Magnetic resonance imaging evaluation and nuclear receptor binding SET domain protein 1 mutation in the Sotos syndrome with attention-deficit/hyperactivity disorder

Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.

Clinical and genetic characteristics of a child with Sotos syndrome and attention-deficit/hyperactivity disorder:A case report

BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.

Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options

Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.

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.

Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.

肝火亢盛型高血压危象患者行耳部刮痧-放血-压豆序贯疗法的效果研究

目的探讨耳部刮痧-放血-压豆序贯疗法在肝火亢盛型高血压危象患者中的应用效果。方法选取2023年1月—2024年3月在浙江省某三级甲等医院心内科3个病区的肝火亢盛型高血压危象患者100例作为研究对象,按随机数字表法分为试验组和对照组各50例,试验组在高血压危象常规治疗和护理的基础上增加耳部刮痧-放血-压豆序贯疗法,对照组采用高血压危象常规治疗和护理。比较两组患者干预前后血压水平、中医证候积分、24 h盐酸乌拉地尔注射液使用总量、靶器官损伤和不良事件发生率。结果两组患者干预后1、2、6和24 h的血压均低于干预前,组间比较干预后1、2、6和24 h的血压试验组低于对照组;24 h盐酸乌拉地尔注射液使用总量试验组50.00(50.00,56.25)mg少于对照组55.00(50.00,81.25)mg,差异具有统计学意义(P<0.05);中医证候积分试验组[1.00(1.00,1.00)]分低于对照组[1.00(1.00,1.25)]分,差异具有统计学意义(P<0.05);干预后24 h内两组患者靶器官损伤发生率试验组低于对照组,但差异无统计学差异(P>0.05);两组均未发生明显不良事件。结论耳部刮痧-放血-压豆序贯疗法能降低肝火亢盛型高血压危象患者的血压水平,改善患者中医证候,减少24 h盐酸乌拉地尔注射液使用总量。但该研究观察的时间较短,远期疗效和靶器官损伤程度不详,后期有待进一步研究。

五行音乐疗法联合时辰穴位贴敷治疗肝阳上亢证原发性高血压患者的效果

目的:分析五行音乐疗法联合时辰穴位贴敷治疗肝阳上亢证原发性高血压患者的效果。方法:选取2023年3月—2024年3月启东市中医院收治的80例肝阳上亢证原发性高血压患者。根据随机数表法将其分为对照组及观察组,各40例。对照组采用常规治疗,观察组在对照组基础上采用五行音乐疗法联合时辰穴位贴敷。比较两组治疗前后血压、中医症候积分、心理状态、生活质量。结果:治疗后,两组舒张压(DBP)和收缩压(SBP)均降低,观察组SBP、DBP均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组眩晕、头痛、面部烘热、烦躁易怒、耳鸣、失眠评分均降低,观察组眩晕、头痛、面部烘热、烦躁易怒、耳鸣及失眠评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均降低,观察组HAMA评分、HAMD评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组精神健康、社会功能、情感职能、躯体功能、活力、身体疼痛、生理职能及总体健康评分均升高,观察组精神健康、社会功能、情感职能、躯体功能、活力、身体疼痛、生理职能及总体健康评分均高于对照组,差异有统计学意义(P<0.05)。结论:五行音乐疗法联合时辰穴位贴敷可有效降低肝阳上亢证原发性高血压患者的血压,提升生活质量。

Clinical observation of Tuina plus electroacupuncture for migraine due to liver-Yang hyperactivity

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus electroacupuncture in treating migraine due to liver-Yang hyperactivity and the effects on the serum levels of calcitonin gene-related peptide (CGRP) and prostaglandin (PG) E_(2). Methods: A total of 122 patients with migraine due to liver-Yang hyperactivity were recruited and randomized into a control group and an observation group, each consisting of 61 cases. The control group was given Tong Nao Huo Luo acupuncture (acupuncture treatment for unblocking brain collaterals), and the observation group was Tuina treatment focusing on cervical Ashi points in addition to the intervention received by the control group. Both groups were treated once daily for 21 consecutive days. When the intervention finished, the two groups were observed for changes in the headache score, symptom and sign scores of traditional Chinese medicine (TCM), the severity of impact on life, and serum CGRP and PGE_(2) levels. The clinical efficacy was compared after 21 d of treatment. Results: The observation group had a higher total effective rate than the control group, 90.2% versus 73.8% (P<0.05);after treatment, the headache and TCM symptom and sign scores decreased in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05);the migraine’s impact on life was less severe in the observation group than in the control group (P<0.05);the levels of serum CGRP and PGE_(2) dropped in the two groups (P<0.05) and were lower in the observation group (P<0.05). Conclusion: Tong Nao Huo Luo acupuncture can produce more significant efficacy in treating migraine due to liver-Yang hyperactivity when combined with cervical Tuina at Ashi points, better alleviating the headache, improving TCM symptoms and body signs, and reducing the impact of headache on life. The mechanism may be associated with inhibiting the expression of serum pain factors CGRP and PGE_(2).

基于R语言探讨儿童抽动障碍合并注意缺陷多动障碍的证型证素及中医用药规律

目的:基于R语言初步探讨儿童抽动障碍(TD)合并注意缺陷多动障碍(ADHD)的证型证素及中医用药规律。方法:计算机检索CNKI、万方、维普、CBM、PubMed、the Cochrane Library、EMBase、Web of Science等数据中建库至2023年11月10日收录的所有中医药治疗TD合并ADHD的文献,采用Excel软件筛选文献,对证型证素及中药规范化整理后,建立数据库,运用R语言及RStudio软件进行相应的数据挖掘,包括关联分析和聚类分析,探索儿童TD合并ADHD证型证素分布及中药分布规律。结果:最终纳入23篇文献。共得到20个证型,频次最高的证型为风痰内扰证,共提取证素16个,主要病位证素是肝、肾、脾、心,主要病性证素是阳亢、阴虚、动风、外风、痰,关联分析后得到支持度和置信度最高的组合是外风-动风。聚类分析后可得到5个聚类组:(1)痰、动风、外风;(2)肝、阳亢、肾、阴虚;(3)脾、气虚;(4)心、火/热、津亏;(5)胃、血虚、气滞、精亏。共纳入中药98味,其中14味频次≥10,排名前5为白芍、龙骨、钩藤、远志、天麻;分为18类,主要为补虚药、解表药、清热药、安神药、息风止痉药;主归肝、心、肺、脾、肾经;关联规则与聚类分析形成以白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志9味药为基础的核心药物组方。结论:儿童TD合并ADHD病位在肝、肾、脾、心,常见病性证素为阴虚、阳亢、动风、外风、痰,以养血滋阴、平肝息风、清热安神为主要治则,核心组方为白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志,需根据辨证灵活加减组方。

功能性胃肠病从“三焦胀”辨治探讨

功能性胃肠病的病理本质是以三焦腑功能受损,进而病及脾胃,导致脾胃功能失调,兼及心失藏神、肝失疏泄、肺失宣肃、肾(膀胱)失气化表现的多系统多方位的临床综合征。“三焦胀”是以三焦气机升降失司导致气机不畅或逆乱为核心、以脾胃功能失调为基本症状,兼及其他脏腑功能失调的脾胃综合征,与功能性胃肠病的各类症状具有高度类同性。三焦与脾胃的关系密切,三焦气机失调容易引发脾胃病症状,说明“三焦胀”与功能性胃肠病具有内在联系。其辨证应以三焦功能为核心,以调复三焦气化为根本,力求“三焦胀”与功能性胃肠病的病、证、理、法、方、药的有机统一,体现临床证治一元论、精准度、靶向性,提高功能性胃肠病的临床疗效。功能性胃肠病表现为“三焦胀”类同症状时常可分为以下4种证型辨治:腠理失通型、三焦郁热型、相火僭越型、水道壅滞型;常用方剂有小柴胡汤、柴胡桂枝汤、旋覆代赭汤、生姜泻心汤、栀子豉汤、乌梅丸等。

Systematic review and meta analysis of randomized controlled trials on Tianmagouteng decoction in treatment of primary hypertension with liverYang hyperactivity syndrome

OBJECTIVE： To assess the efficacy of Tianma- gouteng decoction in the treatment of primary hypertension with liver yang hyperactivity syndrome. METHODS： The databases of MEDLINE （1950- 2012）, EMbase （1980-2012）, China biology medicine （CBM） （1994-2012）, China national knowledge infrastructure （CNKI） （1989-2012）, Weipu （VIP） （1995-2012） and Wanfang （1989-2012） were searched and we performed manual searches for conference proceedings to select randomized controlled trials （RCTs） on Tianmagouteng decoction for the treatment of primary hypertension with liver Yang hyperactivity syndrome. Studies were en- rolled according to the study-selecting criteria. The methodological quality was evaluated, data were extracted and meta-analyses were conducted with RevMan 4.2 software. RESULTS： Nine RCTs were selected involving 784 patients with no significant difference in decrease in systolic blood pressure （SBP）[0R=1.02, 9.5% CI （-0.24, 2.29）, P=0.10] and diastolic blood pressure（DBP） [OR=0.56, 95% CI （-0.10,1.23）, P=0.11] between the Tianmagouteng group and the control group. While there was a significantly larger increase in serum superoxide dismutase （SOD）[OR= 6.26, 95% CI （1.27,11.66）, P=0. 01] in the Tianmagouteng group than that in the control group CONCLUSION： Tianmagouteng decoction can decrease both systolic and diastolic blood pressure and greatly increase serum SOD. Due to poor quality of included studies, the efficacy needs to be further assessed.

Study on the Biological Basis of Hypertension and Syndrome with Liver-Fire Hyperactivity Based on Data Mining Technology

Objective: To construct gene co-occurrence network of hypertension and liver-fire hyperactivity syndrome, to investigate the biological basis of hypertension and liver-fire hyperactivity syndrome and the characteristics of the molecular network from gene level.Materials and Methods: Applying Gen CLip 2.0 online platform to retrieve the up-to-date literature referred to essential hypertension from PubMed database, cluster the abnormal expression of essential hypertension-related genes and analyze their function, combining Kyoto encyclopedia of genes and genomes-pathway analysis to investigate the closely related genes and the signaling molecules.Based on the genes closely related to hypertension, standard diagnostic symptoms of liver-fire hyperactivity were used as keywords to conduct hypertension liver-fire hyperactivity-related gene cluster analysis.Results: The top 1000 genes of essential hypertension were retrieved from GenCLip 2.0 online platform, which mainly clustered in the regulation of ambulatory blood pressure, regulation of renin-angiotensin-aldosterone system(RAAS), and sympathetic nervous system activity, as well as endothelial dysfunction; the closely related genes of hypertension with liver-fire hyperactivity are related to RAAS, gene REN, angiotensin converting enzyme, angiotensinogen, and cytochrome P450 family CYP2D6.Conclusion: A combination of literature mining and data mining can construct the gene network of hypertension and the syndrome-related genes, which provides a new method for the study of the biological basis of hypertension from the genetic level.

正常高值血压肝火亢盛证与血浆同型半胱氨酸的相关性研究

目的探讨正常高值血压肝火亢盛证与同型半胱氨酸相关性及其化验指标的关系。方法选取2016年11月—2019年11月期间山东中医药大学附属医院心病科就诊及体检人群正常高值血压肝火亢盛证患者84例,同时选取同期就诊的理想血压人群53例、高血压肝火亢盛证人群52例,受试者进行一般检查(身高、体质量、血压、静息心率),血浆同型半胱氨酸(Homocysteine,Hcy)、生化指标、尿微量白蛋白检测。结果正常高值血压肝火亢盛证组中血清高同型半胱氨酸(Hyper homocysteine,HHcy)检出率为7.14%,高血压肝火亢盛证组中血清高同型半胱氨酸检出率为76.92%,呈递增趋势。正常高值血压肝火亢盛证组尿微量白蛋白阳性检出率为1.92%,高血压肝火亢盛证组尿微量白蛋白阳性检出率为10.81%,呈递增趋势。LSD-t检验结果可知Hcy在正常血压组与高血压肝火亢盛证组及正常高值血压肝火亢盛证组与高血压肝火亢盛证组之间,差别有统计学意义(P<0.05);总胆固醇在正常血压与正常高值血压之间,差别有统计学意义(P<0.05);低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)在正常血压与正常高值血压之间,差别有统计学意义(P<0.05)。对正常高值血压肝火亢盛证组同型半胱氨酸值行pearson相关分析,结果显示,同型半胱氨酸与血清尿酸、血清肌酐具有相关性(P<0.05)。结论在正常高值血压肝火亢盛证人群中同型半胱氨酸升高,且同型半胱氨酸与血清尿酸、血清肌酐具有相关性。

基于数据挖掘王晓燕教授治疗儿童抽动障碍脾虚肝亢证用药规律

目的运用数据挖掘技术分析并总结王晓燕教授治疗儿童抽动障碍脾虚肝亢证的用药经验。方法收集王教授门诊治疗的脾虚肝亢证抽动障碍患儿,运用中医传承辅助平台(V 2.5)建立数据库,对数据库中处方予频次分析、关联规则分析和复杂系统熵聚分析。结果共收集122首方,涉及中药64味,用药频次前11位分别为麸炒白术、麸炒苍术、炙甘草、炒白芍、蝉蜕、柴胡、陈皮、炒莱菔子、炒酸枣仁、炒僵蚕、珍珠母。药物四气以温寒药居多,五味以苦辛甘为主,归经以肝脾肺居多。药物组合频次超过115次的共30组。得到潜在核心组合6组,潜在新方3首。结论王教授治疗儿童抽动障碍脾虚肝亢证用药以寒温并举,辛苦兼施为主,主张肝脾同调,土木并举,选用自拟方柴术调肝理脾汤为基础加减治疗。

清火消痈汤治疗心肝火旺及热毒内蕴型肺痈临床观察

目的研究清火消痈汤治疗心肝火旺及热毒内蕴型肺痈的临床价值。方法以2021年1月—2021年12月为研究周期,抽取研究对象72例,采用随机数字表法分为研究组、对照组,各36例;对照组予西药治疗,研究组予清火消痈汤治疗,对比两组呼吸功能指标和中医证候积分。结果治疗后,研究组二氧化碳分压(PaCO_(2))水平为(41.42±3.75)mm Hg(1 mm Hg≈0.133 kPa),低于对照组的(47.59±5.88)mm Hg(P<0.05);氧分压(PaO_(2))水平为(82.99±6.75)mm Hg,高于对照组的(73.26±2.48)mm Hg(P<0.05)。治疗后,研究组主证积分为(2.44±0.68)分、次证积分为(0.65±0.11)分、总积分为(3.12±0.64)分,均低于对照组的(5.29±1.05)分、(1.89±0.62)分、(7.28±1.75)分(P<0.05)。结论清火消痈汤治疗肺痈效果显著。

中药结合耳穴埋针治疗原发性高血压阴虚阳亢证临床观察

目的探讨中药结合耳穴埋针对原发性高血压阴虚阳亢证的治疗效果。方法选取2023年2月—2024年2月寿光市人民医院收治的阴虚阳亢型原发性高血压患者80例,随机分为试验组和对照组,各40例,对照组采取西医治疗,试验组采取中药联合耳穴埋针治疗,对比2组的疗效指标。结果治疗后,试验组患者的血压、中医证候积分均低于对照组(P<0.05);试验组生活质量评分高于对照组(P<0.05)。结论中药结合耳穴埋针治疗原发性高血压阴虚阳亢证,可以降低患者血压,改善临床症状,提高生活质量,体现了中医疗法在临床治疗中的价值。

中药穴位贴敷联合耳穴压豆对阴虚阳亢型老年高血压合并衰弱的临床观察

目的探讨中药穴位贴敷联合耳穴压豆对阴虚阳亢型老年高血压合并衰弱的临床效果,为老年高血压合并衰弱患者的防治提供借鉴。方法选取2023年3—11月医院收治的60例阴虚阳亢型老年高血压合并衰弱患者作为研究对象,按照组间基线资料具有可比性的原则分为对照组和观察组,各30例。对照组给予常规降血压护理和健康教育,宣教2周,每周1次,共宣教2次;观察组在对照组基础上采用中药穴位贴敷联合耳穴压豆治疗,每天1次,1周为1疗程,共干预2周。2周结束后,比较两组患者干预后的临床效果。干预前、干预2周后采用电子血压计、中医证候积分量表、老年人衰弱评估量表评估两组患者的收缩压(SBP)、舒张压(DBP)、中医证候积分及老年衰弱评分的改善程度。结果干预前,两组患者血压、中医证候积分、老年衰弱评分比较,差异无统计学意义(P>0.05);干预后,观察组患者在血压、中医证候积分、老年衰弱评分均低于对照组,差异具有统计学意义(P<0.05)。干预后,观察组降压效果优于对照组,两组间比较差异有统计学意义(P<0.05)。结论对阴虚阳亢型老年高血压合并衰弱患者进行中药穴位贴敷和耳穴压豆,根据其证型选穴贴压肝、肾、交感、神门、降压沟、皮质下、胆、心八大穴位,其效果良好,操作简便,无不良反应发生,可有效改善患者血压、中医证候及衰弱症状,促进患者康复。

从痉证论治阵发性交感神经过度兴奋综合征

阵发性交感神经过度兴奋综合征(PSH)是一种与中重度脑损伤相关的临床综合征,以同时发生的肌张力障碍及交感神经功能亢进为临床表现。目前针对PSH的临床治疗侧重于西医对症处理,中医整体观念与辨证论治思维可以兼顾多证,能够对西医治疗进行有效补充。通过临床观察发现,在西药对症治疗基础上联合中药及针灸等中医疗法有助于提高疗效,减少不良反应,同时缩短病程。但由于从发现到逐步认识PSH的时间较短,因此对其病位、病因、病机、分型及中医治疗尚无系统认识。PSH发作时的肌张力障碍表现为四肢肌张力高、角弓反张等,发作表现符合中医痉证范畴,故文章试从痉证论述PSH的中医辨治,以期为PSH的中医治疗提供理论基础。

平肝头痛汤联合西药治疗偏头痛(肝阳上亢证)临床观察

目的观察平肝头痛汤对偏头痛(肝阳上亢证)患者的临床疗效。方法将偏头痛患者64例随机分为两组各32例。其中试验组给予平肝头痛汤联合盐酸氟桂利嗪胶囊,对照组给予盐酸氟桂利嗪胶囊,共治疗4周。比较两组患者中医证候积分、头痛计分法量化评分、HIT-6头痛影响评分的变化及临床总有效率。结果试验组头痛积分疗效、中医证候积分总有效率均为96.88%,分别高于对照组的84.38%、78.13%(P<0.05);两组治疗后头痛计分法量化评分、中医证候积分、HIT-6头痛影响评分均较治疗前降低(P<0.05),且试验组均低于对照组(P<0.05)。结论平肝头痛汤对偏头痛(肝阳上亢证)患者具有较好的临床疗效,能够显著减轻患者症状,并改善患者整体健康状况。

抽动障碍肝阳上亢证病证结合大鼠模型的对比研究

目的构建亚氨基二丙腈(iminodiProPion-itri,IDPN)、2,5-二甲氧-4-碘苯-2-氨基丙烷(5-dimethoxy-4-uodoPhenyl-2-aminoProPan,DOI)、阿扑吗啡(aPomorPhine,APO)3种抽动障碍(tic disorder,TD)大鼠模型对其行为特征、激惹状态及相关递质变化进行比较;选择表观效度及结构效度良好的TD模型分别加载不同应激刺激,构建、评价及筛选最优TD肝阳上亢证病证结合大鼠模型。方法120只SD大鼠随机分为6组:对照组正常饲喂,不做特殊处理;IDPN组腹腔注射IDPN溶液持续1周;DOI组、APO组分别腹腔注射DOI溶液、APO溶液持续2周;APO复合束缚悬吊应激(restraint and suspension stress,RSS)模型组(APO+RSS组)腹腔注射APO溶液2周同时复合慢性束缚悬吊应激持续3周;APO复合声电刺激应激(acoustic and electrical stimulation stress,AESS)模型组(APO+AESS组)腹腔注射APO溶液2周同时复合声电刺激应激持续3周。通过行为学实验评估大鼠刻板运动、自发活动及情绪障碍;酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)法测定纹状体中多巴胺(dopamine,DA)、γ-氨基丁酸(γ-aminobutyric acid,GABA)、谷氨酸(glutamate,GLU)、五羟色胺(serotonin,5-HT)水平变化,血清中血管紧张素II(Angiotensin II,AngⅡ)、精氨酸加压素(arginine vasopressin,AVP)水平变化。结果APO、DOI、IDPN诱导造模结果显示,与对照组比较,3种造模方式均可成功诱导大鼠的自发活动、刻板运动、认知及情绪障碍。IDPN组表现为更明显的刻板运动、认知障碍及焦虑抑郁倾向,与对照组相比DA、GLU水平降低(P<0.05),5-HT水平升高(P<0.05);APO组表现为更明显的自发活动及兴奋、易激惹状态、探索及攻击行为增多,与对照组相比DA、GLU水平升高(P<0.05),AngⅡ水平显著升高(P<0.01);DOI组大鼠行为学表现与APO组相似,但自发活动、刻板运动程度较APO组差;与对照组相比DOI组5-HT水平显著降低(P<0.01)。APO加载复合模型比较结果显示,APO+RSS组大鼠自发活动、刻板运动、探索行为较APO组增加;APO+AESS组表现为更明显的认知障碍。APO+RSS组大鼠纹状体DA、GLU水平、血清AngⅡ较APO组、APO+AESS组增加(P<0.05)。结论APO诱导TD模型表观效度及结构效度良好,并在一定程度上具备中医肝阳上亢证特点;APO复合束缚悬吊应激刺激模型激活RAS系统加重肝阳上亢症状并有利于维持TD模型稳定,是较为理想的TD肝阳上亢证病证结合动物模型。