紫金酒治疗挫伤的临床观察及实验研究

中药复方外用酒剂紫金酒是名老中医李同生教授祖传验方,自咸丰年间应用迄今已有150余年历史,临床治疗软组织挫伤疗效显著。1987年9月以来,我们对72例踝关节损伤患者,用紫金酒及变色酒精分组治疗,对比观察。为了进一步探讨其疗效机理,又从组织学角度对紫金酒治疗急性挫伤     

通腑利肺作用机制的实验研究

目的 从整体、细胞、分子3个层面探讨通腑法通腑利肺的作用机制。方法 将40只SD大鼠随机等分为正常组、模型组、解扎组及治疗组,每组各10只,采用体外直肠不全结扎法造模,治疗组于术后48h从体外解除直肠结扎丝线并继续常规饲养,同时每天以大承气汤灌胃2次,每只每次2ml,服用2天。采用放射免疫分析法检测各组血清IL-8含量,RT-PCR法检测肺组织TNF-α mRNA水平,检测各组支气管肺泡灌洗液（BALF）中肺泡巨噬细胞（PAM）死亡百分率。结果模型组大鼠血清IL-8含量较正常组明显增加（P〈0．01）,解扎组与治疗组IL-8含量较模型组明显降低（P〈0．05,P〈0．01）;治疗组较解扎组明显降低（P〈0．05）。解扎组、治疗组BALF中PAM总数较模型组升高,PAM死亡百分率较模型组降低（均P〈0．05）;治疗组BALF中PAM死亡百分率较解扎组降低（P〈0．05）。模型组TNF-α mRNA表达明显高于正常组,给予大承气汤治疗可降低肺组织TNF-α mRNA表达。结论 通腑法对损伤肺组织起保护作用。     

撰文写稿 贵在创新——兼评《怪病从“痰”辨治的体会》

近读贾河先同志的“怪病从‘痰’辨治的体会”一文(刊在《吉林中医药》1984年5期),觉得贾文内容似与《论中医痰病学说》(朱曾柏著,湖北人民出版社1981年6月出版)相同处甚多。现列举如下: 其一:贾文对痰病痰症有二点认识,即     

CD44对体外培养的成骨细胞及破骨样细胞形成过程中的影响

目的 通过体外细胞培养探讨粘附分子CD44在成骨细胞及破骨样细胞形成过程中的作用.方法 在体外培养的骨髓间充质干细胞向成骨细胞分化过程中,用免疫细胞化学方法来检测其细胞CIM4的表达及其意义;并在细胞核因子kB受体活化因子配基(receptor activator of nuclear factor-k B ligand,RANKL)和巨噬细胞集落刺激因子(Macrophage-colony stimulating factor,M-CSF)诱导的破骨样细胞培养体系中加入CD44抗体,通过抗酒石酸酸性磷酸酶(TRAP)染色鉴定破骨样细胞的形成.结果 成骨细胞培养体系中,空白组及地塞米松干预组间细胞CD44的表达没有显著性差异,但是指数增长期,地塞米松干预组的CD44的表达上升慢;破骨样细胞培养体系中,第6和9天,CD44抗体干预组的TRAP阳性细胞率明显低于对照组.结论 CD44在成骨细胞形成、增殖、成熟过程没有促进作用,但在破骨样细胞形成过程中起着一定的促进作用,它与单个核细胞的融合有一定的关系.     

Effects of salivae miltiorrhizae liguspyragine hydrochloride and glucose injection (参芎葡萄糖注射液) on the levels of main platelet thrombin receptors in chronic haemodialysis patients

Objective:To investigate the effects of Salvia Miltiorrhiza Liguspyragine Hydrochloride and Glucose Injection(参芎葡萄糖注射液,SLGI) on the expression of platelet membrane receptors proteinase-activated receptor-1(PAR1) and proteinase-activated receptor-4(PAR4) in end-stage renal disease(ESRD) patients on chronic haemodialysis(HD).Methods:Eighty-six ESRD patients on HD(treated group) were treated with SLGI,7 days as one therapeutic course,for two successive courses.The previous therapies were unchanged.Flow cytometry was used to assess the expression of platelet PAR1 and PAR4 in the patients,and turbidity method was used to determine the platelet maximum aggregation rate(MAR).Meanwhile,renal function was measured.The final data were compared with those before treatment and with those in the normal control group(54 healthy subjects).Results:Compared with the normal control group,the expressions of PAR1 and PAR4 and platelet MAR in ESRD patients on HD was significantly higher before treatment(P=0.001,P=0.006, and P=0.008);after treatment with SLGI,the above indices in patients were remarkably decreased(P=0.036 and P=0.046),except PAR4(P=0.067),but still higher than those in the normal control group,however,it was not statistically significant.Conclusions:(1) The overexpression of PAR1 and PAR4 might lead to increased platelet aggregation and this could be one of the reasons for the thrombotic events in ESRD patients on HD.(2) SLGI was able to down-regulate the expression of PAR1 in ESRD patients on HD,improve platelet function,and regulate platelet activation.     

规范化术后疼痛护理常规在术后镇痛中的作用

目的研究规范化术后疼痛护理常规能否起到加强疼痛管理、改善急性术后疼痛的作用.方法 80例拟行择期腹部手术的患者随机分为实验组和对照组(每组n=40).实验组制定并执行规范的术后疼痛护理常规,对照组仍按照护理人员现有的护理习惯进行疼痛护理,不作干预.观察2组患者的术后疼痛水平、焦虑水平、镇痛药物使用及其副作用和患者对镇痛泵满意度及总体满意度.结果 实验组术后3天的每日疼痛评分和每日疼痛评分>4分持续时间均低于对照组(P<0.05),实验组术前1天晚上和术后3天状态焦虑评分低于对照组(P<0.05),2组间镇痛药物使用量相当(P>0.05),而实验组恶心、呕吐和嗜睡的发生率较对照组低(P<0.05).实验组患者对镇痛泵的满意度和总体满意度评分均高于对照组(P<0.05).结论 护理人员通过执行规范化的术后疼痛护理常规,可以达到加强疼痛管理、改善急性术后疼痛的目的.     

穴位埋线对实验性结肠炎大鼠的脾淋巴细胞核因子-κB p65及相关信号分子β2AR的影响

目的:探讨穴位埋线治疗溃疡性结肠炎的作用机制.方法:将18只SD大鼠随机分为3组:正常对照组、模型组、穴位埋线组,每组6只.除正常对照组未行造模外,其余2组大鼠均采用三硝基苯磺酸(TNBS)造摸.模型组不予干预,正常饮食,穴位埋线组于"上巨虚""天枢""大肠俞"处进行穴位埋线治疗.治疗15 d后观察大鼠的腹泻、便血症状和结肠病理组织学改变,用western blot法检测大鼠脾淋巴细胞核因子-κB p65(NF-κB p65)及相关信号分子β2肾上腺素受体(β2AR)蛋白的表达.结果:穴位埋线组的大鼠腹泻、黏液脓血便症状得到较快控制,大鼠黏膜组织损伤明显改善;与正常对照组相比,模型组大鼠脾淋巴细胞NF-κB p65增多(P<0.01),β2AR的表达减少(P<0.01),两组差异有统计学意义;与模型组比较,穴位埋线组大鼠脾淋巴细胞NF-κB p65减少(P<0.01),而β2AR的表达增多(P<0.01),两组脾淋巴细胞NF-κB p65和β2AR的表达存在明显差异.结论:穴位埋线治疗实验性结肠炎有明显效果,其作用机制可能是通过调节NF-κB p65及相关信号分子β2AR,从而发挥治疗作用.

Abstract：

T Objective To investigate the mechanisms of catgut implantation at acupoints onulcerative colitis. Methods Eighteen SD rats were randomly divided into a normal control group (NC),a model group (MO) and a catgut implantation group (CI) with 6 rats in each group. Animals in groupMO and group CI were treated by trinitro-benzene-sulfonic acid (TNBS) to establish model with colitis.symptoms of diarrhea and bloody stool, and changes in histopathology were detected 15 days afterthe treatment. Expressions of splenic lymphocyte nuclear factor κB p65 (NF-κB p65) and correlatedsignaling molecules (β2AR) were detected by the western blot method. Results Diarrhea and mucusbloody purulent stool were soon controlled, and mucous injures were obviously improved in group CI.The NF-κB p65 value of splenic lymphocytes was significantly increased (P<0.01) and expression ofβ2AR remarkably reduced in group MO (P<0.01), compared with group NC. But, the NF-κB p65 valuewas significantly decreased (P<0.01) and expression of β2AR remarkably increased in group CI (P<0.01), compared with group MO. Conclusion Catgut implantation at acupoints is obviously effectivein treating experimental colitis. Modulation of NF-κB p65 and the correlated signaling molecules β2ARmay be involved in the mechanisms.     

伤科熏洗方对类风湿性关节炎患者血清肿瘤坏死因子-α和白细胞介素-1β水平的影响

目的探讨伤科熏洗方对类风湿性关节炎(RA)的疗效及其对RA患者血清肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)水平的调节作用。方法选取110例RA活动期患者,随机分为治疗组和对照组,每组55例。治疗组采用伤科熏洗方联合西药治疗,对照组仅用西药治疗,共4周。观察2组的临床疗效以及治疗前后临床症状和实验室指标的变化,采用ELISA法检测患者血清TNF-α和IL-1β水平。结果治疗组和对照组总有效率分别为72.7%和49.1%,治疗组明显高于对照组(P0.05)。治疗组和对照组临床症状均明显改善(P0.05),但治疗组明显优于对照组(P0.05)。治疗组血沉、C反应蛋白、TNF-α和IL-1β水平均明显降低(P0.05),对照组无明显变化(P0.05)。结论伤科熏洗方下调TNF-α和IL-1β可能是其治疗RA的重要机制之一。     

“痛畀帖”在小针刀松解术联合手法推拿治疗肩周炎中的临床应用

目的:观察临床运用小针刀松解剥离联合手法整复治疗肩关节周围炎的临床疗效,并探讨痛畀帖对小针刀松解术后镇痛效果的影响。方法:将99例肩周炎患者分为痛畀帖组(A组48例)和对照组(B组51例)。两组患者患肩均给予小针刀松解剥离术及手法整复术,A组患者患肩处加用痛畀帖治疗。运用视觉模拟评分法(VAS)评定并比较术后1d,3d及1周的疼痛程度,比较两组患者治疗后的综合疗效。结果:A组有效率为81.25%(其中痊愈19例,显效16例,有效4例),B组有效率为78.43%(其中痊愈20例,显效18例,有效2例),两组间有效率比较差异无统计学意义(P>0.05);术后各时点A组VAS评分均低于B组,差异有统计学意义(P<0.01)。结论:小针刀松解剥离术联合手法整复治疗肩周炎临床疗效显著,加用痛畀帖术后镇痛可有效减轻患者的局部疼痛感。     

武汉地区1359例骨密度测定及骨质疏松患病率分析

目的 分析武汉地区人群骨密度（BMD）变化规律及骨质疏松（OP）患病率。方法 使用美国Hologic公司双能X线骨密度仪对武汉地区2－91岁的居民1359人进行L1－4和髋部BMD测定,然后进行比较和统计分析。结果 男性腰椎骨峰值在30－34岁年龄段,女性在35－39岁;男、女性髋部骨峰值均在30－34岁。峰值后随年龄增长BMD逐渐下降,女性在50岁后可见明显的骨质丢失加速,而男性丢失是逐渐和缓慢的。武汉地区50－79岁人群骨质疏松症发病率男性为37．8％,女性为67．3％。结论 骨质疏松研究的重点在中老年妇女,但对于男性也不可忽视;骨质疏松的预防应从青少年开始。