Tong xie yao fang relieves irritable bowel syndrome in rats via mechanisms involving regulation of 5-hydroxytryptamine and substance P

AIM: To investigate whether the Chinese medicine Tong Xie Yao Fang(TXYF) improves dysfunction in an irritable bowel syndrome(IBS) rat model. METHODS: Thirty baby rats for IBS modeling were separated from mother rats(1 h per day) from days 8 to 21, and the rectum was expanded by angioplasty from days 8 to 12. Ten normal rats were used as normal controls. We examined the effects of TXYF on defection frequency, colonic transit function and smooth muscle contraction, and the expression of 5-hydroxytryptamine(5-HT) and substance P(SP) in colonic and hypothalamus tissues by Western blot and RT-PCT techniques in both normal rats and IBS model rats with characterized visceral hypersensitivity.in normal rats and 4.5 ± 1.58 in IBS model rats(P < 0.001). However, the defecation frequency was significantly decreased(3.0 ± 1.25 vs 4.5 ± 1.58, P < 0.05), while the time(in seconds) of colon transit function was significantly increased(256.88 ± 20.32 vs 93.36 ± 17.28, P < 0.001) in IBS + TXYF group rats than in IBS group rats. Increased colonic smooth muscle tension and contract frequency in IBS model rats were significantly decreased by administration of TXYF. Exogenous agonist stimulants increased spontaneous activity and elicited contractions of colon smooth muscle in IBS model rats, and all of these actions were significantly reduced by TXYF involving 5-HT and SP down-regulation. CONCLUSION: TXYF can modulate the activity of the enteric nervous system and alter 5-HT and SP activities, which may contribute to the symptoms of IBS.

Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome

AIM： To investigate the effect and mechanism of electro-acupuncture lEA） at ST25 and ST37 on irritable bowel syndrome （IBS） of rats. METHODS： A total of 21 male Sprague-Dawley rats were randomly divided into normal group, model group and EA group. A rat model of IBS was established by constraining the limbs and distending the colorectum of rats. Rats in EA group received bilateral EA at ST25 and ST37 with a sparse and intense waveform at a frequency of 2/50 Hz for 15 min, once a day for 7 d as a course. Rats in normal and model groups were stimulated by distending colorectum （CR）. An abdominal withdrawal reflex （AWR） scoring system was used to evaluate improvements in visceral hypersensitivity. Toluidine blue-improved method, immunohistochemistry and radioimmunoassay were used to observe mucosal mast cells （MC）, changes of substance P （SP） and substance P receptor （SPR） in colon and change of corticotropin-releasing hormone （CRH） in hypothalamus. RESULTS： The threshold of visceral sense was significantly lower in model group than in normal group,and significantly higher in EA group than in model group. The number of mucosal MC was greater in model group than in normal group and significantly smaller in EA group than in model group. The CRH level in hypothalamus of rats was significantly higher in model group than in normal group, which was remarkably decreased after electro-acupuncture treatment. The SP and SPR expression in colon of rats in model group was decreased after electro-acupuncture treatment. CONCLUSION： EA at ST25 and ST37 can decrease the number of mucosal MC and down-regulate the expression of CRH in hypothalamus, and the expression of SP and SPR in colon of rats with IBS.

Evaluation of Perinatal and Developmental Outcomes in Neonates with Abstinence Syndrome Admitted to NICU

Drug abuse by pregnant women is one of the significant problems for mothers and their neonates.This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria.In a case-control study,clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran,Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome(control group).Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample.Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers.Our data showed that the prevalence of drug addiction was 1.8%among pregnant women,and the most common drugs used by mothers were opium(n=45%,50%),amphetamine(n=30%,33%),and methadone(n=14%,16%).Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn(TTN)(P=0.004),and a prevalence of being admitted to NICU(P=0.05)and for a longer duration(P<0.001).Their mothers had a higher prevalence of having pre-eclampsia(P=0.010).Using morphine vs.amphetamine showed no difference based on their effects on mothers and neonates.Substance use during pregnancy increased the prevalence of pregnancy complications(pre-eclampsia)and neonatal complications(TTN and prevalence and duration of hospitalization).Therefore,planning for the development of health policies to raise awareness among women and more broadly,all members of the community,is important to prevent the tendency to engage in this potentially high-risk behavior.

ANALYSIS OF FILIFORM NEEDLE ANALGESIA AND THE CONTENT OF SUBSTANCE P IN THE SERUM

We deterrnined the content of substance P in the serum of the patients with pain syn-drorne using radioimmunoassay before and after the acupuncture analgesia’ The results suggested thatthe acupuncture rnight obviously reduce the content of substance P in the serum of the patients withpain syndrome. The results proved that the acupuncture analgesia might reduce the release of sub-stance P through some mechanism and produce effects of analgesia. Thereby, the change of the con-tent of substance P in the serum may be used as an objective index to appraise the acupuncture analge-sla.

基于脾火论辨治原发性干燥综合征

基于脾火论辨治原发性干燥综合征(pSS)。论述了脾火论的理论内涵,并区分脾火与阴火及其他脏腑之火的差异。阐释了脾火论与pSS的相关性,认为脾气亏虚,运化无权,脾不升清,郁而化火是pSS病机关键;久而病及他脏,导致络脉瘀滞是pSS的病机转化特点。以健脾益气,除火润燥,生津通络为pSS的治疗大法,为pSS的中医辨治提供思路与方法。

电针治疗尼古丁依赖的疗效观察

目的观察电针治疗尼古丁依赖的临床疗效。方法将60例尼古丁依赖者用随机数字表法分为电针组和对照组,每组30例。对照组采用口服酒石酸伐尼克兰片治疗,电针组予电针治疗。分别于治疗前以及治疗第3天、治疗第1周、治疗第2周、治疗第3周、治疗第4周和第16周随访时,观察两组吸烟量、烟草依赖评估量表(fagerstorm test for nicotine dependence,FTND)、吸烟严重度指数(heaviness of smoking index,HSI)、吸烟渴求简短问卷(brief questionnaire of smoking urges,QSU-Brief)和明尼苏达尼古丁戒断症状量表(Minnesota nicotine withdrawal scale,MNWS)评分的变化。结果治疗第4周及第16周随访时,两组吸烟量、FTND、HSI、QSU-Brief和MNWS的评分均较治疗前降低(P<0.05)。治疗第3天以及治疗第1、第2和第3周,电针组吸烟量评分低于对照组(P<0.05);治疗第4周,两组吸烟量评分比较,差异无统计学意义(P>0.05)。治疗第3天以及治疗第1、第2和第3周,电针组QSU-Brief评分低于对照组(P<0.05);治疗第4周及第16周随访时,两组QSU-Brief评分比较,差异无统计学意义(P>0.05)。结论电针可改善尼古丁依赖者的戒断症状,临床疗效优于口服酒石酸伐尼克兰片,电针疗效的累积效应与时间呈正相关。

穴位埋线治疗便秘型肠易激综合征的疗效观察及对血清SP含量的影响

目的观察穴位埋线治疗便秘型肠易激综合征(constipation-predominant irritable bowel syndrome,IBS-C)的临床疗效及对血清P物质(substance P,SP)含量的影响。方法43例IBS-C患者随机分为观察组(22例)和对照组(21例)。观察组采用埋线方法治疗,对照组采用枸橼酸莫沙必利分散片治疗。观察两组治疗前后及随访期肠易激综合征症状严重程度量表(IBS symptom severity scale,IBS-SSS)评分、肠易激综合征生活质量量表(irritable bowel syndrome quality of life,IBS-QOL)评分和焦虑自评量表(self-rating anxiety scale,SAS)评分的变化及治疗前后血清SP含量变化。结果观察组治疗后及随访期IBS-SSS各项评分与总评分较治疗前降低(P<0.05),随访期IBS-SSS各项评分与总评分较治疗后升高(P<0.05);对照组治疗后IBS-SSS各项评分与总评分较治疗前降低(P<0.05),随访期IBS-SSS各项评分与总分较治疗后升高(P<0.05);观察组治疗后和随访期腹痛不适评分低于对照组(P<0.05)。两组治疗后及随访期IBS-QOL总评分高于治疗前,两组随访期IBS-QOL评分低于治疗后,差异有统计学意义(P<0.05);观察组治疗后及随访期IBS-QOL评分高于对照组(P<0.05)。观察组治疗后及随访期SAS评分均降低(P<0.05),随访期SAS评分高于治疗后(P<0.05);对照组治疗后SAS评分低于治疗前(P<0.05),随访期SAS评分高于治疗后(P<0.05);观察组治疗后及随访期SAS评分均低于对照组(P<0.05)。两组治疗后血清SP含量均降低(P<0.05);观察组血清SP含量低于对照组(P<0.05)。观察组临床疗效高于对照组,差异具有统计学意义(P<0.05)。结论穴位埋线和枸橼酸莫沙必利分散片均能缓解IBS-C患者临床症状,提高其生活质量,但穴位埋线相较于枸橼酸莫沙必利分散片临床疗效更稳定和持久;在改善腹痛和生活质量方面穴位埋线的远期效应更优。穴位埋线治疗IBS-C的作用机制可能与下调血清SP含量密切相关。

循经按摩治疗气滞血瘀型腰椎间盘突出症临床研究

目的:观察循经按摩治疗气滞血瘀型腰椎间盘突出症的临床疗效。方法:将120例气滞血瘀型腰椎间盘突出症患者随机分为常规组、推拿组和循经按摩组,每组40例。常规组给予桃红四物汤加减、中药热奄包、腰背肌力训练、中医辨证施护,推拿组在常规组治疗的基础上行常规推拿手法治疗,循经按摩组在常规组治疗的基础上行循经按摩治疗。观察3组患者治疗前后日本骨科学会(Japanese orthopedic association,JOA)下腰痛评分、数字评分法(numeric rating scale,NRS)、Oswestry功能障碍指数问卷表(Oswestry disability index,ODI)评分变化情况及临床疗效。结果:循经按摩组、推拿组治疗后JOA评分均高于常规治疗组,循经按摩组治疗后JOA评分高于推拿组,差异有统计学意义(P<0.05);循经按摩组、推拿组治疗后NRS评分、ODI评分均低于常规治疗组,循经按摩组治疗后NRS评分、ODI评分低于推拿组,差异有统计学意义(P<0.05);循经按摩组愈显率为85.0%,推拿组愈显率为72.5%,常规组愈显率为32.5%,循经按摩组优于推拿组、常规组,差异有统计学意义(P<0.05)。结论:循经按摩能有效改善腰椎间盘突出症患者症状、腰椎功能,减轻疼痛、功能障碍。

疏肝健脾汤联合马来酸曲美布汀胶囊治疗腹泻型肠易激综合征临床研究

目的:观察疏肝健脾汤联合马来酸曲美布汀胶囊治疗腹泻型肠易激综合征(IBS)的临床疗效。方法:采用随机数字表法将102例腹泻型IBS患者分成对照组、治疗组各51例。对照组给予马来酸曲美布汀胶囊治疗,治疗组在对照组基础上加用疏肝健脾汤治疗,2组均连续治疗4周。比较2组治疗前后中医证候积分及血浆胆囊收缩素(CCK)、酪神经肽(NPY)及P物质(SP)水平;比较2组临床疗效、不良反应发生率及疾病复发率。结果:治疗后,治疗组总有效率为92.16%,高于对照组82.35%(P<0.05)。2组治疗后中医证候积分及血浆CCK、SP水平均低于治疗前(P<0.05),血浆NPY水平高于治疗前(P<0.05);治疗组治疗后中医证候积分及血浆CCK、SP水平低于对照组(P<0.05),血浆NPY水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗组疾病复发率2.13%,低于对照组9.52%(P<0.05)。结论:疏肝健脾汤联合马来酸曲美布汀胶囊治疗腹泻型IBS疗效确切,能够改善患者胃肠功能,降低疾病复发率,安全性较高。

Regulatory effects of Poria on substance and energy metabolism in cold-deficiency syndrome compared with heat-deficiency syndrome in rats

Recent studies have revealed that the property of drug is mainly associated with the body's substance and energy metabolism. The present study aimed to evaluate the drug property of Poria, called Fuling(FL) in traditional Chinese medicine(TCM), in terms of its effects on the substance and energy metabolism in rat models of cold-deficiency and heat-deficiency syndromes, compared with Aconiti Lateralis Radix Praeparaia, called Fuzi(FZ) in TCM, with hot property, and Anemarrhenae Rhizoma, called Zhimu(ZM) in TCM, with cold property, as reference drugs, respectively. The appearance score, toe and rectal temperatures of the animals treated were assessed at different time points. Several indices in vivo correlated with substance and energy metabolism(glucokinas, phosphoglycerate kinase, cytochrome c reductase, cytochrome c oxydase, and Na^+-K^+-ATPase), endocrine system(triiodothyronine, thyroxine, and 17-hydroxycorticosteroid), nervous system(acetylcholin esterase), and cyclic nucleotide system were determined. The changes in appearance score and indices in vivo suggested the successful establishment of cold-deficiency and heat-deficiency syndrome models. FZ reversed the decreased levels of indices(substance and energy metabolism and endocrine system) and alleviated the syndrome of cold-deficiency model, and ZM showed obviously therapeutic effect on heat-deficiency syndrome(appearance score, substance and energy metabolism, and endocrine system). FL could alleviate cold-deficiency syndrome and raise the decreased levels of glucokinas, phosphoglycerate kinase, cytochrome c reductase and triiodothyronine in cold-deficiency model, but had no significant effect on heat-deficiency syndrome. Drug property of FL was inferred as trending to "flat and warm", which still need further study. It was advisable to adopt both cold-deficiency and heat-deficiency models to study the drugs with "flat" property.

Comparative effect of electroacupuncture and moxibustion on the expression of substance P and vasoactive intestinal peptide in patients with irritable bowel syndrome

OBJECTIVE: To compare the impacts of electroacupuncture(EA) and moxibustion(Mox) on the primary gastrointestinal symptoms and the expressions of colonic mucosa-associated neuropeptide substance P(SP) and vasoactive intestinal peptide(VIP)in patients with either diarrhea-predominant or constipation-predominant irritable bowel syndrome(IBS-D and IBS-C,respectively).METHODS: Eighty-five IBS patients were randomly allocated to the EA and Mox groups. Zusanli(ST 36)and Shangjuxu(ST 37) were selected as acupoints for electroacupuncture or warm moxibustion treatment once a day for 14 consecutive days. Before and after the treatment sessions,a Visual Analog Pain Scale and the Bristol Stool Form Scale were used to evaluate gastrointestinal symptoms. There were four dropout cases,leaving 81 participants(41 with IBS-D and 40 with IBS-C) who volunteered to undergo colonoscopy before and after the treatment sessions. During colonoscopy,sigmoid mucosa were collected to detect SP and VIP expression using immunohistochemistry assay.RESULTS: Both EA and Mox treatments were effective at relieving abdominal pain in IBS-D and IBS-C patients. However,Mox was more effective at reducing diarrhea in IBS-D patients,whereas EA was more effective at improving constipation in IBS-C patients. EA and Mox treatments both down-regulated the abnormally increased SP and VIP expression in the colonic mucosa,with no significant difference shown between the two treatments.CONCLUSION: Both EA and Mox treatments are effective at ameliorating gastrointestinal symptoms by reducing SP and VIP expression in the colonic mucosa of IBS patients.

电针天枢、上巨虚对肠易激综合征大鼠模型结肠功能的影响

目的:观察电针天枢、上巨虚对肠易激综合征(IBS)模型大鼠内脏敏感性、肠道运动功能的影响,并探讨电针干预治疗IBS的可能作用机制。方法:选用体质量(200±20)g的雄性清洁型Wistar大鼠61只,分为空白组(11只)和模型组(50只),模型组大鼠采用慢性和急性应激相结合方法连续干预10 d制备IBS模型;造模结束后,模型组大鼠通过腹壁撤回反射半定量评分结合应激后大便颗粒数与空白组相比具有统计学意义,以此筛选制备成功的模型,再随机分为模型组(10只)、天枢组(10只)和上巨虚组(10只);天枢组毫针直刺3 mm,上巨虚组毫针直刺5 mm,分别连接电针;模型组同电针组每天抓取并束缚固定20 min,不针刺;空白组不予以任何操作。干预结束后,各组大鼠在浅麻状态下,运用Powerlab数据采集分析系统,记录不同扩张压力下诱发腹外斜肌放电所产生相对应的结肠痛敏阈值;采用酶联免疫吸附法(ELISA)检测各组大鼠血清中SP含量以及免疫蛋白印迹(Western blot)方法检测远端结肠中SP-神经激肽1型受体(NK-1R)蛋白的表达。结果:与空白组相比,模型组大鼠结肠痛敏阈值明显降低,血清SP含量以及远端结肠NK-1R受体表达均明显升高,差异具有统计学意义(P<0.05);与模型组相比,电针干预治疗后结肠痛敏阈值明显升高(P<0.01),血清SP含量以及远端结肠NK-1R受体表达均明显降低,差异具有统计学意义(P<0.01或P<0.05)。结论:电针天枢、上巨虚可以通过降低血清SP含量和结肠SP受体NK-1R表达,降低IBS大鼠内脏敏感性,升高痛敏阈值,调节肠道运动功能。

清热凉血法治疗血热型银屑病的疗效及对血清P物质、血管内皮生长因子的影响

目的 探讨清热凉血法治疗血热型银屑病的临床疗效及对血清P物质(substance P,SP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)的影响。方法 将43例血热型银屑病患者随机分为观察组(22例)和对照组(21例),在外用尿素乳膏的基础上,观察组予以口服清热凉血方剂,对照组予以口服复方氨肽素片,疗程均为8周。比较两组患者治疗前后银屑病面积与严重性指数(psoriasis area and severity index,PASI)、四条目瘙痒问卷(four-item itch questionnaire,FIIQ)评分、血清SP和VEGF水平,并评估临床疗效和不良反应发生率。结果 观察组临床疗效显著优于对照组(P<0.05)。两组治疗后PASI、FIIQ评分、SP水平、VEGF水平均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更为显著(P<0.05)。与对照组比较,观察组的不良反应发生率更低(P<0.05)。结论 清热凉血法能有效治疗血热型银屑病,缓解瘙痒,降低血清SP和VEGF水平,且不良反应发生率低。

枳术丸合四逆散治疗肝郁气滞证便秘型肠易激综合征的临床效果及对胃肠激素的影响

目的 探讨枳术丸合四逆散治疗肝郁气滞证便秘型肠易激综合征(IBS-C)的临床效果及对患者胃肠激素的影响。方法 将61例肝郁气滞证IBS-C患者随机分为对照组30例和观察组31例。在常规治疗的基础上,给予对照组口服枸橼酸莫沙必利分散片治疗,给予观察组口服枳术丸合四逆散加减治疗,两组疗程均为6周。比较两组治疗前后的中医证候积分、便秘患者生活质量评估(PAC-QOL)量表评分及血清胃动素、血管活性肠肽(VIP)、P物质水平,以及治疗后的临床疗效和治疗期间不良反应发生情况。结果 治疗后,观察组的腹痛腹胀积分、早饱纳差积分、排便次数减少积分、大便硬结积分、排便困难积分、精神症状积分及中医证候总积分低于治疗前及对照组(P<0.05),而两组的嗳气积分较治疗前降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗后,观察组PAC-QOL量表各维度评分及总分低于治疗前和对照组(P<0.05),对照组PAC-QOL量表的生理评分、满意度评分及总分低于治疗前(P<0.05),但治疗前后PAC-QOL量表的心理评分及担忧度评分差异无统计学意义(P>0.05)。治疗后,观察组血清胃动素、P物质水平较治疗前及对照组升高,血清VIP水平较治疗前及对照组降低(P<0.05);对照组血清胃动素水平较治疗前升高,血清VIP水平较治疗前降低(P<0.05),而治疗前后的血清P物质水平差异无统计学意义(P>0.05)。观察组疗效优于对照组(P<0.05)。治疗期间,观察组患者未出现不良反应,对照组有2例出现轻度口干。结论 枳术丸合四逆散治疗肝郁气滞证IBS-C患者的疗效优于枸橼酸莫沙必利分散片,其可能通过调节患者血清VIP、胃动素、P物质水平来缓解患者临床症状,改善其精神状态,提高其生活质量。

抗敏镇咳方治疗咳嗽变异性哮喘风邪恋肺证临床研究

目的:观察抗敏镇咳方治疗咳嗽变异性哮喘(CVA)风邪恋肺证的临床效果。方法:将68例CVA风邪恋肺证患者随机分为对照组和观察组各34例,对照组服用孟鲁司特钠片治疗,观察组予抗敏镇咳方治疗,2组疗程均为2周。治疗前后分别应用视觉模拟评分法(VAS)进行咳嗽评分,检测肺功能参数[第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量的百分比(FEV1/FVC)、剩余肺活量50%时的呼气流速(MEF50)、剩余肺活量25%时的呼气流速(MEF25)],血清P物质(SP)和肺泡灌洗液SP水平。结果:治疗后,2组日间咳嗽积分、夜间咳嗽积分与治疗前比较均下降(P<0.05)。观察组日间咳嗽积分、夜间咳嗽积分均低于对照组(P<0.05)。观察组FEV1、FEV1/FVC及MEF50值、MEF25值均高于治疗前(P<0.05),对照组FEV1、MEF50值、MEF25值均高于治疗前(P<0.05);观察组4项指标值均高于对照组(P<0.05)。2组血清SP、肺泡灌洗液SP水平均较治疗前下降(P<0.05)。观察组血清SP、肺泡灌洗液SP水平均低于对照组(P<0.05)。结论:抗敏镇咳方能够有效缓解CVA风邪恋肺证患者的咳嗽症状,改善肺功能,可能与减轻气道炎症、降低气道高反应性有关。

增液通秘方联合琥珀酸普芦卡必利片治疗实热证便秘临床研究

目的:观察增液通秘方联合琥珀酸普芦卡必利片治疗实热证便秘的临床疗效及对血清P物质(SP)、血管活性肠肽(VIP)及一氧化氮(NO)的影响。方法:采用随机数字表法将60例实热证便秘分为对照组与治疗组各30例。治疗组给予琥珀酸普芦卡必利片联合增液通秘方口服治疗,对照组给予琥珀酸普芦卡必利片口服治疗。比较2组治疗前后中医症状评分及血清肠神经递质水平,并评估2组临床疗效及不良反应发生情况。结果:治疗后,治疗组总有效率为93.33%,高于对照组76.67%(P<0.05)。治疗后,2组腹胀腹痛、排便时间、粪质干硬、口干口渴症状评分低于治疗前(P<0.05),且治疗组治疗后中医症状评分均低于对照组(P<0.05)。治疗后,2组SP水平高于治疗前(P<0.05),VIP、NO水平低于治疗前(P<0.05),且治疗组治疗后VIP、NO水平低于对照组(P<0.05),SP水平高于对照组((P<0.05)。2组均未出现不良反应。结论:增液通秘方联合琥珀酸普芦卡必利片治疗实热证便秘疗效确切,能够有效调节患者肠神经递质水平,缓解患者便秘症状,无不良反应。

痛泻要方拆方对腹泻型肠易激综合征大鼠脑肠肽的影响研究

背景肠易激综合征(IBS)是临床常见的肠道疾病,使用痛泻要方治疗确有疗效,但分析方剂中主要显效药物的相关研究较少。目的观察痛泻要方拆方对腹泻型肠易激综合征(IBS-D)大鼠结肠、海马体组织脑源性神经营养因子(BDNF)、P物质(SP)表达的影响。方法于2020年7月选取6周龄SPF级雄性Wistar大鼠共32只,采用抽签法随机分为空白组、模型组、白芍防风组(B-F组)和陈皮白术组(C-B组),每组8只。除空白组外,其余各组均使用结直肠扩张+慢性束缚应激法建立内脏敏感型IBS-D大鼠模型。造模后B-F组采用白芍防风中药浸膏(4 ml/kg)灌胃治疗,C-B组采用陈皮白术中药浸膏(4 ml/kg)灌胃治疗,空白组和模型组采用蒸馏水灌胃,治疗周期为14 d。比较造模后、治疗后四组大鼠体质量及增长情况、布里斯托大便分类法评分、不同压力梯度下腹部撤退反射(AWR)、结肠及海马体组织中BDNF和SP表达水平的差异。结果建立IBS-D模型大鼠成功,所有大鼠存活。B-F组、C-B组大鼠造模后体质量增长量小于空白组,治疗后体质量增长量大于模型组(P<0.05)。模型组大鼠治疗后布里斯托大便分类法评分高于空白组(P<0.05);B-F组和C-B组大鼠治疗后布里斯托大便分类法评分低于模型组(P<0.05)。治疗后在气囊压力为60 mm Hg时:模型组大鼠AWR评分均高于空白组(P<0.05)。治疗后在气囊压力为60、80 mm Hg时:B-F组大鼠AWR评分低于模型组、C-B组(P<0.05)。模型组、C-B组大鼠治疗后结肠组织BDNF、SP表达水平高于空白组(P<0.05);B-F组大鼠治疗后结肠组织BDNF、SP表达水平低于模型组和C-B组(P<0.05)。模型组大鼠治疗后海马组织BDNF表达水平低于空白组(P<0.05);模型组、C-B组大鼠治疗后海马组织SP表达水平高于空白组(P<0.05);B-F组大鼠治疗后海马组织BDNF表达水平高于模型组,SP表达水平低于模型组(P<0.05)。结论痛泻要方中白芍防风药对、陈皮白术药对均能明显增加IBS-D大鼠体质量、改善腹泻情况。相较于陈皮白术药对,白芍防风药对可明显缓解IBS-D大鼠肠道高敏感,更好地下调海马组织SP和结肠组织BDNF、SP的表达,上调海马组织BDNF的表达,调节相关脑肠肽的平衡。

芩连平胃汤加味对糜烂型口腔扁平苔藓脾胃湿热证的疗效及血清P物质和趋化素水平的影响

目的探讨芩连平胃汤加味治疗糜烂型口腔扁平苔藓(oral lichen planus,OLP)脾胃湿热证的疗效以及对血清P物质和趋化素水平的影响。方法筛选符合条件的糜烂型OLP脾胃湿热证病例共计76例,均来源于医院2018年1月—2021年12月接诊的患者,根据随机数字表法分为治疗组与对照组,每组38例。对照组患者进行常规治疗方案;治疗组于对照组基础上采取芩连平胃汤加味治疗。两组连续治疗4周。比较两组症状体征评分、脾胃湿热证单项症状评分、临床疗效以及血清P物质和趋化素水平。结果治疗4周后,两组症状与体征计分明显减少(P<0.01);治疗4周后,治疗组的症状与体征计分明显低于对照组(P<0.01);治疗4周后,两组脾胃湿热证单项症状评分明显减少(P<0.01);治疗4周后,治疗组的脾胃湿热证单项症状评分明显低于对照组(P<0.01);治疗4周后,治疗组的总有效率为97.37%(37/38),显著高于对照组的78.95%(30/38)(P<0.05);治疗4周后,两组血清P物质和趋化素水平明显下降(P<0.01);治疗4周后,治疗组血清P物质和趋化素水平明显低于对照组(P<0.01)。结论于常规措施的基础上,芩连平胃汤加味治疗糜烂型OLP脾胃湿热证的疗效更优,有利于患者症状、体征及中医证候的改善,以及抑制血清P物质和趋化素水平。

子痫前期的预测进展

子痫前期(PE)是妊娠期特有的严重并发症,发病率高,病情凶险,尤其是早发型子痫前期(EOPE),因此对于PE患者早诊断、早治疗尤为重要。多项研究表明,目前没有理想的单一指标用于预测PE,现有的研究大多是联合多项生化及物理指标进行筛查。本文将对PE的发病机制以及妊娠中期唐氏筛查血清学指标和血糖指标的变化对PE的预测价值做进一步阐述,以便为PE患者早期干预提供一定的理论基础。

四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫临床研究

目的:观察四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫的临床疗效。方法:将86例风寒袭络型急性期周围性面瘫患者按照随机数字表法分为对照组和试验组,每组各43例。对照组给予四物牵正散治疗,试验组在对照组治疗的基础上联合针刺疗法。比较两组患者的临床疗效、不良反应发生率及治疗前后面神经功能评分、面部残疾指数躯体功能(facial disability index physical function, FDIP)评分、面部残疾指数社会功能(facial disability index social function, FDIS)评分、中医证候积分、FaCE量表评分、免疫功能水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况。结果:对照组有效率为81.39%,试验组有效率为93.02%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后面神经功能评分、FDIP评分、FDIS评分高于本组治疗前,中医证候积分较低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后FaCE量表各项评分高于本组治疗前,且治疗后试验组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。试验组不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论:四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫患者,能够调节患者免疫功能,改善临床症状,且不良反应较低。