鞘内注射不同浓度多塞平对大鼠的神经毒性

目的 评价鞘内注射不同浓度多塞平对大鼠的神经毒性.方法 鞘内置管成功的成年雄性Wistar大鼠24只,体重250～300 g,采用随机数字表法,将大鼠随机分为4组(n=6).D10组、D20组和D40组分别鞘内注射10、20和40 mmol/L多塞平0.2 μl/g,N组鞘内注射等容量生理盐水.于鞘内注射后6h时取大鼠腰膨大脊髓背角和脊神经后根,透射电镜下观察超微结构;采用ELISA法测定脊髓髓鞘碱性蛋白(MBP)含量.结果 N组大鼠脊髓背角、脊神经后根超微结构正常;随多塞平浓度增加,脊髓神经元染色质边集、核膜局部凹陷,胶质细胞核固缩,线粒体空泡样变性等细胞凋亡与坏死改变;脊神经后根神经纤维出现线粒体髓样变及空泡样改变.脊髓MBP含量随多塞平浓度增加而降低(P＜0.05).结论 大鼠鞘内注射多塞平可产生脊髓和外周神经毒性,且呈浓度依赖性.     

莫沙必利联合多虑平治疗肠易激综合征的临床研究

目的 观察莫沙必利联合多虑平治疗肠易激综合征的临床疗效.方法 将100例肠易激综合征患者随机均分为两组：研究组50例应用莫沙必利联合多虑平治疗,对照组50例应用莫沙必利治疗,观察两组疗效.结果 治疗后两组临床症状较治疗前均有改善,具有统计学意义（P＜0.05）,研究组改善程度优于对照组,差异具有统计学意义（P＜0.05）.结论 莫沙必利联合多虑平治疗肠易激综合征有较好的临床疗效,值得推广.     

Steady-state kinetics of doxepin and imipramine in Saudi patients with interethnic comparison

The pharmacokinetics of doxepin (DX) was studied in 21 Saudi patients treated long term with oral doses of this tricyclic antidepressant agent. The mean (SEM) values of the dose-normalized steady-state concentration and the apparent clearance after oral administration of this drug were 25.8 (4.8) ng·ml^-1/mg·kg^-1 and 2.529 (0.342) l·h^-1·kg^-1, respectively. The pharmacokinetics of impramine (IMI) was also studied in 30 Saudi patients who received oral doses of this drug for long durations. The mean dose-normalized steady-state concentration of IMI was 68.3 (19.7) ng·ml^-1/mg·kg^-1, and the mean apparent clearance after oral administration of IMI was 1.619 (0.353) l·h^-1·kg^-1. The mean (SEM) ratio of the steady-state concentration of the metabolite desipramine (DES) to that of IMI (DES/IMI) was 0.873 (0.151). Using this value and the ratio of the mean apparent clearance after oral administration (TCL) of DES to that of IMI, the fraction of IMI metabolized to DES was calculated to be 0.489. The TCL of DES was estimated from data obtained for three additional patients who received oral doses of this drug for long durations. A mean value of 0.907 (0.351) l·h^-1·kg^-1 was obtained.     

气相色谱-质谱法快速确证多塞平药物中毒

目的:应用气相色谱-质谱(GC-MS)联用技术,对中毒患者胃内容物和血液样品进行分析鉴定。方法:样品经液-液萃取方法提取,进GC-MS分析。结果:检出和确证了患者服用了三环类抗抑郁药多塞平。结论:本法简便、快速、准确,为医院抢救提供了可靠的依据。     

Comparison of central gastric antisecretory effects of desmethylimipramine,doxepin and pirenzepine in rats

Summary Certain tricyclic drugs, some of which are primarily used clinically as antidepressants, have been shown to act as gastric antisecretory agents. The anatomical site(s) and mechanism(s) of action of these agents is, however, in most cases unclear. In this study, we found that desmethylimipramine (DMI) was approximately 28 times more potent in inhibiting gastric acid secretion when administered intracerebroventricularly (i.c.) than when administered intravenously (i.v.) in pylorus-ligated rats, which is indicative of a site of action in the central nervous system. Qualitatively similar results were obtained with pirenzepine where the i.c./i.v. potency ratio was 8. Doxepin also preferentially inhibited acid secretion when given i.c. at low but not at high doses. Atropine and chlorpromazine were equipotent antisecretory agents by both routes of administration. Doxepin and DMI but not pirenzepine were effective inhibitors of brain stem norepinephrine uptake in vitro thus making this an unlikely common mechanism to explain the central actions of these compounds.     

卡马西平联合多虑平治疗原发性三叉神经痛的疗效观察

目的探究卡马西平联合多虑平治疗原发性三叉神经痛的疗效。方法选取2007年10月至2012年10月在我院接受治疗的原发性三叉神经痛患者80例,将其随机分成A、B两组;A组给予卡马西平联合多虑平治疗,B组只给予卡马西平治疗;所得结果用SPSS10．0统计学软件进行统计学分析,组间对比用爿。检验,P〈0．05为差异具有统计学意义。结果只给予卡马西平与给予卡马西平联合多虑平两组相比,联合用药总有效率为95．0％,而单用卡马西平的总有效率为87．5％,联合用药比单用卡马西平有效率高,不良反应发生率低,差异具有统计学意义（P〈0．05）。结论卡马西平联合多虑平治疗原发性三叉神经痛比单用卡马西平治疗有效率高,而且不易发生不良反应,值得临床医生推广使用。     

枸橼酸莫沙必利联合多虑平治疗老年功能性消化不良伴发抑郁症随机平行对照研究

[目的]观察枸橼酸莫沙必利联合多虑平治疗老年功能性消化不良伴发抑郁症疗效。[方法]使用随机平行对照方法,将113例患者随机分为治疗组57例和对照组56例。对照组使用枸橼酸莫沙必利分散片5mg,3次/d;治疗组在对照组治疗基础上加多虑平12.5mg,3次/d。对患者进行心理测试,采用SDS进行评定,观测治疗1～4周判定疗效。[结果]治疗组总有效率优于对照组(P<0.05),治疗组治疗后SDS粗分评定低于对照组(P<0.01)。[结论]在服用胃动力药构椽酸莫沙比利分散片的基础上,联合抗抑郁药多虑平进行治疗,对老年功能性消化不良的改善有促进作用,可提高疗效,并且疗程短、不易出现不良反应。     

多塞平联合双歧三联活菌治疗腹泻型肠易激综合征疗效观察

目的:观察多塞平、双歧三联活菌联合治疗腹泻型肠易激综合征(D-IBS)的疗效和不良反应.方法:85例D-IBS患者随机分为2组,治疗组43例用多塞平联合双歧三联活菌,对照组42例单用双歧三联活菌.用药前后4周分别作IBS症状评分及SCL-90精神评分.结果:治疗组总有效率88.37%,明显高于对照组的69.05%(P＜...     

多塞平及心理暗示疗法治疗胃肠神经官能症

目的探讨多塞平及心理暗示疗法对胃肠神经官能症的治疗效果。方法胃肠神经官能症116例,随机分为治疗组56例和对照组60例。治疗组给与常规治疗、心理暗示治疗并加用多塞平口服治疗,对照组给与患者常规治疗及心理暗示治疗,疗程2周,随访3月。结果治疗组治愈率（85．7％）明显高于对照组（53．3％）（P〈0．01）。结论多塞平及心理暗示疗法对胃肠神经官能症具有较好疗效,对于临床治疗具有指导性的意义。     

联用卡马西平、多虑平治疗三叉神经痛的临床观察

目的观察卡马西平联合多虑平在特发性三叉神经痛治疗中的疗效和不良反应。方法卡马西平联合多虑平（治疗）组60例,卡马西乎（对照）组60例,均诊断为特发性三叉神经痛,用视觉模拟评分法给疼痛评分,通过治疗后1周、2周、1月、3月视觉模拟评分判断疗效。结果治疗组疗效明显高于对照组,治疗组患者疼痛积分（分别为5．3±1．82,1．8±1．79,1．6±0．96,0．62±0．94）显著低于对照组（6．1±1．74,4．5±1．27,3．36±1．22,2．7±1．14）（P〈0．05）,卡马西平用量、不良反应发生率和程度均较对照组低。结论两种方法对特发性三叉神经痛均有效,但治疗组疗效更好,且不良反应发生率低,更安全。