抗抑郁剂治疗幽门螺杆菌阳性的慢性胃炎的临床对照分析

目的 探讨抗抑郁剂对幽门螺杆菌阳性的慢性胃炎的治疗作用。方法 将56例幽门螺杆菌阳性的慢性胃炎分成A、B两组,A组30例予三联治疗,B组26例予抗抑郁剂(米氮平或帕罗西汀)治疗,对A、B两组治疗前与治疗6周时汉密顿抑郁量表(HAMD)总分、不良反应量表(TESS)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)浓度及治疗6周后幽门螺杆菌的未愈率进行测定、对照。结果 两组治疗后HAMD总分、TESS、IL-6、TNF-α均提示差异有显著性,而幽门螺杆菌阳性的慢性胃炎的幽门螺杆菌未愈率两组比较差异无显著性。结论 抗抑郁剂可能是通过改变患者的免疫功能而抑制幽门螺杆菌的生存,可以作为幽门螺杆菌阳性的慢性胃炎有效治疗途径之一。     

克拉霉素治疗儿童幽门螺杆菌阳性慢性胃炎的临床疗效

目的：探讨克拉霉素治疗儿童幽门螺杆菌阳性慢性胃炎的临床疗效与安全性。方法将2010年1月～2012年12月收治的36例幽门螺杆菌阳性的慢性胃炎患儿随机分成对照组和治疗组。对照组患者每日早晨口服奥美拉唑0.5 mg/（kg.d）,连续服用4周;治疗组在对照组治疗的基础上联合克拉霉素1.0 mg/（kg＆#183;d）,2次/d,连续服用4周。观察两组患者治疗前后胃镜检查及幽门螺杆菌根除结果,随访1年患者慢性胃炎复发情况,并进行统计学分析。结果治疗组总有效率和幽门螺杆菌根除率分别为89.47%和94.74%,明显高于对照组的58.82%和76.47%,差异有统计学意义（P＜0.05）;治疗组慢性胃炎复发率为11.76%,明显低于对照组的25.00%,差异有统计学意义（P＜0.05）。在治疗期间,两组患者中仅有部分患者出现腹痛、腹泻、恶心等不良反应,持续时间短且症状轻微,停药后1周内完全消失。两组患者不良反应发生率比较,差异无统计学意义（P＞0.05）。结论克拉霉素治疗幽门螺杆菌阳性的儿童慢性胃炎具有良好的疗效,安全性好。     

大黄黄连泻心汤治疗幽门螺杆菌阳性慢性胃炎的临床观察

目的对大黄黄连泻心汤治疗幽门螺杆菌阳性的慢性胃炎效果进行观察。方法选取本院2008年1月～2011年12月收治的确诊为慢性胃炎的100例患者,随机分为治疗组和对照组,每组各50例,对照组每日口服抗生素,14d为1个疗程,治疗2个疗程。治疗组服用大黄黄连泻心汤,每天1剂,4周为1个疗程。疗程结束后复查胃镜和Hp。结果治疗组在损伤胃黏膜改善情况、临床疗效和HP清除率方面效果明显较对照组好,差异有统计学意义。结论大黄黄连泻心汤在治疗Hp阳性慢性胃炎时既对症又对因,能有效清除和抑制Hp,效果较好。     

中西医联合治疗慢性胃炎幽门螺杆菌感染的临床效果分析

目的探讨采用中西医联合治疗慢性胃炎幽门螺杆菌感染的临床效果并分析,为临床治疗提供参考。方法本次研究选取2013年6月至2015年6月期间收治的236例慢性胃炎幽门螺杆菌感染患者,随机均分为两组,分别命名为对照组(患者118例)和试验组(患者118例)。对照组的患者采用西药雷贝拉唑、左氧氟沙星以及克拉霉素进行治疗,试验组患者在对照组患者的基础上还采用中药清利化浊方同时进行治疗,以2周为1个疗程,对比并分析两组患者幽门螺杆菌的根除率、治疗效果及不良反应,1个月后随访两组患者的复发率。结果两组患者经治疗后,试验组患者的幽门螺杆菌根除率为92.37%明显要高于对照组患者的76.27%,差异明显,有统计学意义(P<0.05);试验组的患者经治疗后其治疗的总有效率为95.76%显著高于对照组86.44%,进行两组患者疗效差异的对比,其差异明显,有统计学意义(P<0.05);治疗后1个月进行随访,试验组患者有5例发生复发,对照组患者有15例发生复发,两组患者复发率方面差异明显,有统计学意义(P<0.05)。结论与单纯采用西药治疗相比,中西医结合治疗慢性胃炎幽门螺杆菌感染的临床疗效更加突出,且复发率低,治疗的安全性高,值得在临床应用。     

不同药物方案治疗幽门螺杆菌阳性慢性胃炎活动期患者的临床疗效及安全性

目的 探讨三联药物、四联药物及序贯药物方案治疗幽门螺杆菌（Hp）阳性慢性胃炎活动期患者的临床疗效及安全性。方法 选取2015年6月至2017年6月河南省南阳医学高等专科学校第一附属医院收治的Hp阳性慢性胃炎活动期患者180例,采用随机数字表法分为A组、B组及C组3组,每组60例,分别采用三联药物、四联药物及序贯药物方案治疗;比较3组患者疼痛缓解率,症状缓解时间、Hp根除率、不良反应发生率,随访12个月,比较3组患者的复发率。结果 C组疼痛缓解率高于A、B组,疼痛和消化道症状缓解时间短于A、B组,Hp根除率高于A、B组,差异均有统计学意义（P<0.05）;C组不良反应发生率低于A、B组,差异有统计学意义（P<0.05）;C组随访6个月和12个月复发率均低于A、B组,差异有统计学意义（P<0.05）。结论 序贯药物方案治疗Hp阳性慢性胃炎活动期能够有效缓解疼痛,促进症状改善,提高Hp根除率,避免远期复发,并有助于降低不良反应发生风险,优于三联和四联药物方案。     

自拟半夏心汤辅助治疗老年幽门螺杆菌阳性慢性胃炎36例

<正>2000-02～2006-04我们用中西医结合治疗老年幽门螺杆菌阳性慢性胃炎36例,并与单用西药治疗作对照。现报告如下:     

慢性胃炎伴幽门螺杆菌感染患者联合治疗疗效分析

目的探讨慢性胃炎伴幽门螺杆菌患者治疗方案,为幽门螺杆菌感染的根除性治疗提供依据。方法将2009年1月～2010年12月至笔者所在门诊的96例慢性胃炎伴幽门螺杆菌感染的患者随机分为治疗组和对照组,分别采用不同的联合治疗方法,观察其疗效。结果两组患者Hp根治率分别为91.67%和56.25%,差异有统计学意义(P<0.05);症状积分评估结果差异有统计学意义(P<0.05)。结论慢性胃炎伴幽门螺杆菌感染患者采用不同的联合用药方式,其疗效不同,且差异显著。     

幽门螺杆菌感染与慢性胃炎的相关性分析

目的 分析幽门螺杆菌(Hp)感染与慢性胃炎(CG)的相关性,以期为慢性胃炎的临床诊断及治疗提供科学参考及理论依据.方法 选取114例CG患者纳入观察组,另选取100例健康体检者纳入对照组.所有受检者均进行胃镜检查及快速尿素酶(RUT)试验.对比两组受检者Hp感染情况,对比观察组中不同类型CG患者的Hp感染情况,分析CG...     

三联疗法与序贯疗法治疗幽门螺杆菌阳性慢性胃炎的对比分析

目的对比分析三联疗法与序贯疗法治疗幽门螺杆菌阳性慢性胃炎临床疗效。方法选取我院96例幽门螺杆菌阳性慢性胃炎患者,随机分为观察组和对照组,观察组给予序贯疗法治疗,对照组给予三联疗法治疗,比较两组疗效,幽门螺杆菌根除率,不良反应发生率。结果观察组幽门螺杆菌根除率明显大于对照组,观察组总有效率明显高于对照组,差异具有统计学意义。不良反应率无差异。结论应用序贯疗法可提高幽门螺杆菌的根除率,有效缓解患者的临床症状,治疗幽门螺杆菌阳性慢性胃炎效果显著。     

根除幽门螺杆菌治疗慢性胃炎的疗效观察

目的探讨幽门螺杆菌(Hp)根除治疗在慢性胃炎治疗过程中的临床疗效。方法经胃镜、组织病理学检查和幽门螺杆菌检测确诊为幽门螺杆菌相关性胃炎患者99例分为研究组49例和观察组50例,并以同期53例非幽门螺杆菌相关性胃炎患者作为阴性对照组。研究组给予正规的根除幽门螺杆菌三联治疗,其他各组的基本治疗相同。分析每个组治疗前和治疗后4周、1年～1年6个月随访结束时的症状体征、胃镜检查和组织病理学检查结果。结果治疗结束后4周研究组的炎症严重程度和活动度都比观察组的轻(P<0.05)。研究组的炎症严重程度比治疗前明显好转(P<0.05),观察组则无显著性差异(P>0.05)。研究组的复发率比观察组和阴性对照组的都低(P<0.05)。结论对幽门螺杆菌相关性胃炎患者进行正规的根除幽门螺杆菌治疗可以提高慢性胃炎的临床治疗效果,具有非常重要的临床意义。     

Synergistic Effect of Electric Field and Ultrasound on Transdermal Transport

Pharmaceutical Research -     

Sonophoresis. I. The Use of High-Frequency Ultrasound to Enhance Transdermal Drug Delivery

Previous attempts to use ultrasound (1-MHz frequency and 1 to 3-W/cm² intensity) to enhance transdermal drug delivery (so-called sonophoresis) have produced inconsistent results. Theoretical analysis of ultrasound propagation in tissue predicts that higher-frequency ultrasound (>1 MHz) will increase the concentration of energy deposition in the stratum corneum (SC) (typically, the rate-limiting barrier to percutaneous penetration). This hypothesis was tested by comparing the passive transdermal delivery of salicylic acid with that under the influence of ultrasound at 2-, 10-, and 16-MHz frequency; measurements were performed in vivo in hairless guinea pigs. Total drug absorbed was quantified by determining the amount of salicylic acid (1) present in SC tape strips and (2) eliminated in urine. Sonophoresis for 20 min at 2 MHz caused no significant increase in salicylic acid delivery over passive diffusion; treatment with ultrasound at 10 and 16 MHz, on the other hand, significantly elevated salicylic acid transport, by 4-fold and 2.5-fold, respectively. Kinetic analysis of the sonophoretic data at 10 and 16 MHz also revealed that the diffusion lag time associated with transdermal drug delivery (TDD) was reduced. A shorter period (5 min) of sonophoresis again resulted in enhanced TDD (relative to the corresponding control) at the higher frequencies; the delivered dose, and the level of enhancement, however, were lower than those after the 20-min treatment. In a separate series of experiments, it was shown that (a) ultrasound did not alter the release kinetics of salicylic acid from the gel formulation used and (b) pretreatment of the skin with ultrasound at 10 and 16 MHz lowered skin barrier function such that the subsequent delivery of salicylic acid was enhanced compared to passive transport without sonophoresis pretreatment. It follows that the enhancing effect of sonophoresis is due to a direct effect of ultrasound on (presumably) the stratum corneum.     

Percutaneous Absorption Enhancement of an Ionic Molecule by Ethanol–Water Systems in Human Skin

Ethanol–water systems enhance permeation of ionic solutes through human stratum corneum. Optimum enhancement of salicylate ion permeation has been observed with ethanol volume fractions near 0.63. The mechanism of action of ethanol–water systems enhancing skin permeation was investigated by in vitro skin permeation studies combined with Fourier transform infrared spectroscopy experiments. The increased skin permeation of the ionic permeant by the ethanol–water systems may be associated with alterations involving the polar pathway. Polar pathway alterations may occur in either or both the lipid polar head and proteinaceous regions of the stratum corneum. Ion-pair formation may also contribute to increased permeation. However, the decreased permeation of salicylate ion observed at higher volume fractions of ethanol may be attributed to decreased uptake of permeant into the stratum corneum.     

Epidermal Differentiation and Permeability in Fetal Pig Skin

Pharmaceutical Research -     

高乌甲素脂质体凝胶制备工艺及体外释药性能研究

目的：制备高乌甲素脂质体（LA-LIP）经皮给药制剂,对其质量及透皮吸收性质进行考察。方法：采用薄膜分散法制备LA-LIP,以包封率与载药量为指标,运用正交试验法确定LA-LIP的优选处方;以卡波姆-940为基质制备LA-LIP凝胶,采用体外释放试验评估释放能力。结果：正交试验法确定LA-LIP最佳处方工艺组合为卵磷脂与胆固醇质量比为8：1、药脂比为1：8、水化温度为55℃。体外透析袋实验显示,LA-LIP凝胶慢释过程符合Higuchi方程,LA凝胶释放过程符合零级动力学方程;体外透皮结果显示,LA凝胶24 h内皮肤滞留量为8.39 μg·cm^-2,LA-LIP凝胶皮肤滞留量为15.17 μg·cm^-2。结论：本研究发现运用薄膜分散法制备LA-LIP工艺简单可靠,制备成脂质体凝胶剂时,具有缓释效果。     

幽门螺旋菌在慢性胃炎和消化性溃疡中的分布

本文对幽门螺旋菌(Hp)在慢性胃炎和消化性溃疡中的分布进行了观察。发现胃窦部Hp感染率慢性胃炎组为61.13％,Hp感染率随患者年龄的增加而增高,消化性溃疡组为96.88％,较慢性胃炎组明显为高;十二指肠球部Hp感染率,十二指肠溃疡大于非溃疡病例。Hp寄生密度,在胃窦部球溃疡组大于慢性胃炎组,在十二指肠球部二者无显著差别,二组又全显示胃窦部Hp数量比球部高。提示Hp感染与慢性胃炎和消化性溃疡的发病相关,但单独Hp感染产生的损伤尚不足以造成溃疡的发生,还应有其它因素存在。     

Hindered Diffusion of Polar Molecules Through and Effective Pore Radii Estimates of Intact and Ethanol Treated Human Epidermal Membrane

The in vitro passive transport of urea, mannitol, sucrose and raffinose across intact and ethanol treated human epidermal membrane was investigated. The intent of this study was to characterize the barrier properties and permeation pathways of these membranes for polar permeants under passive conditions. Based upon the relative permeabilities of these four solutes and hindered diffusion theory, the experimental data was adequately modeled for both membrane systems according to permeation through a porous membrane. Effective pore radii estimates for intact human epidermal membrane fell between 15 to 25 while similar estimates fell compactly between 15 to 20 for ethanol treated human epidermal membrane. Similarities between the relative permeabilities of human epidermal membrane for the four permeants studied and the relative permeabilities of these same permeants through ethanol pretreated human epidermal membrane indicate that significant similarities exist between the permeation pathways for both membrane systems. The results of this study have important implications for transdermal drug delivery in general and more specifically for strategies of designing effective chemical permeation enhancement systems.     

Emerging strategies for the transdermal delivery of peptide and protein drugs

Transdermal delivery has been at the forefront of research addressing the development of non-invasive methods for the systemic administration of peptide and protein therapeutics generated by the biotechnology revolution. Numerous approaches have been suggested for overcoming the skin’s formidable barrier function; whereas certain strategies simply act on the drug formulation or transiently increase the skin permeability, others are designed to bypass or even remove the outermost skin layer. This article reviews the technologies currently under investigation, ranging from those in their early-stage of development, such as laser-assisted delivery to others, where feasibility has already been demonstrated, such as microneedle systems, and finally more mature techniques that have already led to commercialisation (e.g., velocity-based technologies). The principles, mechanisms involved, potential applications, limitations and safety considerations are discussed for each approach, and the most advanced devices in each field are described.     

Effect of menthone and related compounds on skin permeation of drugs with different lipophilicity and molecular organization of stratum corneum lipids

The objective of this article was to investigate the enhancing effect of menthone, menthol and pulegone on the transdermal absorption of drugs with different lipophilicity and probe their mechanisms of action at molecular level. Five model drugs, namely osthole, tetramethylpyrazine, ferulic acid, puerarin and geniposide, which were selected based on their lipophilicity denoted by logK_o/w, were tested using in vitro permeation studies in which Franz diffusion cells and rat skin were employed. Infrared spectroscopy and molecular dynamic simulation were used to investigate the effect of these enhancers on the stratum corneum (SC) lipids, respectively. Three compounds could effectively promote the transdermal absorption of drugs with different lipophilicity, and the overall promoting capacities were in the following increasing order: pulegone?<?menthol?<?menthone. The penetration enhancement ratio was roughly in parabolic curve relationships with the drug lipophilicity after treatment with menthol or menthone, while the penetration enhancement effect of pulegone hardly changed with the alteration of the drug lipophilicity. The molecular mechanism studies suggested that menthone and menthol enhanced the skin permeability by disordering the ordered organization of SC lipids and extracted part of SC lipids, while pulegone appeared to promote drug transport across the skin only by extracting part of SC lipids.     

参附注射液和高乌甲素对小鼠肝癌细胞H22生长抑制及诱导凋亡作用

目的研究比较高乌甲素注射液和参附注射液对小鼠肝癌细胞株生长抑制及凋亡诱导作用。方法苔盼蓝计数,四甲基偶氮唑盐(MTT)法,流式细胞仪技术分析药物对细胞周期和凋亡指数的影响,琼脂糖电泳技术分析药物对DNA作用。结果氢溴酸高乌甲素注射液对H22作用、细胞数量与形态无明显影响;参附注射液可明显抑制小鼠肝癌H22的生长,细胞表现典型的凋亡形态,在浓度为50 mL/L时,出现明显的凋亡峰;琼脂糖凝胶电泳检测出现DNA ladder。结论参附注射液体外能抑制小鼠肝癌H22细胞株的增殖和诱导细胞凋亡,高乌甲素注射液体外对H22细胞的生长、凋亡没有影响。