自拟活血通络止痛汤加减治疗带状疱疹后遗肋间神经痛的临床观察

目的：观察自拟活血通络止痛汤加减治疗带状疱疹后遗肋间神经痛（PHN）的疗效。方法将84例 PHN患者随机分为观察组及对照组,两组各42例。对照组给予内服维生素 B1、盐酸多塞平片、甲钴胺片加外用1%双氯芬酸钠乳剂等常规治疗,观察组在常规治疗的基础上给予自拟活血通络止痛汤加减治疗。比较治疗后1周、2周、4周的数字疼痛评分量表（NRS）、皮肤病生活质量指数评分（DLQI）、匹兹堡睡眠质量评分（PSQI）及抑郁评分（SDS 评分）,同时比较24 h 疼痛持续时间及24 h 总睡眠时间、疼痛缓解有效率。结果治疗后1周、2周、4周,两组的 NRS 评分、DLQI 评分、PSQI 评分及 SDS 评分均较治疗前降低（ P <0.05）,观察组各项评分均低于对照组（ P <0.05）;治疗后各时间点观察组的24 h 疼痛持续时间明显少于对照组（ P <0.05）,而24 h 总睡眠时间长于对照组（ P <0.05）;治疗后各时间点观察组的疼痛缓解有效率明显高于对照组（ P <0.05）。结论自拟活血通络止痛汤加减治疗带状疱疹后遗肋间神经痛的临床效果显著,能够明显改善患者的疼痛及抑郁症状,提高生活质量,可取的满意的综合疗效。     

Immunology of Helicobacter pylori: insights into the failure of the immune response and perspectives on vaccine studies

Helicobacter pylori infects the stomach of half of the human population worldwide and causes chronic active gastritis, which can lead to peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The host immune response to the infection is ineffective, because the bacterium persists and the inflammation continues for decades. Bacterial activation of epithelial cells, dendritic cells, monocytes, macrophages, and neutrophils leads to a T helper cell 1 type of adaptive response, but this remains inadequate. The host inflammatory response has a key functional role in disrupting acid homeostasis, which impacts directly on the colonization patterns of H pylori and thus the extent of gastritis. Many potential mechanisms for the failure of the host response have been postulated, and these include apoptosis of epithelial cells and macrophages, inadequate effector functions of macrophages and dendritic cells, VacA inhibition of T-cell function, and suppressive effects of regulatory T cells. Because of the extent of the disease burden, many strategies for prophylactic or therapeutic vaccines have been investigated. The goal of enhancing the host's ability to generate protective immunity has met with some success in animal models, but the efficacy of potential vaccines in humans remains to be demonstrated. Aspects of H pylori immunopathogenesis are reviewed and perspectives on the failure of the host immune response are discussed. Understanding the mechanisms of immune evasion could lead to new opportunities for enhancing eradication and prevention of infection and associated disease.     

Augmented glucose-induced insulin release in mice lacking G(o2), but not G(o1) or G(i) proteins

Insulin secretion by pancreatic β cells is a complex and highly regulated process. Disruption of this process can lead to diabetes mellitus. One of the various pathways involved in the regulation of insulin secretion is the activation of heterotrimeric G proteins. Bordetella pertussis toxin (PTX) promotes insulin secretion, suggesting the involvement of one or more of three G(i) and/or two G(o) proteins as suppressors of insulin secretion from β cells. However, neither the mechanism of this inhibitory modulation of insulin secretion nor the identity of the G(i/o) proteins involved has been elucidated. Here we show that one of the two splice variants of G(o), G(o2), is a key player in the control of glucose-induced insulin secretion by β cells. Mice lacking G(o2)α, but not those lacking α subunits of either G(o1) or any G(i) proteins, handle glucose loads more efficiently than wild-type (WT) mice, and do so by increased glucose-induced insulin secretion. We thus provide unique genetic evidence that the G(o2) protein is a transducer in an inhibitory pathway that prevents damaging oversecretion of insulin.     

三黄泻心汤组分配伍方的图谱表征及活血化瘀优势方的成分分析

目的 对9个三黄泻心汤成分配伍方进行特征图谱表征,并对活血化瘀作用优势方进行成分分析.方法 采用高效液相色谱法,Agilent C18柱,乙腈-1％甲酸梯度洗脱,检测波长280 nm,柱温30℃,对三黄泻心汤成分配伍方进行特征图谱分析,并对活血化瘀优势方进行配伍成分的含量测定.结果 9个三黄泻心汤组分配伍方特征图谱中均包含24个特征峰,以化学对照品为对照归属了其中的9个色谱峰.并对活血化瘀优势组分配伍方(组方7)进行了成分分析,该方中黄芩苷、蒽醌苷、蒽醌苷元及盐酸小檗碱的含量比例约为2.8∶ 1.7∶ 1.6∶1.0.结论 所建立的三黄泻心汤组分配伍方特征图谱及含量测定方法稳定可靠,可用于组分配伍方的质量控制.同时,基于三黄泻心汤的活血化瘀组分配伍优势方的成分分析也为进一步揭示组分配伍与其功效的相关性奠定了基础.     

中西医结合治疗系统性红斑狼疮临床研究

目的:观察中西结合治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床疗效。方法:52例SLE患者随机分成治疗组和对照组,每组各26例。对照组治疗以激素、免疫抑制剂为主,治疗组在对照组治疗的基础上加用活血化瘀中药,两组连续治疗6个月后进行疗效对比观察。结果:治疗6月后,两组SLE病情活动指数(SLE disease activity index,SLEDAI)积分较治疗前降低,且治疗组积分(3.62±2.02)低于对照组(6.42±2.19),差异有显著性(P<0.05);治疗后治疗组强的松平均每日维持量为(10.69±4.91)mg,撤减量优于对照组(19.16±7.06)mg,差异有显著性(P<0.05);SLE血瘀证症状有明显改善(P<0.05)。结论:中西医结合疗法可改善SLE血瘀证症状,提高临床疗效。     

中西医结合治疗对糖尿病患者血管内皮功能的影响

目的:观察中西医结合治疗糖尿病患者的临床疗效,及其对患者血管内皮功能的影响。方法:将58例糖尿病患者采取随机数字法平均分成对照组和治疗组。对照组给予西医常规治疗,治疗组在对照组用药的基础上,给予口服益气养阴通络方治疗。两组均4周为1个疗程,连续治疗3个疗程。观察两组治疗前后临床症状、空腹血糖(fasting blood-glucose,FBG)、糖化血红蛋白、胰岛素、胰岛素抵抗指数、NO、内皮素-1(endothelin-1,ET-1)和血管内皮生长因子(vascular endothelial growth factor,VEGF)的变化。结果:1对照组、治疗组有效率为72.4%和86.2%,两组有效率比较,差异有统计学意义(P<0.05);2治疗后治疗组中医证候积分明显降低(P<0.01),对照组改变不显著,两组间比较,差异有统计学意义(P<0.01);3治疗后两组血FPG、GHB、胰岛素、胰岛素抵抗指数较治疗前明显下降(P<0.01),以治疗组改善更为显著(P<0.05或P<0.01);4治疗后两组NO升高、ET-1、VEGF降低(P<0.01),以治疗组改善更为显著(P<0.05)。结论:中西医结合治疗糖尿病疗效显著,能明显改善患者的临床症状,调节血管内皮功能,对防治糖尿病心血管病变具有一定作用。     

刘敬霞教授治疗缺血性卒中

刘敬霞教授治疗缺血性卒中的学术思想,主要体现在临床中重视整体观念及辨证论治,坚持辨体—辨病—辨证相结合的诊疗思路.指出“虚”是缺血性卒中发生的始动因素,“瘀”“痰”“毒”“风”相互胶结为继发因素,贯穿疾病发展的始终.在治疗中遵循益气活血、祛风涤痰、解毒开窍等治疗原则,在用药中尤重视生黄芪、炙黄芪、炒白术、当归、三七、生地黄、葛根、醋柴胡等.在用药的特点上,用药轻灵与质重并举,旨在升清、降浊共存,重用补虚药,并善用祛风药、对药及藤类药.     

血尿冲剂治疗慢性肾小球源性血尿

目的 观察血尿冲剂治疗肾小球源性血尿(肾性血尿)的疗效.方法 对40例确诊为肾性血尿的患者采用血尿冲剂(穿山甲粉、琥珀粉、花蕊石粉等)治疗,8周为1个疗程,比较治疗前后尿常规指标变化和尿常规各项指标的动态变化.结果 治疗1个疗程后,临床控制27例(67.5％),显效6例(15％),有效5例(12.5％),无效2例(5％),总有效率95％,对蛋白尿有一定的改善.结论 血尿冲剂治疗肾性血尿,能活血通络,化瘀止血,使瘀血祛,经络通,出血止,血尿愈,对尿蛋白亦有一定的改善.     

输卵管性不孕症的临床治疗

对于输卵管性不孕症,西医手术治疗的认可度在广大患者中不断提升,常见有输卵管通液、宫腔镜及腹腔镜等手术方法,新兴的介入治疗及辅助生殖技术亦逐渐走向成熟.中医则有内治、外治及其他等多途径疗法,可达到通络止痛,化瘀消炎的效果,可解决输卵管阻塞及因输卵管黏连而影响拾夺卵子及孕卵运行的功能,改善盆腔受孕的内环境.中西医结合治疗,可取长补短,发挥更大疗效,消除不良反应.