尼莫地平联合卡维地洛治疗原发性高血压78例临床分析

目的分析尼莫地平联合卡维地洛治疗原发性高血压的临床疗效。方法将150例原发性高血压随机分成两组,对照组给予尼莫地平治疗,治疗组在对照组治疗的基础上,加之卡维地洛。结果治疗组与对照组显效率分别为33.3%和26.4%,总有效率为88.5%和76.4%,两组相比具有显著性差异（P〈0.05）。结论尼莫地平联合卡维地洛治疗原发性高血压疗效更为显著。     

松龄血脉康抑制肺动脉高压的实验研究

为观察松龄血脉康胶囊对肺动脉高压大鼠肺动脉压的影响，取１００只健康Ｗｉｓｔａｒ大鼠，其中６０只背部注射野百合碱ｍｏｎｏｃｒｏｔａｌｉｎｅ，ＭＣＴ８０ｍｇ／ｋｇ复制出肺动脉高压模型。再将其分为两组，各３０只，其中一组以标准饲料喂养，另一组加用松龄血脉康胶囊１．５ｇ·ｋｇ－１·ｄ－１。其余４０只健康大鼠做为正常对照组，在实验当天、７天、１４天、２１天、２８天、３５天从各组中随机抽取５只行右心导管测肺动脉压。结果：注射ＭＣＴ后肺高压组２８天时达高峰，但加用松龄血脉康组上升幅度明显小于未用药组。结论：松龄血脉康有显著抑制大鼠肺动脉高压发展的作用     

卡维地洛对冠心病患者血浆氧化修饰低密度脂蛋白的影响

目的 :观察临床应用卡维地洛能否降低冠心病患者血浆氧化修饰低密度脂蛋白 (Ox LDL)水平。方法 :选择确诊冠心病患者及年龄、性别相匹配的正常对照组各 30例。冠心病组卡维地洛平均用量为 (10± 2 .5 )mg/d ,共 4个月 ,于服药前、服药后2个月及 4个月 ,分别采集清晨空腹血 ,以检测Ox LDL ,丙二醛 (MDA)。结果 :冠心病组的Ox LDL、MDA水平显著高于对照组 ,在用药后 2及 4个月冠心病组Ox LDL较用药前有显著降低 (P <0 .0 5 ) ,MDA显示出类似的趋势 (P <0 .0 1)。结论 :卡维地洛具有抗氧化作用 ,可以降低冠心病患者血浆Ox LDL水平。     

24h动态血压监测评价卡维地洛对原发性高血压患者的降压效应

目的 :评价卡维地洛对原发性高血压患者的降压效应。方法 :选择我科 2 0 0 3年 7月至 2 0 0 4年 1月住院的原发性高血压患者 4 2例 ,行首次 2 4 h动态血压监测后开始服用卡维地洛 ,初始剂量为 12 .5 mg,每日口服 1次。治疗开始后每日服药前测卧位血压 1次 ,若血压控制不满意 ,可根据病情增加剂量。 4周结束时重复行 2 4 h动态血压监测。治疗前和治疗 4周结束时行血、尿常规、肝肾功能、血脂、血电解质、空腹血糖等检查。结果 :经 4周卡维地洛治疗后 ,显效 37例 (88.10 % ) ,有效 4例 (9.5 2 % ) ,无效 1例 (2 .38% ) ,总有效率 (97.6 2 % )。治疗后患者平均收缩压(SBP)、平均舒张压 (DBP)谷峰比值分别为 6 3%和 6 5 %。结论 :本观察发现卡维地洛降压疗效确切 ,有效率为 97.6 2% ,有满意的谷 /峰比值 ,副作用少 ,是一种很有前途的新型抗高血压药物。     

卡维地洛配伍螺内酯治疗老年难治性高血压的临床观察

目的：评价卡维地洛联合螺内酯对老年难治性高血压的临床疗效及安全性，以指导临床工作。方法：老年难治性高血压患者200例分成两组，观察组（120例）经安慰剂洗脱2周后口服卡维地洛配伍螺内酯治疗，对照组（80例）在原有用药基础上加用螺内酯，治疗后共观察8周，探讨疗效。结果：观察组不良反应发生少，且观察组总有效率明显高于对照组，观察组对改善左心室射血分数和左心室舒张末期内径效果明显。结论：卡维地洛联合螺内酯对老年难治性高血压控制较好，并能改善心室结构，临床应用效果好。     

33 factorial design-based optimization of the formulation of nitrofurantoin microcapsules

A microcapsule form of nitrofurantoin was prepared by a simple coacervation method with carboxymethylcellulose and aluminium sulfate. 3³ factorial design was performed for three independent variables, namely, the particle size of the drug, the size of the microcapsules and the pH of the dissolution medium. The dissolution tests with the formulated microcapsules were carried out according to the United States Pharmacopeia XXII rotating basket method at pH 1.2, 5 and 7.5, which represent the pH of gastrointestinal fluids. Release data were examined kinetically and the ideal kinetic models were estimated and t _63.2 values obtained from RRSBW distribution were used in the factorial design experiment. The influence of the independent variables on the dissolution of nitrofurantoin microcapsules could be expressed as the pH of the dissolution medium > particle size of the microcapsule > particle size of nitrofurantoin. The other aim of this study was to evaluate microcapsule formulation in terms of the United States Pharmacopeia criteria with a minimum of experiments. Our findings suggest that dosage forms which comply with the pharmacopoeia criteria for dissolution can be prepared and selected by factorial design.     

Carvedilol and the kidney

Antihypertensive drugs have differing effects on renal hemodynamics, tubular function, plasma electrolytes, and hormonal responses. Nonselective -blockers without intrinsic sympathomimetic activites, such as propranolol, have been reported to reduce renal blood flow and to cause a modest decrease in glomerular filtration rate. Carvedilol is a new multiple action agent displaying nonselective -blockade without intrinsic sympathicomimetic activity, ₁-adrenoceptor blockade (probably responsible for its vasodilator activity), and possibly also calcium antagonist properties. The presence of these different pharmacodynamic properties results in a different effect on the kidney as compared with, e.g., propranolol. In the dog, intrarenal infusion of carvedilol resulted in a renal vasodilator response with preservation of renal blood flow and without inducing sodium retention; in contrast, propranolol induced a renal vasoconstrictor response and sodium retention in this model. A renal vasodilator response to carvedilol was also reported in spontaneously hypertensive rats (SHR) and in DOCA-salt SHR. In contrast to labetalol, i.v. infusion of hypotensive doses of carvedilol in conscious SHR did not cause sodium retention. Carvedilol was effective in controlling hypertension and preserving renal function in a rat model of progressive hypertensive renal disease. In patients with essential hypertension, carvedilol was reported to reduce renal vascular resistance in the presence of reduced perfusion pressure, allowing for normal renal autoregulation of renal blood flow. Although a small reduction in glomerular filtration rate was seen after acute administration, renal function was preserved during chronic treatment. It is concluded from these studies that renal perfusion and renal function are well maintained during acute and chronic treatment with carvedilol. The compound does not appear to cause sodium retention, and preliminary animal test data suggest the possibility of a renoprotective effect.     

灵宝护心丹联合参松养心胶囊治疗窦性心动过缓的临床观察

目的 探讨灵宝护心丹联合参松养心胶囊治疗窦性心动过缓的临床疗效。方法 选取2019年3月—2020年12月抚州市中医医院内科诊断为窦性心动过缓患者100例,随机分为对照组（50例）和治疗组（50例）。对照组给予参松养心胶囊（每天3次,每次4粒）,治疗组在对照组的基础上给予灵宝护心丹（每天3次,每次4粒）,治疗24周。治疗后比较两组的临床疗效、24 h动态心电图指标、心率变异性时域指标及不良反应。结果 治疗组中医证候有效率84.0%,对照组为60.0%,两组比较差异有统计学意义（P<0.05）。治疗组动态心电图总有效率86.0%,对照组64.0%,两组比较差异有统计学意义（P<0.05）。治疗后,两组平均心率、总心率、最快心率、最慢心率、24 h全部正常心室搏动间距（R wave-R wave,R-R）间期标准差（standard diviation of NN intervals,SDNN）、24 h连续5 min节段正常R-R间期的标准差（standard deviation of sequential five-minute R-R interval means,SDA...     

卡维地洛对高血压大鼠主动脉的保护作用

目的 :研究卡维地洛对核因子 κB(NF κB)、单核细胞趋化蛋白 1(MCP 1)在自发性高血压大鼠 (SHR)大血管中表达的影响 ,探讨其对血管保护的机制。方法 :18只雄性 12周龄SHR随机分为阳性组 ,卡维地洛组 ( 30mg/kg·d) ,美托洛尔组 ( 50mg/kg·d) ,灌喂 8周 ;另选同龄雄性WistarKyoto大鼠为阴性组 (n =6 )。用免疫组化法测各组主动脉NF κB、MCP 1的表达 ,ELISA法测血清MCP 1含量。结果 :与阴性组比较 ,阳性组主动脉组织中NF κB、MCP 1表达增加 (P<0 .0 1) ,且两者正相关 (r=0 .72 8,P <0 .0 1) ;血清MCP 1含量升高 1.6 4(P <0 .0 1)。 8周后 ,治疗组之间血压无明显差异 (P >0 .0 5) ,但卡维地洛更显著抑制NF -κB、MCP 1表达 (P <0 .0 5)。结论 :卡维地洛可能独立于降压外抑制NF κB的活化来调控MCP 1表达。     

反相高效液相色谱法测定双黄连胶囊中绿原酸的含量

目的 :建立中成药双黄连胶囊中绿原酸的含量测定方法。方法 :采用Phenomenex -C1 8(2 5 0mm×4 6mm ,5 μm)柱 ,以水 -乙腈 -冰醋酸 (92∶7∶1 0 )为流动相 ,检测波长 32 6nm ,流速 1 0ml/min。结果 :绿原酸在 0 1 1～ 0 5 5 μg ,都与相应的峰面积呈良好的线性关系 (r=0 9999) ,平均回收率为 99 1 1 % ,RSD为 0 5 8% (n =6 )。结论 :该方法准确可靠 ,可用于双黄连胶囊制剂的质量控制