苓桂术甘汤联合电针风池供血穴治疗椎基底动脉供血不足性眩晕的临床研究

目的:探讨苓桂术甘汤联合电针风池供血穴治疗椎基底动脉供血不足(VBI)性眩晕的临床疗效。方法:选择2017年11月-2019年8月我院收治的VBI性眩晕患者145例为研究对象,采用随机数字表法分成联合组(75例)和对照组(70例)。在基础治疗的前提下,联合组采用苓桂术甘汤联合电针风池供血穴治疗,对照组采用西比灵治疗。比较两组临床疗效、眩晕改善情况、脑动脉血流速度指标、动脉硬化指数(AI)以及血液流变学指标。结果:治疗后联合组总有效率为89.33%,高于对照组的75.71%(P<0.05);治疗后联合组眩晕症状积分、欧洲眩晕评分量表(EEV)评分和眩晕障碍量表(DHI)评分低于对照组(P<0.05);联合组治疗后左侧动脉、基底动脉峰值流速(Vp)、左右侧动脉、基底动脉平均血流速度(Vm)均高于对照组,左侧动脉、基底动脉血管搏动指数(PI)、右侧动脉血管阻力指数(RI)、AI、高切全血黏度、中切全血黏度、低切全血黏度、血浆黏度、红细胞压积均低于对照组(P<0.05)。结论:苓桂术甘汤联合电针风池供血穴治疗VBI性眩晕,能够缓解患者的眩晕状况,疗效确切,改善脑动脉血流速度和脑动脉硬化程度,降低血液黏度。     

"从督论治"针刺治疗颈性眩晕的随机对照临床研究

摘要 目的：观察"从督论治"针刺治疗颈性眩晕的临床应用价值。方法：选取上海市中医医院2020年5月~2022年3月期间收治的296例颈性眩晕患者，采用双色球法将其分为研究组、对照组，各为148例。研究组接受"从督论治"针刺治疗，对照组接受常规针刺治疗。对比两组中医疗效、临床症状评分[颈性眩晕症状与功能评估量表（ESCV）、视觉疼痛模拟评分（VAS）]、动脉血流速度、血液流变学指标。结果：研究组的临床总有效率高于对照组（P<0.05）。治疗后，研究组ESCV评分高于对照组，VAS评分低于对照组（P<0.05）。治疗后，研究组基底动脉（BA）和大脑双侧（L、R）椎动脉（VA）的血管搏动指数（PI）低于对照组，平均血流速度（Vm）高于对照组（P<0.05）。治疗后，研究组全血粘度-高切（HBV）、全血粘度-低切（LBV）、红细胞压积（HCT）、血浆粘度（PV）、红细胞聚集指数（AI）、全血还原粘度（RV）、红细胞刚性指数（IR）、血沉（ESR）、纤维蛋白原（FIB）、红细胞电泳时间（EET）低于对照组（P<0.05）。结论："从督论治"针刺治疗颈性眩晕，可有效改善疼痛、眩晕症状，调节脑血流速度、血液流变学指标。     

补肾调周法联合维生素E治疗功能性痛经的临床疗效及对子宫血流动力学、炎症因子的影响

目的：分析夏桂成教授补肾调周法联合维生素E治疗功能性痛经的临床疗效及对子宫血流动力学、炎症因子的影响。方法：选择我院自2021年1月至2022年12月接诊的106例功能性痛经患者作为研究对象,随机分为对照组和观察组,各53例。对照组予以维生素E治疗,观察组予以补肾调周法联合维生素E治疗。在治疗前及治疗3个月经周期后,检测子宫动脉收缩期血流速度（Vs）、子宫动脉舒张期血流速度（Vd）、平均速度（Vm）、阻力指数（RI）及血清超敏C反应蛋白（hs-CRP）、白细胞介素6(IL-6)、前列腺素（PG）F2α、PGE2水平,比较两组不同时间点的痛经VAS评分、治疗总有效率。结果：观察组治疗后Vs、Vd、Vm均大于对照组,RI小于对照组（P<0.05）;观察组治疗后血清hs-CRP、IL-6水平均低于对照组（P<0.05）;观察组治疗后血清PGF2α水平低于对照组,PGE2水平高于对照组（P<0.05）;观察组治疗结束时及治疗结束后第3个月经周期的痛经VAS评分均低于对照组（P<0.05）;观察组治疗总有效率为94.34%,高于对照组的71.70%(P<0.05)。...     

不同压力二氧化碳气腹对兔血液流变学和微循环的影响

目的：研究不同压力二氧化碳气腹对兔血液流变学和微循环的影响。方法：18只雌性健康实验兔按气腹压力随机均分为三组：气腹压0mmHg组（Ⅰ组）、气腹压10mmHg组（Ⅱ组）和气腹压15mmHg组（Ⅲ组）。每组兔均在不同的压力下接受气腹1h。在二氧化碳气腹前5min（T0）、气腹后30min（T1）、气腹后60min（T2）测定血液流变学指标。监测心率（HR）、平均动脉压（MAP）、耳廓微循环的血流量和血流速率并记录在相应时点的上述参数值。结果：气腹后30min、60min,Ⅱ组与Ⅰ组比较,HR、MAP、全血粘度、红细胞刚性指数和聚集指数显著增加（P〈0.05）,红细胞变形指数、耳廓微循环的血流量和血流速率显著下降（P〈0.05）,Ⅲ组与Ⅰ组比较,各参数变化更为显著（P〈0.01）。血浆粘度和红细胞压积气腹前后无明显变化。结论：二氧化碳气腹后血液流变性减弱;虽然HR、MAP增加,但微循环的血流量和血流速率下降。     

颈性眩晕中医证型与经颅超声脑动脉血流检测结果的相关性分析

摘要 目的：分析颈性眩晕中医证型与经颅超声脑动脉血流检测结果的相关性。方法：选取2021年5月-2023年5月收治颈性眩晕患者作为研究对象,根据不同中医证型分为痰湿中阻组、肝阳上亢组、肝肾阴虚组和气血亏虚组,每组各纳入20例;并另选取健康体检患者30例作为对照组,均给予多普勒超声检查。分析不同中医证型者与对照组者多普勒超声检查特征与脑动脉血流变化[左右椎动脉、基底动脉及大脑中动脉收缩期峰值血流速度（VS）、平均血流速度(Vm)、舒张期峰值血流速度(Vd)及搏动指数(PI)]。结果：痰湿中阻组、肝肾阴虚组和气血亏虚组左右椎动脉、基底动脉及大脑中动脉VS均低于对照组（P＜0.05）;肝阳上亢组左右椎动脉、基底动脉及大脑中动脉VS均高于对照组（P＜0.05）;不同中医证型组间VS比较,肝阳上亢组＞痰湿中阻组＞肝肾阴虚组＞气血亏虚组;痰湿中阻组左右椎动脉、基底动脉均高于对照组（P＜0.05）,大脑中动脉Vm均低于对照组（P＜0.05）;肝阳上亢组左右椎动脉、基底动脉及大脑中动脉Vm均高于对照组（P＜0.05）;肝肾阴虚组左右椎动脉、基底动脉及大脑中动脉Vm均低于对照组（P＜0.05）;气血亏虚组大脑中动脉Vm均低于对照组（P＜0.05）,左右椎动脉、基底动脉Vm和对照组无显著性差异（P>0.05）;不同中医证型组间Vm比较,肝阳上亢组＞痰湿中阻组＞气血亏虚组＞肝肾阴虚组;痰湿中阻组左右椎动脉、基底动脉Vd均低于对照组（P＜0.05）,大脑中动脉Vd均高于对照组（P＜0.05）;肝阳上亢组左右椎动脉、基底动脉及大脑中动脉Vd均低于对照组（P＜0.05）;肝肾阴虚组左右椎动脉及大脑中动脉Vd均低于对照组（P＜0.05）,基底动脉Vd和对照组无差异（P＞0.05）;气血亏虚组左右椎动脉Vd均低于对照组（P＜0.05）,基底动脉Vd和对照组无差异（P＞0.05）,大脑中动脉Vd均高于对照组（P＜0.05）;不同中医证型组间Vd比较,气血亏虚组＞痰湿中阻组＞肝肾阴虚组＞肝阳上亢组;痰湿中阻组和气血亏虚组左右椎动脉、基底动脉及大脑中动脉PI均低于对照组（P＜0.05）;肝阳上亢组和肝肾阴虚组左右椎动脉、基底动脉及大脑中动脉PI均高于对照组（P＜0.05）;不同中医证型组间PI比较,肝阳上亢组＞肝肾阴虚组＞痰湿中阻组＞气血亏虚组。结论：不同中医证型的眩晕患者会出现不同程度脑动脉血流动力学异常,且不同组间存在差异,通过经颅多普勒超声检查,可以对眩晕中医证型提供参考价值。     

哈慈五行针治疗高粘血症机理探讨

引言１９６２年,科学家发现血液粘稠增高是导致心肌梗塞病发生的一个危险因素,并提出了高粘血症这一名词。以后,在高血压病、动脉硬化、脑血栓、糖尿病、肿瘤等多种疾病发现有血液粘度增高。〔１〕。高粘血症病因人体正常时血流速度很快,大循环一个周期大约２０秒左右。如果血液粘度增高,血流速度则下降,尤其在微循环系统最易引起血液瘀滞、阻塞,从而导致微循环障碍。引起高粘血症的因素是多种多样的,其中主要原因之一是红细胞聚集现象的发生。在正常的生理作用之下,红细胞之间有一定间隙和距离（散开游动）,但在某些病理状态下则…     

蝮蛇抗栓酶对高粘血症患者血液流变与微循环影响的观察

静注蝮蛇抗栓酶并口服青龙胶囊治疗高粘血症１４０例患者。结果显示,蝮蛇抗栓酶能明显降低血液粘度,表现为全血粘度、血浆粘度、全血还原粘度及纤维蛋白原降低,同时降低甲襞微循环形态、流态及管周状态积分。探讨其改善血液粘度机制。     

天丹通络胶囊联合丁苯酞软胶囊治疗急性脑梗死的疗效及对炎症因子和脑血流动力学的影响

摘要 目的：探讨天丹通络胶囊联合丁苯酞软胶囊治疗急性脑梗死（ACI）的疗效及对炎症因子和脑血流动力学的影响。方法：按照随机数字表法将合肥市第一人民医院2019年1月-2021年12月间接收的100例ACI患者分为对照组（50例,丁苯酞软胶囊治疗）和观察组（50例,天丹通络胶囊联合丁苯酞软胶囊治疗）。对比两组疗效、量表评分、炎症因子和脑血流动力学,统计两组治疗期间不良反应发生率。结果：观察组84.00%的临床总有效率高于对照组66.00%（P<0.05）。与对照组比较,治疗后观察组Barthel指数评分升高,美国国立卫生研究院卒中量表（NIHSS）评分降低（P<0.05）。观察组治疗后的白介素-6（IL-6）、超敏C反应蛋白（hs-CRP）低于对照组,白介素-10（IL-10）高于对照组（P<0.05）。观察组治疗后的阻力指数（RI）低于对照组,脑血流收缩期峰值血流速度（Vs）、平均血流速度（Vm）、舒张期血流速度（Vd）较对照组高（P<0.05）。不良反应发生率组间对比无差异（P>0.05）。结论：天丹通络胶囊联合丁苯酞软胶囊有助于降低ACI患者的炎症因子水平,改善脑血流动力学,效果显著。     

关节腔注射联合周林频谱仪治疗对类风湿关节炎合并骨关节炎的体会

目的：探讨关节腔注射联合周林频谱仪对类风湿关节炎合并骨关节炎的疗效及护理体会。方法：将本院90例类风湿关节炎合并骨关节炎患者随机分成3组,所有患者治疗前均进行全身情况评估以及相应的常规护理措施．对照A组30例予以玻璃酸钠20mg关节腔内注射,观察A组30例使用玻璃酸钠关节腔内注射联合周林频谱仪患处照射,平均时间（19±4．5）min,照射距离以皮肤感觉温热为宜。观察B组30例在观察A组治疗方案基础上实施康复训练。三组均以15d为一疗程,疗程结束后比较各组患者临床总有效率、血液流变学变化情况以及不良反应的发生率。结果：（1）治疗后观察组临床症状总有效率较对照组比较具有统计学差异（P〈0．05）,观察组优于对照组,治疗后观察B组临床症状总有效率较观察A组比较具有统计学差异（P〈0．05）,观察B组优于观察A组;（2）治疗后三组血流速度（Vs）、平均血流速度（Vd）、舒张末期血流速度（Vm）均较治疗前升高（P〈0．05）,其中观察组升高幅度较对照组明显（P〈0．05）;观察组中观察B组优于观察A组（P〈0．05）;（3）三组不良反应发生率比较无统计学差异（P〉0．05）。结论：玻璃酸钠关节腔内注射联合周林频谱仪对类风湿关节炎合并骨关节炎疗效肯定,能快速改善患者临床症状,科学良好的康复护理干预是促进疗效的关键。     

自拟活血化瘀方对缺血性脑卒中患者生活质量的影响

目的:观察缺血性脑卒中患者采用自拟活血化瘀方治疗对生活质量的以及对相关细胞因子的影响。方法:通过随机数字表法将70例缺血性脑卒中患者分为观察组(自拟活血化瘀方+现代康复训练)35例及对照组(现代康复训练)35例。治疗结束后比较两组视觉模拟(VAS)疼痛评分、血液流变学、临床总有效率以及Bcl-2、Bax与caspase-3蛋白水平表达的变化。结果:(1)治疗后,观察组较对照组的VAS评分、临床症状改善明显(P0.05);(2)治疗后,观察组血流速度(Vs)、舒张末期血流速度(Vm)、平均血流速度(Vd)升高幅度较对照组更为显著(P0.05);(3)与对照组比较,治疗后观察组患者血浆中Bcl-2表达水平升幅度更为显著(P0.05);与对照组比较,治疗后观察组患者血浆中Bax、caspase-3表达水平降低幅度更为显著(P0.05)。结论:自拟活血化瘀方能够有效提高了生活质量,为临床同类治疗开拓思路。     

Regulation of middle cerebral artery blood velocity during recovery from dynamic exercise in humans.

We sought to examine the regulation of cerebral blood flow during 10 min of recovery from mild, moderate, and heavy cycling exercise by measuring middle cerebral artery blood velocity (MCA V). Transfer function analyses between changes in arterial blood pressure and MCA V were used to assess the frequency components of dynamic cerebral autoregulation (CA). After mild and moderate exercise, the decreases in mean arterial pressure (MAP) and mean MCA V (MCA Vm) were small. However, following heavy exercise, MAP was rapidly and markedly reduced, whereas MCA Vm decreased slowly (-23 +/- 4 mmHg and -4 +/- 1 cm/s after 1 min for MAP and MCA Vm, respectively; means +/- SE). Importantly, for each workload, the normalized low-frequency transfer function gain between MAP and MCA Vm remained unchanged from rest to exercise and during recovery, indicating a maintained dynamic CA. Similar results were found for the systolic blood pressure and systolic MCA V relationship. In contrast, the normalized low-frequency transfer function gain between diastolic blood pressure and diastolic MCA V (MCA Vd) increased from rest to exercise and remained elevated in the recovery period (P < 0.05). However, MCA Vd was quite stable on the cessation of exercise. These findings suggest that MCA V is well maintained following mild to heavy dynamic exercise. However, the increased transfer function gain between diastolic blood pressure and MCA Vd suggests that dynamic CA becomes less effective in response to rapid decreases in blood pressure during the initial 10 min of recovery from dynamic exercise.     

Effects of postural changes and removal of vestibular inputs on blood flow to the head of conscious felines.

Prior studies have shown that removal of vestibular inputs produces lability in blood pressure during orthostatic challenges (Holmes MJ, Cotter LA, Arendt HE, Cass SP, and Yates BJ. Brain Res 938: 62-72, 2002; Jian BJ, Cotter LA, Emanuel BA, Cass SP, and Yates BJ. J Appl Physiol 86: 1552-1560, 1999). Furthermore, these studies led to the prediction that the blood pressure instability results in susceptibility for orthostatic intolerance. The present experiments tested this hypothesis by recording common carotid blood flow (CCBF) in conscious cats during head-up tilts of 20, 40, and 60 degrees amplitudes, before and after the surgical elimination of labyrinthine inputs through a bilateral vestibular neurectomy. Before vestibular lesions in most animals, CCBF remained stable during head-up rotations. Unexpectedly, in five of six animals, the vestibular neurectomy resulted in a significant increase in baseline CCBF, particularly when the laboratory was illuminated; on average, basal blood flow measured when the animals were in the prone position was 41 +/- 17 (SE) % higher after the first week after the lesions. As a result, even when posturally related lability in CCBF occurred after removal of vestibular inputs, blood supply to the head was not lower than when labyrinthine inputs were present. These data suggest that vestibular influences on cardiovascular regulation are more complex than previously appreciated, because labyrinthine signals appear to participate in setting basal rates of blood flow to the head in addition to triggering dynamic changes in the circulation to compensate for orthostatic challenges.     

Use of a physiological model of gentamicin pharmacokinetics for individual dosage of the antibiotic]

A new approach to fixing the initial doses of gentamicin (GM) for its intramuscular administration (the most commonly used anyway) is discussed. The approach is based on the physiological model reproducing the individual patterns of GM concentration change in patient's blood. Such parameters of the model as blood flow velocity and actual average volume of specific tissues as well as the tissue to the blood partition coefficient (Kp) are constant. They were used to calculate the volume of distribution in the body specific organs (Vs). The apparent distribution volume (Vd) and total clearance (Cl) are individual parameters. The Vd value was calculated individually for every particular patient depending on the body weight by the known equations. The difference between Vd and Vs was used to calculate the individual Kp for the organs and tissues which were not specially examined. When calculating Cl of GM, the patient's sex, age, weight and creatinine concentrations were taken into account. To evaluate the local velocity of blood flow after antibiotic intramuscular administration, it was important to consider the patient's sex and age. The approach was used to reproduce the individual patterns of GM concentration change after the initial administration of the antibiotic, 80 mg, to 19 male patients (age range, 21 to 73 years; weight range, 50 to 94 kg; blood creatinine concentration, 0.4 to 1.6 mg/dl). The GM concentrations attained with the use of the model were afterwards compared to the data on FPIA. (TDx, Abbott) by measuring the GM concentrations in the blood of the patients 0.5, 1, 5 and 7 hours after the administration.(ABSTRACT TRUNCATED AT 250 WORDS)     

盐酸戊乙奎醚对大白兔耳微循环的影响

目的 通过观察盐酸戊乙奎醚(长托宁)注射液对清醒状态大白兔耳微循环的影响,对盐酸戊乙奎醚改善微循环的作用作初步探讨和研究.方法 用微循环观测仪观测用药前大白兔耳廓微循环血管管径、血流速度、血流量等进行综合评估出正常微循环血流指标作为对照,观察盐酸戊乙奎醚用药后对家兔耳微循环血流量变化,并用山莨菪碱作药效对照.结果 两组...     

灯盏花素注射液联合依达拉奉注射液对未溶栓急性脑梗死患者神经功能、脑血流动力学和血清炎症细胞因子的影响

摘要 目的：观察灯盏花素注射液联合依达拉奉注射液对未溶栓急性脑梗死（ACI）患者神经功能、脑血流动力学和血清炎症细胞因子的影响。方法：选取2020年4月~2022年1月来我院接受治疗的未溶栓ACI患者82例。采用随机数字表法将患者分为对照组（依达拉奉注射液治疗,41例）和实验组（灯盏花素注射液联合依达拉奉注射液治疗,41例）。观察两组临床疗效,神经功能、脑血流动力学和血清炎症细胞因子的变化,记录两组不良反应情况。结果：实验组的临床总有效率为90.24%,高于对照组的68.29%,差异有统计学意义（P<0.05）。实验组治疗7d后美国国立卫生研究院卒中量表（NIHSS）评分低于对照组,日常生活活动能力（ADL）评分高于对照组P<0.05）。实验组治疗7d后脑血流平均血流速度（Vm）、收缩期峰值血流速度（Vs）、舒张期血流速度（Vd）高于对照组（P<0.05）。实验组治疗7 d后白介素-6（IL-6）、超敏C反应蛋白（hs-CRP）水平低于对照组（P<0.05）。两组均未出现严重的不良反应。结论：依达拉奉注射液联合灯盏花素注射液治疗未溶栓ACI患者,可调节脑血流动力学,减轻神经功能损伤,降低血清炎症细胞因子,且具有较好的安全性。     

脑栓通联合丁苯酞治疗缺血性脑卒中的临床价值分析

目的:分析脑栓通联合丁苯酞治疗急性缺血性脑卒中(AIS)的临床价值。方法:选取我院收治的104例AIS患者为研究对象,采用随机数字表法将其分为对照组及观察组,每组各52例。两组均给予抗血小板凝集、控制血压、降糖、调脂等基础治疗,对照组在基础治疗基础上给予丁苯酞治疗,观察组则在对照组基础上予以脑栓通治疗。记录和比较两组的临床疗效、不良反应的发生情况,治疗前及治疗2周后神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)]水平、氧化应激指标[脂质过氧化物(LPO)、甘胱甘肽过氧化物酶(GSH-Px)]、血流动力学指标[大脑中动脉(MCA)收缩期血流速度(Vs)、平均血液流速(Vm)]的变化。结果:治疗后,观察组临床总有效率为96.15%,明显高于对照组(P<0.05)。两组治疗期间并发症发生率比较差异无统计学意义(P>0.05)。治疗2周后,两组NIHSS评分、血清hs-CRP、IL-8、LPO水平均较治疗前显著降低(P<0.05),GSH-Px、MCA Vs和Vm则较治疗前明显升高(P<0.05),且观察组以上指标的变化明显优于对照组(P<0.05)。结论:脑栓通联合丁苯酞治疗AIS具有较好的疗效及较高的安全性,可减轻机体炎症反应与氧化应激反应,改善脑血流灌注及神经功能。     

Effects of bilateral vestibular nucleus lesions on cardiovascular regulation in conscious cats.

The vestibular system participates in cardiovascular regulation during postural changes. In prior studies (Holmes MJ, Cotter LA, Arendt HE, Cas SP, and Yates BJ. Brain Res 938: 62-72, 2002, and Jian BJ, Cotter LA, Emanuel BA, Cass SP, and Yates BJ. J Appl Physiol 86: 1552-1560, 1999), transection of the vestibular nerves resulted in instability in blood pressure during nose-up body tilts, particularly when no visual information reflecting body position in space was available. However, recovery of orthostatic tolerance occurred within 1 wk, presumably because the vestibular nuclei integrate a variety of sensory inputs reflecting body location. The present study tested the hypothesis that lesions of the vestibular nuclei result in persistent cardiovascular deficits during orthostatic challenges. Blood pressure and heart rate were monitored in five conscious cats during nose-up tilts of varying amplitude, both before and after chemical lesions of the vestibular nuclei. Before lesions, blood pressure remained relatively stable during tilts. In all animals, the blood pressure responses to nose-up tilts were altered by damage to the medial and inferior vestibular nuclei; these effects were noted both when animals were tested in the presence and absence of visual feedback. In four of the five animals, the lesions also resulted in augmented heart rate increases from baseline values during 60 degrees nose-up tilts. These effects persisted for longer than 1 wk, but they gradually resolved over time, except in the animal with the worst deficits. These observations suggest that recovery of compensatory cardiovascular responses after loss of vestibular inputs is accomplished at least in part through plastic changes in the vestibular nuclei and the enhancement of the ability of vestibular nucleus neurons to discriminate body position in space by employing nonlabyrinthine signals.     

Nitric oxide influences red blood cell velocity independently of changes in the vascular tone

Nitric oxide (NO) plays a key role in regulation of vascular tone and blood flow. In the microcirculation blood flow is strongly dependent on red blood cells (RBC) deformability. In vitro NO increases RBC deformability. This study hypothesized that NO increases RBC velocity in vivo not only by regulating vascular tone, but also by modifying RBC deformability. The effects of NO on RBC velocity were analysed by intra-vital microscopy in the microcirculation of the chorioallantoic membrane (CAM) of the avian embryo at day 7 post-fertilization, when all vessels lack smooth muscle cells and vascular tone is not affected by NO. It was found that inhibition of enzymatic NO synthesis and NO scavenging decreased intracellular NO levels and avian RBC deformability in vitro. Injection of a NO synthase-inhibitor or a NO scavenger into the microcirculation of the CAM decreased capillary RBC velocity and deformation, while the diameter of the vessels remained constant. The results indicate that scavenging of NO and inhibition of NO synthesis decrease RBC velocity not only by regulating vascular tone but also by decreasing RBC deformability.