从形气神谈溃疡性结肠炎的中西医认识

溃疡性结肠炎(Ulcerative colitis,UC)是一种病情反复、迁延难愈的炎症肠病,已被世界卫生组织列为现代难治病之一[1]。本病病因及发病机制尚不明确,西药治疗效果欠佳。近年来中医药的介入,临床取得显著疗效。西医学认为疾病是机体在一定致病因素的作用下自稳调节紊乱,经过机体内损伤和抗损伤反应的相互斗争,表现出的一系列功能。     

论“天地合气”观与《内经》理论的建构

《内经》中虽对构成人体五脏六腑及其所需精微物质进行了理论阐释,但从"天地合气"的思想出发能更好地理解构成人体的五脏六腑和所需精微物质,如气、血、精、津液以及五运六气的由来。本文主要从上述几个方面予以阐释,以期能深刻领悟到天、地、人三才模式的整体思想。     

贵州省地方性氟中毒地区人群GSTP1基因Ile105Val位点多态性分析

Objective To investigate plasma glutathione S-transferase(GSTs) activity and GSTP1 gene Ile105Val polymorphism in Bijie City, Guizhou Province, a coal-burning fluorosis endemic area. Methods One hundred and sixty villagers from Yachi Twon using non-improved cooking stoves were selected as the non-intervened group in Bijie City, Guizhou Province where coal-burning fluorosis was prevailing; 153 villagers as the intervented group were chosen from Changchun Twon, where cooking stoves were improved; 151 villagers were served as the control group from Baiyunshan Twon, Changshun County without endemic fluorosis. The activity of GSTs was tested by colorimetric analysis with spectrophotometer. The genotype of the GSTP1 gene Ile105Val polymorphism, presenting as either homozygous wild-type (AA), or heterozygous mutation type (AG), or homozygous mutation type (GG), was detected through the PCR-RFLP procedure. Results The activity of GSTs in plasma of non-intervened group [(12.44±4.97) kU/L]was significantly lower than that of intervened group (P < 0.05), and that of intervened group[(20.78±6.20)kU/L]was significantly lower than that of control group[(24.30±6.27)kU/L, P< 0.05]. The difference of the enzyme activity of three groups were statistically significant (F = 51.71, P < 0.05), but this enzyme activity did not vary significantly in each sex of each grnup(P > 0.05). Compared intervened group [AA:67.3%(103/153), AG:29.4%(45/153),GG:3.3%(5/153)]and non-intervened group[AA:66.9%(107/160), AG:30%(48/160), GG:3.1%(5/160)]with control group[AA:74.8%(113/151), AG:25.2%(38/151), GG:0 (0/151)], the Ile105Val polymorphism site of GSTP1 gene had significant difference(χ2= 6.04,6.07, both P< 0.05), but not significant between intervened and non-intervened groups(χ2 = 0.02, P>0.05). Conclusions Fluorosis can decrease the activity of GSTs and introduce the GSTP1 gene Ile105Val polymorphism, intervention with the fluorine intake will improve the effect of fluoride on the body.     

贵州省地方性氟中毒地区人群GSTP1基因Ile105Val位点多态性分析

Objective To investigate plasma glutathione S-transferase(GSTs) activity and GSTP1 gene Ile105Val polymorphism in Bijie City, Guizhou Province, a coal-burning fluorosis endemic area. Methods One hundred and sixty villagers from Yachi Twon using non-improved cooking stoves were selected as the non-intervened group in Bijie City, Guizhou Province where coal-burning fluorosis was prevailing; 153 villagers as the intervented group were chosen from Changchun Twon, where cooking stoves were improved; 151 villagers were served as the control group from Baiyunshan Twon, Changshun County without endemic fluorosis. The activity of GSTs was tested by colorimetric analysis with spectrophotometer. The genotype of the GSTP1 gene Ile105Val polymorphism, presenting as either homozygous wild-type (AA), or heterozygous mutation type (AG), or homozygous mutation type (GG), was detected through the PCR-RFLP procedure. Results The activity of GSTs in plasma of non-intervened group [(12.44±4.97) kU/L]was significantly lower than that of intervened group (P < 0.05), and that of intervened group[(20.78±6.20)kU/L]was significantly lower than that of control group[(24.30±6.27)kU/L, P< 0.05]. The difference of the enzyme activity of three groups were statistically significant (F = 51.71, P < 0.05), but this enzyme activity did not vary significantly in each sex of each grnup(P > 0.05). Compared intervened group [AA:67.3%(103/153), AG:29.4%(45/153),GG:3.3%(5/153)]and non-intervened group[AA:66.9%(107/160), AG:30%(48/160), GG:3.1%(5/160)]with control group[AA:74.8%(113/151), AG:25.2%(38/151), GG:0 (0/151)], the Ile105Val polymorphism site of GSTP1 gene had significant difference(χ2= 6.04,6.07, both P< 0.05), but not significant between intervened and non-intervened groups(χ2 = 0.02, P>0.05). Conclusions Fluorosis can decrease the activity of GSTs and introduce the GSTP1 gene Ile105Val polymorphism, intervention with the fluorine intake will improve the effect of fluoride on the body.     

贵州省鼠疫防治健康教育干预试点效果评估

目的评估贵州省鼠疫疫源乡镇目标人群健康教育干预的效果。方法调查试点乡镇开展鼠疫防治知识宣传教育活动情况,问卷调查目标人群鼠疫防治知识的知晓率和灭鼠行为正确率,了解构建基层疫情报告网络情况和干预后预防性灭鼠的效果。结果干预后,目标人群鼠疫防治和疫情“三报”知识的知晓率,村民为68．14％和83．33％,中小学生为84．13％和81．74％;灭鼠行为正确率,村民为88．73％,中小学生为72．17％;疫情报告率为83．33％、及时率为100％;大面积灭鼠的灭效为77．7％。结论在鼠疫疫源地区实施宣传鼠疫防治、疫情“三报”、科学灭鼠知识和建立基层疫情报告网络等干预措施后,可以增强群众参与鼠疫防治的自觉性和主动性,提高疫情报告的及时性,促进形成正确的灭鼠行为,有利于建立预防控制鼠疫的长效机制。     

贵州省长顺县燃煤污染型地方性氟中毒健康教育处方试点研究

目的探讨健康教育处方在控制燃煤污染型地方性氟中毒(简称地氟病)中的效果和作用。方法采取卫生行政和疾病控制部门协调、对项目乡村干部和医务人员进行相关知识培训、基线调查、确定针对性的健康教育处方内容,并在乡村卫生院(室)实施,实施后随机抽样追踪调查与评估。结果试点研究期间共计开出有效健康教育处方1882人份,作为宣传单自由阅取约4000人份。项目实施后家庭户主知晓率提高近40%,学生知晓率提高约25%,健康教育处方接受者总体知晓率为63.40%,较基线(8.91%)显著提高。干预后炉灶密闭使用率和烟囱出屋率均显著提高。项目乡村居民已全部不用敞煤火干燥玉米,辣椒煤火干燥率显著减少,密闭保存率显著提高。78%的地氟病防治卫生知识知晓人群已向他人讲解传播,47%的人已采取降氟措施。结论地氟病健康教育处方试点工作在促进病区人群自我保健与防护意识、行为改变和形成方面取得初步成效,为深化贵州省地氟病健康教育与健康促进干预研究,探讨地氟病健康教育与健康促进的可持续性发展模式,以及为在全省推广运用提供了基础数据和科学依据。     

贵州省碘缺乏病和地方性氟中毒的地理分布差异及影响因素

研究了贵州碘缺乏病和地方性氟中毒的地理分布及其影响因素。结果发现：贵州外环境缺碘、饮水氟含量低，有较大面积的碘缺乏病和地方性氟中毒流行，前者主要分布在东南部烧柴区，后者主要分布于西北部燃煤区。这种分布与燃料结构和燃烧方式有关。在烧柴区，木柴中碘和氟含量甚低，外环境缺碘和低氟状态没有改变，形成了碘缺乏病区，在燃煤区，煤燃烧释放的碘和氟改善了第一环境的碘不足，避免了碘缺乏病流行，同时环境中过量氟导致地方性氟中毒发生。     

贵州省实施燃煤污染型砷中毒综合防制项目效果评估

目的评价采取综合措施控制贵州省燃煤型地方性砷中毒(地砷病)病区砷污染的效果。方法实施以健康教育为基础,禁止开采高砷煤和改良炉灶为主的综合防治措施后,采取随机抽样的方法对其效果进行评估。结果通过强有力的健康促进,在病区,砷中毒防治知识家喻户晓,深入人心;高砷煤开采得到基本禁止;全部家庭用上了有排烟设施的炉灶,炉灶正确使用率达到90%;家庭玉米和辣椒正确干燥率均达到90%以上;大多数家庭已经养成烹调前淘洗食物的习惯,有效的将煤烟排出室外,基本避免了玉米和辣椒等食物污染,减少了砷的摄入量,机体尿砷排泄显著减少,接近正常人排泄水平。结论在地砷病区实施综合控制措施取得预期成效。     

严重慢性氟中毒对儿童、青少年生长发育的影响

严重的慢性氟中毒,除表现氟斑牙及氟骨症外,是否还可能导致儿童、青小年生长发育障碍,目前国内外报导甚少,尚无定论。为探讨这一问题,我们于1986年对我省地方性氟中毒病区金沙县禹谟区高坪乡联合村儿童、青少年生长发育状况进行了调查,现将调查结果报告于下。一般情况金沙是禹谟区高坪乡联合村地处我省西北部产煤地带:全村总人口764人,海拔1560米左右,以玉米为主食。由于该地区气候较为寒冷、潮湿,当地群众室内烧的敞煤灶常年不熄,并普遍有把收获后的玉米、辣椒等食物常年置于     

贵州南北地区地方性氟中毒病情比较与影响因素初步分析

目的了解贵州西南地区与西北地区燃煤污染型地方性氟中毒（地氟病）病情差异及其影响因素。方法按国家标准调查方法进行。结果西南地区A点海拔1700米,高寒潮湿,年均人收入750元,烘烤玉米食入量约占主食的20%,日人均总摄氟量约8mg,氟骨症检出率55%,无混合型氟骨症患者。西南地区A点海拔1450米,年均人收入400元,烘烤玉米食入量占50%以上,日人均总摄氟量约23mg,氟骨症检出率68.57%,混合型氟骨症检出率为3%,重度和总体氟骨症患者检出率显著高于A点。结论我省西北贫困地区地方性氟中毒的病情较重,除与摄氟量有关外,主要与经济状况、饮食结构等因素有关,此外,地质地理与气候条件也影响病情。