Effect Study of the Recombinant Human Brain Natriuretic Peptide in Patients with Heart Failure Combined with Hypotension

Objective: This paper aims to investigate the effect of applying recombinant human brain natriuretic peptide in patients with heart failure combined with hypotension. Recombinant human brain natriuretic peptide is a synthetic polypeptide drug that is primarily used to treat acute heart failure. Its mechanism of action closely mimics that of human endogenous brain natriuretic peptide. By binding to receptors on cardiomyocytes, it exerts its pharmacological effects. Methods: For the study, 76 heart failure patients with hypotension were selected from our hospital between May 2022 and June 2023. These patients were divided into two groups: a control group and an observation group, each comprising 38 patients. The control group received dopamine treatment, while the observation group was treated with recombinant brain natriuretic peptide. The objective was to compare the effects of the treatments in both groups by analyzing cardiac function indices and levels of vasoactive substances to identify any significant differences in outcomes. Results: The overall response rate of the patients in the observation group and the control group was 94.74% and 73.68%, significantly higher as compared with the observation group (P 0.05). After the following treatment, BNP, ANNP and urine output in the observation group were significantly different compared with the control group, of the statistical significance (P Conclusion: For the treatment of heart failure patients with hypotension, the clinical application of recombinant human brain natriuretic peptide is the most ideal, and significantly improves the cardiac function of patients, which is worth popularizing.

Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure

Lyophilized recombinant brain natriuretic peptide(BNP)is an exogenous peptide synthesized by artificial recombination technology,with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body.It’s main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body,regulating,thus,the imbalance of the vascular system and cardiac hemodynamics,improving the heart’s pumping capacity,and inhibiting sympathetic excitability and myocardial remodeling.Moreover,it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes.In the present study,102 chronic heart failure(HF)patients were randomly assigned to a control and an observation group consisting of 51 patients each.Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets,spironolactone,and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period,plus the standard HF therapy.The recombinant human BNP group(observation group)demonstrated better physical,emotional,social,and economic scores,as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein,N-terminal pro BNP and troponin I levels,compared to the control group.Moreover,cardiac function was also improved,as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group.Interestingly,adverse reactions were not different between the 2 groups.However,these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.

Lyophilized recombinant human brain natriuretic peptide for chronic heart failure:Effects on cardiac function and inflammation

BACKGROUND Chronic heart failure(CHF)is a serious and prevalent condition characterized by impaired cardiac function and inflammation.Standard therapy for CHF has limitations,prompting the exploration of alternative treatments.Recombinant human brain natriuretic peptide(BNP)has emerged as a potential therapy,with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with CHF.However,further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory status.This study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients’cardiac function and microinflammatory status.AIM To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with CHF.METHODS In total,102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups(n=51 patients/group).The control patients were treated with standard HF therapy for 3 d,whereas the observational patients were injected with the recombinant human BNP for 3 d.Clinical efficacy,inflammatory factor levels,myocardial damage,cardiac function before and after the treatment,and adverse reactions during treatment were compared between the two groups.RESULTS The overall clinical efficacy was higher in the observation group than in the control group.Compared with baseline,serum hypersensitive C-reactive protein,N-terminal proBNP,and troponin I level,and physical,emotional,social,and economic scores were lower in both groups after treatment,with greater reductions in levels and scores noted in the observation group than in the control group.The overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group(P>0.05).CONCLUSION Freeze-dried recombinant human BNP therapy can improve heart function and enhance microinflammatory status,thereby improving overall quality of life without any obvious side effects.This therapy is safe and reliable.

Plasma brain natriuretic peptide level in older outpatients with heart failure is associated with physical frailty, especially with the slowness domain

ObjectiveTo 决定在血浆大脑 natriuretic 之间的协会在有心失败( HF )和物理脆弱以及与心血管的药的 106 个门诊病人变老的物理 frailty.MethodsTwo 的每个领域的病人的肽( BNP )水平60岁以上为 HF 被就医了或被给了一为 HF 的药方药被包括。物理脆弱用下列五个领域被估计：缓慢，软弱，疲劳，低活动，并且缩小，根据心血管的健康学习。病人们根据脆弱分数被划分成 nonfrailty 和脆弱组。血浆 BNP 水平被测量。6-min 散步测试被执行测量 endurance.ResultsPlasma BNP 在二个组之间是显著地不同的(脆弱组：158.0 &#x000b1；214.7 pg/mL， nonfrailty 组：65.2 &#x000b1；88.0 pg/mL， P &#x0003c；0.01 ) 。Multivariate 逻辑回归分析表明转变木头的血浆 BNP (木头 BNP ) 显著地与物理脆弱被联系(或：1.68， 95% CI：1.11-2.56 ) ，并且木头 BNP 显著地与缓慢领域被联系(走的速度 &#x0003c；1.0 m/s ) 物理脆弱(或：1.75， 95% CI：1.15-2.67 ) 。另外，木头 BNP 否定地被相关到 6 分钟的散步距离(6MWD )(&#x003c1；=&#x02212； 0.37， P &#x0003c；0.01 ) ，当 6MWD 断然被相关到走速度时(&#x003c1；= 0.66， P &#x0003c；0.01 ).ConclusionsPlasma BNP 水平与物理脆弱有关，特别在缓慢领域。耐力可以在在血浆 BNP 水平和走的速度之间的协会干涉。

Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

BackgroundThe neutrophil-to-lymphocyte (N/L ) 比率与心失败在病人与差的预后被联系了，但是它一直不在有长期的心失败(CHF ) 的老病人与 N 终端支持大脑的 natriuretic 肽(NT-proBNP ) 相比。我们寻求了与 CHF 1355 个老病人使这 comparison.MethodsA 全部被分析。multivariate 逻辑回归模型被用来分析与 atrial 纤维性颤动(AF ) 联系的变量。考克斯回归分析被用来估计在 N/L 比率， NT-proBNP 水平，和随后的主要心血管的事件(MCE ).ResultsIn 之间的 multivariable 关系多重逻辑回归分析， N/L 比率与 CHF 在老病人为 AF 作为一个风险因素被表明[机会比率(或) ：1.079， 95% 信心间隔(CI ) ：1.027-1.134， P = 0.003 ] 。中部的后续时期是 18 个月。在用两个变量的 tertiles 的一个 multivariable 模型， N/L 比率的最高的 tertile 显著地与 MCE 被联系[危险比率(HR ) ：1.407， 95% CI：1.098-1.802， P = 0.007 ] 与最低 tertile 相比。同样，最高的 NT-proBNP tertile 显著地也与 MCE 被联系(HR：1.461， 95% CI：1.104-1.934， P = 0.008 ).ConclusionsIn 有 CHF 的老病人， N/L 比率是为 AF 的重要风险因素之一，它是有到 NT-proBNP 的类似的独立预示的力量的一个便宜、容易地可得到的标记。当 N/L 比率被提高到最高的 tertile 时， MCE 的风险增加 1.407 褶层。

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

Brain natriuretic peptide is a potent vasodilator in aged human microcircula- tion and shows a blunted response in heart failure patients

BackgroundBrain natriuretic 肽(BNP ) 在在发行量的底层是通常在场的，但是它在心失败题目(CHF ) 与拥挤的度同时被提高。BNP 有 natriuretic 效果并且是有势力血管扩张药。BNP 能是在 CHF 的一种治疗学的选择，这被建议。然而，我们要求了在 CHF 的传播 BNP 的高水平可以 downregulate microvascular natriuretic 受体的反应。这被比较 15 个 CHF 病人测试(BNP &#x0003e；3000 ng/L ) 与 10 匹配的、健康 controls.MethodsCutaneous microvascular 血，在前臂的流动被激光 Doppler Flowmetry 测量。本地加热(+44 &#x000b0； C， 10 min ) 被用来唤起一个最大的本地扩张器 BNP 或醋胆素(ACh ) 的 response.ResultsNon 侵略的 iontophoretic 管理，一个已知的内皮细胞层依赖者扩张器，在本地流动得到了增加。氮的氧化物 synthase 禁止者， l-N-Arginine- 甲基酉旨(L 名字) ，堵住了 BNP 反应(在控制) 。有趣地，对在 CHF 病人的 BNP 的回答被归结为在健康控制看见的大约三分之一那些(的增加流动：251% 在 CHF 对 908% 在控制；P &#x0003c；0.001 ) 。相反，对 ACh 并且到本地加热的血管扩张药回答仅仅有点在 CHF 病人被稀释。因此，发信号的扩张器能力和氮的氧化物没被影响到象调停 BNP 的膨胀的一样的程度，第一次显示后者 response.ConclusionsThe 调查结果表演的特定的 downregulation 对 BNP 的 microvascular 回答显著地在 CHF 病人被减少。这与 BNP 受体功能的假设一致是在 CHF 的 downregulated。

Brain natriuretic peptide and optimal management of heart failure

Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease. Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spiro- nolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guid- ance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.

Heart and Brain:A neutro-genomic link

The philosophy of heart and brain are very ancient in our literature where the things good for the heart are not suggested good for the brain and vice-versa.Modern medicine is characterized by a high degree of specialization and the heart-brain connection that could be targeted to treat these complex cardiovascular/brain disorders.The idea that adverse diet/genome interactions can cause disease is not new.In the recent era the science of nutritional genomics have increased our understanding of diet-health-gene interactions and have provided a number of benefits for individuals,groups and societies.Since dietary chemicals are regularly ingested and participate indirectly and directly in regulating gene expression,it follows that a subset of genes regulated by diet must be involved in disease initiation,progression,and severity.In this regards Liver X Receptor(LXR)-a,a key transcription factors,associated with the several chronic pathological situation including coronary heart disease and neurodegenerative diseases have recently been found to be regulated by the dietary components.The crucial findings at molecular biology unit,Post Graduate Institute of Medical Education and Research(PGIMER),Chandigarh,INDIA have not only forced us to explore nutritional genomics as a holistic systems approach to understand the relationship between diet and health,but also to look into the disease preventing and health promoting foods that match our lifestyles,cultures and genetics.After all,we are what we eat.

Effect of Cardioxane and Selenium on Lipoperoxidation and Levels of Dopamine in Rat Brain and Heart

Background: Cardioxane has been probed in patients with advanced malignancies to protect the heart. Selenium, an essential micronutrient exerts varieties of functions such as antioxidant. The aim of this study was to test if cardioxane (CDX) and selenium (Se) have additive antioxidant protective effect on brain and heart, and their relation with dopamine levels. Methods: Thirty-six male Wistar rats divided in groups of 6 animals each, were treated as follows: G1, saline solution 0.9% (control);G2, 100 mg/kg of CDX;G3, 60 μg/kg of Se;G4, 20 mg/kg of 3-nitropropionic acid (3NP);G5, 3NP + CDX and G6, 3NP + Se. 3NP was used as an oxidative stress inducer. Drugs were administered intraperitoneally for 5 days. The animals were sacrificed on the last day of treatment and the brain and heart were extracted and used to measure lipid peroxidation, dopamine, glutathione (GSH), ATPase, calcium, and H2O2. Results: In G2 and G5, dopamine decreased in cortex and striatum while GSH increased in heart, cortex and cerebellum/medulla oblongata. ATPase activity increased in heart and cortex of groups 2, 3, 5 and 6. Lipoperoxidation and H2O2 increased in cortex of animals treated with 3NP. Conclusion: These results suggest that CDX increases antioxidant capacity in the brain and heart while selenium promotes alteration in dopamine metabolism in view of the capacity of 3NP to generate free radicals.

Relationship between hypothermia and heart rate yarialion in severe brain injury

AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The patients were devided into HT therapy group(n=21,body temprature 32-33℃),non-HT therapy group(n=20) and normal control(n=20).RESULTS:In group 1,the reduction of time domain indexes and frequency domain indexes were 3-6 folds and 30-50folds respectively compared with those of the control group,while the corresponding indexes reduction were 2-3 folds and 4-5folds in the group 2(P<0.05,P<0.01,respectively).The difference between groups were significant(P<0.05-0.01);the HRV reduction was more significant in the cerebrovascular accident patients than that of brain injured(P<0.05-0.01);the HRV indexes increased significantly in resuscitated patients than those in coma(P<0.01);the HRV in dead was much lower than that in survival(P=0.01).CONCLUSION:Injury of central nervous system can induce abnormal function of automatic nerve of heart and reduction of HRV.HT therapy can reduce HRV on a higher level;HRV examination can be applied into the prediction of prognosis of the brain injured.

POWER OF DUAL-WAVELENGTH APPROACHES IN STUDYING PHYSIOLOGICAL AND FUNCTIONAL CHANGES OF INTACT HEART AND IN VIVO BRAIN

Since the dual-wavelength spectrophotometer was developed,it has been widely used for studying biological samples and applied to extensive investigations of the electron transport in respiration and redox cofactors,redox state,metabolic control,and the generation of reactive oxygen species in mitochondria.Here,we discuss some extension of dual-wavelength approaches in our research to study the physiological and functional changes in intact hearts and in vivo brain.Specifically,we aimed at(1)making nonratiometricfluorescent indicator become ratiometricfluorescence function for investigation of Ca^(2+) dynamics in live tissue;(2)eliminating the effects of physiological changes on measurement of intracellular calcium;(3)permitting simultaneous imaging of multiple physiological parameters.The animal models of the perfused heart and transiently ischemic insult of brain are used to validate these approaches for physiological applications.

Plasma brain natriuretic peptide and atria natriuretic peptide as predictors for diastolic heart failure in patients with type 2 diabetes mellitus

在糖尿病的病人学习心脏舒张的心脏的功能的变化并且与类型 2 糖尿病 mellitus.Methods 在病人为心脏舒张的心失败决定血浆大脑 natriuretic 肽( BNP )和正厅 natriuretic 肽( ANP )的诊断价值的目的 12 个健康题目和 71 个糖尿病的病人在 study.Plasma 被包括 BNP 和 ANP 与 ofBNP andANP 与 dias 的增加的严厉显著地增加了的 immunoradiometic assay.Results

The influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI

Objective:To observe the influence of tirofiban on the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI and provide scientific basis for treatment of acute myocardial infarction.Methods:A total of 100 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: the control group (50 cases) and the observation group (50 cases). The conventional treatment of PCI was performed on both groups. Tirofiban injection was given to the observation group on the basis of conventional treatment. cTnI, BNP and echocardiography parameters (LVEF, LVEDD, LVESD) were detected before and after treatment.Results:The comparison of cTnI in the two groups before operation was not statistically significant. cTnI in the 2 groups increased 12 h and 24 h after operation. But the cTnI in observation group (0.10±0.23) ng/mL decreased more significantly than that in control group (0.24±0.31) ng/mL, the difference was considered to be statistically significant. The comparison of BNP in the two groups before operation was not statistically significant. BNP in the 2 groups decreased obviously 7 d and 30 d after operation. BNP in observation group decreased more significantly than that in control group and the difference was considered to be statistically significant LVEF in the observation group increased significantly compared with that in control group 7 d after operation. The comparison of LVEDD, LVESD were not considered to be statistically significant. LVEDD and LVESD in the observation group were lower than that in control group obviously 30 d after operation. While the LVEF in the observation group was still higher than that in the control group. The comparsion was considered to be statistically significant.Conclusion:Tirofiban can improve the troponin, brain natriuretic peptide, heart function in patients with Acute Myocardial Infarction after PCI. It can also decrease the heart injury as well as helping the recovery of heart function.

Effect of recombinant human brain natriuretic peptide on serum inflammatory factors, neuroendocrine hormones and cardiac function in patients with acute myocardial infarction complicated with heart failure

Objective:To investigate the effect of recombinant human brain natriuretic peptide (BNP) on inflammatory factors, neuroendocrine hormones and cardiac function indexes in patients with acute myocardial infarction complicated with heart failure.Methods:A total of91 cases of acute myocardial infarction with heart failure patients were divided into the control group (n=44) and observation group (n=47) according to the random data table, two groups of patients were given conventional treatment, based on this, the control group was given intravenous infusion of Nitroglycerin Injection treatment, the observation group received intravenous injection of recombinant human brain natriuretic peptide treatment, compared serum inflammatory factors, neuroendocrine hormone and cardiac function and other indexes of two groups before and after treatment.Results: there was no significant difference between the two groups before treatment. After treatment, the levels of TNF-α, hs-CRP, IL-6, MCP-1, LVESD and LVEDD in the two groups were significantly lower than those within the group before treatment, and the observation group was significantly lower than the control group;The two groups after treatment LVEF levels were significantly higher than those in the group before treatment, and the observation group was significantly higher than that of control group;the observation group after treatment PRA, Ang II and ALD and NE levels were significantly lower than those before treatment, and was significantly lower than the control group after treatment, the difference was significant, PRA, Ang, ALD and NE levels of control group before and after the treatment was no significant difference.Conclusion:recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction with heart failure can effectively reduce the serum inflammatory factors and neuroendocrine hormone levels, improve heart function, and have a certain clinical value.

6min步行距离联合NT-proBNP对射血分数保留型心力衰竭的诊断价值

目的:探讨6min步行距离(6MWD)和N末端脑钠肽前体(NT-proBNP)对射血分数保留型心力衰竭(HFpEF)的诊断价值。方法:回顾性分析2019年1月至2021年4月哈尔滨医科大学附属第一医院心内科收治的80例HFpEF患者(HFpEF组)和同期体检的85例健康对照者(健康对照组)的临床资料。比较两组一般资料、6MWD和血浆NT-proBNP的水平,利用受试者工作特征曲线(ROC)评估6MWD和血浆NT-proBNP及二者联合检测对HFpEF的诊断价值。结果:与健康对照组比较,HFpEF组血浆NT-proBNP水平[436.31(410.93,476.40)pg/ml比960.25(750.40,1460.50)pg/ml]显著升高,6MWD[440.00(412.00,460.00)m比359.00(300.00,403.75)m]显著降低,P均=0.001。ROC曲线分析显示,血浆NT-proBNP和6MWD都对HFpEF具有较高诊断价值(曲线下面积(AUC)=0.935、0.821),其截断值分别为511.9pg/ml和385.0m,且联合检测的AUC(0.943)高于单一检测,提示联合检测具有更高的诊断价值。结论:6min步行距离联合血浆N末端脑钠肽前体检测对HFpEF具有较高的诊断价值。

肾素-血管紧张素系统在血管性痴呆大鼠心肌损伤中的作用

目的探讨肾素-血管紧张素系统在实验性血管性痴呆大鼠心肌损伤中的作用。方法24只成年雄性SD大鼠分为正常组、假手术组和模型组。Morris水迷宫用于评估大鼠学习记忆功能;免疫染色法观察心肌细胞横截面积和间质胶原蛋白分数以评估实验性血管性痴呆引起的心肌改变。检测血清中血管紧张素Ⅱ(AngⅡ)和血管紧张素1-7(Ang1-7)的浓度,以及心肌中血管紧张素转换酶(ACE)、血管紧张素转换酶2(ACE2)、AngⅡ、Ang1-7、血管紧张素1型(AT1)受体和Mas受体的蛋白表达水平。结果与假手术组和正常组比较,模型组大鼠存在明显的认知功能障碍(P<0.01)和心肌损伤(P<0.0001)。此外,模型组大鼠心肌中肾素-血管紧张素系统的ACE/AngⅡ/AT1轴上调(P<0.01),而ACE2/Ang1-7/Mas轴下调(P<0.05)。结论实验性血管性痴呆大鼠心肌损伤可能与肾素-血管紧张素系统失调有关。

卒中及共患疾病诊疗模式探索与实践

近年来,虽然国内外学者对卒中及共患疾病的关注逐步提高,但由于多病共存的特殊性和异质性,针对此类患者的诊治仍存在诸多不足和挑战。卒中及共患疾病的诊疗能力很大程度上反映了医疗机构的神经系统专科技术水平和多学科协同救治能力。构建多学科协同诊疗模式是卒中救治和质量管理体系建设的重要内容之一。医疗机构应运用先进的质量管理工具,优化要素配置和运行机制,建立高效的多学科协同诊疗模式,从而实现卒中及共患疾病整体诊治水平的提升。

基于“肝心同治”探讨软肝化纤汤治疗冠心病合并抑郁的临床疗效

目的:基于“肝心同治”理论探讨软肝化纤汤对冠心病合并抑郁患者的临床疗效。方法:选取符合纳入标准的冠心病合并抑郁患者123例,依据随机数字表随机分为对照组62例和治疗组61例。对照组给予常规西医治疗,治疗组在对照组的基础上口服软肝化纤汤治疗,两组均治疗8周。比较两组患者的临床有效率,治疗前后中医证候评分、汉密顿抑郁量表(HAMD)评分、血脂水平,血浆肾素、醛固酮、超敏C反应蛋白(hs-CRP)及清脑源性神经营养因子(BDNF)和胃促生长素(ghrelin)水平。结果:治疗组的心绞痛和抑郁临床有效率均高于对照组(P<0.05);两组患者治疗后总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平均明显降低,其中治疗组TG、LDL-C明显低于对照组(P<0.05);两组患者治疗后血浆肾素水平升高(P<0.05),hs-CRP含量显著下降(P<0.05),且治疗组hs-CRP含量低于对照组(P<0.05);两组患者治疗后血浆BDNF、ghrelin含量均明显增高(P<0.05),且治疗组高于对照组(P<0.05)。结论:软肝化纤汤可显著改善抑郁、心绞痛等临床症状,其机制与抑制炎症因子、对抗肾素-血管紧张素-醛固酮系统(RAAS)过度活化、改善血管内皮损伤及降低交感神经兴奋性有关。

基于“脑-心-肾-精室”轴探讨填精育嗣方治疗肾精亏损型少弱精子症

少弱精子症是男性不育的重要原因,其发病与多个脏腑有关。肾为先天、脑为髓海、心主藏神、精室主泌精生精,依据郭军教授“脑-心-肾-精室”轴理论,通过肾精亏损的成因及后果、脑心肾失调、精室失用对少弱精子症的影响,发现“脑-心-肾-精室”轴与肾精亏损型少弱精子症密切相关。补肾为本、脑心肾相济、精室为用的填精育嗣方理法方药均契合肾精亏损型少弱精子症,本方滋肾填精、阴阳并补、益脑宁心、充养并清利精室,运用填精育嗣方治疗肾精亏损型少弱精子症,效果良好。