怎会有胆固醇结晶 正常人胆汁中有三种主要脂类,即胆固醇、卵磷脂和胆汁酸.脂溶性胆固醇在胆汁酸和磷脂的帮助下,能完全溶解在胆汁中,不会有胆固醇结晶析出.但是,如果胆汁中的胆固醇含量超过了胆汁酸和磷脂溶解胆固醇的能力,此时就会析出胆固醇结晶而发生沉淀.析出的胆固醇结晶相互聚结,久而久之便会形成胆固醇结石.

西医强调的是标准化治疗,讲究的是有一个恒定的方法.中医讲究的是没有一个恒定的方法,却有着不变的指导思想.中医指导思想的独特之处在于中医离不开其背后蕴含的中国传统文化所特有的思维方式而独立存在,其中经权思想作为中国哲学思想的重要组成部分,很好地解决了中西医并存的问题.经者,常也;权者,变也.知经达权、知常达变的哲学理念指导中医学以“衷中参西”的方式回归传统,即中西医汇通.名医曹颖甫生活在中国内忧外患时期,中西方思想交融与碰撞亦表现出了丰富性和复杂性,加之其治学思想和对经方的亲身体悟,使其能够从学理的高度去把握经方.曹颖甫经方思想主要表现在:①在笃信并运用经方的同时,并不反对使用时方.虽然时方在某些方面与经方背道而驰,但是其归旨实则与经方殊途同归.②通过《伤寒论》《金匮要略》自证、自解经方.经方的特点在于能够在任何时空、条件下稍做变化即可发挥其效用.这种自证、自解的方式实则是融会贯通古今的表现,亦能说明经方能够沟通古今.③通过“衷中参西”解释经方,即坚持回归最纯正的经方医学,以实验精神治病救人,以此证明经方的科学性和效果.

目的:探讨去甲乌药碱对大鼠主动脉平滑肌细胞迁移和增殖的影响.方法:体外培养大鼠主动脉平滑肌细胞,使用不同浓度去甲乌药碱(0、10、30、100?μmol/L)培养24?h后,通过划痕试验观察去甲乌药碱对平滑肌细胞趋化迁移能力的影响,通过CCK-8试验检测去甲乌药碱对平滑肌细胞增殖能力的影响.结果:划痕试验结果示,去甲乌药碱10?μmol/L有抑制大鼠主动脉平滑肌细胞迁移的趋势,但无统计学意义(P>0.05);30?μmol/L及以上浓度均具有抑制细胞迁移的作用(P<0.01),且具有剂量依赖性(P<0.05,P<0.01).CCK-8试验结果示,去甲乌药碱各剂量均有明显的抑制大鼠主动脉平滑肌细胞增殖的作用(P<0.05,P<0.01),且具有剂量依赖性(P<0.05).结论:去甲乌药碱能抑制大鼠主动脉平滑肌细胞的迁移与增殖,且呈剂量依赖性.推测去甲乌药碱可能具有预防血管再狭窄的作用.

目的:本研究通过观察温阳益气活血方联合常规西医治疗慢性心力衰竭C期(阳气亏虚血瘀证)患者治疗前后的症状及相关指标的发展变化,以期评价温阳益气活血方的临床有效性和安全性,为中医药治疗心衰提供临床新证据和新思路.方法:本研究选用慢性心力衰竭C期(阳气亏虚血瘀证)的住院患者共100例,采用随机、双盲、对照的研究方法,分为治疗组和对照组各50例,其中治疗组在常规西医治疗的基础上加服温阳益气活血方,对照组给予常规西医治疗,两组分别治疗8周后,观察两组患者治疗前后中医证候积分、Lee氏心衰积分、明尼苏达心衰生活质量评分(LHFQ)等变化.采用SPSS 21.0统计软件对治疗结果进行统计分析,最后得出结论.结果:经治疗后,最终完成本次临床研究的患者共92例,其中治疗组45例,对照组47例.治疗前后,两组患者中医证候积分及疗效评价、Lee氏心衰积分及明尼苏达心力衰竭生活质量调查等方面均显示差异有统计学意义(P＜0.05).结论:温阳益气活血方联合常规西药治疗心衰,能更好地改善心悸、气短、乏力等症状,改善阳虚、胸闷、自汗等次症、兼症等,明显下调了患者中医证候积分,Lee氏心衰积分,且疗效明显,可适度控制西药的使用量,减少患者耐药性和避免副作用的发生.

Objective: To observe the clinical effects of Yishen granules in treating leukopenia of heart and spleen deficiency pattern. Methods:All 106 patinets were randomly divided into the observation group(54 cases) and the control group (52 cases). The observation group was given Yishen granules, three times one day, one bag once, oral administration; the control group was given batilol tablets, three times one day, 40mg per time, oral administration. The course of two groups were two months. The changes of clinical effects, TCM symtoms scores and WBC were observed in two groups. Results:The total effective rate in the observation group was 83.33%, and that of the control group was 80.77%, there was no statistical difference(P>0.05) between two groups. WBC in two groups increased after treatment in two groups (P<0.05), there was no statistical difference in WBC improvement between two groups (P>0.05). TCM symtoms scores decreased obviously in two groups (P<0.05), the observation group decreased more obviously than the control group(P<0.05). Conclusion:Yishen granules have significant clin-ical effect of treating leukopenia of heart and spleen deficiency pattern.

<正>慢性再生障碍性贫血(简称慢性再障,CAA)是一组由化学生物因素、放射线或不明原因引起的骨髓造血功能衰竭性疾病,以全血减少为特征,属难治性血液病。近年来,国内外针对CAA患者贫血与促红细胞生成素(EPO)及下丘脑-垂体-肾上腺轴(HPA轴)的研究较少,本研究通过探讨CAA患者EPO的表达以及HPA轴中的重要活性物质皮质醇(COR)水平的关系,为CAA患者如何进一步有效治疗提供新的理论依据。

Objective:To discuss the relationship between different levels of EPO and COR in patients with chronic aplastic anemia(CAA)and TCM Differentation Type(TCMDT).Methods:40 chronic aplastic anemia patients were classified into two groups:kidney-yang deficiency group and kidney-ying deficiency group and then different indexes of blood routine,EPO and COR were detected.Results:(1)Compared with healthy controls,EPO in CAA group was significantly increased(P<0.01).(2)Compared with kidney-yang deficiency group,white blood cell count(WBC)and COR in kidney-ying deficiency group were statistically increased(P<0.05,P<0.05).Conclusion: Expression of EPO in CAA patients appeared to be disordered and WBC and COR have certain regulations with TCMDT,which can be taken as indexes in TCM differentation in clinical practice.

我们经长期临床观察研究发现,缺血性中风(脑梗塞),临床辨证除了传统的"肝风内动,气虚血瘀"等征象,同时多与"湿热毒邪"并存。主证可见:舌质紫暗,舌苔黄腻而厚,大便不爽,干结等。采用彩色多普勒颈动脉超声检测可见,颈动脉内膜增厚及斑块形成。作者采用自拟经验方"扶正祛毒通脉汤"临床治疗126例上述缺血性中风病例。结果发现:缺血性中风后遗症的恢复程度与湿热毒邪的消退,黄腻厚苔的改变及颈动脉内膜斑块的消失具有一定的相关性,取得了明显的疗效。同时与对照组68例进行了比较分析。

<正>脉平片由银杏叶提取物、芦丁、何首乌、当归、维生素C组成,近年来在临床上广泛应用,本文就脉平片的临床应用研究作一综述。1冠心病心绞痛的治疗冠心病患者常伴有心绞痛,戚刚[1]用脉平片治疗120例冠心病心绞痛患者,结果治疗组总有效率及中

肿瘤放疗和化疗会导致贫血,例如由化学生物因素、放射线或不明原因引起的骨髓造血功能衰竭性疾病,以全血细胞减少为特征,属难治性血液疾病[1].目前,国内外已将环孢素A推荐为治疗再生障碍性贫血的一线药物[2],其有效率可达60%.本研究将环孢素A与小牛脾提取物注射液(商品名:斯普林)联合治疗30例慢性再生障碍性贫血患者.

Objective:TO discuss the relationship between different factors of endocine system and immune system in patients with chronic aplastic anemia and TCM Differentation Type(TCMDT).Methods:Classified the 60 chronic aplastic anemia patients into three groups,respectively kidney-yang deficiency group,kidney-ying deficiency group and kidney-ying-and-yang deficiency group and then dectected different indexes of endocrine system and immune system.Results:(1)Compared with kidney-yang deficiency group,CD+8,CD3,CD4,Cortisol(COR),Testosterone(T) and Free Thyroxine(FT4)in kidney-ying deficiency group is statistically increased(P0.01,P0.01,P0.01,P0.05,P0.01,P0.01)and CD+4 and E2 decreased(P0.01,P0.01),while CD+4in kidney-ying-and-yang deficiency group decreased(P0.01)(2)Compared with kidney-ying deficiency group,Estradiol(E2)in kidney-ying-and-yang deficiency group is statistically increased(P0.01),while CD+8,CD3,CD4,COR and T decreased(P0.01,P0.01,P0.01,P0.01,P0.01).Conclusion:CD+4,CD+8,CD3,CD4,COR,T,E2 and FT4 has certain regulations among TCMDT groups,which can be taken as indexes in TCM differentation in clinical practice.

目的 探讨慢性再生障碍性贫血(chronic aplastic anemia,CAA)患者外周血共刺激分子CD28表达与外周血象的相关性.观察共刺激分子与造血抑制的关系.方法 采用流式细胞仪技术,测定45例CAA患者、加例健康对照者外周血T细胞CD4+及CD8+中共刺激分子CD28的表达水平.并对CD28及白细胞、血红蛋白、血小板计数进行相关性分析.结果 CD28+、CD4+CD28+、CD8+CD28+与CAA患者外周血血红蛋白含量存在负相关性(r=-0.411,P＜0.05;r=-0.37,P＜0.05;r=-0.417,P＜0.05),共刺激分子的表达与白细胞、血小板无明显相关性(P＞0.05).结论 CAA的发病机制与T细胞的异常激活相关.共刺激分子可作为选择治疗方案及对预后估计的参考指标.

Objective:To discuss relationship between the Expression of CD28 and Fas and TCM Differenciation Type in Patients with Chronic Aplastic Anemia.Methods:Using flow cytometry to detect the CD28 and Fas expression in 45 in-patients or out-patients and 20 healthy subjects for control,and to discuss the relationship between TCM Differenciation Type in Patients with Chronic Aplastic Anemia and the Expression of CD28 and Fas.Results:① The level of the expressions of CD+28,CD+8 CD+28/CD+8 CD-28(P0.05),CD+4CD+28/CD+4CD-28(P0.01),CD+8 CD+28in the CAA patients are higher than the normal contrast group;While CD+95,CD+3 CD+95,CD+8 CD+95 is lower(P0.05).②Compared with the yang-deficiency group,the level of the expressions of yin-deficiency group of CD+28,CD+3 CD+28,CD+4CD+28,CD+8 CD+28(P0.001),CD+4CD+28/CD+4CD-28,CD+8 CD+28/CD+8 CD-28(P0.05)are higher;While CD+95,CD+3 CD+95,CD+4CD+95,CD+8 CD+95 are lower(P0.01).Conclusion:The abnormal expression of Co-stimulatory molecule CD28 and Fas in the peripheral blood of CAA patients suggested CD28 and Fas disorder may play an important role in immuno-pathogenesis of CAA,and contribute to the differentiation of syndrome types and serve as the guideline of the effect of treatment and prognosis;The abnormality of the Co-stimulatory molecule and CD95 of kidney yin-deficiency patients are worse,which indicates the seriousness of the disease.

Objective:To discuss the relationship between factors of sex,age,couse of disease,degree of hypocytosis,past treatments and immunoresponsive level in patients with chronic aplastic anemia and TCM differenciation of syndromes.Methods:Review and summerize the medical records,and use immune turbidimetry and flow cytometry to detect serum content of complement 3,4 and immunoglobin(Ig),and expression level of T subsets in peripheral blood(PB) in 37 patients of kidney-yang deficiency group and 23 patients of kidney-yin deficiency group with CAA,and to analysis their relationships.Results:①There is no difference between kidney-yang deficiency group and kidney-yin deficiency group in factors of sex,age,couse of disease,degree of hypocytosis,past treatments and immunoresponsive level of body.②Serum content of C_3,C_4 and expression level of T subsets in PB are remarkably different between two groups.The former group shows lower level of C_3,C_4 in serum,the latter group shows high expression of CD~+_8 cells;and the serum content of C_3 has positive correlation with expression of PBCD~+_8 cells and negtive correlation with value of CD_4/CD_8.Conclusion:Differenciation of syndromes of CAA has association with immunal indices of serum content of C_3,C_4 and expression level of peripheral CD~+_4,CD~+_8 cells,no relation with factors of sex,age,couse of disease,degree of hypocytosis,past treatments.

Objective]To analyse the therapeutic effect of qinggan huayu(purging liver and eliminating stasis) decoction on patients with chronic granulocytic leukemia and the effect on its influence on psychological factors,and to discuss the mechanism of qinggan huayu decoction on CGL from the point of view of psychosomatic medicine. [Method]Self rating Anxiety Scale(SAS),Self rating Depression Scale(SDS) and Quality of Life Questionaire(QLQ) were selected to ask the CGL patients and healthy person, as control, to fill in guiding by the doctors. The long term effect of qinggan huayu decoction on CGL was reviewed and summarized. [Results] The incidence rate of anxiety were 82% and 5% in control group and treatment group respectively, the rate of depression were 84% and 5% and the rate of anxiety complicated with depression were 76% and 0(P0.01). The score of anxiety and depression had negative correlation with quality of life. Five year survival rate of 50 CGL patients was 76%, the median intravitam was 74 months. [Conclusion] CGL patients have obvious tendency of anxiety and depression. Qinggan huayu decoction can effectively improve the psychological status and the life quality of CGL patients,and prolong the intravitam.

OBJECTIVETo explore the relationship between CD8+ T-cell CD28 molecular expression in peripheral blood and TCM type in patients with chronic aplastic anemia (CAA).METHODSUsing flow cytometry to detect the CD28 expression in 45 in-patients or out-patients and 24 healthy subjects for control. And the relation with TCM type was analyzed from the immunological aspect.RESULTS(1) The levels of CD8, CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- were all higher in the CAA patients than those in the healthy subjects (P < 0.05 or P < 0.01). (2) The levels of CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- were all higher in the CAA patients of Shen-Yin deficiency type than those in the CAA patients of Shen-Yang deficiency type (P < 0.05 or P < 0.01).CONCLUSION(1) The abnormal high expression of peripheral blood co-stimulatory molecules CD28 suggested CD28 disorder may play an important role in immuno-pathogenesis of CAA. (2) The levels of peripheral CD28, CD8+ CD28+ expression and CD8+ CD28+/CD8+ CD28- can be taken as an objective indexes for TCM typing of CAA, which was disordered more severe in patients of Shen-Yin deficiency type than in those of Shen-Yang deficiency type.