目的:探讨化痰通络汤联合常规西医治疗对缺血性卒中患者神经功能、血小板功能及血清炎性因子的影响.方法:选取我院于2016年2月～2019年2月接收的缺血性卒中患者101例,按照乱数表法将其随机分为对照组(n=50)和研究组(n=51).对照组给予常规西医治疗,研究组在对照组基础上联合化痰通络汤治疗,比较两组患者临床疗效,治疗前、治疗28d后的神经功能、血小板参数、血清炎性因子水平及治疗期间的不良反应发生情况.结果:两组患者治疗28d后美国国立卫生研究所卒中量良(NIHSS)评分均下降,且研究组低于对照组(P＜0.05).研究组的临床总有效率为88.24％(45/51),高于对照组的66.00％(33/50)(P＜0.05).两组治疗28d后血小板聚集率、血小板体积均下降,且研究组低于对照组(P＜0.05).两组治疗28d后血清白细胞介素-4(IL-4)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均降低,且研究组低于对照组(P＜0.05).两组不良反应发生率对比无差异(P.0.05).结论:采用化痰通络汤联合常规西医治疗缺血性卒中可有效改善患者血清炎性因子水平及血小板功能,减轻神经功能损伤,且用药安全性较好,具有一定的临床应用价值.

目的 观察复方威灵仙颗粒对高尿酸血症(HUA)患者血尿酸(UA)临床疗效及胰岛素抵抗的影响.方法 HUA患者63例,随机分成复方威灵仙颗粒组31例和别嘌呤醇组32例,在基础治疗的基础上,分别给予复方威灵仙颗粒(1剂/d,2次/d)及别嘌呤醇片(100 mg/次,3次/d),8 w为1个疗程.观察治疗前后血UA及临床疗效、空腹血糖(FPG)、空腹胰岛素(FINS)及胰岛素抵抗指数.结果 复方威灵仙颗粒组与别嘌呤醇组治疗后的血UA均较治疗前有明显下降(P<0.01),治疗总有效率分别为86.7%与90%,2组对血UA的疗效相当,差异无统计学意义(P>0.05),复方威灵仙颗粒组治疗后与治疗前比较FINS及胰岛素抵抗指数明显降低(P<0.01),而别嘌呤醇组治疗后与治疗前比较FINS及胰岛素抵抗指数无明显下降(P>0.05).结论 复方威灵仙颗粒具有降低血UA及改善胰岛素抵抗作用.

目的了解拉莫三嗪（LTG）及卡马西平（CBZ）对成年癫痫患者甲状腺激素水平的影响。方法 选择新确诊的74例成年癫痫病人随机分为LTG组（n=40）、CBZ组（n=34），用化学发光法测定用药前甲状腺激素水平并与30例成年健康对照进行比较；再经LTG和CBZ单药治疗6个月及1年后检测血中甲状腺激素水平，并分别与治疗前比较。结果 未经治疗的癫痫病人甲状腺激素水平与正常对照组比较无显著性差异(P>0.05)；与治疗前相比，CBZ治疗6个月及1年后的游离甲状腺素（FT4）、总甲状腺素（TT4）和总三碘甲状腺原氨酸（TT3）显著降低（P<0.05)，而服用CBZ后各时点的游离三碘甲状腺原氨酸（FT3）、促甲状腺素（TSH）无显著性变化(P>0.05)；经LTG治疗后的不同时点的甲状腺激素水平与治疗前比较均无显著性差异(P>0.05)。结论 LTG并不引起成年癫痫患者甲状腺激素水平的改变，而CBZ可造成成年癫痫患者TT4、FT4、TT3的降低。但甲状腺激素水平的降低并未造成临床或亚临床甲状腺功能减退。

Metabonomics is a new developing omics after genomics,transcriptomics and proteomics.It can detect small molecular metabolite profiling in the human body fluid to reflect human physiological and pathological state.and TCM syndrome is a pathologic generalization in a stage in the progress of the disease of cause,location,nature and trend of disease.Obviously,it brings a new idea for using metabonomics to study the essence of TCM syndrome.

The low-grade inflammation is a non-specific,chronic,continuous,low-grade inflammation.It often appears on obesity,diabetes mellitus,hyperlipidemia,hypertension,coronary heart disease,cerebral infarction,metabolic syndrome,malignant tumours,polycystic ovary syndrome and so on,and plays a very important role in the pathogenesis,damage characteristics and diagnosis and prognosis of these diseases.Based on TCM theory,its pathogenesis is deficiency in origin and excess in superficiality,deficiency is focused on Qi,and excess is mainly caused by Qi stagnation,phlegm retention,blood stasis and heat-toxin.Qi deficiency and Qi stagnation are important conditions in occurrence of low-grade inflammation,phlegm retention and blood stasis are the pathogenic causes of low-grade inflammation,and heat-toxin is an important factor in development of low-grade inflammation.

目的 探讨超敏C反应蛋白(hs-CRP)的变化与偏头痛发病机制的关系,观察颅痛煎治疗偏头痛疗效及对hs-CRP的影响.方法 选取65例偏头痛患者和30例健康人进行检测hs-CRP,再将65例病人随机分为颅痛煎汤治疗组(简称颅头煎组)32例,给予颅痛煎,一日一剂,水煎分2次服;西比灵对照组(简称西比灵组)33例,给于西比灵5mg,一天1次,谷维素20mg,一天3次.共治疗28天后.观察两组患者的治疗前后疼痛程度、持续时间、发作频度及检测hs-CRP,计算其头痛指数和头痛疗效.结果 偏头痛组hs-CRP含量明显高于正常对照组(P<0.01),治疗后颅痛煎组的hs-CRP水平明显低于西比林组(P<0.05),颅痛煎组的临床基本恢复、总有效率、头痛指数明显好于西比灵组(P<0.01、<0.05).结论 hs-CRP的增高与偏头痛的发生有关,颅痛煎治疗偏头痛疗效明显优于西比灵,可能与颅痛煎降低偏头痛患者的hs-CRP有关.

Objective: To study the protective effect of Naomaian capsule on focal cerebral isebemia in rat neurons. Methods: Rat models of focal cerebral ischemia were established by thread ligation in middle cerebral artery ooelusions(MCAO). After 24 hours, the brains were removed to observe the morphological changes of rat cerebral cortical neurons under optical microscope through HE staining, detect the content of MDA,LD and the activity of SOD,LDH,Na+-K+-ATP enzyme in isehemic cerebral brain by spectrophotometry. Results: Compared with control, ischemia models group have obviously neurological deficits. Cerebral cortex has significant ischemic morphologic changes, such as neuronal edema. The content of MDA,LD was much higher, that of SOD, LDH and Na+-K+-ATP enzyme was much lower, in ischemia cerebra ( P<0.01 ) . Naomaian capsule group can be improved neurological deficits of MCAO rats and reduce neuronal edema. The concentration of MDA,LD were lower, whereas that of SOD,LDH and Na+-K+-ATP enzyme was much higher in Naomaian capsule group ( P<0.05,P<0.01). Conclusion: Naomaian capsule had the effect of lightening the injury degree of brain tissues, inhibiting the production of free radical and decreasing lipid peroxidation. It alleviated cerebral injury and had an obvious protective effect on focal cerebral iscbemia in rats, to a certain extent, inhibited the production and the effect of the toxic reaction.

Objective To observe the curative effect of Naomai`an Capsules in patients with acute cerebral infarction (ACI) of syndrome type of phlegm-stasis obstructing collaterals and its influence on plasma endothelin (ET). Method The patients with diagnosed ACI of syndrome type of phlegm-stasis obstructing collaterals (n=88) were randomly divided into the treatment group and control group (each n=44). Two groups had the same basic treatment and then the treatment group was given Naomai`an Capsules orally and the control group, nimodipine and aspirin orally. The changes of European stroke scale (ESS) and ET were observed in two groups before and after the treatment. Result After treatment for 2 weeks ESS was improved and ET level was decreased significantly in the treatment group than those in the control group (P<0.001). Conclusion Naomai`an Capsules has a reliable curative effect on ACI of syndrome type of phlegm-stasis obstructing collaterals.

目的:探讨急性脑梗死中医辨证分型与血浆同型半胱氨酸(Hcy)、血清超敏C反应蛋白(hs-CRP)水平的关系.方法:选取210例急性脑梗死患者及30例健康者,对脑梗死患者按中医辨证分为风痰瘀阻型、阴虚风动型、气虚血瘀型、痰热腑实型、风痰火亢型、风火上扰型、痰湿蒙神型7组,分别测定急性脑梗死患者和健康对照者血浆Hey及血清hs-CRP水平,并进行组间比较.结果:急性脑梗死患者血浆Hey及血清hs-CRP水平显著高于对照组(P＜0.01),且急性脑梗死各中医证型中,风痰瘀阻型血浆Hcy水平较其他6型明显增高(P＜0.05);痰热腑实型、风痰火亢型、风火上扰型的血清hs-CRP水平较风痰瘀阻型、气虚血瘀型、阴虚风动型及痰湿蒙神型显著升高(P＜0.05).结论:血液Hcy、hs-CRP水平的升高是动脉粥样硬化性血栓性脑梗死的重要危险因素,血液Hcy、HsCRP水平可作为急性脑梗死中医辨证分型的客观指标.

目的:探讨忘忧方治疗30～50岁抑郁障碍患者的临床疗效.方法:将所收集的63例抑郁障碍患者,按随机表法分成治疗组36例和对照组27例,治疗前行HAMD量表初次评分,治疗组予中药忘忧方治疗;对照组予西药氟西汀治疗;疗程均为6周,治疗后第6周末再次进行HAMD量表及Asberg氏抗抑郁剂副反应量表(SERS)评定.结果:各组治疗前后HAMD分值差异显著(P<0.05),两组之间治疗无显著差异(P>0.05);治疗组的副作用较对照组小,且差异显著(P<0.05).结论:忘忧方治疗与氟西汀治疗抑郁障碍均有疗效,二者治疗结果无明显差异,但忘忧方组的副作用较氟西汀组少.

目的:了解厦门地区抑郁障碍患者就诊年龄在30～50岁人群发病的影响因素.方法:对来就诊的符合CCMD-3抑郁障碍患者,让其填写一般情况调查表、CES-D表;与健康体检者一般情况调查表、CES-D评分比较,进行因素分析.结果:对63例抑郁障碍患者与健康体检者31例进行单因素分析显示:是否患抑郁障碍与工作性质、行为类型、有否抑郁症的家族史、家族中是否有人自杀及自杀倾向、活动参与度这五种因素关系密切.将上述因素再进行多因素分析,纳入回归方程,发现行为类型及活动参与度相关性较强.结论:本次研究结果显示抑郁障碍与工作性质、行为类型、抑郁症的家族史、家族中是否有人自杀及自杀倾向、活动参与度这五个因素密切相关.

Objective To investigate the effect of Naomaian Capsules on expression of brain-derived neurotrophic factor(BDNF) mRNA in acute cerebral infarction tissue of rats.Methods 36 SD male rats were randomly divided into 6 groups,with 6 rats in each group: low-dose Naomaian Capsules group(A),moderate-dose Naomaian Capsules group(B),high-dose Naomaian Capsules group(C),west medicine(nimodipine)group(D),sham-operation group(E),and 24h ischemia model group(F).The model of focal cerebral ischemia was made by thread-occluded method.In each group,the brain tissues of 3 rats were taken out 24 hours after the operation and the injuries of their cerebral cortex cells were observed by HE staining and the brain tissues of another 3 rats were taken out to extract the total mRNA for amplification of BDNF mRNA specific fragment by RT-PCR and analyze the changes of BDNF mRNA expression of each group.Results Obvious symptoms of neural function deficiency and ischemic morphological changes such as cellular edema were observed in 24h ischemia model group.Relative optical density of the amplified products of BDNF mRNA in 24h ischemia model group was obviously higher than in sham-operation group(P<0.01).The relief of cortex neuron edema and relative optical density of amplified products of BDNF mRNA in Naomaian Capsules group with all dosages and west medicine group were obviously higher than 24h is chemia model group,and the results had statistical significances(P<0.01).Conclusion Naomaian Capsules can up-regulate the expression of BDNF to cause the recovery of the neurological function,which contributes to its therapeutic effect for acute cerebral infarction.

Activating blood flow and removing blood stasis proved by lots of basic and clinical studies has good preventing and treating effects on angina pectoris,myocardial infarction,acute thrombosis,abrupt vessel closure and restenosis after percutaneous transluminal coronary angioplasty,lately activating blood flow and removing blood stasis is paid attention to therapeutic angiogenesis in the medicinal coronary artery bypass grating and got remarkable treating effects.

催乳素(PRL)瘤是功能性垂体瘤中最常见者,约占50%[1],由于PRL瘤位于垂体窝内有部位特殊性,有远距分泌激素功能、具有功能特殊性,早期临床表现具有多样性、不典型性,故早期极易误诊及漏诊.我们收集我院2005-07～2007-07 PRL瘤误诊23例,分析如下.

活血化瘀,瘀血去则新血生,称之“祛瘀生新”。生新不仅是传统意义上的生新血,还包含有生新络的含义,瘀血去,则新血及新络生,生新又反过来促进瘀血祛除,这与缺血性中风治疗性血管新生有异曲同工之妙。活血化瘀可促进缺血脑组织的血管生成生长因子的释放,不仅可促血管新生,改善缺血脑组织的血供,而且还具有促进神经发生、神经营养、神经保护和抗凋亡作用,促进神经功能恢复,改善预后,从而为活血化瘀治疗缺血性中风提供新的理论依据。

目的:观察自拟头风愈痛汤治疗偏头痛的疗效.方法:将60例随机分为治疗组30例,予头风愈痛汤治疗.对照组30例,予西比灵治疗.观察疼痛程度、持续时间、发作频度,计算其头痛指数和头痛疗效.结果:治疗组的临床基本恢复、总有效率、头痛指数明显优于对照组(P<0.01、P<.05).

目的观察破瘀消水、化痰开窍法治疗急性脑梗死的疗效.方法将 96例急性脑梗死患者随机分为对照组与治疗组,两组均予血塞通注射液静滴,治疗组加服中药.两组治疗前后进行血液流变学指标的测定.结果治疗组疗效及血液流变学指标的改善均优于对照组.结论破瘀消水、化痰开窍法治疗急性脑梗死疗效确切.

以中医整体观念和辨证论治为基础,对疑难杂症的辨证思路与方法进行了系统的探讨,提出了双向调节法、治风祛风法、扶正缓治法、活血化瘀法、豁痰泄浊法等为辨治疑难杂症的基本方法.

辨证论治是中医学的精髓,是中医区别于西医临床诊疗模式的基本特点之一,但随着医学的发展,各种先进检测手段的不断出现和改进,一些疾病在未出现症状或体征时已被确诊.

慢性肾小球肾炎(简称慢性肾炎)是临床上颇为棘手的免疫性疾病,由于起病隐匿而缓慢,病情迁延,时轻时重,经常因治疗不及时、失治误治而导致肾功能逐渐减退,最终发展为尿毒症,预后不良.