慢性肾炎激素撤退过程中中药治疗钩玄

慢性肾炎是临床上的一种常见病，目前大多数人认为人类的慢性肾炎是免疫介导的疾病。一般认为免疫是疾病的始发机理，在此基础上和某些炎症介质参与下，后导致肾脏损伤和产生临床症状［1］。正是基于这种认识，肾上腺皮质激素(以下简称激素)的使用成为慢性肾炎治疗的重要手段。激素的使用可以使部分慢性肾炎病例的病情得到不同程度的缓解，但是这种方法又可造成患者对激素的长期依赖，而长期依赖激素的结果是下丘脑-垂体-肾上腺皮质-胸腺(HPAT)轴功能抑制，导致垂体、肾上腺皮质储备能力下降，同时长期激素的使用又可导致血液的高凝状态、脂肪代谢的紊乱等多种并发症。因此，激素能否顺利撤退成为慢性肾炎治疗的一个关键，因为在这些病例激素撤退过程中，如果激素撤退过快，经常会出现病情反跳，导致疾病反复，甚至出现危象。而中医中药的参与，已经成为帮助慢性肾炎患者顺利减撤激素的重要方法。

Objective: To evaluate the therapeutic effect of Chinese patent drug Shu Feng Huo Luo Pian (疏风活络片 Pill for Dispelling Wind and Activating Collaterals) for the treatment of osseous arthritis. Method: 50 cases of osseous arthritis were divided randomly into two groups, the Shu Feng Huo Luo Pian group (the experimental group), including 30 cases (aged 63.5±4 years), treated with 2 such pills, po, bid; and the control group, including 19 cases (aged 63±5 years), treated with Sulindac 0.2g, po, bid. The two groups were all supplemented by medication of calcium Caltrate D 0.6g, po, qd. The above-mentioned medications were administered for 2 courses, 2 weeks constituting a course. Result: The total effective rate of the experimental group evaluated by the doctors was 83.3%, and that evaluated by the patients was 90%, with mild side effects. Conclusion: Shu Feng Huo Luo Pian is an effective Chinese patent drug for treating osseous arthritis, with less and mild side effects. Osseous arthritis is characterized mainly by chronic arthralgia, ankylosis, and arthroncus accompanied with dysfunction of the joint. It affects predominantly the movable joints of the human body, such as the joint of the hip, knee, ankle, elbow, and finger. It is a commonly seen disease, which mostly affects the life activities of the aged people. Its morbidity rises along with age. X-ray mass survey has shown that the morbidity of this disease among people aged 15-24 years is about 10%, while that among people aged 55 years is about 80%1. As China is entering an aged society, due attention should be paid to this kind of disease. This article offers a clinical observation on the therapeutic effect of Shu Feng Huo Luo Pian (疏风活络片 Pill for Dispelling Wind and Activating Collaterals) for 50 cases of osseous arthritis as reported below.

Diabetic neuropathy (DN) is one of the common complications of diabetes mellitus (DM), its incidence can be as high as over 90%. The lesion can involve the sensory, motor and vegetative nerves. As a whole, the lesion can be divided into symmetric multiple neuropathy and asymmetric single neuropathy. Because the pathogenesis of the disease is not clear, no specific therapy is available so far. Besides control of blood sugar level, vitamin B, vasodilators and analgesics are often used in Western medicine for expectant treatment. Basic studies on chronic complications of DM show that aldose reductase and non-enzymatic glycosylation of protein are factors initiating the pathological changes, inhibitors against them have been tested in experimental studies and proved effective. Unfortunately, they are not used clinically due to severe side effects. Screening for herbal drugs to treat DN is still a popular trend in the TCM circle.

In recent years, with the establishment of the theory of air passage inflammation concerning the pathologic mechanism of asthma, the glucocorticoid hormone (referred to hereafter only as hormone for short), a strong inflammation killer, has become a fundamental medication for treatment of asthma. However, long period of hormone administration will result in general side effects in the whole body as well as hormone dependence, which has now become a hard problem for physicians. Now a non-hormone medication of immunosuppressant has been chosen in western medicine to treat asthma as a replacement or partial replacement of hormone. Nevertheless, its therapeutic effect is not reliable and its side effects severe, hence hardly acceptable to patients. Traditional Chinese medicine (TCM) always adheres to the principle of holistic treatment and has a great advantage in the treatment of this disease. TCM doctors have made some trials and researches in this area and obtained some accomplishments. The following is a brief account of general researches on the treatment of asthma with TCM.

肥厚型心肌病心房颤动:决定因素、临床进程与处理

心房颤动(房颤)是一个全球性健康问题,东西方患病率相同,反映人群老化,心血管病负担加重.在肥厚型心肌病(HCM)患者中,房颤是常见的持续性心律不齐,常见的并发症之一,对临床病程与预后影响很大.房颤成为HCM治疗的棘手问题,特别年轻患者,需要一致的循证治疗策略.尽管HCM房颤的循证依据不多,近期证据提示,新的治疗方法给某些患者带来了希望.我们需要更加深入的理解房颤的病理生理学,特别是遗传性心脏病患者房颤的病理生理学.我们重点复习HCM房颤的发病与临床预后及处理的进展.

专题报告-S1草药的药理学与毒理学

Beginning from the report of the renal injury induced by aristolochic acid, the poisonous side effects of Chinese medicines have attracted more and more attentions, which have produced huge influence on the progress of traditional Chinese medicines.

Objectives To assess weight loss efficacy ,safety and tolerability of sibutramine in simple obese subjects.Methods Randomized, double-blind, placebo-controlled clinical trial. Four hospital outpatient clinics in Shanghai, Chongqing, Shandong and Tianjin, respectively. Participants: 233 men and women, 18-65 years old, with body mass index (BMI) ranging from 27 to 40*!kg/m2 were randomly divided into an intervened group and a placebo control group. Sibutramine 10 mg or placebo once a day. Main outcome measures: Body weight, routine laboratory and clinical safety monitoring.Results Of 233 eligible patients, 120 received sibutramine and 113 received placebo. Weight reduction was significantly greater in the intervened group (6.8±3.1) kg than the placebo control group (0.48±2.6) kg from week 4 onwards to week 24 (P<0.001). Some minor side effects were noticed in the subjects who took sibutramine. But the symptoms were light and short term. Sibutramine was will tolerated.Conclusions Sibutramine 10*!mg once a day is an effective an safe therapy for weight reduction in simple over-weighted and obese subjects.

"小柴胡汤副作用引起死亡"事件的真相

在日本,随着中药煎剂的简单化,中药制剂进入了"颗粒提取物制剂"的时期,有学者发表了小柴胡汤用于难治的慢性肝炎有效的报告,此后,小柴胡汤被西医医生们广泛应用.研究结果发表后,引起反响.日本的西医医师们忽视辨证论治,对慢性肝炎患者投用小柴胡汤,厚生省对此进行了调查,2000年1月的全国报纸报道了"小柴胡汤的副作用引起死亡事件",全世界的汉方家、中医学家、临床医学家们非常震惊.在此,将其真相发表,希望能为今后的研究起到抛砖引玉作用.The Truth of the Accident-Some Patients Died from Side Effects of Xiao Chai Hu Tang

格拉司琼预防化疗后呕吐65例分析

BACKGROUND:During the therapy of cencers,it is difficult to continue chemiotherapy due to frequent vomiting,especially commonly used drugs such as side effects of cisplatin.Although new pharmacy appeared in greatly relieve vomiting effect of the chemiotherapy, there were no satisfied drugs to settle this problem.

中西医并治急性期痛风性关节炎关节红肿痛120例

Background:The acute gouty arthritis causes painful joints and obvious swelling. Sometimes it also causes liquid in joints. The joints are so painful that touch is resisted, it has trouble to curve and extend and the function is greatly hampered. Also fever, palpitation and fatigue are caused. Most cases are in fat people with good diet. The incidence is greatly increased with the development of living condition in recent years and male cases are more than female cases (about 20:1). Purine and colchinine cause slow effect and serious side effects. We began to treat it with Chinese medicine combined with western medicine from 1998 and gained some experience

安坦治疗精神疾病所致锥体外系副反应分析

Background: Inequality in degree of extrapyramidal side effects (EPS) caused by antipsychotic drugs is due to that nigrostriate dopamine(DA) system is blocked by drugs,then the activity of acetylcholine(Ach) is relatively stimulated.The application of Anticholinergic agent can keep the relative equilibration between DA and Ach,then relieves or obliterates EPS.When part of patients are undertaking the antipsychotic drugs of antipsychotic drugs,they offen use artane simultaneously.Especially chronically sick persons, whether they need necessarily the application of anticholinergic agent long term or not,and we do some relatetive analysis on that.

肾移植病人的饮食康复治疗

Background:Now renal transplantation is extensively used and recetpted in the clinic for treating chronic renal failure.Nutrition support and diet treatment are necessary for postoperative rehabilitation of patients underwent renal transplantation.Rigid nutrition treatment could prevent and treatment postoperative diabetes mellitus,hypertension and hyperlipemia.Diet control was also necessary for patients receiving immunodepressant.Standards and protocol for diet treatment are unavailable now.The incidence of acute rejection and allograft failure during the first year posttransplantation has been greatly reduced by advances in operative techniques, immunosuppressive agents and our understanding of their toxicities, donor selection and preservation, and donor and patient management. However, life-long immunosuppression is required to prevent the development of chronic rejection. Thus, either chronic rejection or the adverse side effects of chronic immunosuppression limit long-term survival. There is increasing incidence that posttransplant lipoprotein abnormalities may contribute to the development of cardiovascular disease (CVD). CVD is one of the most common causes of morbidity and mortality following renal transplantation. In addition, there is some indirect evidence that posttransplant lipoprotein abnormalities may influence the progression of chronic transplant nephropathy. While there are no intervention trials examining whether antilipemic therapy is beneficial in the prevention of CVD in renal transplant patients, it is reasonable to assume that the benefits of treating hyperlipidemia in renal transplant recipients may be comparable to those found in the general population. Objective:Protocol for diet treatment was determined for patients underwent renal transplantation to reduce renal load,promote recovery of renal function,and decreased the incidence of complications.

前瞻性随机试验:活检针口径大小对经会阴前列腺活检患者的疼痛和并发症发生率的影响

Drug holidays and attention deficit/hyperactivity disorder

The concept of ‘drug holidays’ (defined as "...the structured interruption of pharmacological treatment..."[1]) in the management of attention deficit hyperactivity disorder (ADHD) is well established,but poorly researched[1].The question is whether there is indeed a justifiable basis for the practice.In the opinion piece by Professors Du and Wang[2],they argue that on the balance of available evidence it is not justified.Herein lies the issue-the evidence.In reality significant numbers of parents both report side effects[3] and stop medication intermittently[1],and many sufferers stop treatment prematurely[4] (generally due to adverse effects).

强脉冲光与红光治疗糖皮质激素依赖性皮炎临床疗效分析

目的 回顾性分析比较强脉冲光与红光治疗糖皮质激素(简称激素)依赖性皮炎的临床疗效及不良反应.方法 应用强脉冲光治疗以面部毛细血管扩张为主要表现的激素依赖性皮炎患者70例,能量密度20～23 J/cm2,其中脉宽为2.6～5.0 ms,延迟时间为15 ～ 20 ms,间隔4周治疗1次,平均3.49次.使用波长(633±3)nm红光治疗以面部皮肤敏感为主要表现的激素依赖性皮炎患者197例,能量密度128J/cm2,每次照射20 min,每周治疗2次,平均4.23次.对每次治疗的疗效及不良反应进行评价.结果 强脉冲光治疗激素依赖性皮炎的总有效率为88.57％；红光治疗的总有效率为83.76％.强脉冲光3脉冲治疗组和2脉冲治疗组的疗效差异有统计学意义(x2=8.14,P＜0.05).所有患者均未出现严重不良反应.结论 强脉冲光和红光治疗激素依赖性皮炎均有较好疗效.

赛乐特治疗广泛性焦虑症门诊患者的开放对照研究

选择性5-HT 回收抑郁制剂(SSRI)治疗焦虑性障碍已有报道［1-2］。本研究旨在以多虑平为对照，评价赛乐特(Paroxetine)治疗门诊广泛性焦虑症(GAD)患者的疗效与副反应。1 对象与方法1.1 研究对象 在门诊连续就诊的病人，并符合中国精神疾病诊断标准第二版修订版(CCMD-Ⅱ-R) GAD的标准。汉密尔顿焦虑量表(HAMA) 总分大于15分，性别不限，年龄18～70岁。入组前2周未进行系统抗焦虑治疗者。同时排除脑器质性精神病、精神活性物质依赖、妊娠或哺乳妇女以及严重心、肝、肾疾患或重性精神病。符合上述条件者随机分为赛乐特组与多虑平组。