目的:探讨黄芪颗粒对紫癜性肾炎的临床疗效,为本病的后续治疗提供更多的药物选择。方法:对我院2003年至2008年收治的51例紫癜性肾炎患儿进行出院后的后续治疗并作随访对照观察。对照组根据病情酌情使用双嘧达莫、泼尼松、中药及对症等。治疗组加服黄芪颗粒,6个月～3岁:每次1/2袋,3～6岁每次2/3袋,6～13岁每次1袋,一天两次,疗程2～3个月。结果:治疗组尿常规异常2例(2/26),对照组8例(8/25),差异有统计学意义(χ2=478,Plt;005);治疗组肾炎复发1例(1/26),对照组5例(5/25),差异有统计学意义(χ2=1543,Plt;001)。结论:黄芪颗粒在紫癜性肾炎后续治疗中有肾脏保护作用,可以明显减少尿常规异常和肾炎复发。
Objective Astragalus polysaccharide (APS) has promoting angiogenesis function. To explore the effects of APS collagen sponge on enhancing angiogenesis and collagen synthesis so as to provide evidence for the future tissue engineering appl ication as a kind of angiogenic scaffold. Methods APS collagen sponges were prepared by covalent binding with collagen polypeptides by using of crossl inking agents at the ratio of 1 ∶ 1 (W/W). Twenty 10-week-old SpragueDawley rats (10 males and 10 females, and weighing 200-250 g) were selected. Longitudinal incision was made at both sides of the back to form subcutaneous pockets. APS collagen sponges of 5 mm × 5 mm × 5 mm at size were implanted into the left pockets as the experimental group, collagen sponges without APS of the same size into the right pockets as the control group. The general conditions were observed after operation. At 3, 7, 14，and 21 days, 5 rats were sacrificed and the samples were harvested to count the number of microvessels, to measure the contents of the hydroxyprol ine (Hyp), and to detect the mRNA expressions of angiopoetin 1 (Ang1), matrix metalloproteinases 9 (MMP-9), and tissue inhibitors of metalloproteinases 1 (TIMP-1). Results All rats were al ive during experiment period. The number of microvessels increased gradually, and reached the peak at 14 days in 2 groups; the expermental group was significantly higher than the control group (P lt; 0.05). The contents of Hyp increased gradually in 2 groups, and the experimental group was significantly higher than the control group (P lt; 0.05). The mRNA expressions of Ang1 and MMP-9 in the experimental group were significantly higher than those in the control group at 3, 7, and 14 days (P lt; 0.05); the mRNA expression of TIMP-1 in the experimental group was significantly lower than that in the control group at 3 days and was significantly higher at 14 and 21 days (P lt; 0.05). Conclusion The APS collagen sponges can improve angiogenesis and collagen synthesis in wound heal ing by regulating the expressions of Ang1, MMP-9, and TIMP-1.
Objective To investigate the effect of astragalus polysaccharides(AP) on chitosan／polylactic acid(AP／C／PLA)scaffolds and marrow stromal cells(MSCs)tissue engineering on periodontal regeneration of horizontal alveolar bone defects in dogs． Methods MSCs were isolatedfrom the bone marrow and then cultured in conditioned medium to be induced to become osteogenic．The MSCs were harvested and implanted into AP／C／PLA and C／PLA scaffolds．A horizontal alveolar bone defect(5 mm depth, 2 mm width)were produced surgically in the buccal side of the mandibular premolar 3 and 4 of 10 dogs．The defects were randomly divided into 4 groups(n=10)：Group A, root planning only(blank contro1); group B, AP／C／PLA with conditioned medium(medium contro1);group C, C／PLA with MSCs(scaffolds contro1); and group D, AP／C／PLA with MSCs(experimental group)．Eight weeks after surgery， block sections of the defects were collected for gross, histological and X-ray analysis. Results MSCs induced in vitro exhibited an osteogenic phenotype with expressingcollagen I and alkaline phosphatase． X-ray film observation showed that the bone density and height had no changes in group A; in group B, the bone density was increased to a certain extent and furcation area reached a few height, but no height was increased in interdental septum; in group C，the bone density was increased and furcation area nearly reached the native height,but interdental septum reached a few height;in group D,the bone density was increased significantly and furcation area and interdental septum reached the native height. Histological evaluation showed that there was greater tissue formation in group D than that in groups A, B and C, in which new alveolar bone, new cementum, periodontal ligament with Sharpey’s fibers, and new bone tissue was similar to native periodontal tissues. Ingroup A，B, C and D respectively, the amount of new alveolar bone regeneration was 0.83±0.30, 1.46±0.55, 2.67±0.26 and 2.90±0.41 mm; new cementum regeneration was 0.78±0.45，1.30±0.60，2.29±0.18 and 2.57±0.22 mm; the amount of connective tissue adhesion was 0.80±0.22，1.33±0.34，2.23±0.42 and 2.64±0.27 mm; all showing significant differenecs between group D and groups A, Band C (Plt;0.05)．Conclusion The technology of tissue engineering with AP／C／PLAscaffolds and induced MSCs may contribute to periodontal regeneration．
Objective To observe the effect of Chinese Herbal Preparation -Mingjing Granule on the recruitment and adhesion of bonemarrow derived cells (BMCs) to choroidal neovascu1arization (CNV) in mice induced by laser photocoagulation. Methods A total of 75 C57BL/6 mice were divided into treatment group (30 mice), control group (30 mice) and normal control group (15 mice). CNV was induced by krypton laser in the mice of treatment group and control group. BMCs from GFPtransgenic mice were injected through tail vein to those mice 0.5 -1.0 hours after laser surgery. On day one after laser surgery, the mice of treatment group were gavaged with 0.3 ml Mingjing Granule solution every day［30 g/(kg?d)］, while the control group mice were gavaged with distilled water. The mice of normal group fed with normal cereals. 7, 14, 28 days after treatment, choroidal flatmount were prepared to measure the CNV severity and BMCs recruitment. The choroidal histopathological change was observed by optical microscope. CXCR4 level in peripheral blood was measured by enzymelinked immuno sorbent assay (ELISA). Stromal cell derived factor1alpha; (SDF-1alpha;), vascular cell adhesion molecule-1 (VCAM-1), inter-cellular adhesion molecule 1 (ICAM-1) were detected by immunofluorescent staining. Results Choroidal flatmount showed that CNV developed in treatment group and control group, but not in normal group. On day seven and 14, CNV lesions in the treatment group showed less incorporation of BMCs and smaller CNV in size compared with the control group (t=10, 9; P=0.007, 0.024), histologic sections also showed less severe lesions in the treatment group. CXCR4 level in peripheral blood in the treatment group was less than that in the control group and normal control group on day seven and day 14（t=8.107, 2.747;P＜0.05). The expression of SDF-1alpha;, ICAM-1 and VCAM-1 in the treatment group was lower compared with the control group. Conclusions Mingjing Granule could inhibit the recruitment and adhesion of BMCs in peripheral blood to CNV at the early stage. The mechanism may be related with the action of Mingjing Granule in lowing chemokines levels in peripheral blood and expression of adhesion molecules around CNV.
Objective To assess the clinical effectiveness and safety of astragalus injection plus androgen versus androgen alone for patients with aplastic anemia (AA). Methods Such databases as The Cochrane Library (Issue 3, 2011), PubMed (1966 to March 2011), EMbase (1974 to March 2011), CNKI (1994 to March 2011), VIP (1989 to March 2011) and Wanfang Data (1997 to March 2011) were searched to include the randomized controlled trails (RCTs) according to the inclusive and exclusive criteria. The data were extracted, the quality was assessed, and meta-analysis was conducted by using Revman5.0.24 software. Results Seven RCTs involving 518 patients with AA were included. The meta-analysis showed that the astragalus plus androgen treatment group was superior to the androgen alone group in the total effective rate with significant difference (OR=3.12, 95%CI 2.09 to 4.66, Plt;0.000 01); the adverse events in the treatment group were fewer than those in the control group with significant difference (OR=0.30, 95%CI 0.12 to 0.76, P=0.01); but the promotion degree of myelosis between the two groups was similar without significant difference (OR=1.93, 95%CI 0.85 to 4.38, P=0.11). Conclusion The astragalus plus androgen treatment is superior to the androgen alone treatment in the total effective rate and fewer adverse events. More high-quality trails are required to verify this conclusion due to the low quality and small scale of the included studies.
Objective To assess the effect of astragaulus membranaceus in the treatment of pulmonary tuberculosis. Methods Through applying the methods provided by the Cochrane Collaboration, the randomized controlled trials (RCTs) or quasi-RCTs of astragaulus membranaceus in the treatment of pulmonary tuberculosis were searched in The Cochrane Library (Issue 3, 2010), CNKI (1991 to May 2010), VIP (1989 to May 2010), EMbase (1981 to May 2010), and PubMed (1981 to May 2010). Two reviewers independently screened the included studies, extracted the data, assessed the quality, and cross checked then. The RevMan 5.0 software was used to conduct meta-analyses. Results Twelve RCTs involving 1 054 patients were included. All trials were tested in the mainland China. The results of meta-analyses showed that: a) The astragaulus membranaceus could assist the conventional drug to cure pulmonary tuberculosis, promote sputum negative conversion, focal absorption and cavity reduction in lung; b) The astragaulus membranaceus could reduce the adverse reactions of the conventional drug; c) The astragaulus membranaceus combined with the conventional drug could improve the patients’ symptoms and signs; and d) The astragaulus membranaceus combined with the conventional drug could reduce the bacterial relapse rates in follow-up after treatment. Conclusion The current evidence shows that the astragaulus membranaceus has some effects and is relatively safe to treat pulmonary tuberculosis. However, it is far from enough to recommend astragaulus membranaceus as a conventional adjuvant therapy for pulmonary tuberculosis because of no sufficient evidence obtained from this study for its small sample and low methodology quality. Therefore, more double-blind multi-center RCTs with high quality, large sample, and adequate follow up are required for further verification.
Objective To review systematically the effectiveness and safety of astragaulus membranaceus in the treatment of diabetic nephropathy (DN). Methods A Cochrane systematic review of all relevant randomized or quasi-randomized controlled trials of astragaulus membranaceus for diabetic nephropathy was performed. Clinical trials were searched for in the Cochrane Central Refister of Controlled Trials, MEDLINE, EMBASE, the Chinese Biological Medicine Database, and the Chinese Science and Technology Journal Full-text Database as well as in the references lists of all included trials. Two reviewers works independently to select studies, assess methodological quality and extract data. The following indexes were included to assess the clinical effectiveness and safety of astragaulus membranaceus: 24-hour urinary albumin excretion rate (UAER), 24-hour urinary protein, clearance of creatinine (Ccr), serum creatinine (Scr), blood urea nitrogen (BUN), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), triglyceride (TG), total cholesterol (TC), and serious adverse events. Results Thirty-four clinical trials involving 2 356 patients met the inclusion criteria, but most of these trials were small and of low quality . A “funnel plot” showed asymmetry, which indicated possible publication bias, such that trials with negativeresults might not have been published. Meta-analyses showed that astragaulus membranaceus had some effects on the decrease of the 24-hour UAER, 24-hour urinary protein, Scr and BUN, and also on the improvement of Ccr. Therefore, astragaulus membranaceus, to a certain extent, was found to be effective in improving renal functions of DN patients. However, astragaulus membranaceus might have similar effects in decreasing the 24-hour UAER and Scr compared with angiotensin-converting enzyme inhibitor and angiotensin receptor blockers. Compared with other Chinese medicines, astragaulus membranaceus was more effective in decreasing the 24-hour urinary protein. No serious adverse events were observed during the treatment period. Conclusion Astragaulus membranaceus has some effect and is relatively safe in treating patients with diabetic nephropathy. However, the present evidence was not enough to support the recommendation of astragaulus membranaceus as a routine drug in the clinical management of DN.Since most included trials are small and of low quality, high-quality, large-sample, multi-centre, randomized, double-blind and placebo-controlled trials of astragaulus membranaceus for DN are needed.
目的 观察黄芪三七合剂（Aamp;R）对肾缺血再灌注损伤（IRI）大鼠血液活性氧（ROS）变化的影响，探讨其抗IRI损伤的机制。 方法 雄性Sprague-Dawley（SD）大鼠30只，随机分为正常组（n=5）、假手术组（SG）（n=5）和IRI 24 h组（n=10），Aamp;R组（n=10）。造模：采用微血管夹夹闭双侧肾蒂，22 min后松开动脉夹，用5/0尼龙缝合线缝合腹部。再灌注24 h后将小鼠行麻醉处死。Aamp;R组给予Aamp;R（3 mL/d），假手术组及IRI 24 h组给予同等体积的生理盐水。采用全自动生化分析仪检测各组大鼠的肾功能，苏木精-伊红染色了解肾脏病理损害，流式细胞仪检测红细胞ROS。 结果 IRI 24 h组和Aamp;R组肾小管出现不同程度的管腔扩张、变性与坏死，间质炎性细胞浸润、充血水肿等变化。IRI后24 h时，IRI 24 h组、Aamp;R组血清尿素氮（BUN）和肌酐（Cr）均高于假手术组、正常组，差异有统计学意义（P＜0.05）；Aamp;R组ROS荧光强度阳性率显著低于IRI 24 h组，差异有统计学意义（P＜0.05）。Aamp;R组肾小管损伤评分明显低IRI 24 h组（P＜0.05）。相关性分析发现，红细胞ROS荧光强度阳性率与肾小管损伤评分、肌酐、尿素氮水平成正相关（r=0.917，P＜0.01；r=0.897，P＜0.01；r=0.896，P＜0.01）。 结论 Aamp;R对肾脏缺血再灌注损伤具有明显的保护作用，其机制可能为抑制血液中ROS的活性，从而抑制氧化应激对肾脏的损伤。
【摘要】 目的 观察黄芪煎剂对冠心病不稳定型心绞痛患者冠状动脉事件的预防作用。 方法 2008年1-9月在达州市第二人民医院心内科住院的76例冠心病不稳定型心绞痛患者纳入观察。随机分为对照组(36例)和黄芪组(40例),随访观察6个月,对比观察两组患者冠状动脉事件的发生情况。 结果 黄芪组心绞痛发作频率、平均持续时间、主要不良心脏事件发生率均明显低于对照组。 结论 黄芪能够有效预防冠心病不稳定型心绞痛患者冠脉事件的发生。【Abstract】 Objective To observe the effect of astragalus membranaceus (AM) to prevent the cronary events in patient with unstable angina pectoris(UA) . Methods Seventysix patients with UA were randomly divided into two groups: the control group (34 patients) with general treat of UA; the AM group (40 patients) with general treat and AM. All the patiens would be followed up in the next six months. Results The frequency of angina pectoris,time of angina pectoris and the incidence of major adverse cardiac events in AM group were significant lower than those in control group. Conclusion AM can prevent the cronary events in patients with UA.