[目的]评价祛酸胶囊治疗慢性痛风合并高尿酸血症患者的临床疗效和安全性.[方法]采用双盲随机对照的方法,将80例慢性痛风患者按1:1比例随机分成试验组40例(口服祛酸胶囊,2片/次,3次/d)和对照组40例(口服祛酸胶囊模拟剂,2片/次,3次/d),治疗期2个月,随访期3个月.主要疗效指标为治疗前后血尿酸(serum uric acid,SUA)水平的差值,次要疗效指标为两组受试者痛风发作次数、SUA达标率(SUA水平降低到360μmol·L-1以下的患者比例).以上指标在治疗前、治疗后以及随访期检测.[结果]最后完成试验并纳入统计的受试者为69例,其中试验组35例、对照组34例,两组患者的一般资料和基线值具有可比性(P>0.05).通过对两组受试者治疗前后的SUA差值进行独立样本t检验,结果显示组间差异有统计学意义(t=2.28,P=0.026).两组患者的痛风发作次数、SUA达标率比较均无统计学差异(P>0.05).肝肾功能检测结果和不良反应总结提示祛酸胶囊具备较好的安全性.[结论]祛酸胶囊可以明显降低受试者的SUA水平,具备较好的安全性.

目的 研究菝葜治疗排卵障碍型不孕症和输卵管炎性不孕症大鼠模型的疗效及其初步机制.方法 Sprague Dawley大鼠70只,采用雄激素致排卵障碍型不孕症大鼠模型,采用苯酚胶浆法致输卵管炎性不孕症大鼠模型,分别设立菝葜组、对照组、模型组和正常组.排卵障碍型不孕症大鼠菝葜组和对照组分别灌胃菝葜提取物12g/(kg·d)、枸橼酸克罗米芬4.5mg/(kg·d),模型组和正常组均灌胃蒸馏水12mg/(kg·d).输卵管炎性不孕症大鼠除对照组灌胃妇科千金片3.0g/(kg·d),余三组同排卵障碍性不孕症.对排卵障碍型不孕症大鼠检测体质量差、子宫指数、卵巢指数、血清雌二醇(E2)、促黄体生成素(LH)和卵泡刺激素(FSH);对输卵管炎性不孕症大鼠进行炎症评分,检测血清肿瘤坏死因子(TNF-α)和白细胞介素-2(IL-2).结果 排卵障碍型不孕症大鼠菝葜组体质量差比对照组和模型组明显减轻[(37.00±4.78)g比(44.37±2.26)g、(45.12±2.29)g,P<0.01],卵巢指数比模型组偏高[(32.51±1.51)比(30.37±1.40),P<0.05],子宫指数与模型组无差异(P>0.05),血清E2、LH、FSH浓度比正常组和对照组均低,但比模型组明显偏高[E2:(619.75±25.40)pg/mL比(959.25±15.14)pg/mL、(781.00±42.69)pg/mL、(572.37±3.15)pg/mL;LH:(5.10±0.19)mIU/mL比(5.27±0.12)mIU/mL、(6.10±0.19)mIU/mL、(4.32±0.15)mIU/mL;FSH:(0.98±0.16)mIU/mL比(1.37±0.04)mIU/mL、(1.31±0.04)mIU/mL、(0.66±0.07)mIU/mL;P<0.05或P<0.01].输卵管炎性不孕症大鼠菝葜组炎症评分比模型组明显降低[(1.71±0.35)分比(3.28±0.77)分,P<0.01],与对照组比较差异无统计学意义(P>0.05),血清TNF-α和IL-2与模型组比较差异均有统计学意义[TNF-α:(0.46±0.04)ng/mL比(1.13±0.22)ng/mL;IL-2:(1.70±0.01)ng/mL比(1.00±0.17)ng/mL;P<0.01],与对照组相比差异无统计学意义(P>0.05).结论 菝葜对雄激素致排卵障碍型不孕症大鼠模型的体质量有较好的干预作用,对卵巢指数的增加有一定的帮助,对血清E2、LH、FSH有一定的良性调节;菝葜对输卵管炎性不孕症大鼠模型的炎症评分有明显改善,对血清TNF-α和IL-2具有很好的调节作用.

恶性淋巴瘤是常见的免疫系统恶性肿瘤之一.史奎钧教授认为其是因虚、痰、火引起的正虚邪实、痰毒结聚之症.史教授在临床治疗中注重辨病与辨证结合,以扶正固本配合化痰散结、清火解毒为治疗原则,根据数十年临床经验组建振元抑瘤方,临床上常取得满意疗效.

Objective: By observation of the changes of extracellular regulated protein kinases(ERK) and c-fos in mice with asthma airway remodeling to explore its preventive and therapeutic mechanism. Methods: Mice were randomly divided into normal control group, model control group, dexamethasone group, Pingchuan Ⅰ Formula low, middle and high-dose groups. According to the experimental period, each treatment group was divided into 2 weeks group, 4 weeks group and 6 weeks group. Asthma model was established and induced with respiratory syncytial virus. Real time PCR and Western blot were used to measure the levels of c-fos mRNA and ERK1 protein in the lung tissue, respectively. Results: The values of Wat and Wam and the levels of c-fos mRNA and ERK1 protein in model control group were all signii cantly higher than those in normal control group(P0.01). While, the values of Wat and Wam and the levels of c-fos mRNA and ERK1 protein in all treatment group were all signii cantly lower than those in model control group(P0.05). And, those in Pingchuan ⅠFormula high-dose group were superior to those in dexamethasone group during the 4th week and the 6th week(P0.05). Conclusion: ERK signal transduction pathway plays an important role in asthma airway remodeling. Pingchuan Ⅰ may regulate the related factor of ERK signal transduction pathway, which could relieve the airway remodeling of asthma and improve the respiratory symptoms.

糖尿病足溃疡是糖尿病的慢性严重并发症之一,因糖尿病下肢血管、神经病变后合并感染引起,也是糖尿病人致残致死的重要原因,其发病人群以糖尿病史较长且血糖控制不良的老年患者为主.据报道,10％的糖尿病患者患有糖尿病足溃疡,14％～24％的糖尿病足溃疡患者需要截肢,严重威胁人民群众的公共健康安全.因此,积极治疗糖尿病足溃疡显得尤为重要.我们近几年来,在常规治疗的基础上加用血栓通粉针注射液联合自制三黄散中药外用的方法治疗糖尿病足溃疡,取得较好的疗效,现报告如下.

糖尿病性视网膜病变(DR)是最常见的视网膜血管病,为50岁以上人群主要致盲眼病之一.本病早期无自觉症状,病变发展到黄斑后出现不同程度的视力减退.近几年来,笔者采用自拟滋阴活血方治疗糖尿病性视网膜病变31例,疗效显著.现总报道下.

[Objective] To introduce the clinical experience of treating thyroid adenoma by Shi Kuijun.[Methods] Through copying prescription with the teacher and carding records,combined with studying on Chinese literature by Shi Kuijun,sum up Shi Kuijun insights for the etiology,pathogenesis,disease location,pathological diagnosis and the theory of therapeutic principles and methods of thyroid adenoma.[Results] Shi Kuijun puts forward the treatment of thyroid adenoma when treating from the liver,treating the liver goes first,supplemented by reducing phlegm and resolving masses and promoting blood circulation.[Conclusions ]The treatment of thyroid adenoma form liver has achieved satisfactory effect in clinical practice and provides the significant guid ance in the clinical practice.

目的:探讨桂乌汤治疗类风湿性关节炎(RA)的临床疗效.方法:将93例活动期的RA患者随机分为中西医结合组49例与西药对照组44例.中西医结合组采用桂乌汤结合MTX治疗,西药对照组单用MTX治疗.结果:中西医结合组的临床总有效率为87.6%,西药对照组为67.4%,两者差异具有显著性意义(P<0.01).中西医结合组在临床治疗各阶段能减轻关节肿胀、疼痛、晨僵,降低实验室检查指标,与西药对照组相比有显著的优越性(P<0.01或P<0.05).结论:桂乌汤与MTX联合治疗RA的临床疗效明显优于单用MTX治疗.

急性痛风是由尿酸钠结晶沉积在关节周围软组织而引起急性炎症疼痛及病理损害的一种疾病,临床以小关节剧烈痛肿胀或局部发热、皮色暗红为主要表现,而高尿酸血症为其主要生化指征.近5年来,我们用祛浊通痹颗粒治疗急性痛风61例,并设四妙汤对照组20例,秋水仙碱对照组25例,总结报告如下.