过敏,是再常见不过的一类问题,可以累及呼吸道、消化道、皮肤等多个器官.在几类常见的过敏性疾病中,过敏性鼻炎(季节性鼻炎)常会出现鼻痒、鼻塞,连续不断打喷嚏、流清涕;过敏性支气管炎则常出现咽痒、连续咳嗽;过敏性哮喘常表现为胸闷、咳嗽、气紧、喘鸣;过敏性皮炎则包括有荨麻疹、湿疹,皮肤局部出现瘙痒、起风团;除此之外,还有变应性胃肠炎、过敏性眼结膜炎等.

目的 探讨银屑平丸对银屑病样小鼠模型Notch1和Jagged1表达水平的影响.方法 将48只小鼠随机分为空白组、模型组、阿维A胶囊组、银屑平丸高、中、低剂量组,每组8只.各组小鼠背部脱毛后,每日外用咪喹莫特乳膏造模形成银屑病样小鼠,干预方式是同时予以相应药物给每组小鼠灌胃.观察并记录小鼠背部皮肤,予银屑病皮损面积与严重度指数(PASI)评分;运用形态观察、HE染色病理分析皮损组织形态学变化;免疫组化、反转录聚合酶链反应方法来检测小鼠皮肤组织Notch信号通路中Notch1、Jagged1的表达.结果 与空白组相比,模型组呈现明显的银屑病病理变化,在光镜下可表现为不同程度的角化不全,乳头上棘层变薄,乳头水肿,血管扩张充血;而银屑平丸高、中、低剂量组及阿维A胶囊组变化均较少.与空白组相比,模型组、银屑平丸高、中、低剂量组及阿维A胶囊组造模后PASI评分均升高(P<0.05);与模型组相比,银屑平丸高、中、低剂量组及阿维A胶囊组造模后PASI评分均降低(P<0.05),其中银屑平丸高剂量组PASI评分降低最明显,其次为阿维A胶囊组(P<0.05).与空白组相比,模型组Notch1、Jagged1表达量均增加(P<0.05);与模型组相比,银屑平丸高、中、低剂量组及阿维A胶囊组Notch1、Jagged1表达量均降低(P<0.05).与空白组相比,模型组Notch1、Jagged1 mRNA表达量均增加(P<0.05);与模型组相比,银屑平丸高、中、低剂量组及阿维A胶囊组Notch1、Jagged1 mRNA表达量均降低(P<0.05).结论 银屑平丸能够降低银屑病样小鼠模型的PASI评分,使银屑病的皮损能够改善;银屑病可能与Notch1/Jagged1信号通路相关联;银屑平丸治疗银屑病可能是通过降低Notch1、Jagged1的方式来表达.

问:为何从不过敏的人突然出现过敏反应? 答:原因可能有以下几种:1.内分泌和激素水平发生变化,导致免疫系统的应激反应也随之变化,从而诱发过敏反应.比如,妊娠、月经期、劳累或大手术后、放化疗后.2.环境变化.比如有些人本身对动物皮屑过敏,以前并没有接触过猫、狗等动物,后来养了动物之后才发现;或者居住新家,接触油漆;或者去西藏、海南等地接受长时间紫外线照射时,可能出现紫外线不耐受.3.食物的成分发生了变化.比如,本身对虾蟹不过敏的人,因为养殖环境受到污染或养殖过程中添加了药物等成分,导致这些人在食用虾蟹后出现过敏症状;或者对牛肉不过敏的人,却对牛肉制作过程中添加的调料产生过敏情况.

目的:通过检测STAT3/Survivin信号转导通路在银屑病患者的表达来观察银屑平丸对银屑病患者该信号转导通路的干预作用,认识银屑病的发病机制和银屑平丸治疗寻常型银屑病的作用靶点.方法:21例寻常型银屑病患者口服银屑平丸,记录治疗前后PASI积分.选取治疗前后典型皮损,同时选取20例整形切除术后的正常皮肤,用免疫组化法检测其STAT3、Survivin的表达.结果:治疗组治疗后PASI评分显著下降,差异有统计学意义(P＜0.05);治疗组治疗前皮损STAT3、Survivin的平均灰度明显高于正常组皮损(P＜0.05),治疗后皮损STAT3、Survivin的平均灰度较治疗前皮损表达明显减少(P＜0.05).治疗组治疗前后皮损STAT3、Survivin平均灰度与正常组比较,差异有统计学意义(P＜0.05).结论:在寻常型银屑病中存在STAT3、Survivin表达异常增高,证实寻常型银屑病的发生、发展与两者相关.银屑平丸通过降低皮损中STAT3、Survivin的表达水平,调节银屑病中角质形成细胞的增殖和细胞凋亡,改善银屑病对机体的损伤.

Objective To observe the clinical efficacy of Yinxieping pills combined with calcipotriol ointment on psoriasis vulgaris in stationary phase. Methods Eighty patients in stationary phase of psoriasis vulgaris were randomly divided into 2 groups, the control group with 40 cases and the treatment group with 40 cases. The control group was external used only with calcipotrio ointment. And the treatment group were treated with both calcipotriol ointment and Yinxieping pills at the same time, the course of treatment was for 8 weeks. The clinical efficacy of two groups, lesion area and severity index (PASI) before and after treatment were observed. Results The effectiveness rate of treatment group was 87.5% and that of control group was 67.5%. The difference of the total efficiency between two groups was statistically significant (P<0.05). The PASI score after treatment in the two groups showed statistically significant difference (P<0.05). Conclusion The clinical efficacy of Yinxieping pills combined with calcipotriol ointment on psoriasis vulgaris in stationary phase is exact and definite.

目的 通过观察银屑平丸对寻常型银屑病患者皮损中STAT3(信号转导与转录活化因子3)和P-STAT3(磷酸化信号转导与转录活化因子3)表达的影响,探讨银屑病的发病机制及银屑平丸治疗寻常型银屑病的作用靶点.方法 21例寻常型银屑病患者予口服银屑平丸治疗,疗程8周.用免疫组化法检测其治疗前后皮损STAT3、P-STAT3的表达,并与20例整形切除术后的正常皮肤相比较.结果 银屑平丸治疗组治疗前皮损STAT3、P-STAT3的平均灰度值与正常组相比,其表达明显升高(P＜0.01);治疗后皮损STAT3、P-STAT3的平均灰度值较治疗前表达明显下降(P＜0.05).治疗组治疗前后STAT3、P-STAT3的表达呈正相关(P＜0.05).结论 在寻常型银屑病中存在STAT3、P-STAT3的高表达,证实寻常型银屑病的发生、发展与两者相关.银屑平丸通过降低皮损中STAT3、P-STAT3的表达水平,调节银屑病中角质形成细胞的增殖和细胞凋亡,改善银屑病对机体的损伤.

Objective To study the effects of Yinxieping pill on psoriasis vulgaris in blood-heat syndrome and its impacts on IL-8 in serum.Methods 70 patients with blood-heat syndrome of psoriasis vulgaris were randomly divided into treatment group and control group.the patients in treatment group were treated with Yinxieping pill and in control group with Compound Qingdai pill,the therapeutic course was 8 weeks in both.In addition,20 healthy volunteers were selected in control group.Before and after treatment,PASI score was calculated and peripheral blood serum IL-8 content was measured.Results PASI scores were significantly decreased after treatment in treatment group and control group(P0.01,P0.01),and the results in treatment group was more significant than that in control group(P0.01).Serum IL-8 was also significantly decreased after treatment in both groups(P0.01,P0.01),and the changes in treatment group were also more significant than that in control group(P0.01).Conclusion Yinxieping pill can decrease the IL-8 level and PASI score in blood-heat syndrome of psoriasis vulgaris.It has obvious curative effects on psoriasis vulgaris.

<正>Kaposi水痘样疹是一种在特应性皮炎或其他皮肤病基础上感染了单纯疱疹病毒或牛痘病毒、柯萨奇A病毒而发生的皮肤病[1]。临床多见于儿童。笔者经治1例老年红皮病患者继发Kaposi水痘样疹,运用中西医结合方法疗效确切,因本病在诊断上有一定难度,临床上易误诊,现将该病例报告如下。

<正>近十年来,随着女性乳腺增生发病率的不断增长,该病已成为临床上严重影响青、中年女性身心健康的常见疾病。我院刘丽芳教授从事中医外科工作近三十载,在乳房疾病手术及中医药治疗方面卓有成效。刘教授在继承中医经典研究的基础上,结合自身丰富的临床经验,总结出以"疏肝理气、软坚化痰法"为主治疗乳腺增生的方法取得较好的临床效果。现将刘教授治疗本病的宝贵经验整理归纳如下,以期共同提高。

Objective:To study the proliferative inhibition effect of nano size Alum-Borneol emulsion to L-929 cell.Methods:The cytopathogenic effect inhibition assay and MTT method were applied.The adherent L-929 cell were added diluted drug and cultrued 24h,48h in 7℃,5% CO2 condition.The normal cell group and traditional Alum-Borneol liquid group were set as control.The effect of drugs to cell morphology and growth were detected by inverted microscope and OD assay respectively.Results:Compared with traditional Alum-Borneol liquid group,the nano size Alum-Borneol emulsion could increase the proliferative inhibition effect on L-929 cell with increasing of drug concentration(P0.05).The proliferative inhibition rate of nano size Alum-Borneol emulsion was lower than traditional Alum-Borneol liquid at same time and concentration(P0.05).The proliferative inhibition rate of nano size Alum-Borneol emulsion was decreased with decreasing drug concentration and cultural time compared with normal control group(P0.05).The morphology results show a good cell shape in inverted microscope.Conclusion:The nano size Alum-Borneol emulsion has no cytotoxicity to L-929 cell and could applied to clinic.

Objective To observe the embellish skin relieving itching emulsion on treating chronic eczema of blood deficiency wind dry permit syndrome.Methods 60 patients with chronic eczema of blood deficiency wind dry permit syndrome were randomly divided into itching moisturizing emulsion treatment group and urea ointment group.The integral itching degree,lesions points of these two groups were recorded before and after treatment.Results After treatment,symptoms of the patients in these two groups were all improved.After treating for two weeks,the effect of embellish skin relieving itching emulsion was not better than Triamcinolone Acetonide urea ointment.But after treating for four weeks,the effect of embellish skin relieving itching emulsion was obviously better than Triamcinolone Acetonide urea ointment.Embellish skin relieving itching emulsion could improving itching syndrome,but changes in skin lesions were not as good as Triamcinolone Acetonide urea ointment.Conclusion The efficacy of embellish skin relieving itching emulsion on treating chronic eczema of blood deficiency wind dry permit syndrome is better.And the patients compliance is good.

Objective: To observe the Qi Zhen granules clinical treatment of severe alopecia areata and its effect on serum cortisol.Methods: 90 patients met the inclusion criteria of severe alopecia areata patients were randomly divided into traditional Chinese medicine group(A group),the WM group(B group),the WM group(C group),respectively,received appropriate treatment,3 months for a course,2 courses of treatment to determine efficacy,and detection of serum cortisol levels.Results:(1) 3 group after drug treatment,including group C and A,B group hair loss symptom score and clinical effects of the differences were statistically significant(P<0.05),A group and B group,the difference was not statistically significant(P>0.05);(2) 3 groups of serum cortisol levels,the differences were statistically significant(P<0.05);treatment serum cortisol levels after 3,the difference was not statistically significant(P>0.05).Conclusion: The three heavy-duty treatment of liver and kidney insufficiency alopecia areata are valid,including Qi Zhen granules prednisone alopecia areata treatment of severe liver and kidney insufficiency significant clinical efficacy,Qi Zhen granules can reduce liver and kidney insufficiency in patients with severe alopecia areata serum cortex alcohol content.

目的 观察清疣洗剂联合5%咪喹莫特乳膏治疗肛周和外生殖器尖锐湿疣的临床疗效.方法 将120例患者随机分为两组,治疗组用清疣洗剂外泡后局部外用5%咪喹莫特乳膏,对照组单纯局部外用5%咪喹莫特乳膏,治疗8周后,观察两组临床疗效.结果 治疗组有效率为89.47%,对照有效率为48.15%,两组间的差异具有统计学意义(P<0.05);两组均无系统不良反应,仅有给药部位的局部不良反应,以轻度和中度红斑为多见,两组间差异无统计学意义(P>0.05).结论 清疣洗剂联合5%咪喹莫特乳膏治疗肛周和外生殖器尖锐湿疣的临床疗效较好,不良反应少.

The paper expounded on implementation of case teching and considered that case teching of Surgery of Chinese Medicine was beneficial to students to stimulate their learning interest,improved their ability of clinical questions analysis and solution,and beneficial to improve teacher's professional quality and teaching level.The selection of case was crucial and carefully designing of teaching link was the important measure to ensure case teching quality.

目的:观察润肤止痒乳剂治疗寻常型银屑病血虚风燥证的疗效及安全性。方法:选择60例寻常型银屑病血虚风燥证患者,随机均分为治疗组和对照组,治疗组30例外用润肤止痒乳剂,日2次;对照组30例外用维A酸乳膏,日2次,疗程均为2月。结果:用药2个疗程后治疗组总有效率为86.7%,对照组总有效率为70.0%,两组比较差异有显著性(P<0.05),均无严重不良反应发生。结论:润肤止痒乳剂治疗寻常型银屑病血虚风燥证患者临床疗效较好,患者依从性较强。

目的观察乳增宁膏对乳腺增生病模型大鼠内分泌激素及免疫功能等相关指标影响,探讨乳增宁膏治疗乳腺增生病的作用机制。方法采用注射苯甲酸雌二醇、黄体酮造模,60只大鼠随机分为5组,正常对照组,乳腺增生模型组,乳增宁膏低、高剂量组,乳癖消灌胃组,乳癖消外敷组。待造模成功后,乳增宁膏高、低剂量组每天进行乳增宁膏外贴,乳癖消外敷,于实验第61天处死动物,取颈动脉血检测和乳腺组织观察相关指标。结果乳增宁膏高、低剂量组能提高P、E2、PRL水平,使导管上皮细胞层数、腺泡数明显减少,降低乳腺病理组织ER、PR积分,与模型组比较,差异均有统计学意义(P<0.05),以高剂量组疗效更为显著,乳增宁膏高剂量组还能提高CD3、CD4、CD8等免疫指标。结论乳增宁膏具有调节血清中E2、P、PRL激素水平的作用。其作用机制可能是通过调节实验动物下丘脑-垂体-卵巢性腺轴的功能,从而改善血清性激素的异常而实现的。

Objective To observe the effect and safety of Alum Borneol Nanoemulsion on the superficial second degree burn. Methods Totally 120 patients were randomized into treatment group and control group,and were treated with Alum Borneol Nanoemulsion and Alum Borneol Fluid respectively for 10 days. The comprehensive effect,time of the main symptom getting relieved (hour) and disappeared (day),immediate effect of pain relief,dynamic healing rate of the wound,time of total healing of the wound,and safety were evaluated. Results The total effective rate of the treatment group was 100%,with 90% of healed or markedly effective,being higher than those of the control group,i.e.95% and 81.7% respectively,but there was not significant difference (P0.05). The relief of local redness,swelling and pain in the treatment group was better than those of the control group (P0.05 or P0.01). The dynamic healing rate and time of total healing of the wound in the treatment group were better than those of the control group (P0.01). After treatment,there was no significant difference in blood,urine and stool routines,liver and kidney functions,as well as electrocardiogram of both groups compared with those before treatment (P0.05). Conclusion Both Alum Borneol Nanoemulsion and Alum Borneol Fluid are effective for superficial second degree burn,however,the Nanoemulsion is superior to the fluid in improving main symptoms,relieving pain and promoting healing of the wound.

目的:探讨黄丹凝胶治疗寻常痤疮临床疗效.方法:100例寻常痤疮患者,采用随机对照的原则分成黄丹凝胶治疗组、邦力痤疮王对照组,记录治疗前及治疗2、4周后靶部位皮损类型、脂溢情况、皮损数目、皮损颜色及肿胀破溃,根据评分标准表进行评分比较.结果:(1)治疗4周后两组患者症状均有改善,黄丹凝胶组疗效明显优于邦力痤疮王组,组间相比差异有统计学意义(P＜0.05).(2)对于患者的脂溢情况,黄丹凝胶有显著疗效,组间相比差异有统计学意义.结论:黄丹凝胶时寻常痤疮有较好疗效.

目的:观察内服清肺饮外用甲硝唑擦剂治疗寻常痤疮的疗效.方法:将106例患者随机分成2组,对照组40例内服维胺脂胶囊,外搽顺峰痤疮王;治疗组86例,内服清肺饮,外用甲硝唑擦剂.结果:治疗组总有效率为95.3%,对照组总有效率为75.0%,治疗组明显优于对照组(P＜0.01).结论:内服清肺饮外用甲硝唑擦剂治疗寻常痤疮有较好的疗效.

目的:探讨丹参注射液配合体针治疗带状疱疹后遗神经痛(PHN)的疗效.方法:将60例PHN患者随即分成两组,对照组予以卡马西平、维生素等西药治疗,治疗组予以丹参注射液配合针刺治疗.用VAS法观察两组疼痛程度的变化.结果:治疗1周后两组疼痛程度无明显变化,治疗2周后治疗组治疗前后疼痛指标显著改善,明显优于对照组.结论:丹参注射液配合体针能有效改善带状疱疹后遗神经痛.