摘要：Objective：Although chondroprotective activities have been documented for polysaccharides,the potential target of different polysaccharide may *** study was aimed to explore the effect of glucan HBP-A in chondrocyte monolayer culture and chondrocytes-alginate hydrogel constructs in vivo,especially on the expression of type Ⅱ ***：Chondrocytes isolated from rabbit articular cartilage were cultured and verified by immunocytochemical staining of type Ⅱ *** viability was assessed after being treated with HBP-A in different *** status of chondrocytes-alginate hydrogel constructs in vitro was observed by scanning electron microscope（SEM）.The constructs were treated with HBP-A and then injected to nude mice *** weeks after transplantation,the specimens were observed through transmission electron microscopy（TEM）.The mRNA expressions of disintegrin and metalloproteinase with thrombospondin motifs 5（ADAMTs-5）,aggrecan and type Ⅱ collagen in both monolayer culture and constructs were determined by real time polymerase chain reaction（PCR）.The expression of typeⅡ collagen and matrix metalloproteinases-3（MMP-3） in chondrocyte monolayer culture was also tested through Western blot and enzyme linked immunosorbent assay（ELISA）,***：MMP-3 secretion and ADAMTs-5 mRNA expression in vitro were inhibited by HBP-A at 0.3 mg/mL *** morphological study,there were significant appearance of collagen in those constructs treated by ***,in both chondrocyte monolayer culture and chondrocytes-alginate hydrogel constructs,the expression of type Ⅱcollagen was increased significantly in HBP-A group when compared with control group（P〈0.001）.Conclusions：The study documented that the potential pharmacological target of glucan HBP-A in chondrocytes monolayer culture and tissue engineered cartilage in vivo may be concerned with the inhibition of catabolic enzymes MMP-3,ADAMTs-5,and increas

摘要：目的:观察复方紫荆消伤巴布膏治疗慢性软组织损伤的临床疗效和安全性。方法:采用区组随机、双盲、阳性药及安慰剂平行对照、多中心(10家医院)临床试验设计。试验设置复方紫荆消伤巴布膏组、骨通贴膏组和安慰剂组共3组,按照3∶1∶1的比例纳入患者分别采用复方紫荆消伤巴布膏、骨通贴膏及复方紫荆消伤巴布膏模拟剂治疗。治疗时将贴膏贴于患处,每天1贴,连续使用14 d。试验期间紧急用药选用布洛芬缓释胶囊。选取治疗开始后7 d和14 d两个时间点进行疗效评价。疗效评价指标选择疼痛视觉模拟量表(visual analogue scale,VAS)评分降低值和以中医证候疗效标准评定的有效率。同时观察治疗期间不良事件的发生情况。结果:①一般情况。共纳入221例患者,其中复方紫荆消伤巴布膏组133例、骨通贴膏组44例、安慰剂组44例。至试验结束时,复方紫荆消伤巴布膏组和安慰剂组分别有2例和4例因失访脱落。②疼痛VAS评分降低值。复方紫荆消伤巴布膏组和骨通贴膏组治疗开始后7 d时的疼痛VAS评分降低值比较,差异无统计学意义(协变量:F=33.010,P=0.000;区组因素:F=8.790,P=0.000;分组因素:F=0.900,P=0.345;协变量与分组因素交互作用:F=0.470,P=0.894;修正均数:试验组2.30分,阳性对照组2.13分)。复方紫荆消伤巴布膏组和骨通贴膏组治疗开始后14 d时的疼痛VAS评分降低值比较,差异无统计学意义(协变量:F=43.000,P=0.000;区组因素:F=40.480,P=0.000;分组因素:F=0.290,P=0.591;协变量与分组因素交互作用:F=0.230,P=0.990;修正均数:试验组4.08分,阳性对照组4.02分)。复方紫荆消伤巴布膏组和安慰剂组治疗开始后7 d时的疼痛VAS评分降低值比较,差异无统计学意义(协变量:F=18.120,P=0.000;区组因素:F=9.040,P=0.000;分组因素:F=0.620,P=0.434;协变量与分组因素交互作用:F=1.040,P=0.411;修正均数:试验组2.25分,阳性对照组2.04分)。复方紫荆消伤巴布膏组治疗开始后14 d时的疼痛VAS评分降低值高于安慰剂组(协变量:F=39.200,P=0.000;区组因素:F=40.890,P=0.000;分组因素:F=11.210,P=0.001;协变量与分组因素交互作用:F=4.300,P=0.000;修正均数:试验组4.00分,阳性对照组3.27分)。③中医证候疗效。治疗开始后7 d时,3组患者的有效率比较,差异无统计学意义(χ~2=5.867,P=1.000)。治疗开始后14 d时,3组患者的有效率比较,差异有统计学意义(P=0.022);复方紫荆消伤巴布膏组和骨通贴膏组的有效率比较,差异无统计学意义(χ~2=0.000,P=1.000);复方紫荆消伤巴布膏组和骨通贴膏组的有效率均高于安慰剂组(χ~2=6.375,P=0.012;χ~2=4.208,P=0.004)。④不良事件发生率。共有4例患者发生不良事件4件,其中复方紫荆消伤巴布膏组1例发生贫血、1例发生口腔溃疡,骨通贴膏组1例发生贫血,安慰剂组1例出现局部皮肤瘙痒。4例患者发生的不良事件均被判定为轻度,均未采取治疗措施,均无后遗症。3组患者的不良事件发生率比较,差异无统计学意义(P=1.000)。结论:复方紫荆消伤巴布膏可有效改善慢性软组织损伤患者的临床症状,疗效与骨通贴膏相当,且安全性较高。

摘要：近年来针灸治疗腰椎间盘突出症(LDH)主要包括:毫针疗法、温针灸疗法、电针疗法、穴位注射疗法、针刀疗法、刺络拔罐疗法、腹针疗法等,有效率基本在80%以上。但也存在诸多不足的方面,因此,今后应建立统一的针灸治疗LDH临床诊断标准、病例纳入标准、排除标准、疗效判定标准;严格按照多中心、大样本、随机、对照、盲法设计临床试验;取穴、电针参数做到统一、临床试验结果要有重复性;建立稳定的动物模型,进一步加强机理研究和实验研究,为针灸治疗LDH提供坚实的理论基础。