。结论益气养阴活血中药可提高中国小型猪AMI后心肌收缩力,改善血流动力学指标;增加SOD活性,降低MDA含量,提高细胞膜Ca^2＋-Mg^2＋ATP酶和Na^＋-K^＋ATP酶活力,起到干预AMI后VR和保护心肌的作用。     

王玉英治疗抑郁症经验

王玉英教授认为,抑郁症是以情绪抑郁为主,伴有一系列身体症状,表现为生命力低下的精神性疾病,即睡眠、食欲、性欲、社会适应能力等多方面的衰退。其发病原因是情志内伤、肝气郁结。发病和传变规律是初病在气,久病及血,累及五脏。临证将本病分为气机郁滞、气滞血瘀、心肝血虚和痰气郁结4型。气机郁滞型用丹栀逍遥散或癫狂梦醒汤加减;气滞血瘀型用膈下逐瘀汤加减;心肝血虚型用天王补心丹加减;痰气郁结型用十味温胆汤加减。治疗首重睡眠,次重饮食,再考虑其他症状,临床疗效显著。     

Effects of Bojungikgi-tang on anorexic patients with atopic dermatitis: A protocol for a randomized,usual care-controlled,assessor-blinded,parallel, pilot clinical trial

Background:Anorexia and atopic dermatitis (AD) are highly prevalent diseases, and the herbal medicine Bojungikgi-tang (BJT) has been frequently used for the treatment of both anorexia and AD. However, no study has simultaneously evaluated the effects of BJT for both anorexia and AD.Methods:A prospective, randomized, usual care-controlled, assessor-blinded. parallel, pilot clinical trial has been designed to explore the feasibility, preliminary effectiveness, and safety of BJT for the treatment of anorexic patients with AD. Forty anorexic patients with AD will be randomly assigned (1:1) to BJT or the usual care group. The BJT group will be administered BJT granules twice a day for 8 weeks and followed up for 4 weeks whereas the usual care group will not receive BJT granules. All participants in both groups will be provided with over-the-counter topical corticosteroids as a relief drug. Data will be collected at baseline and at 4, 8, and 12 weeks after randomization. The primary outcome is the score on the anorexia visual analog scale at 8 weeks post-treatment. The secondary outcomes include body weight, body fat percentage, body fat mass, skeletal muscle mass, SCORing of Atopic Dermatitis index, Validated Investigator Global Assessment scale for Atopic Dermatitis, Dermatology Life Quality Index, EuroQoL 5 Dimension 5 Level, deficiency and excess pattern identification questionnaire, total immunoglobulin E, eosinophil count, and frequency and amount of use of topical corticosteroids. Adverse events and laboratory test results will be monitored to assess safety. Fecal samples to check for gut microbiome changes and blood samples to check immune and metabolic markers will be collected before and after taking BJT.Discussion:This is the first trial that explores the preliminary effectiveness and safety of BJT for the treatment of anorexic patients with AD. The results of this pilot study will provide the basic evidence for large-scale, confirmatory, multicenter, high-quality clinical trials.Trial registration:Clinical Research Information Service, KCT0006784 (registered on November 26, 2021).     

Population Pharmacokinetic Analysis of Mizoribine in Chinese Renal Transplant Recipients

Background

We calculated the population pharmacokinetics of mizoribine in adult Chinese patients and compared the parameters with those of Japanese patients to determine whether there are any ethnic differences in blood concentration transition between these 2 populations.

正气辨析

正气属中医学的气学范围,是一身之气或人气相对邪气时的称谓,是指人体内具有抗病、祛邪、调节、修复等作用的一类细微物质;正气以其运动而发挥防御、调节、修复等作用,具有物质运动的自然科学属性。正气分布到腑腑经络,则为脏腑经络之气;分布到脉之内外,则为营气和卫气。脏腑经络之气和营卫之气的防御、修复和调节作用,可因其构成成分和所在部位的不同而有所区别,但都是正气的功能体现。     

益气活血通络法对气虚血瘀型慢性阻塞性肺疾病急性发作(AECOPD)血小板活化指标的影响

目的评价对气虚血瘀型慢性阻塞性肺疾病急性发作(AECOPD)患者应用益气活血通络法的临床价值以及对其血小板活化指标的影响。方法选取2017年9月～2019年5月我院收治的136例慢性阻塞性肺疾病急性发作患者为研究对象,采用数字随机表法将其分成2组(试验组与对照组),每组68例。其中对照组运用临床常规治疗措施,试验组在此基础上运用益气活血通络法治疗。对其治疗前后血小板活化指标、中医症候积分等数据进行统计分析。结果①试验组与对照组治疗前中医证候积分比较,差异无统计学意义(P0.05),治疗后试验组评分低于对照组同等数据评分,差异有统计学意义(P0.05);②两组患者治疗前D-二聚体、PAC-1、CD62p比较,差异无统计学意义(P0.05),治疗后试验组D-二聚体、PAC-1、CD62p等均低于对照组,差异有统计学意义(P0.05);③试验组治疗总有效率97.06%(66/68)高于对照组治疗总有效率88.24%(60/68),差异有统计学意义(P0.05)。结论针对慢性阻塞性肺疾病急性发作患者给予常规治疗基础之上开展益气活血通络法治疗,相比常规治疗效果显著,对改善其血小板活化指标具有重要帮助,是临床治疗该种疾病的有效措施。     

芪加真武汤联合糖皮质激素体外对SLE患者外周血淋巴细胞凋亡及Fas、FasL表达的影响

目的 探讨中药芪加真武汤联合糖皮质激素对系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL)凋亡及Fas、FasL表达的影响。方法 采用血清药理学方法 ,制取芪加真武汤含药兔血清。运用流式细胞仪检测19例SLE患者外周血淋巴细胞在不同浓度的芪加真武汤的含药血清(20%、10%、5%)、地塞米松(0.001mol/L)及两者联合刺激下细胞凋亡和Fas、FasL表达的变化。结果 ①SLE患者PBL凋亡率明显高于正常组(P<0.001),Fas表达明显多于正常组(P<0.01),FasL表达与正常组差异不明显(P>0.05)。②10%、20%含药血清显著减少SLE患者PBL的凋亡率(P<0.01),显著降低Fas表达(P<0.01),升高FasL的阳性细胞率(P<0.05);③地塞米松可增高SLE患者PBL的凋亡率(P<0.05),但对Fas、FasL的表达无影响(P>0.05);④含药血清联合地塞米松显著减少PBL凋亡率(P<0.01),降低Fas表达(P<0.05),明显升高FasL的阳性细胞率(P<0.01)。结论 SLE患者PBL存在凋亡及凋亡相关蛋白表达的紊乱,中药芪加真武汤在体外可纠正其紊乱,缓解由地塞米松引起的PBL过度凋亡。     

Experimental coronary arterial occlusion and release: Effects on enzymes,electrocardiograms, myocardial contractility and reactive hyperemia

After less than 1 hour of coronary arterial occlusion, the myocardium suffers irreversible changes as revealed by electron microscopy. Yet, the earliest clinical laboratory indexes of myocardlal infarction—elevated serum enzyme levels and significant Q waves on the electrocardiogram—are not detected until at least 6 hours after coronary occlusion. To study the early period after coronary occlusion in the dog, occlusion of the left anterior descending coronary artery for 1 to 3 hours was followed by release, and coronary sinus and venous enzyme levels, the electrocardiogram and myocardial contractility from the infarcted area, and reactive hyperemia were monitored. Coronary sinus enzyme levels rose within 15 minutes after release of occlusion in half of the experiments with $\text{1}\text{to}\text{1}\text{1}\text{2}$ hours and in all of those with 2 to 3 hours of occlusion, and this rise preceded the rise in venous levels by only 10 to 20 minutes. Significant Q waves appeared 15 to 30 minutes after release of occlusion as the serum enzymes were increasing. Thus, clinically, the delayed appearance of increased serum enzymes and significant electrocardiographic Q waves is probably largely due to a lack of circulation in the infarcted area rather than to prolonged survival time. Also, the venous enzyme level reflects the coronary sinus level minutes later. The presence of viable myocardium in the infarcted area was suggested by elevation of the S-T segment upon reclamping, and by residual myocardial contractility and retained capacity for reactive hyperemia. These findings occurred in some experiments even In the presence of a significant Q wave.