益肾活血汤联合缬沙坦治疗2型糖尿病合并男性性功能障碍的临床研究

目的 探讨益肾活血汤联合缬沙坦治疗2型糖尿病（type 2 diabetes mellitus,T2DM）合并男性性功能障碍患者的临床疗效及安全性。方法 将T2DM合并男性性功能障碍患者146例,按随机数字表法分为对照组和观察组,每组73例。对照组患者予缬沙坦胶囊口服,观察组患者加服益肾活血汤,4周为1个疗程,连续治疗3个疗程。观察治疗前后两组患者国际勃起功能障碍指数（International index of erectile dysfunction-5,IIEF-5）、阴茎勃起时间、阴茎头、根部平均硬度及血清性激素[促卵泡生成素（Follicle stimulating hormone,FSH）、黄体生成素（Luteinizing hormone,LH）、雌二醇（estradiol,E₂）和睾酮（testosterone,T）]水平变化;评估两组患者治疗后性生活满意度和不良反应发生率;比较两组患者治疗后临床总有效率。结果 观察组患者临床总有效率84.93%明显高于对照组的50.68%（P<0.05）;两组患者治疗后IIEF-5、阴茎勃起时间、阴茎头、根部平均硬度及血清T水平均较治疗前明显升高（P<0.05）,血清FSH、LH及E₂水平均显著下降（P<0.05）,且观察组各项指标的改善明显优于对照组（P<0.05）;观察组患者性生活总满意度91.78%明显高于对照组的68.49%（P<0.05）;两组患者在治疗期间均未出现明显不良反应。结论 益肾活血汤联合缬沙坦治疗T2DM合并男性性功能障碍临床疗效确切,能有效改善患者的阴茎状态和血清性激素水平,改善患者的性生活,安全性高,值得临床推广应用。     

Effects of preventing hyperphagia on glycolipid metabolic abnormalities in Spontaneously Diabetic Torii fatty rats

Spontaneously Diabetic Torii (SDT) fatty rats, made by introducing the fa allele of the Zucker fatty rat into the SDT rat genome, represent a new model of obese type 2 diabetes. SDT fatty ^fa/fa (SDT fatty) rats exhibit overt obesity, hyperglycemia, and hyperlipidemia from about six weeks of age, and this is associated with hyperphagia by an induced disorder of leptin action. The present study was conducted to elucidate whether suppression of hyperphagia can improve reduce abnormalities in SDT fatty rats. SDT fatty rats were subjected to pair-feeding with SDT fatty ^{+/ +} (SDT) rats from 6 to 26 weeks of age, and the effects on metabolic parameters and diabetic complications were assessed. Body weights of the pair-fed rats were similar with those of SDT rats during the experimental period. Improvement of hyperglycemia or hypertriglyceridemia was observed from 8 to 16 or 12 weeks of age in the pair-fed rats, but hypercholesterolemia was not entirely improved during the experimental period. We also examined mRNAs expression in liver, and found that the expression associated with glyconeogenesis, such as glucose-6-phosphatase (G-6-Pase) and phosphoenolpyruvate carboxykinase (PEPCK), tended to decrease in the pair-fed rats, and the mRNA expression of hydroxymethylglutaryl-CoA (HMG-CoA) was elevated. Renal parameters, such as blood urea nitrogen and urinary albumin excretion, were improved in the pair-fed rats. The incidence or progression of diabetic complications, such as renal lesions and cataract, was reduced. In conclusion, suppression of hyperphagia in SDT fatty rats was effective in temporally improving hyperglycemia or hypertriglyceridemia, and reducing the incidence or progression of diabetic complications, but was ineffective in reducing hypercholesterolemia.     

王行宽教授论治糖尿病的学术观点及临证经验

国家级名中医王行宽教授善于从心肝肾三脏论治糖尿病,认为心肝火旺、耗伤阴血为发病之本;心火亢盛,肝气郁结,郁火燔灼游行三焦,内外皆病,故善饥消渴;肾精亏损,阴阳不调,津液不布,燥热内生,发为消渴则是疾病演变的必然结果。王教授临床采用自拟消渴方清肝泻心、补益肝肾、滋阴润燥治疗消渴,获满意疗效。     

Emphysematous cystitis in a chemically-induced diabetic dog

Emphysematous cystitis is a rare disorder caused by bacterial infection and characterized by gas accumulation within the bladder wall with cyst formation. This report describes the histopathological characteristics of emphysematous cystitis found in a diabetic female beagle induced by streptozotocin and alloxan. Macroscopically, multiple cyst-like structures were observed on the cut surface of the urinary mucosa. During fixation, small specimens cut from the mucosa floated on the surface of the fixative solution. Histopathologically, multiple cysts were lined with a single layer of flattened cells found to be immunohistochemically positive for vimentin, partially positive for α-smooth muscle actin or macrophage scavenger receptor, class A, and thought to be myofibroblasts, fibroblasts or macrophages. Multinucleated giant cells were observed around the cysts, and gram-negative short bacilli were observed in the lumen of the urinary bladder. From these findings, this case was diagnosed as emphysematous cystitis.     

人参白虎汤对糖尿病大鼠周围神经病变的影响

目的:探讨人参白虎汤对实验性糖尿病大鼠周围神经病变的影响。方法:四氧嘧啶尾静脉注射复制高血糖大鼠模型,以大鼠机械刺激痛阈、大鼠坐骨神经传导速度与坐骨神经病理形态学改变为主要指标,观察人参白虎汤对糖尿病大鼠周围神经病变的影响。结果:人参白虎汤可明显提高糖尿病大鼠痛阈值(P<0.05或P<0.01),提高坐骨神经传导速度P<0.01),明显地改善高血糖引起的神经纤维髓鞘变性(P<0.05或P<0.01),具有一定的抗糖尿病周围神经病变的作用。     

普洱茶提取物与绿茶提取物降糖功效的研究

通过整体动物模型研究比较普洱茶提取物与绿茶提取物的降糖功效。以C57BL/6J小鼠作为对照组,将遗传性糖尿病（KKAy）小鼠随机分组,分别灌胃给予普洱茶提取物与绿茶提取物4周,以空腹血糖、血糖曲线下面积作为观察指标,比较二者的药效作用;以SD雄性大鼠一次性腹腔注射链脲佐菌素（STZ）造模糖尿病大鼠,根据初始空腹血糖值随机进行分组,连续灌胃给予普洱茶提取物与绿茶提取物4周,以空腹血糖、血糖曲线下面积和空腹血清胰岛素作为观察指标。结果显示普洱茶提取物和绿茶提取物对KKAy小鼠和STZ糖尿病模型大鼠空腹血糖均有降低作用,同时均能降低血糖曲线下面积,但是不同的是普洱茶提取物在降低动物空腹血糖和血糖曲线下面积方面要优于绿茶提取物,同时普洱茶提取物能够较模型组显著降低大鼠空腹血清胰岛素,而绿茶提取物在降低大鼠空腹血清胰岛素与模型组相比无明显差异。比较了两种茶提取物对糖尿病的体外靶酶糖醛还原酶和PTP1B的抑制作用,发现普洱茶提取物对PTP1B活性有较强的抑制作用,抑制率88.0%,绿茶提取物对该酶无抑制作用。综合实验结果表明,普洱茶提取物的降糖功效优于绿茶提取物。     

新型降血糖中药方剂对STZ诱导小鼠糖尿病的影响

为获得糖尿病治疗的中药方剂,探讨由葛根、丹参、枳椇子组成的中药方剂对小鼠的抗糖尿病效应及潜在机制。利用链脲佐霉素(STZ)建立糖尿病模型,以空腹血糖大于11mmol/L为建模成功。30只小鼠分为空白组(健康小鼠)、试验组(糖尿病小鼠)和阴性对照组(糖尿病小鼠),每天对试验组进行中药方剂水煎服给药,空白组和阴性对照组每天灌服同等剂量蒸馏水,对小鼠的肝脏和肾脏生理指标变化进行检测。结果表明:STZ诱导的糖尿病小鼠给予葛根、丹参及枳椇子中药方剂灌服7d,试验组与阴性对照组相比,其空腹血糖降低,体重回升,肝脏指标白蛋白(ALB)下降31.58%,碱性磷酸酶(ALP)下降57.43%,谷丙转氨酶(ALT)回升87.80%,谷草转氨酶(AST)下降51.72%,总蛋白(TP)下降31.94%。由葛根、丹参和枳椇子组成的中药方剂在浓度为1g/L时对糖尿病小鼠有显著的治疗效果。