康泰方对腹泻型肠易激综合征患者结肠黏膜血红素氧合酶-1和一氧化氮合酶mRNA表达的影响

【目的】观察疏肝健脾安神和胃法组成的康泰方对肝郁脾虚腹泻型肠易激综合征(D-IBS)患者结肠黏膜血红素氧合酶(HO-1)和一氧化氮合酶(iNOS) mRNA表达的影响。【方法】将63例受试对象随机分为治疗组和对照组2组。治疗组32例采用康泰方口服治疗,对照组31例采用得舒特口服治疗,2组疗程均为8周。另设15例健康体检者为正常对照组。观察治疗前后症状积分改善情况及结肠黏膜HO-1和iNOS mRNA表达的变化。【结果】(1)治疗组治疗后各症状积分均较治疗前显著下降(P<0.05),对照组治疗后除腹痛、腹胀、便溏等症状积分较治疗前显著下降(P<0.05)外,其他各症状积分治疗前后比较差异无显著性意义(P>0.05)。(2)治疗后2组的HO-1平均光密度值均显著降低,iNOS蛋白的阳性单位均显著升高(与治疗前比较,P<0.05或P<0.01)。治疗组治疗后与正常对照组比较,差异均无显著性意义(P>0.05),提示治疗组已基本恢复到正常对照组水平;而对照组治疗后与正常对照组比较,差异均有显著性意义(P<0.05),提示对照组还未恢复到正常对照组水平。(3)治疗后2组的结肠黏膜iNOS基因相对表达量均显著升高,HO-1基因表达量均显著降低(与治疗前比较,P<0.05)。2组治疗后与正常对照组比较,差异均无显著性意义(P>0.05)。(4)相关性研究结果表明,腹痛、腹胀、便溏和大便不尽感等主要临床症状与HO-1均呈正相关,与iNOS呈负相关。HO-1和iNOS之间相关系数为-0.7512,呈负相关。HO-1蛋白表达量和HO-1基因表达量明显相关,iNOS蛋白表达量和iNOS基因表达量也明显相关。【结论】结肠黏膜HO-1和iNOS mRNA表达异常可能是肝郁脾虚型D-IBS临床表现的致病机制之一,康泰方可通过上述机制改善患者的临床症状。

Clinical observation of Yiqi Qingdu Prescription(益气清毒方)on the treatment of intermediate-stage and advanced non-small-cell lung cancer

OBJECTIVE:To observe the effects of the Yiqi Qingdu prescription(益气清毒方)on intermediate-stage and advanced non-small-cell lung cancer(NSCLC).METHODS:In total,300 patients with intermediate-stage or advanced NSCLC were randomly and equally divided into three groups using computer-generated random numbers as follows:Western medicine(WM),Chinese medicine(CM),and integrated Traditional Chinese and Western Medicine(IM).After 3 months of treatment,the overall response rate(ORR);disease control rate(DCR);symptom score(SS);Karnofsky performance status(KPS);adverse event score;counts of CD3^(+),CD4^(+),and CD8^(+)cells;CD4^(+)/CD8^(+)ratio;and carcinoembryonic antigen(CEA)level were compared among the groups.RESULTS:The ORRs were 30.36%,20.24%,and 7.87%in the IM,CM,and WM groups,respectively,whereas the DCRs were 85%,75%,and 73%,respectively.Compared to the CM group,the ORR was significantly higher in the WM and IM groups,whereas the DCR was significantly higher in the IM group(all P<0.05).SS was obviously higher in the WM group than in the other two groups(both P<0.01).KPS was significantly lower in the WM group after treatment(P=0.005).The mean number of adverse events was significantly lower in the CM(2.2±1.3)and IM(2.4±1.3)groups than in the WM group(4.6±1.7,both P<0.05).CD3^(+)cell counts were significantly decreased in the WM group(P=0.031).In the IM group,CD8^(+)cell counts were increased after treatment,whereas the CD4^(+)/CD8^(+)ratio was decreased(both P<0.01).Compared with the WM group,CD3^(+)(P=0.01),CD4^(+)(P=0.044),and CD8^(+)(P=0.009)cell counts were significantly higher in the IM group,whereas the CD4^(+)/CD8^(+)ratio was significantly lower(P=0.011).Relative to the CM group,CD8^(+)cell counts were significantly higher(P=0.001)and the CD4^(+)/CD8^(+)ratio was significant ly lower in the IM group(P=0.001).CEA levels were significantly increased in the CM group(P=0.023).CONCLUSION:The Yiqi Qingdu prescription can improve the outcomes of WM in patients with NSCLC.

双康联用在肛周疾病术后康复中的应用及效果探究

目的 观察双康(康泰方、康复新液)联用在肛周疾病术后康复中的应用及效果。方法 选取2020年5月—2020年12月该院收治的208例肛周疾病术后患者作为观察对象,根据患者入院先后顺序随机分为观察组与对照组各104例,对照组患者术后第2天开始给予高锰酸钾熏洗液治疗,观察组患者给予口服康泰方及康复新液熏洗治疗,两组患者治疗10 d。比较两组患者临床疗效、切口情况(切口渗液时间、切口腐肉脱落时间、新生上皮出现时间、切口愈合时间),观察术后第2天、治疗10 d后两组患者临床症状评分(疼痛程度、分泌物、肉芽形态),随访半年,统计两组患者肛周疾病复发情况。结果 观察组患者临床总有效高于对照组(P<0.05)。观察组患者切口渗液时间、切口腐肉脱落时间、新生上皮出现时间、切口愈合时间均短于对照组(P<0.05)。治疗10 d后,观察组患者临床症状(疼痛程度、分泌物、肉芽形态)评分均低于术后2 d及对照组(P<0.05);观察组患者肛周疾病总复发率低于对照组(P<0.05)。结论 双康联用在肛周疾病术后康复中应用效果显著,能有效缩短切口渗液时间、切口腐肉脱落时间、新生上皮出现时间及切口愈合时间,改善术后疼痛等临床症状,且能降低疾病复发情况,对创面恢复具有积极的促进作用。