919糖浆对肝郁气滞血瘀证模型大鼠脑胃ghrelin通路的影响

目的研究肝郁气滞血瘀证模型大鼠下丘脑及胃内饥饿素(ghrelin)表达的变化以及护肝方919糖浆的干预作用。方法 40只Wistar大鼠随机分为正常组,模型组,919糖浆高、中、低剂量组(27、13.5、6.75 g·kg^(-1)),每组8只。除正常组外,其余各组采用夹尾急性激怒法制作肝郁气滞血瘀证模型,各组给予相应的干预措施,造模21天。其间监测各组大鼠的摄食量及体质量。实验结束后采用ELISA法测定各组大鼠血清酰基化ghrelin浓度,Western blot法测大鼠胃及下丘脑ghrelin蛋白表达,RT-PCR法检测胃中ghrelin、生长激素促分泌受体(GSHR)、5-羟色胺2b受体(5-HT_(2b)R)mRNA表达以及下丘脑ghrelin、5-羟色胺2c受体(5-HT_(2c)R)mRNA水平。结果与正常组比较,模型组大鼠血清酰基化ghrelin水平显著升高(P<0.01),下丘脑及胃ghrelin蛋白表达增加(P<0.01),胃内ghrelin、GHSR及下丘脑ghrelin mRNA表达水平显著上调(P<0.01),胃内5-HT_(2b)R及下丘脑内5-HT_(2c)R mRNA水平显著下调(P<0.01)。与模型组比较,919糖浆治疗组能显著逆转模型大鼠血清、胃内及下丘脑ghrelin水平的升高(P<0.01),下调模型大鼠胃内GHSR mRNA水平(P<0.01),上调胃内5-HT_(2b)R及下丘脑内5-HT_(2c)R mRNA水平(P<0.01)。结论 ghrelin是肝郁气滞血瘀证的重要物质基础;919糖浆能通过调节模型大鼠脑胃ghrelin通路的异常表达,从而发挥其防治肝郁气滞血瘀证的作用。

护肝方919糖浆干预产后束缚应激小鼠对仔代体质量及血浆Leptin的影响

目的研究919糖浆干预产后束缚应激小鼠对仔代体质量及血浆Leptin的影响。方法将产后雌鼠分为对照组、应激组及919糖浆治疗组。各组在束缚应激的同时,919糖浆治疗组每天灌胃给予919糖浆(27 g·kg^(-1)·d^(-1)),应激组给予等剂量的0.9%NaCl溶液,对照组不作任何干预。3周后断乳,观察仔鼠体质量、血浆Leptin及肝脏Ob-Rb mRNA的变化情况。结果与对照组相比,6、13、18、23周应激组与919糖浆治疗组仔鼠均出现低体质量,差异有统计学意义(P<0.05);应激组与919糖浆治疗组比较,仔鼠体质量差异无统计学意义(P>0.05)。23周龄时,应激组仔鼠较对照组血浆Leptin水平提高,919糖浆治疗组较应激组仔鼠血浆Leptin水平下降,差异均有统计学意义(P<0.01)。23周龄时,与对照组比较,应激组仔鼠肝脏Ob-Rb mRNA相对表达水平升高,差异有统计学意义(P<0.01); 919糖浆治疗组较应激组仔鼠肝脏Ob-Rb mRNA表达下降,差异有统计学意义(P<0.05); 3组之间雄性仔代小鼠比较,肝脏Ob-Rb mRNA表达差异无统计学意义(P>0.05)。结论产后束缚应激导致仔代低体质量与Leptin相关,护肝方919糖浆可通过调节肝脏OB-Rb mRNA来改善Leptin的变化。

从脑胃ghrelin通路探讨应激对大鼠食欲的影响

目的从脑胃饥饿素(ghrelin)通路研究应激影响食欲的分子机制。方法32只雄性Wistar大鼠随机分为对照组和应激组,每组16只,每笼2只。采用夹尾应激方法每日2次,连续21 d刺激大鼠,监测各组大鼠的摄食量及体质量;在实验第7、21天每组各选取8只大鼠,E L I S A法检测血清酰基化ghrelin质量浓度;蛋白质印迹法检测大鼠胃及下丘脑中ghrelin蛋白表达,以及下丘脑中腺苷酸活化蛋白激酶α2(Amp-activated protein kinaseα2,AMPKα2)表达水平;实时荧光定量PCR检测胃中ghrelin、生长激素促分泌素受体(growth hormone secretagogue receptor,GHSR)、瘦素(leptin),以及下丘脑中ghrelin、AMPKα2、神经肽Y(neuropeptide Y,NPY)、刺鼠基因相关蛋白(agouti-related protein,AgRP)mRNA水平。结果实验第7天应激组每笼大鼠的总摄食量多于对照组(P<0.05),第21天两组大鼠的总摄食量未见明显差异(P>0.05);在第7、21天,两组大鼠的体质量均无明显差异(P>0.05)。应激可以明显上调血清中酰基化ghrelin水平(P<0.01),胃及下丘脑中ghrelin蛋白(P<0.05)以及下丘脑中AMPKα2蛋白(P<0.01)的表达也均明显上调。应激还能明显上调胃内ghrelin及GHSR mRNA水平(P<0.01),下调胃内leptin mRNA水平(P<0.01);同时上调下丘脑内ghrelin、AMPKα2、NPY及AgRP mRNA水平(P<0.01)。结论夹尾应激能导致大鼠中枢及外周ghrelin水平的上调,可能对大鼠食欲暂时性增加有影响。

Effect of electroacupuncture combined with repetitive transcranial magnetic stimulation on limb dysfunction in patients with ischemic stroke

(rTMS) on limb dysfunction in ischemic stroke patients. Methods: A total of 63 stroke patients were divided into an observation group and a control group using the random number table method. Thirty-one patients in the control group were treated with routine Western medicine combined with rTMS;32 patients in the observation group were treated with EA in addition to the intervention in the control group. The duration of treatment was 3 months. The National Institutes of Health stroke scale (NIHSS), the Fugl-Meyer assessment (FMA), the modified Barthel index (MBI), and the motor evoked potential (MEP) latency of transcranial magnetic stimulation were observed before and after treatment in both groups. Results: Two cases withdrew from the observation group and 1 case withdrew from the control group. After treatment, the NIHSS score in both groups was lower than that before treatment, the FMA and MBI scores were higher than those before treatment, and the latency period of MEP was shorter than that before treatment, and the differences were statistically significant (P<0.05). After treatment, the NIHSS, FMA, and MBI scores and MEP latency period of the observation group improved more than those of the control group, and the differences between the groups were statistically significant (P<0.05). Conclusion: EA combined with rTMS can improve the motor function of limbs in ischemic stroke patients and improve their self-care ability. The mechanism may be related to increasing the excitability of the motor cortex and improving the electrophysiological function of the central nervous system.

非酒精性脂肪性肝病中医痰湿证与血脂、血尿酸关系的临床研究

目的观察非酒精性脂肪性肝病(NAFLD)的痰湿证与血脂、血尿酸关系。方法以复旦大学附属金山医院在职职工为研究对象,采用病证结合法对诊断为NAFLD的89例患者,根据中医证型虚、痰、瘀证评分标准观察中医证型分布、并对其相应的血生化指标进行研究。结果89例NAFLD患者中痰证患者64例,占74.42%且身体质量指数(BMI)最高,与阴虚证比较有统计学差异(P<0.05);生化指标血脂4项中阴虚证甘油三酯(TG)最低,与痰湿、气虚及阳虚证比较有统计学差异(P<0.05);肾功能中血尿酸(BUA)的数值,阳虚证最高,痰湿证次之,二者与阴虚证比较,均有统计学差异(P<0.05)。64例痰湿证中最常见症状是形体肥胖、倦怠乏力及舌苔白腻,生化指标中血脂异常最多。结论NAFLD患者痰湿证最多,痰湿证患者的形体肥胖及倦怠乏力与血脂、血尿酸关系紧密,本研究对临床NAFLD的中医证型客观化有一定的意义。