捏脊疗法对脾虚证家兔血清胃动素的影响

目的观察捏脊疗法对脾虚证家兔血清胃动素（motilin,MOT）的影响。方法采用腹肌注射利血平法制作家兔脾虚证模型。将32只家兔随机分为空白组、模型组、捏脊组与四君子汤组,每组8只,空白及模型组予胃管灌喂蒸馏水,捏脊组予捏脊疗法,四君子汤组予胃管灌喂四君子汤处理。采用放免分析法测定血清MOT的含量。结果造模后家兔血清MOT的含量均明显升高,与空白组比较有统计学意义（P〈0．01）;治疗后,捏脊组与四君子汤组家兔血清MOT的含量明显降低,与模型组比较有统计学意义（P〈0．05）,两组之间比较,差异无统计学意义（P〉0．05）。结论捏脊疗法与四君子汤均可使脾虚证家兔血清MOT含量明显降低而发挥治疗作用,且作用相当;考虑小儿服药不便,小儿脾虚证可选择捏脊疗法治疗。     

调肝运脾汤治疗腹泻型肠易激综合征的实验研究

目的?观察调肝运脾汤对腹泻型肠易激综合征（DIBS）大鼠模型体质量、小肠推进率、部分脑肠肽含量的影响。方法?采用番泻叶煎剂灌胃及夹尾刺激建立腹泻型IBS大鼠模型,实验设空白组、模型组、调肝运脾汤高、中、低剂量组、得舒特组,实验结束后测小肠推进率、结肠组织和血清5羟色胺（5HT）含量、结肠组织P物质（SP）、血管活性肽（VIP）含量。结果?调肝运脾汤可明显改善由番泻叶引起的动物腹泻症状,使动物体质量增长,减缓小肠推进率;可明显降低血清和组织中5HT含量,降低组织中SP、VIP含量,与模型组比较,差异显著（P＜0.05,P＜0.01）;模型组大鼠血清5HT含量及结肠5HT、SP、VIP含量呈上升趋势,与空白组比较有显著差异（P＜0.05,P＜0.01）。结论?调肝运脾汤可能通过降低血清5HT含量及结肠组织5HT、VIP、SP含量,从而改善胃肠动力,发挥治疗肠易激综合征的效应。      

慢性应激大鼠肝郁脾虚证水通道蛋白的表达

目的:观测水通道蛋白在慢性应激肝郁脾虚证模型大鼠胃肠黏膜中的表达。方法:30只大鼠随机分为正常组、模型组及逍遥丸组,采用慢性应激加过度疲劳及饮食失节法复制大鼠肝郁脾虚证模型。采用免疫组化法检测各组大鼠胃肠黏膜组织中AQP3、AQP8的表达。结果:1胃肠黏膜AQP3:与正常组比较,模型组大鼠胃、小肠、结肠黏膜中AQP3表达均显著降低(P0.01);与模型组比较,逍遥丸组胃、小肠、结肠黏膜中AQP3表达均上调(P0.05,P0.01)。2胃肠黏膜AQP8:与正常组比较,模型组大鼠胃、小肠、结肠黏膜中AQP8表达均显著降低(P0.01);与模型组比较,逍遥丸组胃、小肠、结肠黏膜中AQP8表达上调(P0.05,P0.01)。结论:抑郁症肝郁脾虚模型大鼠胃肠黏膜组织中AQPs的表达出现异常。     

艾灸对腹泻型肠易激综合征模型大鼠结肠及下丘脑组织中P物质、血管活性肠肽表达的影响

目的 观察艾灸对腹泻型肠易激综合征(IBS-D)模型大鼠结肠及下丘脑组织中P物质(SP)、血管活性肠肽(VIP)表达的影响。方法 将36只SPF级健康SD雄性大鼠采用随机数字表法分为空白组、模型组、艾灸组3组,每组12只。除空白组外,艾灸组和模型组大鼠采用慢性束缚联合番泻叶溶液灌胃的方法制备IBS-D模型。艾灸组采用艾条温和灸干预治疗,穴位选取两侧天枢和上巨虚,每日灸30 min,连续治疗14 d;空白组和模型组不采取任何干预措施。干预结束后,采集各组大鼠的结肠及下丘脑组织,采用反转录聚合酶链反应(RT-PCR)法检测结肠及下丘脑组织中的SP、VIP的相对表达量;于造模结束后和干预结束后分别计算各组大鼠当日的稀便率,并进行比较。结果 与空白组比较,模型组大鼠结肠及下丘脑组织中的SP、VIP相对表达量均明显升高,差异有统计学意义(P0.01);与模型组比较,艾灸组大鼠结肠及下丘脑组织中的SP、VIP相对表达量均明显降低,差异有统计学意义(P0.01)。干预后,与模型组比较,艾灸组大鼠稀便率明显下降,差异有统计学意义(P0.01)。结论 艾灸天枢、上巨虚穴可降低IBS-D模型大鼠结肠及下丘脑组织中的SP、VIP表达水平,从而延缓痛觉传递、减轻炎症反应、调节胃肠功能紊乱,这可能是艾灸治疗IBS-D的作用机制之一。     

捏脊疗法对脾气虚证兔血清D-木糖的影响

目的 观察捏脊疗法对脾气虚证兔血清D-木糖(D-xylose)的影响.方法 采用腹肌注射利血平法制作兔脾气虚证模型.将32只兔随机分为空白组、模型组、捏脊组与四君子汤组,每组8只,空白及模型组予胃管灌喂蒸馏水,捏脊组予捏脊疗法,四君子汤组予胃管灌喂四君子汤药液.采用间苯三酚显色法测定血清D-木糖的含量.结果 造模后兔血清D-未糖的含量均明显降低,与空白组比较差异有统计学意义(P＜0.01);治疗后,捏脊组与四君子汤组兔血清D-木糖的含量均明显升高,与模型组比较差异均有统计学意义(P＜0.05),捏脊组与四君子汤组之间比较,差异无统计学意义(P＞0.05).结论 捏脊疗法可使脾气虚证兔血清D-木糖含量明显升高,且与四君子汤的作用相当.     

人参水提物对脾虚小鼠胃肠动力和血清Ghrelin的影响

目的探讨人参水提部位对脾虚小鼠胃肠动力和血清Ghrelin等胃肠激素水平的影响。方法雄性昆明小鼠40只,随机分成空白对照组、模型组、西沙必利组和人参水提物组,每组10只。除空白对照组外,其他3组小鼠连续灌胃大黄水煎剂7 d,制备脾虚病理模型。空白对照组和模型组分别灌胃给予生理盐水0.2 mL/d,西沙必利0.5 mg/(kg·d),人参水提液2.5 g/(kg·d),连续给药6 d。以葡聚糖蓝(BD)作为标记物,观察受试药物对胃内色素相对残留率及小肠推进率的影响;同时应用ELISA法检测血清胃动素(MTL)和Ghrelin的水平。结果与空白组相比,脾虚模型组小鼠胃肠动力显著下降(P 0.01),血清胃动素(MTL)和Ghrelin水平均下降(P 0.05,P 0.01);与模型组比较,西沙必利组和人参水提物组小鼠胃内色素相对残留率显著减少(P 0.01),小肠推进率显著增加(P 0.01),西沙必利组小鼠血清胃动素(MTL)和Ghrelin显著增加(P 0.01),人参水提物组小鼠血清Ghrelin显著增加(P 0.01),而胃动素(MTL)水平无明显变化。结论人参水提物能够通过调节胃肠激素Ghrelin而改善脾虚小鼠胃肠动力不足。     

香砂六君颗粒对脾虚大鼠胃肠动力和胃肠激素的影响

目的:通过动物实验观察香砂六君颗粒对脾虚大鼠胃肠动力和胃肠激素的影响,以探讨该药治疗脾虚胃病的机制.方法:用利血平注射液股四头肌注射复制脾虚大鼠模型,随机分为香砂六君颗粒高剂量组(A组)、中剂量组(B组)、低剂量组(C组)、香砂六君丸组(D组)、自然恢复组(E组),进行相应治疗,疗程结束后用葡聚糖蓝2000(BD2000)标记胃肠测量胃残留率和小肠推进比,同时下腔静脉采血放免法测胃泌素(GAS)、胃动素(MTL)、生长抑素(SS).结果:与健康对照组(F组)比较,E组胃残留率增加,小肠推进比升高,MTL、GAS降低,SS升高(P＜0.01).与E组比较,A、B两组胃残留率降低(P＜0.01),小肠推进比降低(P＜.01),MTL升高(P＜0.01),GAS升高(P＜0.01),SS降低(P＜0.01);C组胃残留率降低(P＜0.05),小肠推进比降低(P＜0.01),MTL升高(P＜0.05),GAS升高(P＜0.05),SS降低(P＜0.01);D组胃残留率降低(P＜0.05),小肠推进比降低(P＜0.01),MTL、GAS升高(P＜0.05),SS降低(P＜0.05).与C组比较,A组胃残留率、小肠推进比降低,MTL、GAS升高,SS降低(P＜0.01).与B组比较,D组胃残留率升高(P＜0.05),小肠推进比升高(P＜0.01),MTL、GAS降低,SS升高(P＜0.05).A组与F组比较各项指标均无显著性差异.结论:香砂六君颗粒可提高脾虚大鼠血浆胃动素和血清胃泌素水平,降低血浆生长抑素水平,促进胃排空,延缓小肠推进,其作用优于香砂六君丸,并具有剂量依赖性,其对胃肠动力的调节作用可能是通过影响血液中胃肠激素水平实现的.     

新安固本培元方对脾虚型溃疡性结肠炎大鼠细胞因子的影响

目的:观察固本培元方对脾虚型溃疡性结肠炎大鼠模型细胞因子的影响。方法:将60只大鼠随机分为空白组、模型组、SASP组(柳氮磺吡啶组)、固本培元方高、中、低剂量组6组,每组10只。除空白组外其余大鼠用番泻叶与冰乙酸造模,SASP组予以柳氮磺吡啶灌胃,高、中、低剂量组给予新安固本培元方煎剂灌胃,空白组及模型组灌服等量生理盐水。观察各组大鼠症状、体征,计算结肠黏膜形态损伤评分,检测血清IL-6、IL-8、IL-10及TNF-α的浓度。结果:模型组大鼠血清IL-6、IL-8及TNF-α的浓度及结肠黏膜形态损伤评分较空白组明显升高,IL-10含量显著降低(P0.01);与模型组比较,SASP组、高、中、低剂量组血清IL-6、IL-8及TNF-α的浓度及结肠黏膜形态损伤评分均明显下降(P0.01),且高剂量组降低TNF-α、减轻结肠黏膜损伤的效果优于中、低剂量组(P0.05)。结论:新安固本培元方对脾虚型大鼠溃疡性结肠炎有较好的治疗作用,适合在临床上应用和推广。     

苍术提取物调节脾虚证大鼠胃肠动力障碍的作用机制研究

目的 观察苍术提取物对实验性脾虚证大鼠胃肠动力的影响,探讨苍术提取物调节胃肠动力的作用机制.方法 将雄性SD大鼠随机分为正常组、模型组、多潘立酮组和苍术提取物高、中、低剂量组.除正常组外,其余各组喂饲小承气汤煎剂加饥饱失常建立脾虚证大鼠模型,造模时间15 d.造模结束后,苍术提取物低、中、高剂量组分别灌胃5、10、20 g/kg的中药煎剂2mL,多潘立酮组灌胃5 mg/kg的多潘立酮混悬溶液2mL,正常组及模型组则灌胃生理盐水2mL,1次/d,持续灌胃10 d.10 d后所有大鼠均用炭末灌胃法行大鼠胃内残留率、小肠推进率的测定,腹主动脉采血用放射免疫法检测血浆胃动素(MTL)、P物质(SP)、生长抑素(SS)含量,比色法测定大鼠空肠上皮细胞三磷酸腺苷(ATP)的含量,免疫组化法测定大鼠胃窦平滑肌细胞内肌球蛋白轻链激酶(MLCK)及结肠组织中c-kit表达量.结果 与模型组比较,正常组、多潘立酮组和苍术提取物高、中、低剂量组的胃内残留率明显下降、小肠推进率明显升高,而大鼠血浆MTL、SP和SS含量不同程度升高,差异均有统计学意义(P＜0.05或P ＜0.01);与模型组比较,正常组、多潘立酮组和苍术提取物高、中、低剂量组大鼠空肠上皮细胞ATP的含量及胃窦平滑肌细胞内MLCK和结肠组织中c-kit的表达量不同程度升高,差异均有统计学意义(P＜0.05或P＜0.01).结论 苍术提取物可从不同方面整体改善由于脾虚导致的大鼠胃肠功能障碍,对因脾虚导致的胃肠功能紊乱有较好的调节和治疗作用.     

小承气汤、厚朴三物汤、厚朴大黄汤对阳明腑实证模型大鼠胃肠动力的影响

【目的】观察小承气汤、厚朴三物汤、厚朴大黄汤对阳明腑实证模型大鼠胃肠动力的影响。【方法】复制大鼠阳明腑实证模型。将110只大鼠随机分为空白组,模型组,厚朴三物汤高、中、低剂量治疗组,厚朴大黄汤高、中、低剂量治疗组,小承气汤高、中、低剂量治疗组。采用间苯三酚法测定大鼠血清D-木糖含量,采用酶联免疫吸附分析(ELISA)检测大鼠血清P物质(SP)含量变化,采用葡聚糖蓝-2000灌胃法测定小肠推进率,采用苏木素—伊红(HE)染色法观察各组空肠组织病理变化。【结果】模型组血清D-木糖、SP含量及小肠推进率低于空白组(P0.05);用药后各治疗组血清D-木糖、SP含量及小肠推进率显著升高(P0.05),其中以厚朴三物汤效果最好。厚朴大黄汤组及小承气汤组Cajal间质细胞(ICC)数量及结构可见明显减少及破坏,而厚朴三物汤组与空白组相似,细胞数量及结构未见明显减少及破坏。【结论】小承气汤、厚朴三物汤、厚朴大黄汤3方均有促进阳明腑实证模型大鼠胃肠动力的作用,其中厚朴三物汤效果更好。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…