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1.
肥胖的高血压病患者中医体质分类与胰岛素抵抗的关系   总被引:13,自引:1,他引:13  
[目的]探讨中医的体质分型与胰岛素抵抗的关系。[方法]按体质分型标准将一组肥胖的高血压病患者,分为阳亢质组(28例)和痰湿质组(34例),进行葡萄糖耐量试验(OGTT)和胰岛素释放试验(InRT)检测,采用胰岛素敏感指数(ISI)、胰岛素抵抗指标(Homa-IR)和胰岛β细胞功能指数(MBCI)等指标做比较分析。[结果]1.痰湿质组高血压病人胰岛素的水平高于阳亢质组高血压病人,尤其是空腹时和30分钟时的胰岛素值分别为1.03±0.24mU/L、1.93±0.22mU/L和0.85±0.17mU/L、1.72±0.38mU/L,差异明显且有统计学意义(P=0.002、0.01)。2.痰湿质组和阳亢质组2组ISI分别为-1.77±0.26、-1.60±0.17,(P=0.004);Homa-IR分别为0.41±0.26、0.25±0.17,(P=0.005);MBCI分别为16.92±14.89、8.83±6.76,(P=0.012)。[结论]痰湿质组高血压患者为维持血糖在正常水平,胰岛β细胞的功能是亢进的,胰岛素的分泌也明显增加,与阳亢质组相比,胰岛素的敏感性下降,胰岛素抵抗现象严重。痰湿质的高血压患者心血管的易损性可能比阳亢质组更明显。  相似文献   

2.
目的 探讨在排除抗精神病药物影响下精神分裂症患者及其正常Ⅰ级亲属的糖代谢情况.方法 选择58例符合中国精神障碍分类与诊断标准第3版(CCMD-3)和精神障碍诊断统计手册第4版(DSM-Ⅳ)中分裂症诊断标准的、首发且未服药的精神分裂症患者(患者组),以及其22例正常Ⅰ级亲属(亲属组)、24例普通人群(正常对照组)为研究对象.检测空腹血糖、胰岛素、C-肽以及口服葡萄糖耐量试验(OGTY)后2h血浆中血糖、胰岛素和C-肽水平.结果 患者组OGTT后2h血糖[(8.51±2.05)mmol/L]和糖代谢异常发病率(48.3%)均显著高于与亲属组[(5.61±1.38)mmol/L,9.1%]、正常对照组[(5.88±1.21)mmol/L,4.2%](均P<0.01),且患者组的空腹胰岛素、C-肽、OGTT后2h胰岛素及胰岛素抵抗指数(IRI)也都明显高于正常对照组[分别为(19.18±7.92)mU/L,(14.51±6.87)mU/L;(76.83±36.65)mU/L,(55.05±26.91)mU/L;(472.44±167.69)pmol/L,(324.27±160.23)pmol/L;(4.56±2.05),(3.24±1.55)],差异有显著性(均P<0.05).结论 与普通人群相比,精神分裂症患者具有较高的糖代谢异常发病率,精神分裂症与糖代谢异常之间存在一定的相关性.  相似文献   

3.
目的 通过对心理应激大鼠颞下颌关节(tempommandibular joint,TMJ)的形态、生理学评估及相关炎性因子的检测,探讨心理应激对TMJ的可能致病机制.方法 采用交流箱心理应激动物模型,检测空白对照组、心理应激组(PS组)、心理应激加地西泮组(PS+DI组)大鼠血清中Cor和ACTH水平;运用RT-PCR技术检测心理应激不同时期大鼠TMJ内炎性因子IL-1和IL-6的表达变化.结果 空白对照组血清中Cor和ACTH值与PS组有显著差异(P<0.01),空白对照组血清中Cor和ACTH值与PS+DI组无显著差异(P>0.05);空白对照组IL-1(分别为(0.453±0.021)mg/L,(0.439±0.028)mg/L,0.454±0.023)mg/L、IL-6[分别为(0.525±0.028)mg/L,(0.515±0.028)mg/L,(0.518±0.022)mg/L]与PS组IL-1[分别为(0.981±0.024)mg/L,(0.746±0.017)mg/L,(0.510±0.016)mg/L]、IL-6[分别为(0.820±0.023)mg/L,(0.694±0.019)mg/L,(0.579±0.015)mg/L]有显著差异(P<0.05),与PS+DI组IL-1[分别为(0.549±0.014)mg/L,(0.498±0.014)mg/L,(0.444±0.022)mg/L]、IL-6[分别为(0.599±0.015)mg/L,(0.541±0.015)mg/L,(0.487±0.008)mg/L]差异无显著性(P>0.05).结论 心理应激可能在TMD形成过程中起着重要作用.  相似文献   

4.
徐建萍  张丙芳  邱建华  吴昌归 《医学争鸣》2005,26(15):1411-1413
目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者血清瘦素水平及其与胰岛素抵抗(IR)的关系.方法:测量研究对象的身高、体质量,行多导睡眠图(PSG)检查.根据睡眠呼吸暂停低通气指数(AHI)和体块指数(BMI)将研究对象分为四组:A组肥胖OSAS患者16例(BMI≥27,AHI≥5);B组非肥胖OSAS患者10例(BMI<25,AHI≥5);C组单纯肥胖10例(BMI≥27,AHI<5);D组对照10例(BMI<25,AHI<5).瘦素及胰岛素测定采用放免法,血糖采用葡萄糖氧化酶法.结果:①A,B,C三组空腹胰岛素水平分别为(15.6±3.6),(11.7±2.3),(11.3±2.5)mU/L,均较D组(9.1±1.8)mU/L升高(P<0.01),且A组胰岛素也显著高于B,C组(P<0.01);②A,B,C三组瘦素水平分别为(6.6±1.4),(4.7±0.9),(4.2±0.7)μg/L均较D组(3.4±1.0)μg/L非常显著升高(P<0.05~0.01),且A组瘦素也显著高于B,C(P<0.01);③A,B,C三组稳态模式估计法(HOMA)胰岛素抵抗指数(HOMA-IR)分别为(4.0±1.4),(3.0±0.8),(2.8±0.6),均较D组显著升高(2.1±0.6)(P<0.05~0.01),且A组HOMA-IR也显著高于B,C组(P<0.01);④OSAS患者血清瘦素水平与空腹胰岛素水平,BMI,HOMA-IR正相关,相关系数分别为:0.4074(P<0.05),0.7543(P<0.01),0.4312(P<0.05),0.4352(P<0.05).结论:OSAS患者血清瘦素水平及HOMA胰岛素敏感指数明显高于单纯肥胖组及对照组,OSAS患者体内瘦素水平可能与其IR有关.  相似文献   

5.
目的 探讨替米沙坦对胰岛素抵抗大鼠胰岛素敏感性的影响及其机制.方法 选择30只雄性SD大鼠,将大鼠随机分为对照组(10只)和高脂组(20只),对照组给予常规饲料喂养,高脂组用高脂饲料喂养8周制备胰岛素抵抗模型.8周后再将成模大鼠随机分为模型组和干预组.干预组大鼠给予替米沙坦5 mg·kg-1·d-1灌胃6周.测定3组大鼠血糖等血清指标及内脏脂肪组织脂联素、肿瘤坏死因子-α(TNF-α)的表达水平,用胰岛素敏感指数(ISI)评价胰岛素抵抗.结果 模型制备成功后,模型组和干预组大鼠空腹胰岛素水平[(30.1±3.6)mU/L和(30.3±3.5)mU/L]及ISI[(-5.14±0.35)和(-5.15±0.28)]与对照组[分别为(14.5±2.1)mU/L和(-4.35±0.27)]比较,差异均有统计学意义(P<0.05).替米沙坦干预6周后干预组大鼠空腹胰岛素水平[(23.3±2.9)mU/L]及ISI(-4.86±0.30)与模型组[分别为(33.1±3.6)mU/L和(-5.28±0.30)]比较,差异有统计学意义(P<0.05).干预组大鼠TNF-α及脂联素表达水平与模型组比较,差异均有统计学意义(P<0.01).结论 替米沙坦能提高内脏脂肪组织脂联素水平,降低TNF-α表达,提高胰岛素的敏感性.  相似文献   

6.
目的分析正常孕妇妊娠期甲状腺功能的变化。方法选取2012年1月至2014年12月在香河县人民医院产科就诊的正常孕妇妊娠早期400例为A组、妊娠中期440例为B组,妊娠晚期370例为C组,同期选取非妊娠妇女410例为对照组。采用化学发光免疫法检测4组妇女的甲状腺激素和甲状腺自身抗体。分析妊娠期甲状腺功能的变化特点,测定正常孕妇妊娠期血清促甲状腺激素(TSH)、游离甲状腺素(FT_4)和游离三碘甲状腺原氨酸(FT_3)的参考范围,探讨妊娠期甲状腺功能异常的患病率。结果 A组、B组、C组TSH和FT_4水平显著低于对照组[(1.18±0.45)mU/L、(1.63±0.32)mU/L、(2.35±0.59)mU/L比(3.03±0.84)mU/L;(15.6±1.6)pmol/L、(15.0±1.3)pmol/L、(12.6±1.1)pmol/L比(17.3±1.6)pmol/L],差异有统计学意义(P<0.05)。A组FT_3水平与对照组比较差异无统计学意义[(4.92±0.41)pmol/L比(4.97±0.43)pmol/L](P>0.05)。B组、C组FT_3水平显著低于对照组[(4.71±0.35)pmol/L、(3.85±0.24)pmol/L比(4.97±0.43)pmol/L](P<0.05)。正常妊娠期妇女妊娠早、中、晚期血清TSH的参考值分别为0.03~3.73 mU/L、0.10~3.85 mU/L、0.35~4.76 mU/L,血清FT_4的参考值分别为11.24~20.13 pmol/L、10.06~17.57 pmol/L、9.45~15.26 pmol/L,血清FT_3的参考值分别为3.62~6.01 pmol/L、3.44~5.87 pmol/L、2.85~5.04 pmol/L。妊娠期甲状腺功能异常总患病率为6.78%(82/1210),显著高于对照组2.93%(12/410),差异有统计学意义(P<0.05)。A组、B组、C组发病率显著高于对照组[8.25%(33/400)、6.14%(27/440)、5.95%(22/370)比2.93%(12/410)],差异有统计学意义(P<0.05)。结论妊娠期孕妇甲状腺相关激素受到内分泌变化的影响,与非妊娠期妇女存在较大的差异。  相似文献   

7.
目的:研究子宫胎盘功能不足所致宫内生长迟缓(intrauterine growth retardation,IUGR)大鼠成年期胰岛β细胞功能及外周组织胰岛素敏感性,初步探讨IUGR大鼠发生2型糖尿病的机制.方法:结扎妊娠17 d孕鼠(n=14)双侧子宫动脉(uterine artery ligation,UAL)建立IUGR大鼠模型,对照组(n=8)行平行开腹术.以UAL组新生鼠出生体重低于对照组均值的2个标准差为IUGR.选取两组子代成年雄鼠为研究对象进行葡萄糖耐量实验和高胰岛素正常血糖钳夹实验,计算胰岛β细胞功能指数(modified beta-cell function index,MBCI)和稳态葡萄糖输注率(glucose intake rate,GIR),对大鼠胰岛β细胞分泌功能及外周组织胰岛素敏感性进行评价.结果:(1)UAL组仔鼠平均出生体重(4.49±0.56)g明显低于对照组仔鼠体重均值(6.16±0.30)g的2个标准差以下,P<0.001;UAL组仔鼠成年后(12周)体重(382±37.51)g已显著超过对照组(339±24.06)g,P<0.01;(2)UAL组雄仔鼠12周时糖耐量实验各时点血糖水平[0 min,(3.96±0.25)mmol/L;30 min,(6.61±0.57)mmol/L;60 min,(7.34±0.47)mmol/L;120 min,(6.27±0.37)mmol/L]明显高于对照组[0 min,(3.56±0.22)mmol/L;30 min,(5.74±0.32)mmol/L;60 min,(5.89±0.29)mmol/L;120 min,(3.89±0.25)mmol/L],P<0.05,糖负荷后胰岛素分泌高峰延迟,120 min胰岛素值(84.65±11.79)mU/L明显高于对照组(50.01±7.43)mU/L,P<0.05;UAL组雄仔鼠MBCI值(26.42±5.59)较对照组(55.88±10.20)明显降低,P<0.001;(3)高胰岛素正常血糖钳夹实验结果示UAL组雄仔鼠GIR值[16.86±1.59 mg/(kg·min)]明显低于对照组[20.35±2.38 mg/(kg·min)],P<0.05.结论:子宫胎盘功能不足所致IUGR雄鼠成年期出现肥胖趋势,并发生胰岛细胞功能受损和胰岛素抵抗,是其发生2型糖尿病的危险因素.  相似文献   

8.
目的:研究放射治疗对鼻咽癌患者甲状腺功能的影响.方法:51例伴有颈部淋巴结转移的鼻咽癌患者于放疗前、后进行甲状腺动态显像,获得甲状腺动脉灌注的峰时和反映血流情况的摄取常教K值,并分别测定血清中游离3,5,3'-三碘甲状腺原氨酸(free triodothyronine,FT3),游离3,5,3',5'-四碘甲状腺原氨酸(也称游离甲状腺素,free thyroxine,FT4)和促甲状腺激素(thyroid stimulating hormone,TSH)的水平.结果:放疗前左、右两侧甲状腺动脉灌注峰时分别为:(14.5±2.1)s,(15.1±1.9)s,放疗后为(19.3±3.2)s,(20.2±3.5)s,放疗后两侧甲状腺峰时明显延迟(均P<0.001).放疗前左、右两侧甲状腺摄取常数K值分别为:0.0265±0.0074,0.0249±0.0065,放疗后为0.0173±0.0062,0.0167±0.0053,放疗后两侧甲状腺摄取常数明显降低(均P<0.001).放疗前FT3明显高于放疗后[(4.76±0.95)pmol/L vs.(3.85±0.71)pmol/L,P<0.001];放疗前FT4明显高于放疗后[(18.63±3.84)pmol/L vs.(15.69±3.27)pmol/L,P<0.001];放疗前后TSH比较无统计学差异(1.17±0.52)mU/L vs.(1.22±0.76)mU/L,P>0.05].结论:放射治疗对鼻咽癌患者甲状腺的动脉峰时、血流灌注均有损伤,放疗后血清FT3和FT4降低,但TSH无明显变化.  相似文献   

9.
目的 探讨肺源性心脏病(简称肺心病)心力衰竭患者血清甲状腺激素水平的变化及其临床意义.方法 用放射免疫法测定82例肺心病心力衰竭患者和75名正常人血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离T3(FT3)、游离T4(FT4)、促甲状腺激素(TSH).结果 轻度肺心病心力衰竭患者T3 (1.01±0.21) nmol/L、T4 (89.92±22.01) nmol/L、FT3(2.80±0.30) pmol/L、FT4(11.39±2.99)pmol/L、TSH(1.44±0.38)mU/L与对照组T3(1.05±0.20)nmol/L、T4(90.01±21.38)nmol/L、FT3(2.81±0.28)pmol/L、FT4(11.42±2.71)pmol/L、TSH(1.40±0.40)mU/L比较差异均无统计学意义(t=0.84、0.017、0.14、0.045、0.42,均P>0.05).重度肺心病心力衰竭患者T3(0.61±0.19)nmol/L与对照组比较明显降低(t=8.83,P<0.05),T4(88.97±21.20)nmol/L、FT3(2.76±0.32)pmol/L、FT4(11.27±2.76)pmol/L、TSH(1.39±0.39)mU/L与轻度肺心病患者比较差异均无统计学意义(t=0.14、0.46、0.13、0.42,均P<0.05),治疗后心力衰竭减轻时T3(1.02±0.28)nmol/L明显升高(t=5.34,P<0.05).结论 血清T3水平的改变对判断肺心病心力衰竭患者的预后、严重程度和疗效有一定的指导意义.  相似文献   

10.
Bao YQ  Jia WP  Zhu M  Lu JX  Chen L  Xiang KS 《中华医学杂志》2004,84(21):1781-1784
目的 应用高葡萄糖钳夹技术探讨糖耐量异常 (IGT)及糖尿病 (DM )个体胰岛素分泌功能的改变 ,以及与超重 /肥胖 (OW /OB)的关系。方法 根据糖耐量情况将上海地区 6 4例受试者分为正常糖耐量 (NGT)组、IGT组及DM组 ;再以体重指数 2 5kg/m2 为切割点 ,把不同糖耐量的受试者分成 6个组 :正常体重 (NW )NGT(NW NGT)组、NW IGT组、NW DM组、OW /OB NGT组、OW /OB IGT组、及OW /OB DM组。应用高葡萄糖钳夹技术研究IGT及DM个体各时相胰岛素分泌指数。结果  (1)IGT及DM个体胰岛素分泌形态的变化表现 :第一时相胰岛素分泌进行性降低 (IGT 186mU/L± 38mU/L ,DM 71mU/L± 10mU/L ,P <0 0 5 ) ;第二时相胰岛素分泌明显减退 (IGT 70mU/L± 14mU/L ,DM 32mU/L± 4mU/L ,P <0 0 5 )。 (2 )NW IGT及NW DM者 ,第一时相 (NW IGT16 4mU/L± 4 7mU/L ,NW DM 6 1mU/L± 17mU/L)、第二时相 (NW IGT 4 4mU/L± 18mU/L ,NW DM 2 6mU/L± 5mU/L)及最大胰岛素分泌功能 (NW IGT 5 3mU/L± 2 1mU/L ,NW DM 34mU/L± 6mU/L)均显著减退 (P <0 .0 5 )。 (3)单纯OW /OB个体第一、第二时相胰岛素分泌指数及最大胰岛素分泌量显著高于NW NGT者 (分别为 5 4 6mU/L± 6 2mU/L、138mU/L± 18mU/L、16 3mU/L± 2 4mU/L ,P <0 0 5 ) ,OW /O  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

14.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

15.
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.  相似文献   

16.
Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.  相似文献   

17.
INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5  相似文献   

18.
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.  相似文献   

19.
Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.  相似文献   

20.
In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.  相似文献   

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