Hemodynamics and vasoactive substance levels during renal congestion that occurs in the anhepatic phase of liver transplantation

AIM: To explore hemodynamics and vasoactive substance levels during renal vein congestion that occurs in the anhepatic phase of liver transplantation.METHODS: New Zealand rabbits received ligation of the hepatic pedicle, supra-hepatic vena cava and infrahepatic vena cava [anhepatic phase group(APH); n = 8], the renal veins(RVL; n = 8), renal veins and hepatic pedicle [with the inferior vena cava left open)(RVHP; n = 8)], or a sham operation(SOP; n = 8). Hemodynamic parameters(systolic, diastolic, and mean arterial blood pressures) and the levels of serum bradykinin(BK) and angiotensin Ⅱ(ANGII) were measured at baseline(0 min), and 10 min, 20 min, 30 min, and 45 min after the surgery. Correlation analyses were performed to evaluate the associations between hemodynamic parameters and levels of vasoactive substances.RESULTS:All experimental groups(APH,RVL,and RVHP)showed significant decreases in hemodynamic parameters(systolic,diastolic,and mean arterial blood pressures)compared to baseline levels,as well as compared to the SOP controls(P<0.05 for all).In contrast,BK levels were significantly increased compared to baseline in the APH,RVL,and RVHP groups at all time points measured(P<0.05 for all),whereas no change was observed in the SOP controls.There were no significant differences among the experimental groups for any measure at any time point.Further analyses revealed that systolic,diastolic,and mean arterial blood pressures were all negatively correlated with BK levels,and positively correlated with ANGII levels in the APH,RVL,and RVHP groups(P<0.05 for all).CONCLUSION:In the anhepatic phase of orthotopic liver transplantation,renal vein congestion significantly impacts hemodynamic parameters,which correlate with serum BK and ANGII levels.

Association of severity and sex with vasoactive substance and sexual hormone level in patients with vascular dementia in the type of kidney asthenia and blood stasis syndrome

BACKGROUND: Kidney asthenia is the basic cause of the development of vascular dementia (VD). Kidney asthenia lasting for a long time will result in blood stasis. Also, the cause of VD may have relationships with endothelin (ET), nitric oxide (NO), homocysteine (HCY), estrogen (E2), and testosterone (T). OBJECTIVE: To observed clinical curative effect of the kidney tonic, pancreas tonic, and blood tonic with promoting blood circulation components in treating kidney asthenia with blood stasis syndrome of VD. DESIGN: Case controlled study. SETTING: Geriatric Institute of Integrated Medicine, Fujian College of Traditional Chinese Medicine. PARTICIPANTS: A total of 70 patients, including 39 males and 31 females aged 60-80 years, were selected from Department of Neurology, Pingshan Hospital from May 2000 to September 2002. Diagnostic criteria were used for probable VD of the American Psychiatric Association. Diagnostic and Statistical of Manual of Mental Disorder, 4th ed (DSM-Ⅳ), 1994 revised, mini-mental state examination (MMSE), and criteria of kidney asthenia with blood stasis with mixed weak and sthenia syndrome of Guidelines of Clinical Research of New Chinese Medicine in Treating Dementia. According to score of kidney asthenia with blood stasis syndrome, they were classified to three groups: mild (n =22), moderate (n =33) and severe (n =15). All of them with complete chest X-Ray, ECG, blood chemistry and other related examinations, exclusive of cardiovascular, liver, kidney diseases, homeopathy and psychiatry diseases. And hereby we also select 30 normal people as the comparing group, having no substantial diseases in heart, brain, kidney, liver, lung and other main organic systems after medical examination. Of this group, 11 were males and 19 were females, ranging from 62 years old to 78 years old. There were no obvious differences between the above two groups in sex, age, and education level after statistical analysis. All patients observed in Pingxi Hospital, Fuzhou, from May 2000 to September 2002. METHODS: ① According to the diagnoses standard of blood stasis syndrome: 0-89: The increase in score indicated that blood stasis syndrome was getting serious. ② According to MMSE: All the test samples were evaluated, those with scores of 0-30, in which the non-educated ≤ 17, primary school ≤ 20, above middle school ≤ 24 were categorized. ③ Testing all sample's ET, E2 and T by using radioimmunoassay, the RIA kits were provided by Scientific and Technological Development Center of General Hospital of PLA. ④ Testing the level of NO by using colorimetic method. ⑤ Testing the level of HCY by using Enzyme-linked Immunoassay. ⑥ Meanwhile, analyzing the blood stasis score by comparing with every standard. The differences of data were compared by using t test and F test. MAIN OUTCOME MEASURES: ① Blood plasma ET, blood serum NO, HCY, E2 and T. ② The analyzing results obtained from comparing score of blood stasis with every indicators. RESULTS: The result analysis was including of both the 70 patients of VD with kidney asthenia and blood stasis and compared group consist of 30 healthy people. ① ET, NO, HCY and ET/NO: The levels of ET, HCY and ET/NO were increasing with pathography, while the levels of ET, NO, HCY and ET/NO were decreasing with the pathography, and the difference in statistics was significant (P < 0.01). ② The level of E2 and T: The levels of both E2, T and E2/T for male VD patients were (67.72±12.18) pg/L and (351.58±155.02) ng/L, 0.24±0.12 respectively, which were higher than the compared group [(53.96±16.13) pg/L, (471.83±143.99) ng/L, 0.12±0.00, P < 0.05]. The level of E2 in the female VD patients was lower than the compared group [(34.23±10.99), (44.81±14.65) pg/L, P < 0.05]. ③ The relationship between the score of blood stasis and each indicators: The levels of ET, ET/NO and HCY had significant positive relationship with blood stasis mark (r = 0.352, 0.754, 0.347, P < 0.05-0.01), obvious negative relationship with NO (r =-0.528, P < 0.01) and no clear relationship with female E2/T and male E2/T (r = -0.210, 0.04, P > 0.05). CONCLUSION: ① The levels of ET, HCY and ET/NO are increasing with pathography, while the level of NO is decreasing, which may be the evidence that the possibility of VD pathography may have relationship with the indicators above. ② The level of E2 increase in male's VD patients, and decrease in male's. And the decrease of the female may have relationship with the VD.

The effect of continuous Jue tone intervention on blood pressure and vasoactive substances in hypertensive rats with a liver-fire hyperactivity pattern

Objective:Jue tone is a kind of sound,using 3-mi as the main tone,and is melodious,profound,makes people feel comfortable and pleasant.This study aimed to explore the probable mechanism of Jue tone to reduce blood pressure(BP)in hypertensive rats with a liver-fire hyperactivity pattern by observing changes in BP as well as physiochemical indexes in plasma.Methods:Sixteen male spontaneous hypertensive rats(SHR)with a liver-fire hyperactivity pattern were randomly divided into a control group and a Jue tone group.The rats in the Jue tone group were treated with Jue tone(55e65 dB,played by the five elements of music rhythm instrument,a kind of physiotherapy regimen music played by Shen Wu)once a day for 4 weeks.The BP levels in each group were measured twice a week,on Monday and Friday.The levels of angiotensin II(Ang-II),thromboxane B2(TXB2),endothelin-1(ET-1),calcitonin gene-related peptide(cGRP),norepinephrine(NE),cortisol(CORT),and 5-hydroxytryptamine(5-HT).in plasma were detected by enzyme-linked immunosorbent assay after 4 weeks of intervention.Results:BP and the levels of TXB2 and ET-1 in the plasma of the treatment group were significantly lower than those of the control group,while the level of cGRP was significantly higher.Conclusion:Jue tone can reduce the BP of hypertensive rats with a liver-fire hyperactivity pattern.The mechanism may correlate with a reduction in TXB2 and ET-1 and an increase in cGRP with the reduction of reactive oxygen species(ROS).

The Changes of Vasoactive Substances Originated Endotheiium in Patients with Unstable Angina Pectoris Treated by Improved Thrombolytic Therapy

Objectives To analyze the changes of vasoactive substances originated from endo- theiium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mech- anisms of the drug to treat unstable angina pectoris. Methods 120 patients with unstable angina pectoris who were not well responsed to common medication were studied. Their ECG stress tests were abnormal and there were ischemic changes in Holter. Urokinase 300,000 U was added in 100 ml normal saline and in- jected within 30 min once a day for 3 days. 300 mg as- pirin was administrated a day before and during uroki- nase applications. Before and after urokinase treat- ments , endothelin-1 , plasma tissue plasminogen activa- tor and its inhibitor-lwere determined. Results Compared with pretreatments, after treatments, the ac- tivities of tissue plasminogen activator increased, endo- thelin-1 and the inhibitor-1 decreased. The changes were significant. Conclusions Modified thrombolytic therapy can regulate the vasoactive substances origina- ted endotheiium in patients with unstable angina pecto- ris . The major substances include endothelin-1, plasma tissue plasminogen activator and inhibitor-1. This mechanism may suggest that urokinase can treat coro- nary heart disease effectively.

Effect of ulinastatin on vasoactive substances, oxidative stress and inflammatory response in patients with acute exacerbation of COPD

Objective:To study the effect of ulinastatin on vasoactive substances, oxidative stress and inflammatory response in patients with acute exacerbation of COPD.Methods:Patients with acute exacerbation of COPD who were treated in Chengdu Fifth People's Hospital between August 2013 and July 2016 were selected as the research subjects and randomly divided into ulinastatin group and normal control group who received ulinastatin combined with conventional therapy and conventional therapy respectively. The serum contents of vasoactive substances, stress response hormones, oxidative stress products and inflammatory response mediators were detected before treatment and 7 d after treatment.Results: 7 d after treatment, serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of both groups of patients were significantly lower than those before treatment while TT3 and TT4 contents were significantly higher than those before treatment;serum D-D, AT-II, pro-BNP, ACTH, FC, NE, MDA, 8-iso-PG, HSP27, HSP70, PCT, CRP, CCL18 and MSP contents of ulinastatin group 7 d after treatment were significantly lower than those of normal control group while TT3 and TT4 contents were significantly higher than those of normal control group.Conclusion:Ulinastatin therapy can correct the disturbance of vasoactive substances, and inhibit the oxidative stress and inflammatory response in patients with acute exacerbation of COPD.

The predictive value of serum S1P and Adropin levels for the restenosis after cerebrovascular stent implantation and their relationship with vasoactive substances and cytokines

Objective:To explore the predictive value of serum S1P and Adropin levels for the restenosis after cerebrovascular stent implantation and their relationship with vasoactive substances and cytokines.Methods:A total of 109 patients with cerebral infarction who accepted cerebrovascular stent implantation in our hospital between July 2012 and May 2016 were selected, their treatment outcome were reviewed, 35 patients with restenosis after cerebrovascular stent implantation were selected as observation group, and 74 patients without restenosis after cerebrovascular stent implantation were selected as control group. Serum S1P and Adropin levels were compared between two groups of patients before and after stent implantation, and the inner link of S1P and Adropin levels with vasoactive substance and cytokine levels in patients with restenosis after cerebrovascular stent implantation was further explored.Results: Before stent implantation, the differences in serum levels of S1P, Adropin, vasoactive substances and cytokines were not statistically significant between two groups of patients. After stent implantation, serum S1P and Adropin levels in observation group were lower than those in control group;serum vasoactive substance NO level was lower than that in control group while ET-1, TXB2 and AngⅡ levels were higher than those in control group;serum inflammatory factors TNF-α, IL-6, IL-10 and IL-13 levels were higher than those in control group. Pearson test showed that serum S1P and Adropin levels in patients with restenosis after cerebrovascular stent implantation were directly correlated with the levels of vasoactive substances and cytokines.Conclusion: Serum S1P and Adropin are lowly expressed in patients with restenosis after cerebrovascular stent implantation, and their specific expression are directly correlated with the levels of vasoactive substances and inflammatory cytokines, and can be used as the reliable indexes for early prediction of restenosis after cerebrovascular stent implantation.

Explore the direct and/or the synergistic antihypertensive effects of wind-dispelling herbs involving Fangfeng and Baizhi on hypertensive rats with liver-yang hyperactivity based on vasoactive substances

Objective： To explore the direct and/or the enhancing antihypertensive effects of wind-dispelling herbs involvingFangfeng （Saposhnikoviae Radix） and Baizhi （Angelicae dahuricae Radix） using liver-yang hyperactivity renalhypertension rat. Methods： Model rats with hyperactivity of liver-yang hyperactivity were prepared using male SD rats.Once successful, the rats were randomly divided into groups and given medicine by gavage for 4 weeks. Blood wascollected from the abdominal aorta to prepare serum. Serum nitric oxide （NO） concentration was determined bychemical colorimetry. The contents of ET, TXB2 and 6-K-PGF1a were determined by enzyme linked immunosorbentassay （ELISA）. Results： Compared with the control model group, the blood pressure, serum ET and TXB2 of rats in thewind dispelling medicine group was not significantly reduced, while those of rats in captopril group, Tianma GoutengDecoction I group （TGD group） decreased significantly （P 〈0.05 for both）. Interestingly, the blood pressure, serum ETand TXB2 of rats in the combination group （wind dispelling medicine ＆ TGD） decreased significantly compared withboth wind dispelling medicine group and TGD group. Meanwhile, the levels of serum NO and 6- K-PGF1a in thecombination group was much higher than those in the wind dispelling medicine group or TGD group （P 〈0.05 for both）.However, the levels of serum NO and 6- K-PGF1a in the wind dispelling medicine group was not significantly increasedcompared with the model group. Conclusion： There is no direct pressure lowering effects of wind dispelling medicinealone, while wind dispelling medicine could potentiates the antihypertensive effects of Tianma Gouteng Decoction I.Besides, the synergistic effects may be related to decreased ET and TXB2 levels and the increased NO and 6- K-PGF1alevels.

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。

针刺激痛点联合盐酸氟桂利嗪治疗偏头痛的临床研究

目的观察针刺激痛点联合盐酸氟桂利嗪治疗偏头痛患者的疗效及对炎症相关指标、血管活性物质的影响。方法选择2017年1月—2022年1月首都医科大学附属北京中医医院诊治的80例偏头痛患者为研究对象,根据随机数字表法按1:1比例将患者分为观察组、对照组,每组40例。对照组予以假针刺+口服盐酸氟桂利嗪治疗,观察组予以激痛点针刺+口服盐酸氟桂利嗪治疗,针刺隔天治疗1次,2组均治疗4周。比较2组治疗后头痛情况,临床疗效,血清炎症相关指标[环氧化酶-2(COX-2)、降钙素基因相关肽(CGRP)、前列腺素E 2(PGE_(2))]及血管活性物质[血管性血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮(NO)]水平、脑血流速度及不良反应发生情况。结果治疗后,观察组偏头痛发生次数、头痛发作总时间、疼痛程度VAS评分均明显低于对照组(P均<0.05);观察组总有效率明显高于对照组[92.5%(37/40)比75.0%(30/40),P<0.05];观察组血清COX-2、CGRP、PGE_(2)、vWF、ET-1水平均明显低于治疗前及对照组(P均<0.05),NO水平均明显高于治疗前及对照组(P均<0.05);观察组大脑前动脉、大脑中动脉、大脑后动脉、椎动脉、基底动脉的血流速度均明显慢于治疗前及对照组(P均<0.05)。治疗期间2组不良反应发生率比较差异无统计学意义(P>0.05)。结论针刺激痛点联合盐酸氟桂利嗪治疗偏头痛疗效显著,可有效缓解患者的疼痛症状,降低炎症相关指标水平,改善血管内皮功能和脑血流动力学,且治疗安全。

Hp感染与溃疡性结肠炎患者血清胃肠激素和单胺类神经递质水平的关系

目的探讨幽门螺杆菌(Hp)感染与溃疡性结肠炎患者血清胃肠激素、单胺类神经递质水平的关系。方法将初诊溃疡性结肠炎患者145例作为研究组,另选取同期行胃肠镜检查无异常人群140名作为对照组。2组均采用13C-尿素呼气试验(13C-UBT)检测Hp感染情况,并检测胃肠激素[P物质(SP)、内皮素(ET)、血管活性肠肽(VIP)]和单胺类神经递质[去甲肾上腺素(NE)、5-羟色胺(5-HT)]水平。比较研究组中活动期和缓解期患者血清胃肠激素、单胺类神经递质水平,另比较Hp阳性和阴性患者血清胃肠激素、单胺类神经递质水平,并应用Logistic回归分析法分析溃疡性结肠炎患者Hp感染与胃肠激素和单胺类神经递质相关指标的关系。结果研究组Hp感染率和VIP水平低于对照组(P<0.05),SP、ET、NE、5-HT水平均高于对照组(P均<0.05)。活动期组患者Hp感染率和VIP水平低于缓解期组(P<0.05),SP、ET、NE、5-HT水平均高于缓解期组患者(P均<0.05)。研究组中Hp阳性患者SP、ET、NE、5-HT水平均低于Hp阴性患者(P均<0.05),VIP水平高于Hp阴性患者(P<0.05)。Logistic回归分析结果显示,SP、ET、NE、5-HT水平升高均是溃疡性结肠炎患者Hp感染的保护因素(P均<0.05),VIP水平升高则是危险因素(P<0.05)。结论在溃疡性结肠炎中,Hp感染和未感染患者胃肠激素与单胺类神经递质水平存在差异,Hp感染可能与患者胃肠激素和单胺类神经递质水平变化具有相关性。

温针灸联合腹针对脑卒中后下肢痉挛性瘫痪患者功能恢复及血清血管活性物质水平的影响

目的研究温针灸联合腹针对脑卒中后下肢痉挛性瘫痪患者的功能恢复及血清血管活性物质水平的影响。方法选取2020年5月—2022年5月期间接诊的120例脑卒中后下肢痉挛性瘫痪患者作为研究对象。按随机数表法随机分为研究组与对照组各60例。对照组采用常规治疗方法,研究组采用温针灸联合腹针进行治疗。两组患者均连续治疗5周,记录并比较两组患者在治疗前后Fugl-Meyer运动功能量表(FMA)评分、改良Barthel指数(MBI)评分、Berg平衡量表(BBS)评分、痉挛指数评分、10 m步行时间、血管内皮生长因子(VEGF)、血管紧张素-1(Ang-1)水平。结果治疗前,两组患者的FMA评分、MBI评分、BBS评分相比,差异无统计学意义(P>0.05),治疗后,两组患者的FMA评分、MBI评分、BBS评分均升高,且研究组明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组患者的痉挛指数评分、10 m步行时间相比,差异无统计学意义(P>0.05),治疗后,两组患者的痉挛指数评分、10m步行时间均降低/缩短,且研究组低/短于对照组,差异有统计学意义(P<0.05);治疗前,两组患者的VEGF、Ang-1水平相比,差异无统计学意义(P>0.05),治疗后,两组患者的VEGF、Ang-1水平均升高,且研究组高于对照组,差异有统计学意义(P<0.05)。结论温针灸联合腹针能有效地促进脑卒中后下肢痉挛性瘫痪患者的功能恢复,这可能与血清血管活性物质水平的升高有关,具有临床应用价值,值得推广。

微血管心绞痛患者心肌微循环血流动力学的探索

目的探索原发性微血管心绞痛患者心肌微循环血流动力学及血管活性物质的变化。方法选择2017年12月至2018年12月阜外华中心血管病医院22例原发性微血管心绞痛住院患者为试验组,无心绞痛症状冠状动脉造影正常的18例住院患者为对照组,比较两组患者心肌微循环血管灌注压力、阻力及局部血管活性物质的变化。结果试验组冠状动脉口处的收缩压、舒张压、平均动脉压及脉压指数均高于对照组,差异有统计学意义(P<0.05)。试验组造影剂从冠状动脉起始至血管远端显影所需的帧数、冠状窦充盈时间、微循环阻力指数均高于对照组,血浆内皮素-1(ET-1)水平高于对照组,一氧化氮水平(NO)低于对照组,差异有统计学意义(P<0.05)。结论原发性微血管心绞痛患者推动血流循环的动力并未降低,血液通过心肌微循环的速度减慢,微循环阻力增高,与局部心肌循环中的ET-1、NO水平变化相关。

复方丹参滴丸对慢性心衰患者血管活性物质及炎性因子水平的影响

目的:探讨慢性心力衰竭(Chronic heart failure,CHF)患者采用复方丹参滴丸治疗的效果。方法:将医院2020年1月~2022年6月收治的CHF患者80例按照随机数表法分为2组,各40例。对照组采用常规治疗,观察组加用复方丹参滴丸治疗,均治疗8周,比较两组治疗效果、血管活性物质及炎症因子水平。结果:观察组治疗总有效率95.00%(38/40),比对照组77.50%(31/40)高(P<0.05);治疗后,两组血管紧张素Ⅱ(Angiotensin II,AngⅡ)、内皮素1(Endothelin 1,ET-1)及脑利钠肽(Brain natriuretic peptide,BNP)水平均比治疗前低,且观察组比对照组低(P<0.05);治疗后,两组超敏C反应蛋白(Hypersensitivity C reactive protein,hs CRP)水平、白细胞介素(Interleukin 6,IL-6)水平均比治疗前低,且观察组比对照组低(P<0.05)。结论:CHF患者采用复方丹参滴丸治疗效果满意,可抑制血管活性物质生存,调节炎性因子水平。

Effects of Wei Chang An pill(胃肠安丸) on enzyme activity and levels of vasoactive peptide and substance P in the small intestine of rats with compound diarrhea

OBJECTIVE:To investigate the regulatory effects of Wei Chang An Pill(WCAP) on enzyme activity and gastrointestinal hormones in the small intestine of rats with compound diarrhea.METHODS:Forty Wistar rats were randomly divided into a control,diarrhea model,and WCAP high,medium,and low dose groups.The control group was not treated,and the model group was administered intragastric distilled water.The WCAP groups were given WCAP suspension,80,60 or 40 mg · kg-1 · d-1,for 4 days.Stool properties were observed.After the experiment,thymus and spleen indices were measured,and the activities of lactate dehydrogenase(LDH),malate dehydrogenase(MDH),and disaccharidase(lactase) in the small intestinal mucous membrane,and levels of substance P(SP) and vasoactive peptide(VIP) in the colon were determined.RESULTS:Compared with the control group,thymus and spleen indices were significantly decreased,LDH,MDH,and disaccharidase activity in the small intestine was decreased,and SP and VIP levels in the colon were significantly increased inthe diarrhea model group.Compared with the model group,thymus and spleen indices were significantly increased,and LDH,MDH,and disaccharidase activity in the small intestine and SP and VIP levels in the colon were significantly decreased in theWCAP medium dose group.CONCLUSION:The diarrhea model rats exhibited pathological changes including atrophy of the thymus and spleen,decreased enzyme activity in the small intestine,and gastrointestinal hormone disturbance.WCAP can increase the activity of intestinal digestive enzymes and regulate gastrointestinal hormones,thereby relieving diarrhea.

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.

热敏灸治疗中风后气虚型便秘的疗效观察及对血清SP、VIP水平的影响

目的观察热敏灸治疗中风后气虚型便秘的临床疗效以及对血清P物质(substance P,SP)和血管活性肠肽(vasoactive intestinal peptide,VIP)水平的影响。方法将60例中风后气虚型便秘患者随机分为针刺组和热敏灸组,每组30例。两组均予药物对症治疗,针刺组采用针刺治疗,热敏灸组采用热敏穴悬灸治疗。观察两组治疗前后的症状积分评定表、便秘临床评分(clinic constipation score,CCS)量表、便秘患者生存质量量表(patient assessment of constipation quality of life,PAC-QOL)评分及血清SP和VIP水平变化,并比较两组临床疗效。结果两组治疗后症状积分均低于治疗前,且热敏灸组低于针刺组;两组治疗后CCS均下降,且热敏灸组低于针刺组;两组治疗后PAC-QOL评分均下降,且热敏灸组低于针刺组,差异均有统计学意义(P<0.05)。两组治疗后血清SP水平升高,血清VIP水平下降;且热敏灸组血清SP水平高于针刺组,血清VIP水平低于针刺组,差异均有统计学意义(P<0.05)。两组临床疗效比较,差异有统计学意义(P<0.05)。结论在药物治疗的基础上,热敏灸治疗中风后气虚型便秘疗效优于针刺,可有效改善便秘症状,提高生存质量,机制可能与升高血清SP水平、降低血清VIP水平有关。

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。

穴透刺联合口服丁苯酞胶囊对大脑中动脉狭窄CT脑灌注成像及血管活性物质的影响

目的:探讨穴透刺联合口服丁苯酞胶囊对大脑中动脉(MCA)狭窄CT脑灌注成像及血管活性物质的影响。方法:选取单侧MCA狭窄病人60例为研究对象,根据随机数表法分为观察组与对照组,每组30例。2组病人均采用基础治疗(拜阿司匹林100 mg+氯吡格雷片75 mg+阿托伐他汀钙20 mg联用),观察组在此基础上增加头穴透刺联合丁苯酞治疗。所有入组病人治疗前后行CT灌注成像(CTP),测量并计算脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰时间(TTP)及相对灌注参数,即rCBV、rCBF、rMTT、rTTP值;采集治疗前后空腹静脉血行血管活性物水平检测,包含一氧化氮(NO)、内皮素-1(ET-1)、血栓素B2(TXB2)、血管紧张素Ⅱ(AngⅡ)、血管内皮生长因子(VEGF)。结果:治疗后,观察组各CTP参数与治疗前相比差异均有统计学意义(P<0.05~P<0.01),观察组CBV、CBF指标均显著高于对照组,MTT、TTP、rMTT指标均显著低于对照组(P<0.05~P<0.01),对照组治疗前后差异无统计学意义(P>0.05);治疗后,2组血管活性物与治疗前相比均差异均有统计学意义(P<0.05),其中观察组NO、VEGF水平显著高于对照组,ET-1、TXB2、AngⅡ水平显著低于对照组(P<0.05~P<0.01)。观察组不良反应发生率6.67%,与对照组的16.67%比较差异无统计学意义(P>0.05)。结论:头穴透刺联合丁苯酞可改善MCA狭窄病人脑血流动力学状态,有效调节血管活性物质的水平,促进早期新血管形成,保护脑组织。

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。

苯噻啶片联合晕痛定胶囊对偏头痛患者血清致炎因子及血管活性物质水平的影响

目的 探讨苯噻啶联合晕痛胶囊低偏头痛患者血清致炎因子及血管性物质水平的影响。方法 选取82例偏头痛患者为研究对象,随机将其均分为两组并给予不同的治疗方案,采用苯噻啶片治疗为对照组,采用苯噻啶片联合晕痛定胶囊为研究组,两组均治疗6周后,对比两组患者治疗效果,治疗前后两组患者血清致炎因子水平及血管活动物质水平的变化。结果研究组治疗效果显著优于对照组(P<0.05);研究组血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、同型半胱氨酸(Hcy)、内皮素-1(ET-1)和血栓素B2(TXB2)均低于对照组(P<0.05);5-羟色胺(5-HT)、一氧化氮(NO)和多巴胺(DA)均高于对照组(P<0.05)。结论 苯噻啶片联合晕痛定胶囊可提高治疗偏头痛患者的治疗效果,改善机体炎症和血管活性物质水平。