目的 观察右美托咪定作为佐剂对罗哌卡因在锁骨上入路臂丛神经阻滞效果的影响。方法 将55例上肢择期手术的受试者随机分为右美组和对照组。右美组:30 μg右美托咪定(0.3 mL)＋0.5%罗哌卡因,对照组:生理盐水(0.3 mL)＋0.5%罗哌卡因。在臂丛神经阻滞操作后,按步骤评估和记录臂丛感觉、运动阻滞程度和起效时间。在术中定期监测和记录生命体征、不良事件的发生。手术后评估和记录术毕24小时生命体征、术后镇痛时间、臂丛神经感觉、运动阻滞的持续时间、术后恶心呕吐评分、补救镇痛药物用量和不良事件等数据。结果 在臂丛神经的感觉和运动起效时间、感觉和运动阻滞持续时间、术后镇痛时间方面,右美组长于对照组,存在统计学差异(P<0.05)。两组间在术后生命体征变化、补救镇痛药物用量、术后恶心呕吐评分、不良事件等数据的比较,未见明显统计学差异(P>0.05)。结论 右美托咪定(30 μg)作为佐剂能加快罗哌卡因在锁骨上入路对臂丛神经阻滞的起效时间,增加其术后镇痛时间和对臂丛神经的感觉、运动阻滞时间,同时较少影响患者生命体征,具备一定的有效性和临床安全性。

Objective To observed the effect of dexmedetomidine as an adjunction with ropivacaine in supraclavicularbrachial plexus block. Methods 55 subjects with elective upper extremity operation were randomly divided into two groups: DEX group and control group. The drugs in DEX group was 30 μg dexmedetomidine (0.3 mL) + 0.5% ropivacaine, 20 mL in total. And the one in control group was normal saline (0.3 mL) +0.5% ropivacaine, 20 mL in total. After the operation of brachial plexus block, the value of sensory and motor block of brachial plexus and the onset time were evaluated and recorded according to the protocol. Vital signs and adverse events were monitored and recorded regularly during the operation.Postoperative vital signs, postoperative analgesia time, duration of brachial plexus sensationsensory and motion block, postoperative nausea and vomiting score, dosage of remedial analgesics and adverse events were assessed and recorded in 24 hours after surgery. Results In terms of sensory and motor onset time of brachial plexus, duration of sensory and motor block and postoperative analgesia, DEX group was longer than the control group, with statistical differences (P<0.05).There were no significant statistical differences between the two groups in postoperative vital signs, the amount of remedial analgesic drugs, postoperative nausea and vomiting scores, adverse events etc(P>0.05). Conclusion As an adjuvant, dexmedetomidine (30 μg) can accelerate the onset time of ropivacaine in the supraclavicular approach of brachial plexus block.It can also increase the postoperative analgesia time and sensory and motor block time of brachial plexus.With less impact on the vital signs of patients, the efficacy and clinical safety of dexmedetomidinecan be found in our study.

目的 运用三维斑点追踪成像(3D-STE)技术,检测系统性红斑狼疮(SLE)患者的左室收缩期峰值应变(S)和应变率(Sr)及舒张指数,探讨其评价 SLE 患者左室整体收缩及舒张功能的临床应用价值。方法 选择 30 例 SLE 患者(SLE 组)和 30 例正常人(对照组),分别对其进行二维超声心动图和3D-STI检查,获取心尖四腔、两腔、三腔及心尖长轴二维超声及M型超声切面,测量左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左心室后壁舒张末期厚度(LVPWd)、左心室后壁收缩末期厚度(LVPWs)、左心室射血分数(LVEF)、左心室缩短分数(LVFS)、每搏输出量(SV)、左室舒张末期容积(EDV)、收缩末期容积(ESV)、心输出量(CO)、球形指数(SPI)、左室舒张末期质量(LV EDmass)、左室收缩末期质量(LV ESmass)。应用3D-STI行心肌运动分析, 测量左心室整体纵向、圆周、径向及面积收缩期峰值应变(GLS、GCS、GRS、GAS),经胸采集四维全容积图像,应用公式计算各方向相应的舒张期前1/3点时的应变显像舒张指数(SI-DI),公式为(SI-DI=(A-B)/A×100%)。应用统计学分析上述指标在各组间的差异性及其之间的相关性。结果 SLE 组超声心动图的测量数值(LVEF、 LVFS、SV、EDV、CO、LV EDmass、LV ESmass)较对照组降低,差异有统计学意义(P＜0.05),(LVEDd、LVEDs、IVSd、IVSs、LVPWd、LVPWs、ESV、SPI) 与对照组比较, 差异亦均无统计学意义(P＞0.05)。SLE组左心室 GLS、GCS、GRS、GAS均较对照组减低, 差异均有统计学意义(P<0.05)。GAS诊断SLE的敏感度为93.3%,高于GLS(80%)、GCS(66.7%)、GRS(86.7%),GCS诊断SLE的特异度为(93.3%),高于GLS(86.7%)、GAS(86.7%)和GRS(73.3%);应用公式计算得出,SLE组左心室L-SI-DI、C-SI-DI、R-SI-DI 及A-SI-DI均低于正常对照组,差异均有统计学意义(P<0.05);ROC 曲线显示C-SI-DI敏感度(93.3%)及L-SI-DI敏感度(86.7%)高于R-SI-DI(80.0%)、A-SI-DI(80.0%);A-SI-DI特异度(93.3%)及R-SI-DI特异度(93.3%)高于L-SI-DI(73.3%)、C-SI-DI(73.3%)。结论 SLE 患者左室总体收缩及舒张功能减低,4D-STI超声斑点追踪技术可早期检测 SLE 患者左心室收缩及舒张功能的异常。

Objective To detect left ventricular systolic peak strain(S), strain rate(Sr) and diastolic index in patients with systemic lupus erythematosus(SLE) by three-dimensional speckle tracking imaging(3D-STE), and to evaluate the left ventricular total in SLE patients and clinical application value of systolic and diastolic function. Methods Thirty patients with SLE(SLE group) and 30 normal controls(control group) were enrolled. Two-dimensional echocardiography and 4D-STI were performed to obtain sections of apical four-chamber, two-chamber, three-chamber and apical long axis of ultrasound and m-mode ultrasound. To measure left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), ventricular septal end-diastolic thickness(IVSd), ventricular septal end-systolic thickness(IVSs), left ventricular posterior wall diastolic end-stage thickness(LVPWd), left ventricular posterior wall end-systolic thickness(LVPWs), left ventricular ejection fraction(LVEF), left ventricular shortening fraction(LVFS), stroke volume(SV), left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), cardiac output(CO), spherical index(SPI), left ventricular end-diastolic mass(LV EDmass), left ventricular end-systolic mass(LV ESmass). 4D-STI myocardial motion analysis, the total longitudinal, circumferential, and radial and area systolic peak strains(GLS, GCS, GRS, GAS) of the left ventricle were measured, and the four-dimensional full-volume images were collected through the thoracic, and the formula was used to calculate the first 1/3 of the diastolic phase in each direction. The formula of strain imaging diastolic index(SI-DI) is(SI-DI=(AB)/A×100%). Statistical analysis was used to analyze the differences between the above indicators and the correlation between the groups. Results The measured values of two-dimensional echocardiography(LVEF, LVFS, SV, EDV, CO, LV EDmass, LV ESmass) in the SLE group were lower than those in the control group, and the difference was statistically significant(P＜0.05). In LVEDd, LVEDs, IVSd, IVSs, LVPWd, LVPWs, SPI, there were no significant differences compared with that of control group(P＞0.05). The left ventricular GLS, GCS, GRS, and GAS in the SLE group were lower than those in the control group. The differences were statistically significant(P<0.05). The sensitivity of GAS in the diagnosis of SLE was 93.3%, higher than GLS(80%), GCS(66.7%), and GRS(86.7%). The specificity of GCS for the diagnosis of SLE was(93.3%), higher than GLS(86.7%), GAS(86.7%) and GRS(73.3%). The left ventricle L-SI-DI, C-SI-DI, in the SLE group was calculated by the formula. R-SI-DI and A-SI-DI were lower than the normal control group, the difference was statistically significant(P<0.05);the ROC curve showed C-SI-DI sensitivity(93.3%) and L-SI-DI sensitivity(86.7%) was higher than R-SI-DI(80.0%), A-SI-DI(80.0%);A-SI-DI specificity(93.3%) and R-SI-DI specificity(93.3%) was higher than L-SI-DI(73.3%) and C-SI-DI(73.3%). Conclusion Total left ventricular systolic and diastolic function in patients with SLE are reduced. 4D-STI ultrasound speckle tracking technique can detect left ventricular systolic and diastolic dysfunction in patients with SLE.

目的 探讨脾脏炎性假瘤样滤泡树突细胞肉瘤( IPT-like FDCS )的临床病理学特征、诊断及其鉴别诊断。方法 对2例脾脏 IPT-like FDCS 病例进行临床、组织病理学、免疫组织化学及原位杂交特征的观察及总结,并复习国内外相关文献。结果 2例患者均以腹部不适入院,平均年龄66岁,影像学检查提示脾脏占位;镜下特点:肿瘤由圆形、卵圆形及梭形细胞组成,呈编织状、束状或席纹状排列,背景中见多量淋巴细胞、浆细胞及少许中性粒细胞混杂并伴灶性出血、坏死;免疫组化结果:肿瘤细胞不同程度地表达CD21、CD23滤泡树突细胞标记物,两例均不表达CD35,EBER(EBV-encoded RNA)原位杂交显示瘤细胞散在阳性。结论 脾脏IPT-like FDCS 是一种好发于老年女性的罕见的低度恶性肿瘤,与EB病毒感染有关,其生物学行为相对惰性,手术完整切除肿瘤是最佳治疗方式,合理选用免疫标记物、原位杂交检测结合组织病理学可帮助正确诊断。

Objective To study the clinicopathologic features,diagnosis and the differential diagnosis of inflammatory pseudotumor-like follicular dendritic cell sarcoma. Methods We analyzed clinical features,histopathological,immunohistochemical results and in situ hybridization characteristics of two cases. Besides,to relevant literatures of domestic and aboard were also reviewed. Results Two patients were hospitalized for abdominal discomfort, their average age was 66. Imageological examination showed splenic space-occupying. The neoplasms were composed of round,oval and spindle cells and were arranged in whorls and a spiral or storiform growth pattern,mixed with abundant lymphocytes and plasma cells and a few neutrophils with focal bleeding and necrosis. Immunohistochemically,varying degrees, tumor cells showed the expression of at least one of the FDC markers,including CD21 and CD23 protein except with CD35,with scattered positive EBER in situ hybridization. Conclusion Inflammatory pseudotumor-like follicular dendritic cell sarcoma of the spleen is a rare low-grade malignant tumor associated with EBV infection,which is older female predominated and with a inert biological behavior.The best treatment of the tumor is to complete surgical removal.Using reasonable application of immunohistochemical markers, in situ hybridization combined with histopathology are helpful for correct diagnosis.

目的 应用三维斑点追踪成像(3D-STI)技术评价睡眠呼吸暂停综合征患者左、右心室整体收缩功能。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。用三维斑点追踪成像技术测量各组左心室整体纵向应变(LVGLS)、圆周应变(LVGCS)、径向应变(LVGRS)、面积应变(LVGAS)以及右心室整体纵向应变(RVGLS)、圆周应变(RVGCS)、径向应变(RVGRS),并比较各组间参数的差异。结果 与轻度OSAS组比较,中、重度OSAS组LVGLS、LVGAS降低,差异有统计学意义(P<0.05);与中度OSAS组相比较,重度组LVGLS、LVGCS、LVGRS以及LVGAS均降低,差异有统计学意义(P<0.05);右心室部分应变参数变化早于左心室。结论 应用3D-STI技术能够在患者左心室射血分数(LVEF)发生改变之前发现早期左、右心室功能收缩障碍,为临床早期诊断及干预提供可靠的依据。

Objective To evaluate left and right ventricular systolic function of patients with obstructive sleep apnea syndrome (OSAS) by using three-dimensional speckle tracking imaging(3D-STI). Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index (AHI), the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. The left ventricle global longitudinal strain (LVGLS), left ventricle global circumferential strain (LVGCS), left ventricle global radial strain (LVGRS), left ventricle global area strain (LVGAS) and right ventricle global longitudinal strain (RVGLS), right ventricle global circumferential strain (RVGCS) and right ventricle global radial strain (RVGRS) were measured by three-dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results Compared with mild OSAS group, LVGLS and LVGAS were decreased in moderate and severe OSAS groups, and the difference was statistically significant (P<0.05). Compared with the moderate OSAS group, LVGLS, LVGCS, LVGRS and LVGAS in the severe group all decreased, and the difference was statistically significant (P<0.05). Some of right ventricle strain parameters were earlier than that of left ventricle. Conclusion The application of 3D-STI technology can detect early left and right ventricular dysfunction before left ventricular ejection fraction(LVEF)changes, provide a reliable basis for early clinical diagnosis and intervention.

目的 探讨二维斑点追踪成像技术（Two-dimensional speckle tracking imaging,2D-STI）检测心肌肥厚患者左心室短轴收缩功能变化的效果。方法 选择2016年1月—2018年6月我院接诊的心肌肥厚100例为观察组,选取同期在我院行健康体检的健康者100例,均接受2D-STI检查,比较两组左心室短轴收缩期圆周应变与最大径向应变参数。结果 观察组前侧壁、前壁、下壁、后侧壁、前间隔、后间隔左心室短轴收缩期最大圆周应变均低于对照组,差异有统计学意义（P<0.05）;观察组前侧壁、前壁、下壁、后侧壁、前间隔、后间隔左心室短轴收缩期最大径向应变均低于对照组,差异有统计学意义（P<0.05）。结论 2D-STI可测量心机肥厚患者左心室短轴收缩功能,准确评价其心室局部运动,值得临床推广。

Objective To investigate the effect of two-dimensional speckle tracking imaging （2D-STI） on the changes of left ventricular short-axis systolic function in patients with cardiac hypertrophy. Methods 100 cases of cardiac hypertrophy received from our hospital from January 2016 to June 2018 were selected as observation group. 100 healthy subjects who underwent physical examination in our hospital during the same period were examined by 2D-STI. The left ventricle was compared between the two groups. Short-axis systolic circumferential strain and maximum radial strain parameters were compared . Results The maximum circumferential strain of the anterior wall of the anterior wall, anterior wall, inferior wall, posterior wall, anterior septum and posterior septum of the left ventricle was lower than that of the control group, and the difference was statistically significant （P<0.05）. The maximum radial strain of the anterior wall, anterior wall, inferior wall, posterior wall, anterior septum and posterior septal left ventricle was lower than the control group, and the difference was statistically significant （P<0.05）. Conclusion 2D-STI can measure the left ventricular short-axis systolic function in patients with cardiac hypertrophy and accurately evaluate the local ventricular motion, which is worthy of clinical promotion.

目的 探讨分阶段延续护理对改善留置输尿管支架管老年农民患者并发症的效果。方法 按时间顺序将106例患者分为对照组52例和观察组54例,对照组给予常规电话随访,观察组实施三个阶段的延续护理。30天后测评患者并发症持续时间和发生率、自我管理能力。结果 观察组腰痛、血尿、膀胱刺激征持续时间缩短,尿路感染、支架管移位和滞留的发生率下降,自我管理能力各维度评分升高,与对照组比较差异均有统计学意义(P＜0.01)。结论 分阶段延续护理能提高留置输尿管支架管老年农民患者的自我管理能力,增强依从性,减少并发症的发生,促进早日康复。

Objective To investigate the effect of staged continuous nursing on complications in elderly agricultural-workerpatients with indwelling ureteral stent. Methods According to the chronological order, 106 patients were divided into control group (52 cases) and observation group (54 cases). The control group received routine telephone follow-up, and the observation group received three stages of continuous care. 30 days later, the complications' duration, incidence and self-management ability were assessed. Results In the observation group, pain, hematuria and bladder irritation were obviously shorten. Urinary tract infection and the incidence of stent displacement and retention were decreased. Scores in all dimensions of self management ability were increased. Comparing with the control group, it had significant difference (P<0.01). Conclusion The phased continuous nursing may improve the self-management ability of the elderly agricultural-worker with indwelling ureteral stents, strengthen the compliance, reduce the occurrence of complications and promote early rehabilitation.

目的 初步研究木棉花水提取物抗炎镇痛作用。方法 采用二甲苯和醋酸作为致炎和致痛因子,通过小鼠耳廓肿胀实验、腹腔毛细血管通透性实验与扭体实验,考察灌胃高、中、低剂量的木棉花水提取物的抗炎、镇痛作用。结果 小鼠对于木棉花水提取物的最大耐受量为300 g/kg;木棉花水提取物高剂量(150 g/kg)和中剂量(100 g/kg)均能抑制小鼠耳廓肿胀,降低小鼠腹腔血管通透性;木棉花水提取液各剂量组均能有效地减少小鼠的扭体次数,且作用随剂量增加而增强。结论 木棉花水提取物具有抗炎镇痛作用。

Objective To study the anti-inflammatory and analgesic effect of water extract of Bombax malabaricum DC. Flower. Methods The xylene and acetic acid were used as inflammation and pain factors. The auricle swelling test,intraperitoneal capillary permeability test and writhing experiment were performed to study the anti-inflammatory and analgesic effect with high,medium and low dose of water extract of Bombax malabaricum DC. Flower. Results The maximum tolerated dose of mice for Bombax malabaricum DC. Flower was 300 g/kg. High dose (150 g/kg) and medium dose (100 g/kg) of water extract of Bombax malabaricum DC. Flower could both inhibit mouse auricle swelling and reduce mouse peritoneal vascular permeability. All dosages of the water extract of Bombax malabaricum DC. Flower were effective in reducing the number of writhing in mice,and the effect is strengthened with the increase of dosage. Conclusion Water extract of Bombax malabaricum DC. Flower has anti-inflammatory and analgesic effects.

目的 分析睾丸非肿瘤性病变的超声与CT诊断价值。方法 回顾性分析58例经临床病史、超声、CT或病理证实的睾丸非肿瘤性病例,结合临床病史,分析其超声与CT表现,包括炎性(或感染性)病变、外伤性病变、先天性病变及扭转急症。结果 所有病例均行CT检查,睾丸炎症性病变共39例(包括一般性炎症,脓肿和结核),其中19例行超声检查;睾丸外伤8例,隐睾9例,睾丸扭转2例,均行超声检查。睾丸炎症性病变临床表现为患侧或双侧阴囊不同程度的红、肿、痛,或白细胞升高、其他脏器伴发结核,超声表现为睾丸体积不同程度增大,根据炎症坏死程度不同,回声表现为回声均质、回声减低、回声不均质,坏死灶内无血流信号;CT表现为睾丸体积增大,根据炎症性病变的不同可表现为睾丸轻度强化、环形强化,可伴有睾丸鞘膜积液、点状钙化或积气;睾丸外伤均有阴囊外伤史,根据受伤程度表现为白膜下血肿、实质出血、睾丸破裂;隐睾表现为睾丸位置异常或缺如;睾丸扭转表现为睾丸短时间内剧烈疼痛,并进行性加重,超声表现为“镯环征”,CT表现为精索扭转、水肿,睾丸实质水肿。结论 睾丸非肿瘤性病变超声与CT征象均具有特征性,结合患者病史可作出准确诊断。超声检查较为便捷,CT检查可免除受检者接触性疼痛、可对盆腔及腹腔进行更为全面的观察。

Objective: Discussion on diagnosis of testicular non-tumorous lesions by ultrasound and CT.Methods: Rretrospective analysis of 58 testicular non-tumor cases proved by clinical history, Ultrasound, CT or pathologically,combined with the clinical history, and analysis of the Ultrasound and CT features,including inflammatory or infectious disease, traumatic disease, congenital disease and acute torsion.Results: All cases were examined by CT,the testicular inflammatory lesions were 39 cases, 19 of them were examined by ultrasound; testicular trauma 8 cases,cryptorchidism 9 cases, testicular torsion in 2 cases, all of them were examined by ultrasound. The clinical symptom of the inflammatory lesions of the ipsilateral or bilateral scrotum with different degrees of red, swollen, painful, or leukocytosis, other organs associated with TB, Ultrasound showed the testicular volume increased to varying degrees,according to the degree of inflammation and necrosis, the echo showed homogeneous echo, echo reduction, echo heterogeneity, and no blood flow signal in the necrotic area.CT showed an increase in testicular volume, according to the different inflammatory lesions showed mild enhancement of testis, ring enhancement, with a hydrocele, calcification or gas; testicular trauma had scrotal trauma history, according to the severity of injury showed subcapsular hematoma, hemorrhage and rupture of testis; testicular cryptorchidism showed abnormal position or absent; testicular torsion showed testicular short time severe pain, and progressive, Ultrasound showed “bracelet ring sign”, CT showed testicular torsion, edema, testicular parenchyma edema.Conclusion: Ultrasound and CT features of testicular non-tumorous lesions are characteristic, and the accurate diagnosis can be made with the combination of the patient's clinical history. Ultrasound examination is more convenient, CT examination can relieve the patient's contact pain, can be more comprehensive observation of the pelvic and abdominal.

目的 观察两种不同剂量的阿托品对右美托咪定心脏窦房结及房室结抑制作用的逆转效果。方法 健康志愿者20名,男12名,女8名,18～30岁。受试者先后给予右美托咪啶(1.5±0.5)μg/kg负荷量,持续泵注量(0.75±0.25)μg/(kg·h)进行试验观察。试验过程中如受试者心率＜(50±5)次/分,房室结前传2∶1小于150次/分的受试者随机进入0.5 mg阿托品剂量拮抗组(A₁),1 mg阿托品剂量拮抗组(A₁),每组10例。与泵注前(T₀),静脉泵注右美托咪定后(50±5)min(T₁),阿托品静脉推注后(10±5)min(T₂)经食道左心房调搏测定窦房结恢复时间(SNRT),校正窦房结恢复时间(CSNRT),房室结前传2∶1点阻滞点和房室结有效不应期(AVNERP)测量。结果 组内比较:泵注右美托咪定后T₁时点与基础值T₀时点比较两组窦房结及房室结功能受到抑制,SNRT 均延长(P<0.05),CSNRT比较无差异(P>0.05),房室结前传2∶1阻滞点降低(P<0.05), AVNERP延长(P<0.05)。阿托品使用后T₂时点的A₁组的各指标及A₂组的AVNERP恢复到基础水平(P>0.05),A₂组的SNRT、CSNRT均较T₀时点缩短(P<0.05),A₂组房室结前传2∶1阻滞点均较T₀时点增高(P<0.05)。组间比较:2组T₀时窦房结及房室结功能各指标比较均无差异(P>0.05),T₂时点A₂组SNRT、AVNERP较A₁缩短(P<0.01),T₂时点A₂组2∶1阻滞点均较A₁组增高(P<0.05)。结论 0.5 mg阿托品能逆转右美托咪定心脏窦房结及房室结抑制作用,1 mg阿托品增进右美托咪定影响下的窦房结及房室结传导功能。

Objective To investigate two different doses atropine make reverse effects on the function of sinus node and the atrioventricular node inhibiting action dexmedetomidine (Dex). Methods 20 healthy volunteers were included in the clinical trials aged 18~30 years (12 male, 8 female). The volunteers were administered with Dex at loading dose 1.5±0.5 μg/kg and then at 0.75±0.25 μg/(kg·h). During the trail, the volunteers who happened the minimal heart rate less than 50±5 bpm, atrioventricular node forward 2∶1 block point less than 150 bpm needed to randomly accept 0.5 mg(group A₁)or 1 mg(group A₂)atropine to antagonize(n=10). SNRT, CSNRT, AVN 2∶1 block point and AVNERP were recorded through TELAP. Results Intra-group comparison indicated functional parameters of SN and AVN were inhibited by Dexsat T₁. SNRT were prolonged (P<0.05), AVN 2∶1 block point were decreased (P<0.05),AVNERP were prolonged at T₁ compared with T₀(P<0.05). All indexes in group A₁ and AVNERP in group A₂ were back to basal level after using atropine at T₂(P<0.05). SNRT, CSNRT were shorted at T₂ compared with T₀ in group A₂(P<0.05). AVN 2∶1 block point had more increased at T₂ compared with T₀ in group A2(P<0.05). Inter-group comparison indicated no significant differences in functional parameters of SN、AVN at T₀(P>0.05). SNRT, AVNERP were shorted at T₂ in group A₂ compared with group A₁. AVN 2∶1 block point were increased at T2 in group A₂ compared with group A₁. Conclusion 0.5 mg atropine may reverse the function of SN and AVN that are inhibited by Dex. 1 mg atropine may increase functions of SN and AVN that are inhibited by Dex.

目的 观察平胃散联合耳穴治疗单纯性肥胖的临床疗效及其对血清神经肽Y(Neuropeptide Y,NPY)和瘦素(Leptin,LP)水平的影响。方法 64例单纯性肥胖患者,采用数字表法随机分为治疗组33例和对照组31例。治疗组予口服平胃散免煎颗粒配合耳穴治疗,对照组予口服奥利司他胶囊治疗,疗程4周。观察治疗前后体质量、体质量指数(bodymass index,BMI)、体脂百分比(Fat%,F%)、腰臀比(Waist Hip Ratio,WHR)、NPY、LP的变化。结果 治疗后,治疗组和对照组体质量、BMI、F%、WHR、相关疾病的危险度均下降(P＜0.001)。比较治疗前后体质量、BMI、F%、WHR差值,治疗组下降均比对照组明显(P＜0.01、P＜0.001)。治疗组临床疗效优于对照组(P＜0.05)。治疗组和对照组血清NPY、LP水平均下降(P＜0.001),且治疗组较对照组下降(P＜0.001)。结论 平胃散联合耳穴有较好的减肥作用,其机制可能是通过降低血清中NPY、LP含量。

Objective Clinical observation of Pingwei Powder combined with auricular point therapy in treating simple obesity and the effect on serum NPY and leptin Levels. Methods 64 cases of simple obesity patients were randomized into treatment group(33 cases) and control group(31 cases). The treatment group was given Pingwei Powder combined with auricular point therapy.The control group was given Orlistat capsules. After being treated for 4 weeks, body weight, bodymass index(BMI), fat% (F%), waist hip ratio (WHR),neuropeptide y (NPY) and leptin(LP) were determined. Results After post-treatment in treatment group and control group, body weight, BMI, F%, WHR, the risk of related diseases all decreased (P＜0.001), The body weight, BMI, F%, WHR before and after treatment were lower than those in the control group(P＜0.01, P＜0.001). The clinical efficacy of the treatment group was better than that of the control group(P＜0.05). Serum NPY and LP levels in treatment group and control group were decreased (P＜0.001), and that the treatment group were lower than of the control group (P＜0.001). Conclusion Pingwei Powder combined with auricular point therapy have better in weight loss, which is possibly by way of reducing serum NPY, LP Levels.