目的:观察补肾益肠汤对溃疡性结肠炎患者(直肠、乙状结肠溃疡)修复愈合的情况,对补肾益肠汤的临床应用提供实验支持及评价,为临床治疗溃疡性结肠炎提供有效的中医药治疗方法.方法:采用数字双盲法对对江油市人民医院收治的80例溃疡性结肠炎患者随机分为两组.A组40例,使用用补肾益汤直肠滴入治疗;B组40例,使用柳氮磺吡啶口服治疗;于治疗4周后复查肠镜评价患者愈合效果.6月后复查肠镜随访复发情况.结果:治疗组溃疡性结肠炎患者的临床总有效率(97.5％)高于对照组(82.5％);治疗后中医证候总积分治疗组(9.2±2.1)低于对照组(10.8±1.9).结论:补肾益肠汤直肠滴入治疗在溃疡性乙状结肠、直肠炎患者中有效性和安全性均较高,有助于临床症状的改善.

目的:探讨肝病退黄汤直肠滴入治疗慢性乙型病毒性肝炎高胆红素血症的临床疗效.方法:50例慢性乙型病毒性肝炎高胆红素血症中医属湿热发黄证患者随机分为两组,对照组25例,治疗组25例.对照组患者给予常规内科综合治疗;治疗组在内科综合治疗基础上给予肝病退黄汤150ml直肠滴入,每日两次,疗程4周.治疗前及治疗4周后比较两组患者的临床转归、血清总胆红素、血清白蛋白、血清前白蛋白、总胆汁酸、凝血酶原活动度、乙肝DNA水平变化.结果:治疗组总有效率为88％,与对照组总有效率80％比较,差异无统计学意义;治疗组有效患者中患者的TBIL、TBA较对照组明显降低,ALB、PA、PTa明显升高;2组患者血清HBV-DNA水平均明显下降,差异无统计学意义.结论:对于慢性乙型病毒性肝炎属湿热发黄患者,在常规内科综合治疗的基础上,给予肝病退黄汤直肠滴入能够明显降低患者胆红素水平,改善肝功能,提高临床疗效.

肠易激综合征是一种以腹痛或腹部不适伴排便习惯改变为特征的功能性肠病,现代医学对本病的病因和发病机制尚不清楚,而祖国医学缺乏对肠易激综合征的专论.笔者试从五运六气对肠易激综合征进行论述.

目的:探讨中药外敷治疗肝硬化腹水的有效方法.方法:将97例患者随机分为治疗组49例,对照组48例,疗程均为4周.结果:治疗组总有效率95.9％,明显高于对照79.2％(P＜0.05).结论:中药外敷可明显提高常规西药治疗肝硬化腹水的临床疗效.

目的 观察加味当归四逆汤配合常规西药治疗慢性肺源性心脏病的疗效.方法 将患者57例随机分治疗组和对照组,2组均予以常规西药治疗,治疗组加用加味当归四逆汤.结果 治疗组咳嗽、咯痰、气喘、食欲不振、乏力、双下肢水肿、肺部啰音改善优于对照组;治疗组总有效率高于对照组,治疗组PaO2改善优于对照组,P＜0.05.结论 加味当归四逆汤配合常规西药治疗慢性肺源性心脏病有较好的疗效.

目的:观察温阳健脾法治疗腹泻型肠易激综合征(IBS)的临床疗效.方法:将130例腹泻型IBS患者随机分为治疗组(66例)和对照组(64例).对照组患者口服曲美布汀0.2g tid,蒙脱石3g tid,饭前30min服用;治疗组患者在对照组基础上加用补肾健脾汤,每日1剂,并予以中药腹部穴位贴敷疗法,每天1次,7次为1个疗程,3个疗程后停止穴位贴敷治疗.两组患者均于治疗6周后观察比较临床疗效.结果:经过治疗,治疗组患者临床总有效率为93.94％,显著高于对照组的70.32％,两组患者临床疗效比较差异具有统计学意义(P＜0.05).结论:采用温阳健脾法治疗腹泻型IBS患者可明显改善患者腹泻、腹痛症状,降低复发率,值得临床推广应用.

Objective: To investigate the effect of Jiejufushenning on urine transforming growth factor-beta 1 and kidney function of diabetic rats.Methods: Diabetic rats induced by injection of streptozotocin(STZ) were randomly divided into diabetic control group(group B),and Jiejufushenning group(group C),age-matched normal SD rats served as normal control group(group A).After 12 weeks of treatment,renal function,urinary volume 24h Pro and creatinine determined by normal methods,TGF-β1 was determined by ELISA method,and the morphological structure of renal tissue was observed by light microscope.Results: Compared with group B,the levels of wrine BUN,Scr,24hPro,volume and TGF-β1 obviously decreased(P<0.05),and the excretion of urine creatinine obviously increased in group C(P<0.05).Conclusion: Jiejufushenning has the protecting effect on kidney of diabetic rats;the mechanism might be related to the decreasing level of TGF-β1 in urine.

Objective To investigate the effect of Jieju Fushenning(JJFSN)on osteopontin(OPN) and macrophages antigen(CD68) expression in renal tubules,and to observed its renal protective effect in diabetic nephropathy rats.Methods The diabetic SD rats induced by STZ were divided into four groups:diabetic model group,JJFSN group,irbesartan group and JJFSN combined with irbesartan group.Meanwhile,a normal control group was set up.The rats in each group were respectively treated with corresponding drugs according to the experimental design for 12 weeks.The renal index,blood glucose,blood urea nitrogen(BUN),serum creatinine(Scr),and urinary albumin excretion rate(UAER) were detected by routine methods.The pathological changes of the rat kidney were observed by HE staining.Expression of OPN and CD68 in renal tubules were determined by immunohistochemical technique,and OPN in kidney was detected by western blot methods.Results The blood glucose,UAER,urea nitrogen,serum creatinine,kidney index were significantly increased,the expression of OPN and CD68 were significantly increased,and obvious changes of the tubular structure were found under light microscope in diabetic model group.The above indexes in JJFSN group,irbesartan group and JJFSN combined with irbesartan group were significantly lower than those in diabetic model group(P 0.01),and the abnormality of renal ultrastructure was improved.The improvement of all the above indexes in JJFSN combined with irbesartan group was most significant(P 0.01),but the indexes still did not arrive to the normal levels.Conclusion JJFSN has protective effect on renal histology and function,and its mechanism may be related to the decrease of renal OPN level and the down regulation of CD68 expression.

目的观察解聚复肾宁（Jiejufushenning,JJFSN）对糖尿病（Diabetes mellitus,DM）大鼠肾组织肿瘤坏死因子-α（Tumor necrosisfactor-alpha,TNF-α）、单核细胞趋化蛋白-1（Monocyte chemoattractant protein-1,MCP-1）和血清TNF-α的影响,探讨其肾保护作用机制。方法腹腔注射链脲佐菌素（Streptozotocin,STZ）建立SD大鼠DM模型,将成模DM大鼠随机分为3组:DM模型组（B组）、JJFSN组（C组）、厄贝沙坦（Irbesartan）组（D组）,另设正常对照组（A组）。采用相应干预措施处理12周。常规方法测定12周末各组大鼠空腹血糖（FBG）、血尿素氮（BUN）、血肌酐（Scr）、肾重/体重（KW/BW）、24 h尿蛋白（24 huPro）;放免法测血清TNF-α含量;免疫组织化学方法测肾组织TNF-α、MCP-1的表达;PAS染色评估细胞外基质;电镜观察肾组织超微结构改变。结果与A组相比,B组大鼠FBG、BUN、Scr、KW/BW、24 huPro及血清TNF-α升高（P＜0.05）,肾组织TNF-α、MCP-1表达明显增高（P＜0.05）;肾组织超微结构明显异常;C组和D组上述指标显著改善（P＜0.05）,肾组织超微结构异常改善。结论JJFSN能延缓DM大鼠肾损害进程,其机制可能与抑制TNF-α、MCP-1上调有关。

Objective:To investigate the effects of Jiejufushenning on advanced glycation end products(AGEs)in serum and expression of receptor for advanced glycation end products(RAGE) in kidney in diabetic rats.Methods:Diabetic SD rats were induced by injection of streptozotocin,then the diabetic rats were randomly divided into four groups:diabetic control group(group B),Jiejufushenning group(group C),aminoguanidine group(group D),Jiejufushenning and aminoguanidine group(group E),age-matched norma1 SD rats served as norma1 contro1 group(group A).After 12 weeks of treatment by corresponding intervention,blood glucose,renal function,the quantitation of urine protein of 24 hours(24hPro)and urine creatinine were determined by the normal methods.The levels of AGEs in serum were determined by fluorospectrophotometry,and the expressions of RAGE in kidney were determined by immunohistochemical methods.Results:The levels of blood glucose,urea nitrogen(BUN),serum creatinine(Scr)and 24hPro in rats of group C,group D and group E were obviously lower than those of group B,but higher than those of group A;The levels of urine creatinine of group C,D and E were obviously higher than that of group B(P0.05),but lower than those of group A;the levels of AGEs in serum and expressions of RAGE in kidney in group C,group D and group E were obviously lower than those of group B,and the level of group D was lower than that of group C,and the level of group E was the lowest,but still higher than that of group A.Conclusion:Similar to AG,JJFSN has effect on inhibiting the action of proteinum unenzyme glycosylation,decreasing the production of AGEs in serum and the expression of RAGE in kidney and decreasing blood glucose,24hPro,BUN and Scr;Combination of JJFSN and AG have a significantly cooperated action.

目的探讨解聚复肾宁对糖尿病(DM)大鼠肾组织结缔组织生长因子(CTGF)、纤维连接蛋白(FN)表达及肾脏保护作用与机制。方法建立STZ诱导的DM大鼠模型,将成模大鼠随机分成4组:DM对照组、解聚复肾宁治疗组、厄贝沙坦治疗组和解聚复肾宁联合厄贝沙坦治疗组(联合治疗组),同时设正常对照组。各组大鼠采用相应的干预措施处理12w。常规方法检测各组大鼠第12周时肾重/体重(KW/BW)、血糖、尿素氮、血肌酐、尿白蛋白排泄率(UAER),免疫组化法检测肾组织CTGF表达,免疫荧光法检测肾组织FN表达,透射电镜观察肾脏超微结构。结果DM对照组大鼠肾皮质CTGF表达显著升高,FN沉积显著增多,肾脏超微结构改变明显,血糖、UAER、尿素氮、血肌酐、肾重/体重显著增高。解聚复肾宁治疗组、厄贝沙坦治疗组和联合治疗组血糖、UAER、尿素氮、血肌酐、肾重/体重、CTGF和FN表达显著低于DM对照组(均P<0.01),肾脏超微结构改变明显改善。联合治疗组各项指标改善明显优于DM对照组、解聚复肾宁治疗组和厄贝沙坦治疗组(P<0.01),但未达到正常对照组水平。结论解聚复肾宁对DM大鼠肾脏形态和功能有明显保护作用,其机制可能与下调肾组织CTGF表达,减少细胞外基质(ECM)沉积,减轻肾组织纤维化有关,联合厄贝沙坦治疗效果更明显。

Objective To investigate the renal protective effect of Jieju Fushenning( JJFSN) on diabetic mellitus (DM) in rats. Methods The diabetic SD rats induced by STZ were divided into four groups: diabetic control group, JJFSN group, Irbesartan group, JJFSN+ Irbesartan group, and the normal control group. After treatment with the above responding drugs by gavage for 12 weeks, the kidney weight, body weight, blood sugar, urea nitrogen, serum creatinine, and urinary albumin excretion rate (UAER) were detected by routine laboratory methods, angiotensinⅡ (AngⅡ ) in renal tissue was detected by radioimmunoelectrophoresis, and connective tissue growth factor (CTGF) in renal tissue was detected by immunohistochemical techniques, and ultrastructure of kidney was observed under transmission electron microscope. Results The expression of renal cortex CTGF was increased in diabetic rats .The ultrastructure of kidney was noticeably changed, and the blood sugar, UAER, urea nitrogen, serum creatinine, ratio of kidney weight and body weight, and angiotensinⅡ content were significantly increased in diabetic rats. While the above indexes in JJFSN group, Irbesartan group and JJFSN+ Irbesartan group were significantly lower than those in diabetic control group (P 0.01), and ultrastructure of kidney was improved. The improvement of all indexes in JJFSN + Irbesartan group was superior to Irbesartan group (P 0.01). Conclusion JJFSN exerts protective effect on renal histological features and renal function of DM rats, and its protective mechanism maybe related with the decrease of AngⅡ level and down regulation CTGF expression in the renal tissue.

本试验主要探讨治疗糖尿病(diabetes mellitus,DM)临床疗效较好的经验方解聚复肾宁(Jiejufushenning,JJFSN)对DM大鼠肾脏的保护作用及其可能机理.

持续高血糖引起的蛋白质非酶糖基化及由此形成的晚期糖基化终产物(Advanced glycation end products,AGEs)增多,在糖尿病(Diabetic mellitus,DM)慢性并发症的发病机制中起重要作用.因此,减少内源性AGEs的形成对于防治DM慢性并发症有重要意义.本文就晚期糖基化终产物的研究现状作一综述.