2型糖尿病中医(中西医结合)证治研究

1　概　述2型糖尿病的发病与胰岛素抵抗和胰岛B细胞分泌功能减退有关 ,是多种遗传和环境因素 (肥胖、高热量饮食、体力活动减少等 )共同作用的结果。其病理改变可引起全身代谢紊乱及大、中、小、微血管病变与神经病变 ,因此其并发症较多。常见的并发症有高血压、冠心病、缺血性脑血管病、糖尿病肾病、糖尿病视网膜病变、糖尿病足、糖尿病周围神经病变等。糖尿病因其典型的临床表现有“三多”(多食、多饮、多尿 )“一少”(消瘦 )的症状 ,因此可归属于中医消渴病的范畴。但临床也有不典型的表现 ,并非少见。 2型糖尿病不典型者相对较多见。根…     

冠心平颗粒对大鼠实验性心肌缺血的保护作用

观察冠心平颗粒对大鼠实验性心肌缺血的保护作用。给大鼠灌药7d后,以垂体后叶素造成实验性心肌缺血的模型,观察心电图造模前后的变化和血清肌酸磷酸激酶值,并与空白组与地尔硫卓对照组进行比较。提示造模后大鼠虽有心率下降,T波升高,但与用药前比较,无统计学意义（P＞0．05）;心率下降和T波升高幅度与空白组比较,具有统计学意义（P＜0．05）;血清肌酸磷酸激酶与空白组比较,有统计学意义（P＜0．05）。以上结果显示冠心平颗粒可抑制垂体后叶素所致大鼠心率、T波的改变,降低血清肌酸磷酸激酶,有一定的防治心肌缺血,保护心肌细胞的功能。     

Effect of acupuncture on hippocampal mitochondrial proteome expression in SAMP8 mouse model with Alzheimer disease

Objective

To observe the effect of acupuncture on the expression of mitochondrial proteome in hippocampus of senescence-accelerated mouse prone 8 (SAMP8) mice models with Alzheimer disease (AD), and to explore the possible protective mechanism of acupuncture on mitochondria.

Methods

Sixty 6-month-old male SAMP8 mice were randomly divided into an acupuncture at acupoint group, an acupuncture at non-acupoint group and a model group, 20 mice in each group. The 20 male senescence-accelerated mouse/resistance 1 (SAMR1) mice of the same age were used as a normal control group. Shenshu (BL 23), Baihui (GV 20), Xuehai (SP 10) and Geshu (BL 17) were selected for acupuncture intervention in acupuncture at acupoint group. After an 8-week intervention, mitochondrial tissues were extracted from the hippocampus. Differentially expressed proteins were identified by subcellular organelle proteomics. Western blot was used to verify the expressions of some related proteins in hippocampal mitochondria.

Results

Compared with the model group, there were 13 differentially expressed protein spots in the acupuncture at acupoint group, of which, 9 were up-regulated, including neurofilament light polypeptide (NFL), actin (cytoplasmic 1, database ID: ACTB), tubulin beta-2A chain (TBB2A), tropomodulin-2 (TMOD2), pyruvate dehydrogenase E1 component subunit beta (PDHE1-β), NADH-ubiquinone oxidoreductase 75 kDa subunit (database ID: NDUS1), heat shock cognate 71 kDa protein (HSC71), pyruvate dehydrogenase E1 component subunit alpha (PDHE1-α) and ATP synthase beta subunit (ATP-β); 4 were down-regulated, including glial fibrillary acidic protein (GFAP), pyruvate dehydrogenase phosphatase 1 (PDP1), mitochondrial-processing peptidase subunit alpha (MMP-α) and adenosine kinase (ADK). According to the information provided in the protein database, most of the differentially expressed proteins involve the regulation of mitochondrial function and structure. The expression levels of NFL and TBB2A in the normal control group and the acupuncture at acupoint group were significantly higher than those in the acupuncture at non-acupoint group (P<0.05). ATP-β and NDUS1 expression levels were significantly higher in the acupuncture at acupoint group than those in the acupuncture at non-acupoint group (P<0.05); there was no significant difference between the acupuncture at non-acupoint group and the model group (P>0.05).

Conclusion

Acupuncture may achieve the potential therapeutic effect on AD by regulating the structure and functional proteins of hippocampal mitochondria.

     

益智健脑颗粒治疗老年痴呆病临床观察

目的观察益智健脑颗粒对老年痴呆病的临床疗效。方法将60名患者随机分为两组,对照组服用脑复康片,治疗组服用脑复康片加益智健脑颗粒,2个月为1疗程,观察两组的治疗效果。结果两组的临床症状有所改善,两组的超氧化物歧化酶(SOD)、过氧化脂质(LPO)和血脂各指标均有改善(P<0.05),但以治疗组为优(P<0.05,P<0.01)。结论益智健脑颗粒结合脑复康治疗老年痴呆病的疗效优于单纯脑复康治疗。     

复方菝葜颗粒治疗中晚期非小细胞肺癌的临床研究

目的观察复方菝葜颗粒(compound rhizoma smilacinus granule,CRSG)治疗中晚期非小细胞肺癌的临床疗效。方法将60例非小细胞肺癌患者随机分为2组,中药治疗组采用纯中药制剂复方菝葜颗粒治疗,西药对照组采用西医化疗,观察治疗后患者生存期、病灶变化、生存质量等指标。结果治疗后患者生存期及生存质量,中药治疗组疗效较西药对照组差异有显著性(P<0.05);治疗后病灶变化,二者差别无统计学意义。结论复方菝葜颗粒治疗中晚期非小细胞肺癌具有一定的临床疗效。     

复方菝葜口服液治疗原发性气管肺癌51例

采用中药复方菝葜口服液治疗原发性支气管肺癌５１例，部分缓解者３３例（占６４．７％），稳定１３例（占２５．５％），进展５例（占９．８％）。提示复方菝葜口服液对原发性支气管肺癌肿瘤病灶具有较高的缓解作用，能改善症状，延长生存期，提高患者生活质量。     

2型糖尿病中西医结合诊疗方案的临床观察

目的通过临床验证2型糖尿病中西结合诊疗方案，评价中医证候的诊断价值及中西医结合治疗的临床疗效。方法对60例确诊为2型糖尿病的患者随机分为中西结合治疗组和西药治疗组，观察血糖、血脂、糖化血红蛋白、积分的前后变化。评价两组疗效。结果两组空腹血糖，餐后2h血糖和糖化血红蛋白均下降明显（P〈0．05）；治疗组血脂、证候积分下降明显（P〈0．05）；对照组治疗前后的血脂、证候积分无明显变化（P〉0．05）；两组治疗后空腹血糖。餐后2h血糖。糖化血红蛋白、血脂、证候积分比较有显著性差异（P〈0．05）；两组疾病疗效和中医证候疗效的比较均有显著性差异（P〈0．05）。结论中医证候诊断方案统一和规范了2型糖尿病辨证分型；中西医结合治疗2型糖尿病疗效肯定。     

冠心平治疗椎基底动脉供血不足性眩晕34例总结

采用中药冠心平颗粒剂治疗椎基底动脉供血不足性眩晕３４例,显效率５０％,总有效率９７％。对照组３４例,显效率３２％,总有效率８２％,两组比较有显著性差异（Ｐ〈０．０１）。同时冠心平对改善椎基底动脉供血不足性眩晕的症状,增加椎 动脉管径,提高椎动脉血流量,改善微循环及脑部供血、供氧均有良好的作用。     

复方菝葜颗粒对非小细胞肺癌A549细胞Bcl-2和Bax基因表达的影响

目的:观察复方菝葜颗粒(compound rhizoma smilacinus granule,CRSG)对非小细胞肺癌A549细胞Bcl-2和Bax mRNA表达水平的影响,探讨CRSG抑制非小细胞肺癌的作用机制.方法:雄性SD大鼠30只,随机分为两组,每组15只.一组灌服复方菝葜颗粒,2次/d;另一组灌服等剂量的蒸馏水,第6次灌胃后的2 h提取血清.A549细胞株随机分为中药实验组、西药对照组、正常对照组,分别加入10%的含药血清、顺铂3 μg/mL和10% SD大鼠血清,培养48h后收集细胞,RT-PCR测定Bcl-2和Bax mRNA的表达水平.结果:各组细胞培养48 h后中药实验组、西药对照组细胞Bcl-2 mRNA表达下调,Bax mRNA表达上调, Bcl-2/Bax比值则显著降低,与正常对照组比较差异均有统计学意义(P＜0.01). 结论:非小细胞肺癌A549细胞存在Bcl-2 mRNA高表达、Bax mRNA低表达,复方菝葜颗粒干预后可使Bax mRNA表达量显著增加,Bcl-2 mRNA表达及Bcl-2/Bax比例显著降低,这可能是其对非小细胞肺癌发挥抑瘤作用的分子机制之一.     

复方菝葜颗粒对非小细胞肺癌A549细胞P53基因、细胞周期的影响

目的 观察复方菝葜颗粒对非小细胞肺癌A549细胞P53基因及细胞周期的影响,探讨复方菝葜颗粒治疗非小细胞肺癌的部分作用机制.方法 雄性SD大鼠30只,随机分为两组,每组15只.一组灌服复方菝葜颗粒,2次/d;另一组灌服等剂量蒸馏水,第6次灌胃后2h提取血清.A549细胞株随机分为中药实验组、西药对照组、正常对照组,分别加入100,6的舍药血清、顺铂3μg/mL和10%SD大鼠血清,培养48h后收集细胞,KT-PCR.测定P53 mRNA表述;流式细胞技术检测细胞周期.结果 中药实验组和西药对照组G1期细胞数及P53 mRNA相对表达量高于正常对照组相(P＜0.05). 结论 A549细胞存在P53 mRNA低表达,复方菝葜颗粒能够上调抑癌基因P53 mRNA表达.并将癌变的细胞阻滞在G1期,这可能是复方菝葜颗粒治疗非小细胞肺癌的作用机制之一.