隔药饼灸对高脂血症合并动脉粥样硬化兔肝脏过氧化酶体增殖物激活型受体γ、B类Ⅰ型清道夫受体蛋白及基因表达的影响

目的:观察隔药饼灸对高脂血症合并动脉粥样硬化(AS)兔胆固醇逆转运中过氧化酶体增殖物激活型受体γ(PPARγ)、B类Ⅰ型清道夫受体(SR-B 1)蛋白及基因表达的影响,探讨隔药饼灸促胆固醇逆转运抗AS形成的作用机制。方法:新西兰大耳白兔随机分为正常组、模型组、隔药饼灸组、辛伐他汀组,每组10只。采用高胆固醇饲料配合丙基硫氧嘧啶喂养方式制备高脂血症合并AS兔模型。隔药饼灸组予隔药饼灸处理,施灸穴位分为两组,第1组为"巨阙"与双侧"天枢""丰隆",第2组为双侧"心俞""肝俞""脾俞",两组穴位交替使用;辛伐他汀组将辛伐他汀粉(1.96mg·kg^(-1)·d^(-1))拌入第1口饲料;均每天治疗1次,连续4周。测定各组兔血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)含量;Western blot法测定肝脏PPARγ、SR-B 1蛋白表达量,RT-PCR法测定肝脏PPARγ、SR-B 1mRNA表达量。结果:与正常组比较,模型组血浆TC、TG、LDL-C均升高(P<0.01),HDL-C降低(P<0.01),PPARγ、SR-B 1蛋白及mRNA表达均降低(P<0.01)。与模型组比较,隔药饼灸组及辛伐他汀组TC、TG、LDL-C均降低(P<0.01),HDL-C均升高(P<0.01),PPARγ、SR-B 1蛋白及mRNA表达均升高(P<0.01,P<0.05)。结论:隔药饼灸调节血脂抗AS的作用机制与增加肝脏中PPARγ的表达、诱导SR-B 1表达,从而促进胆固醇逆转运有关。

Therapeutic observation on electroacupuncture at Zusanli(ST 36) and Fenglong(ST 40) for senile dementia

Objective： To explore the clinical effects of electroacupuncture（EA） at Zusanli（ST 36） and Fenglong（ST 40） in treating senile dementia. Methods： A total of 74 patients were randomly divided into an EA group and a medication group based upon the random digital table, 37 cases in each group. EA at Zusanli（ST 36） and Fenglong（ST 40） was given in the EA group, once every day, for six treatments per week. Donepezil Hydrochloride Tablets were given to the medication group, 5 mg per time and once a day in the former four weeks, 10 mg per time and once a day after 4 weeks, oral administration before sleep at night. The courses of the treatment were 12 weeks in both groups. The scores of mini-mental state examination（MMSE） and Barthel index（BI） were observed before and after the treatment, for processing the comparative analysis of the clinical effects after the course of the treatment. Results： The total effective rate was 86.5% in the EA group and 70.3% in the medication group. The therapeutic effect was better in the EA group than that in the medication group, and the difference between the two groups was statistically significant（P〈0.05）. MMSE and BI scores after the treatment in the two groups were all elevated than those of the same groups before the treatment（P〈0.05, P〈0.01）. The improving situation was obviously better in the EA group than that in the medication group, and the difference between the two groups was statistically significant（P〈0.05）. Conclusion： EA at Zusanli（ST 36） and Fenglong（ST 40） is affirmative in the therapeutic effect for senile dementia and can also improve the cognitive function and enhance the patients＇ quality of life.

老年人内脏脂肪面积与血脂水平及冠心病的相关性研究

目的探讨内脏脂肪面积与血脂水平及冠心病的相关性。方法选取2018年4月安徽广德农村地区参与体检的老年人(年龄≥60岁)共139例,结合当地基层医疗档案仔细询问冠心病病史,将于当地医院确诊为冠心病者57例分为冠心病组(CHD),其余体检者共82例为非冠心病组(NC)。清晨空腹抽取静脉血测定血总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平。嘱受检者免冠、脱鞋、空腹,仅着单衣测量身高体重。随后使用韩国Inbody S10人体成分分析仪,应用生物电阻抗原理测量肥胖相关指标:内脏脂肪面积、体脂率、体脂含量、体质量指数。分析内脏脂肪面积与血脂水平及冠心病的相关性。结果 CHD组的内脏脂肪面积[(92.57±39.29)cm^2]及其他肥胖相关指标和血低密度脂蛋白[(3.96±0.86)mmol/L]水平均高于NC组。回归分析显示内脏脂肪面积增高者及高低密度脂蛋白血症者发生冠心病的风险增加,分别为NC组的4.052倍及2.348倍。相关性分析显示,内脏脂肪面积与血甘油三酯水平呈正相关。结论内脏脂肪面积和低密度脂蛋白与冠心病密切相关,老年冠心病个体中内脏脂肪面积及其他肥胖指标显著高于非冠心病个体,当内脏脂肪面积增加或高低密度脂蛋白血症时,老年人冠心病发病风险明显增高。随着内脏脂肪面积增加,血甘油三酯水平增高。故可利用生物电阻抗法分析老年人肥胖相关指标,结合血脂水平对冠心病的预防及预后进行动态监测。