Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy:a meta-analysis

BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulinpotassium(GIK) therapy on clinical outcomes in acute coronary syndrome(ACS) patients receiving reperfusion therapy.METHODS:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs) that compared high-dose GIK and placebos in ACS patients receiving reperfusion therapy.The primary endpoint was major adverse cardiovascular events(MACEs).RESULTS:Eleven RCTs with 884 patients were ultimately included.Compared with placebos,high-dose GIK markedly reduced MACEs(risk ratio [RR] 0.57,95% confidence interval [95% CI]:0.35 to 0.94,P=0.03) and the risk of heart failure(RR 0.48,95% CI:0.25 to 0.95,P=0.04) and improved the left ventricular ejection fraction(LVEF)(mean difference [MD] 2.12,95% CI:0.40 to 3.92,P=0.02) at 6 months.However,no difference was observed in all-cause mortality at 30 d or 1 year.Additionally,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95% CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95% CI:1.74 to 47.29,P=0.009) and hypoglycemia(RR 6.50,95% CI:1.28 to 33.01,P=0.02) but not reinfarction,hyperkalemia or secondary reperfusion.In terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD) activity but not glutathione peroxidase(GSH-Px) or catalase(CAT) activity.CONCLUSION:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering eflcacy in response to high-dose GIK.Moreover,with a higher incidence of complications such as phlebitis,hyperglycemia,and hypoglycemia.Furthermore,there were no observed survival benefits associated with high-dose GIK.More trials with long-term follow-up are still needed.

High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding:A meta-analysis

AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis.The primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and mortality.The meta-analysis was performed with a fixed effects model or random effects model.RESULTS:Nine eligible RCTs including 1342 patients were retrieved.The results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.

Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy

AIM To evaluate toxicity and treatment outcome of highdose radiotherapy(RT) for cervical esophageal cancer(CEC).METHODS We reviewed a total of 62 consecutive patients who received definitive RT for stage Ⅰ to Ⅲ cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded. Treatment failures were divided into local(occurring within the RT field), outfield-esophageal, and regional [occurring in regional lymph node(s)] failures. Factors predictive of esophageal stenosis requiring endoscopic dilation were analyzed.RESULTS Grade 1, 2, and 3 esophagitis occurred in 19(30.6%), 39(62.9%), and 4 patients(6.5%), respectively, without grade ≥ 4 toxicities. Sixteen patients(25.8%) developed post-RT stenosis, of which 7 cases(43.8%) were malignant. Four patients(6.5%) developed tracheoesophageal fistula(TEF), of which 3(75%) cases were malignant. Factors significantly correlated with post-RT stenosis were stage T3/4(P = 0.001), complete circumference involvement(P < 0.0001), stenosis at diagnosis(P = 0.024), and endoscopic complete response(P = 0.017) in univariate analysis, while complete circumference involvement was significant in multivariate analysis(P = 0.003). A higher dose(≥ 60 Gy) was not associated with occurrence of postRT stenosis or TEF. With a median follow-up of 24.3(range, 3.4-152) mo, the 2 y local control, outfield esophageal control, progression-free survival, and overall survival(OS) rates were 78.9%, 90.2%, 49.6%, and 57.3%, respectively. Factors significantly correlated with OS were complete circumference involvement(P = 0.023), stenosis at diagnosis(P < 0.0001), and occurrence of post-RT stenosis or TEF(P < 0.001) in univariate analysis, while stenosis at diagnosis(P = 0.004) and occurrence of post-RT stenosis or TEF(P = 0.023) were significant in multivariate analysis. CONCLUSION Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up.

High-dose interferon-α2b induction therapy in combination with ribavirin for treatment of chronic hepatitis C in patients with non-response or relapse after interferon-a monotherapy

AIM： To evaluate the daily high-dose induction therapy with interferon-α2b （IFN-α2b） in combination with ribavirin for the treatment of patients who failed with interferon monotherapy and had a relapse, based on the assumption that the viral burden would decline faster, thus increasing the likelihood of higher response rates in this difficult-totreat patient group. METHODS： Seventy patients were enrolled in this study. Treatment was started with 10 NU IFN-α2b daily for 3 wk, followed by IFN-α2b 5 NU/TIW in combination with ribavirin （1 000-1 200 mg/d） for 21 wk. In case of a negative HCV RNA PCR, treatment was continued until wk 48 （IFN-α2b 3MU/TIW＋1000-1200 mg ribavirin/daily）. RESULTS： The dose of IFN-α2b or ribavirin was reduced in 16% of patients because of hematologic side effects, and treatment was discontinued in 7% of patients. An early viral response （EVR） was achieved in 60% of patients. Fifty percent of all patients achieved an end-oftreatment response （EOT） and d0% obtained a sustained viral response （SVR）. Patients with no response had a significantly lower response rate than those with a former relapse （SVR 30% vs 53%; P=0.049）. Furthermore, lower response rates were observed in patients infected with genotype la/b than in patients with non-1-genotype （SVR 28% vs7d%; P=0.001）. As a significant predictive factor for a sustained response, a rapid initial decline of HCV RNA could be identified. No patient achieving a negative HCV-RNA PCR at wk 18 or later eventually eliminated the virus. CONCLUSION： Daily high-dose induction therapy with interferon-α2b is well tolerated and effective for the treatment of non-responders and relapsers, when interferon monotherapy fails. A fast decline of viral load during the first 12 wk is strongly associated with a sustained viral response.

Dose-individualization Efficiently Maintains Sufficient Exposure to Methotrexate without Additional Toxicity in High-dose Methotrexate Regimens for Pediatric Acute Lymphoblastic Leukemia

Objective:Methotrexate(MTX)can be safely administered to most patients but may cause severe toxicity in others.This study aimed to summarize the characteristics of high-dose methotrexate(HD-MTX)chemotherapy and to evaluate whether the modified dose-adjustment program was able to improve the maintenance of sufficient MTX exposure levels while minimizing toxicities.Methods:We evaluated 1172 cycles of high-dose MTX chemotherapy from 294 patients who were treated according to the CCCG-ALL-2015 protocol(clinical trial number:ChiCTR-IPR-14005706)and analyzed the data of actual MTX dosage,MTX concentration,toxicity,and prognosis.We compared data between the dose-adjustment Program 1(fixed 20%reduction in dose)and the dose-adjustment Program 2(dose-individualization based on reassessment of the creatine clearance rate and the MTX concentration-monitoring point at 16 h),which were applied if the MTX clearance was delayed in the previous cycle.Results:The patients who used Program 2 had higher actual MTX infusion doses and infusion rates and were able to better maintain the MTX concentration at 44 h at the established target value than those on Program 1(P<0.001).No significant differences in toxicities were found between these two programs except that abnormal serum potassium levels and prolonged myelosuppression in intermediate-risk/high-risk patients were more frequently observed in patients using Program 2(P<0.001).No significant correlations were observed between the MTX dose,dose-adjustment programs,or MTX concentrations and relapse-free survival.Conclusion:Adjusting the MTX dose using Program 2 is more efficient for maintaining sufficient MTX exposure without significantly increasing the toxicity.

Extraction Process and Quality Standard of Danshen Jianxin Capsules

[Objectives]This study was conducted to establish the quality standard of Danshen Jianxin Capsules.[Methods]Orthogonal design was adopted to optimize the water extraction process by taking the amount of water added,extraction time and extraction times as factors,and the content of tanshinone I as the index.Salviae Miltiorrhizae,Notoginseng Radix Et Rhizoma and Radix Astragali in the capsules were qualitatively identified by TLC,and the content of tanshinone I in the capsules was determined by HPLC.[Results]The best water extraction process included the steps of adding 12 times of water each time,extracting the materials twice,for 1 h each time.In TLC identification,the test samples showed spots of the same color at the positions corresponding to tanshinone II A,ginsenoside Rg1,notoginsenoside R1 and astragaloside IV reference samples.[Conclusions]Danshen Jianxin Capsules was prepared by the water extraction method,which is characterized by high efficiency and being suitable for mass production.The quality control method is reliable,fast and accurate,which can effectively control the quality of the product.

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psychological support, with particular emphasis on bed-rest duration and applicator removal. The development of effective interventions (both pharmacological and non-pharmacological) is needed to improve women’s experiences of brachytherapy for locally advanced cervical cancer.

Very-high-dose olanzapine for treatment-resistant schizophrenia

Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.

Comparison of High-Dose Dexamethasone and Prednisone for Initial Treatment of Adult Primary Immune Thrombocytopenia

Prednisone is the most common first-line treatment for adult primary immune thrombocytopenia (ITP). However, the best initial therapeutic approach is still a matter of debate. Prior studies have shown that high-dose dexamethasone (HD-DXM) produces a high sustained efficacy not achieved by conventional prednisone therapy. However, the definition of response widely differs between individual reports, and this heterogeneity makes comparison of the efficacy difficult. The aim of our study was to compare the therapeutic outcomes of a conventional dose of prednisone with HD-DXM for adult ITP patients as initial therapy. Thirty patients treated with prednisone and 22 patients treated HD-DXM were retrospectively analyzed. No significant differences between the HD-DXM and prednisone groups were observed for the rates of complete response (68% vs. 70%) and response (18% vs. 17%). However, 1 year probability of sustained response was significantly greater in the HD-DXM group than in the prednisone group (78% vs. 38%;P = 0.008). No adverse events necessitating discontinuation of treatment were observed in either group. Our retrospective analysis showed that initial treatment with HD-DXM produced longer response duration compared to a conventional dose of prednisone. Randomized clinical trials are warranted to establish the optimal initial steroid therapy for adult ITP.

A New Variant of Combined Pulmonary Fibrosis and Emphysema from Long-Term High-Dose of Glucocorticoid Therapy: A Case Report

Recent studies have described the combination of both pulmonary emphysema and idiopathic interstitial lung disease (ILDs) by means of high-resolution computed axial tomography (HRCT). Definition of this syndrome was first named by Cottin as combined pulmonary fibrosis and emphysema (CPFE). Functional and radiological findings have showed that these patients are suffering from severe breathlessness, but whose pulmonary functional tests revealed no signs of obstruction, normal static lung volumes, and depressed DLco, most with a history of smoking [1] [2]. The radiological and endoscopic studies especially show that these patients have both areas of upper-lobe predominant emphysema and lesions compatible with fibrosis in both lung bases [3]. No prior research has reported any cases of such condition in person with no prior history of smoking as well as long-term high-dose of glucocorticoid therapy. In this case report, we discuss the presentation, diagnosis, and management of a 53-year-old non-smoker with increasing shortness of breath with a long-term high-dose of glucocorticoid therapy discovered to have an abnormal variant or presentation of CPFE. The cause of disease was attributed to a certain history of smoking in most studies;other potential risk factors have yet to be properly analyzed. This clinical report features a special case about the problem and solution surrounding this issue.

丹参片联合那屈肝素钙注射液对髋部骨折术后下肢静脉血流参数的影响

目的探讨丹参片联合那屈肝素钙注射液对髋部骨折术后下肢静脉血流参数的影响。方法将2021年12月至2022年12月接受髋部骨折手术治疗的108例患者作为研究对象,按随机数字表法分为对照组和观察组,每组54例,2组均在术后开始用药,对照组采用那屈肝素钙注射液治疗,观察组采用丹参片联合那屈肝素钙注射液治疗,2组均治疗7 d后,对比术前及术后7 d患肢小腿直径差,对比术前及术后7 d疼痛分级(NRS)、下肢静脉血流参数(股总静脉、股浅静脉、股深静脉)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、骨碱性磷酸酶(BALP)、骨钙素(BGP)、Ⅰ型胶原羧基端交联肽(CTX-1),比较2组术后下肢静脉血栓发生率、药物不良发生率。结果观察组术前及术后7 d患肢小腿直径差明显低于对照组,NRS评分低于术前及对照组术后7 d,差异均有统计学意义(P<0.05);术后7 d观察组股总静脉、股浅静脉、股深静脉参数、TT、PT、APTT、BALP、BGP水平明显高于术前及对照组术后7天,CTX-1水平明显低于术前及对照组术后7天,差异均有统计学意义(P<0.05);2组不良反应总发生率比较,差异无统计学意义(P>0.05);观察组下肢脉血栓发生率明显低于对照组(P<0.05)。结论丹参片联合那屈肝素钙注射液用于髋部骨折术后,能缓解患者肿胀及疼痛,加快下肢静脉血流,降低患者血液高凝状态,改善骨代谢指标,进而降低血栓发生率。

丹参及其制剂治疗冠心病的药理及机制研究新进展

传统中药丹参及其制剂在临床应用范围广泛,对于冠心病(coronary heart disease,CHD)有良好疗效,其脂溶性成分丹参酮ⅡA具有抗动脉粥样硬化、抗心肌缺血、抗心肌纤维化和抑制心肌肥厚等作用,通过作用于Toll样受体/核转录因子-κB(toll like receptor 4/nuclear transcription factor-κB,TLR/NF-κB)、丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)/NF-κB、磷脂酰肌醇3-激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3 K/AKT)、雷帕霉素靶蛋白/内皮型一氧化氮合酶(mammalian target of rapamycin/endothelial nitric oxide synthase,mTOR/eNOS)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)/Smad2/3、应激激活蛋白激酶(stressac-tivated pro-tein kinase,SAPK)/MAPK、胞外信号调节蛋白激酶(extracellular regulated protein kinases,ERK)/核转录因子红细胞系2相关因子2(nuclear factor erythroid-2-related factor 2,Nrf2)、胱抑素C/Wnt(cystatin C/Wnt,Cys-C/Wnt)等信号转导通路发挥效应;隐丹参酮通过抑制炎性介质预防早期冠脉粥样硬化。水溶性成分丹酚酸A通过调节PI3 K/Akt、丝氨酸/苏氨酸激酶(serine/threonine kinase,GSK-3β)、c-Jun氨基末端激酶(c-Jun N-terminal kinase,JNK)和ERK1/2等通路抑制心肌细胞凋亡,降低炎症水平,改善心肌梗死;丹酚酸B通过抑制TLR4和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性体表达减轻心肌损伤;丹参素通过抑制Janus酪氨酸蛋白激酶(janus tyrosine protein kinase,JAK)/信号转导及转录激活因子(signal transduction and transcriptional activator,STAT)信号通路改善微循环、抗炎抗氧化、抗内皮损伤和抗血小板聚集。丹参水溶性成分制剂的主要靶点有前列腺素-内过氧化物合酶(prostaglandin-endoperoxidase synthase 2,PTGS2)、半胱氨酸天冬氨酸蛋白酶(Caspase-3)、表皮生长因子受体(epidermal growth factor receptor,EGFR)、基质金属蛋白酶9(matrix metalloproteinase-9,MMP9)、MAPKs、TLR4、JUN、STAT3、TLR/NF-κB、PI3 K/Akt、JAK2/STAT3和Nrf2/血红素加氧酶-1(heme oxygenase-1,HO-1)等,具有抗炎、改善血液流变性、保护血管内皮、抗血小板聚集等药理作用;复方丹参滴丸具有扩张冠脉、减少心肌耗氧、增加冠脉流量、增强心肌收缩等作用,还具备用量小、不良反应少,对胃肠刺激小等优点;冠心宁片治疗CHD的靶点包括核受体共激活因子2(nuclear receptor coactivator 2,NCOA2)、一氧化氮合酶2(nitric oxide synthase 2,NOS2)等,主要调控PI3 K/Akt、白细胞介素-17(interleukin-17,IL-17)、低氧诱导因子-1(hypoxic inducible factor-1,HIF-1)等通路;新加丹参饮具有扩张冠脉、增加血流量、改善微循环等作用;冠心丹参方的主要药理活性在于增加冠脉血流量,降低心肌耗氧,从而改善心肌缺血,提高心功能。

基于网络药理学和分子对接探究复方丹参滴丸治疗骨关节炎的作用机制

目的基于网络药理学和分子对接方法预测复方丹参滴丸(CDDP)治疗骨关节炎(OA)的作用机制。方法利用TCMSP数据库筛选CDDP主要化合物及靶点信息;查询GeneCards、OMIM、DisGenet数据库搜集OA相关蛋白靶点;利用Venn在线工具构建药物和疾病共同靶点;利用String 11.0平台构建蛋白质相互作用网络;采用Cytoscape 3.9.1软件构建药物-成分-靶点-疾病网络;使用R包clusterProfiler进行基因本体(GO)及京都基因与基因组百科全书(KEGG)通路富集分析;采用AutoDock Vina进行分子对接。结果CDDP与OA交集靶点有44个,KEGG通路富集发现,磷脂酰肌醇3-激酶/蛋白激酶B及白细胞介素-17信号通路等与药物作用通路相关;分子对接显示槲皮素、芹菜素和木犀草素与11个核心靶点结合良好,尤其槲皮素与金属蛋白酶9。结论CDDP可能通过多成分、多靶点、多通路共同发挥抗OA的作用.

山楂丹参分散片的制备工艺研究

目的考察山楂丹参分散片最佳制备工艺。方法以丹参药材中丹参素钠、山楂药材中金丝桃苷为指标,采用L_(9)(3^(4))正交试验设计,对丹参、山楂提取工艺开展研究;通过对山楂丹参分散片中填充剂、润湿剂、崩解剂的考察,以分散均匀度为考察指标,对山楂丹参分散片处方和工艺进行筛选。结果山楂丹参分散片的最佳制备工艺为取丹参药材,加10倍量水回流提取3次,每次2 h,取山楂药材,用10倍量75%乙醇回流提取2次,每次1 h,分别将药液浓度至1.0 g/mL,并通过AB-8型大孔吸附树脂柱洗脱、浓缩、干燥,将上述丹参、山楂提取物混匀,过80目筛,再分别加入微晶纤维素、硫酸钙、羧甲基纤维素钠、交联羧甲基纤维素钠(过100目筛),混合均匀,以50%乙醇为黏合剂,24目筛制粒,60℃干燥。结论按最佳制备工艺制备的丹参、山楂提取物中丹参素钠、金丝桃苷含量较高;山楂丹参分散片在3 min内分散均匀,各项指标均符合2020年版《中华人民共和国药典》(四部)规定,表明山楂丹参分散片制备工艺稳定可行,筛选处方合理,可进一步研发。

加减柴陷丹参饮合二陈汤联合常规西药治疗冠心病的效果观察

目的观察加减柴陷丹参饮合二陈汤联合常规西药治疗冠心病的效果。方法选取2023年1至12月收治的冠心病患者151例,按照治疗方法分为观察组73例和对照组78例。对照组给予常规西药治疗,观察组在对照组基础上给予加减柴陷丹参饮合二陈汤治疗。比较2组治疗后心绞痛次数及持续时间、血脂指标[总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、炎症指标[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]、心肌酶指标[肌酸激酶、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、中医证候积分及临床疗效。结果治疗后,观察组心绞痛次数少于对照组,持续时间短于对照组(P<0.01)。治疗后观察组总胆固醇、三酰甘油、LDL-C含量低于对照组,HDL-C含量高于对照组(P<0.05);治疗后观察组hs-CRP、IL-6、肌酸激酶、CK-MB、LDH含量低于对照组(P<0.01);观察组中医证候积分低于对照组,中医证候疗效总有效率[94.52%(69/73)]高于对照组[83.33%(65/78)],西医临床总有效率[90.41%(66/73)]高于对照组[82.05%(64/78)],差异有统计学意义(P<0.05,P<0.01)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论柴陷丹参饮合二陈汤联合常规西药疗法能有效缓解冠心病患者心绞痛次数和持续时间,调节血脂,减轻炎症反应,缓解中医证候,提高临床疗效,且安全性较高。

基于中和医派以丹参注射液治疗肺动脉高压所致右心衰竭临床观察

目的 研究中和派思想指导下,以丹参注射液治疗肺动脉高压所致右心衰竭的临床效果。方法 收集2021年1月—2022年2月九江市第一人民医院收治的肺动脉高压伴右心衰竭患者111例,按随机数字表法分为3组,分别为对照组、西药组和联合组,每组37例;对照组采用临床常规治疗方案,西药组在对照组的基础上加用托伐普坦,联合组在西药组基础上加用丹参注射液,3组均治疗28 d,观察临床疗效及血清N末端B型利钠肽原(NT-proBNP)、β2微球蛋白(β2-MG)水平。结果联合组总有效率为94.59%(35/37)、西药组总有效率为89.19%(33/37),均显著高于对照组的78.38%(29/37)(P<0.05)。与治疗前比较,3组中医临床症状体征积分均明显降低,且治疗后联合组中医临床症状体征积分低于西药组及对照组(P<0.05)。与治疗前比较,3组患者NT-proBNP、β2-MG水平均明显降低(P<0.05),且联合组NT-proBNP、β2-MG水平明显低于西药组及对照组(P<0.05)。结论 丹参注射液联合托伐普坦治疗肺动脉高压伴右心衰竭,能够显著提高临床效果、改善临床症状、降低患者血清NT-proBNP、β2-MG水平,值得临床应用。

丹参注射液联合硝苯地平治疗对子痫前期患者子宫动脉血流动力学、血压的影响

目的探讨硝苯地平与丹参注射液联合治疗对子痫前期患者子宫动脉血流动力学、血压的影响。方法回顾性选取2020年2月—2023年2月山东省潍坊市中医院收治的100例子痫前期患者的临床资料,依据用药方法分为观察组(硝苯地平与丹参注射液联合治疗)与对照组(硝苯地平单独治疗),各50例。比较两组患者子宫动脉血流动力学、血压、平均动脉压、临床疗效、分娩方式、分娩情况、围生期结局。结果用药后,观察组脐动脉收缩末期峰值/舒张末期峰值、阻力指数、搏动指数、收缩压、舒张压、平均动脉压、剖宫产率均低于对照组,自然分娩率高于对照组,分娩孕周大于对照组,差异有统计学意义(P均>0.05)。观察组产妇不良妊娠结局发生率、新生儿不良结局发生率均低于对照组,差异有统计学意义(P均<0.05)。观察组治疗总有效率为92.00%(46/50),高于对照组的76.00%(38/50),差异有统计学意义(χ^(2)=5.741,P<0.05)。结论硝苯地平与丹参注射液联合治疗子痫前期,较硝苯地平单独治疗,更能改善患者的子宫动脉血流动力学及血压指标水平。

杂合式血液净化序贯疗法与丹参注射液联合治疗重症急性胰腺炎的效果分析

目的分析杂合式血液净化序贯疗法与丹参注射液联合治疗重症急性胰腺炎(SAP)的效果。方法98例SAP患者,使用随机数字表法分为对照组(49例)与研究组(49例)。两组均接受基础治疗,对照组应用杂合式血液净化序贯疗法,研究组在其基础上联合丹参注射液治疗。比较两组患者的临床疗效、症状与体征改善时间、不良反应发生情况。结果研究组患者总有效率95.92%高于对照组的81.63%(P<0.05)。研究组腹痛腹胀消失时间、血尿淀粉酶恢复正常时间、尿恢复正常时间、体温恢复正常时间分别为(4.23±0.95)、(4.15±1.06)、(6.00±0.92)、(5.02±0.85)d,均短于对照组的(6.00±0.86)、(6.45±1.09)、(7.56±1.00)、(6.50±0.79)d(P<0.05)。两组不良反应发生率比较未见差异性(P>0.05)。结论杂合式血液净化序贯疗法与丹参注射液联合治疗SAP效果确切,能够促进患者症状与体征恢复,具有临床推广价值。

复方丹参滴丸联合阿托伐他汀钙治疗慢性心力衰竭临床观察

目的探讨复方丹参滴丸联合阿托伐他汀钙对慢性心力衰竭(congestive heart failure,CHF)患者心功能及细胞因子的影响。方法选取2020年8月—2022年8月就诊于济宁市中医院CHF患者92例进行研究,按照随机数字表法分为2组,各46例。对照组予以阿托伐他汀钙片进行治疗,观察组在对照组基础上采用复方丹参滴丸进行治疗,于治疗3个月后评估。对比2组临床疗效、心功能、细胞因子、血管活性物质、不良反应。结果观察组治疗总有效率(95.65%)高于对照组(80.43%),差异有统计学意义(P<0.05)。治疗前2组心功能、细胞因子、血管活性物质对比,差异无统计学意义(P>0.05);与对照组对比,观察组治疗后左室射血分数(left ventricular ejection fractions,LVEF)高,左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)低,6 min步行距离(six minute walk distance,6MWD)长,可溶性生长刺激表达基因2蛋白(soluble growth stimulation expression gene 2 protein,sST2)、半乳糖凝集素-3(galectin-3)水平均低,内皮素-1(endothelin-1,ET-1)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、脑利钠肽(brain natriuretic peptide,BNP)水平均低(P<0.05)。观察组不良反应(13.04%)与对照组(10.87%)对比,差异无统计学意义(P>0.05)。结论CHF患者经复方丹参滴丸与阿托伐他汀钙治疗后心功能得到显著改善,且血清细胞因子水平趋于正常,血管活性物质生成有效一致,且安全性高。

复方丹参滴丸配合阿托伐他汀对冠心病患者行经皮冠状动脉介入术后血管内皮功能和血管炎性反应的影响

目的分析复方丹参滴丸配合阿托伐他汀对冠状动脉粥样硬化性心脏病(简称冠心病)患者行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后血管内皮功能和血管炎性反应的影响。方法选取2023年1月—2024年1月中南大学湘雅医院收治的94例冠心病患者为研究对象,所有患者均接受PCI,按治疗方法不同分组,每组47例。单药组采用阿托伐他汀治疗,联合组给予复方丹参滴丸、阿托伐他汀联合治疗,对比两组临床疗效、血管内皮功能、血管炎性反应。结果联合组临床总有效率为95.74%(45/47),高于单药组的74.47%(35/47),差异有统计学意义(χ^(2)=9.598,P<0.05)。治疗8周后,联合组的血管性血友病因子、内皮素-1、肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平低于单药组,血清一氧化氮水平高于单药组,差异有统计学意义(P均<0.05)。结论冠心病患者PCI术后应用复方丹参滴丸配合阿托伐他汀治疗,可有效抑制炎症因子释放,改善血管内皮功能,临床疗效显著。