一氧化氮在支气管哮喘中的作用

一氧化氮是一种具有广泛并且复杂生物活性的小分子化合物,参与多种病理生理过程.众多研究表明,其在支气管哮喘的发病机制中有着多种复杂的双相调节作用.本文通过对一氧化氮在支气管哮喘发病机制中的调节作用研究的历史回顾和现状的阐述,探讨辩证法与系统论在科学研究中的应用.     

支气管哮喘的历史回顾与哲学思考

支气管哮喘是一种常见的呼吸道疾病,到目前为止,其发病机理尚未完全阐明,在哮喘的认识过程中,经在认识的感性阶段;变态反应性疾病阶段,气道高反应性阶段多;多种细胞与的慢性气道炎症阶段。从这个过程可以看出：１．哮喘的认识经历了从现象到本质及辨证发展的理性思维过程;２．哮喘的发展过程体现了理论指导实践,实践了反过来检验并丰富理论．３哮喘概念发展体现了科学发现的一般规律。     

支气管哮喘的历史回顾及哲学思考

支气管哮喘是一种常见的呼吸道疾病,到目前为止,其发病机理尚未完全阐明。在哮喘的认识过程中,经历了认识的感性阶段;变态反应性疾病阶段;气道高反应性阶段;多种细胞参与的慢性气道炎症阶段。从这个过程可以看出：１哮喘的认识经历了从现象到本质以及辩证发展的理性思维过程;２哮喘的发展过程体现了理论指导实践,实践反过来检验并丰富理论;３哮喘概念的发展体现了科学发现的一般规律。     

支气管哮喘治疗重点的转移与“祛痰化瘀”的治则渊源

随着对支气管哮喘(哮喘)发病机制深入的研究,医学界将哮喘治疗的目标被定位于气道炎症的消除,但其治疗仍局限在气道局部炎症的控制,而对全身免疫功能紊乱束手无策。祖国医学讲究整体观念和治病求本,将气道炎症及与此相关的炎症介质和因子统归于痰瘀。气道炎症与痰瘀阻肺为不同医学体系对同一病症的诠释,二者殊途同归。祖国医学注重辩证施治、合理运用理法方药,疗效确实,副作用小,可以弥补糖皮质激素等药物的不足。     

支气管哮喘治疗重点的转移与"祛痰化瘀"的治则渊源

随着对支气管哮喘(哮喘)发病机制深入的研究,医学界将哮喘治疗的目标被定位于气道炎症的消除,但其治疗仍局限在气道局部炎症的控制,而对全身免疫功能紊乱束手无策.祖国医学讲究整体观念和治病求本,将气道炎症及与此相关的炎症介质和因子统归于痰瘀.气道炎症与痰瘀阻肺为不同医学体系对同一病症的诠释,二者殊途同归.祖国医学注重辩证施治、合理运用理法方药,疗效确实,副作用小,可以弥补糖皮质激素等药物的不足.     

支气管哮喘伴发抑郁与人格、应对和社会支持的关系分析

研究分析支气管哮喘伴发抑郁与人格、应对和社会支持的关系。对216例支气管哮喘患者应用自评抑郁量表、大五人格量表、特质应对方式问卷和社会支持评定量表进行调查,对收集到的数据进行Pearson相关分析、多元逐步回归分析和路径分析。结果显示49．1％的支气管哮喘患者存在不同程度的抑郁情绪;哮喘患者的抑郁程度、人格、应对方式和社会支持之间存在着不同程度的显著相关;人格、应对和社会支持都是影响支气管哮喘伴发抑郁的影响因素,人格的神经质是其重要的预测因素,它除了能直接影响哮喘患者的抑郁程度,还能通过社会支持和应对方式对其起间接的作用。研究提示人格的神经质、公正严谨性和消极应对方式是支气管哮喘伴发抑郁的直接的预测因素。     

支气管哮喘患者预防性吸入治疗的依从性及综合干预

支气管哮喘的预防重于治疗,长期小剂量吸入糖皮质激素是预防支气管哮喘的最佳选择,已得到国际医学界的广泛认可.本文通过对300例成人支气管哮喘患者预防性吸入治疗依从性进行调查分析,提示医务人员在支气管哮喘患者预防性治疗期间,应针对每个个体,从各个不同角度对患者进行综合干预,以达到预防性治疗的目的.     

支气管哮喘诊断和治疗的哲学启示

1　支气管哮喘诊断和治疗的发展演化支气管哮喘 (Ｂｒｏｎｃｈｉａｌａｓｔｈｍａ)简称哮喘 (Ａｓｔｈ ｍａ) ,是一种古老的疾病 ,表现为反复发作性的气喘、胸闷、咳嗽、咳痰 ,可在短时间内自行缓解或经药物治疗而缓解 ,缓解时可完全恢复正常。早在 2 50 0～ 30 0 0年以前人们就已认识到气道阻力增高可以引起呼吸困难。但由于当时对本病的病因、病理缺乏认识 ,对本病的治疗只能是凭经验用一些简单的草药治疗。随着对呼吸系统的深入研究 ,对支气管哮喘的研究也有了很大的进展。 2 0世纪 50年代末至 70年代初 ,人们把支气管哮喘定义为 :发作性…     

阿尔茨海默病发病机制及治疗手段多样性研究

阿尔茨海默病(Alzheimer’s disease,AD)是一种重要的神经退行性疾病,其发病机制复杂,目前无任何一种学说可单独解释AD的病因,因而导致AD的治疗手段多样性,但无任何一种手段可完全有效治疗AD。探讨了AD的多种发病机制和治疗手段,通过其研究的复杂性说明认识事物过程的复杂性和曲折性。     

哮喘防控模式的几点思考

简单介绍了在支气管哮喘患者教育和管理工作中的若干体会。结果表明,我们所采取的哮喘教育管理体系(包括哮喘患者门诊、哮喘患者协会和哮喘宣教中心)是一种先进的医疗服务模式,不仅可以有效地改善医患关系,还可以显著提高哮喘患者对哮喘认知水平和防治疾病的依从性,提高哮喘控制水平、生命质量,减少非预约门诊、急诊、住院次数,降低医疗费用。     

小儿支气管哮喘和胃食管返流关系的哲学思考

支气管哮喘是当今世界上最常见的气道慢性炎症性疾病,运用哲学的观点认识小儿支气管哮喘与胃食管返流之间的关系,对于支气管哮喘合并胃食管返流的临床治疗非常重要.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

过敏性鼻炎和支气管哮喘治疗的统一性与整体观

过敏性鼻炎和支气管哮喘是常见的上下气道联合炎性疾病。尽管其治疗手段多样,效果良好,但由于目前对过敏性鼻炎的认识及重视程度不够,治疗现状并不乐观。从哲学上辩证统一的认识过敏性鼻炎和支气管哮喘的治疗,并以现代整体医学的观点分析两者的同一性,为临床实践中针对两者进行整体治疗提供理论依据。     

Locus of control among psychosomatically and chronically ill children and adolescents

In a matched group design, two groups of children suffering from a psychosomatic disease (bronchial asthma and ulcerative colitis) were compared with two groups of children suffering from other chronic illnesses affecting the same organ (cystic fibrosis and Crohn's disease) and with healthy subjects with regard to locus of control. With the exception of bronchial asthma, all clinical groups were characterized by greater internal locus of control. There were no significant relationships between the IE-dimension and further clinical parameters specific to each disease. Furthermore, there was an indication that psychiatric disturbance in general is related to external locus of control. The IE dimension did not contribute to a differentiation between the types of psychosomatic and chronic illness.     

Modulation of stress consequences by hippocampal monoaminergic, glutamatergic and nitrergic neurotransmitter systems

Several findings relate the hippocampal formation to the behavioural consequences of stress. It contains a high concentration of corticoid receptors and undergoes plastic modifications, including decreased neurogenesis and cellular remodelling, following stress exposure. Various major neurotransmitter systems in the hippocampus are involved in these effects. Serotonin (5-HT) seems to exert a protective role in the hippocampus and attenuates the behavioural consequences of stress by activating 5-HT1A receptors in this structure. These effects may mediate the therapeutic actions of several antidepressants. The role of noradrenaline is less clear and possibly depends on the specific hippocampal region (dorsal vs. ventral). The deleterious modifications induced in the hippocampus by stress might involve a decrease in neurotrophic factors such as brain derived neurotrophic factor (BDNF) following glutamate N-methyl-D-aspartate (NMDA) receptor activation. In addition to glutamate, nitric oxide (NO) could also be related to these effects. Systemic and intra-hippocampal administration of nitric oxide synthase (NOS) inhibitors attenuates stress-induced behavioural consequences. The challenge for the future will be to integrate results related to these different neurotransmitter systems in a unifying theory about the role of the hippocampus in mood regulation, depressive disorder and antidepressant effects.     

A case of bronchial asthma treated by behaviour therapy

Desensitization employing the reciprocal inhibition principle was applied to a case of intractable bronchial asthma. Therapy has resulted in dramatic and maintained improvement. An explanation, in terms of learning theory, is given on the development of the psychosomatic symptom, and the rationale of the treatment explained. It is suggested that should relapse occur, booster treatments administered on an out-patient basis would be a feasible proposition.     

诱导性一氧化氮合酶在动脉硬化中的作用

动脉硬化是心脑血管疾病的基础,严重危害人类健康的脑血栓,脑出血以及冠心病的发生都和动脉硬化有着密切的联系。近年来随着对动脉硬化发生机制的研究,诱导性一氧化氮合酶越来越受到关注,其和动脉硬化发生的关系已不容忽视。本文就诱导性一氧化氮合酶和动脉硬化的关系作简要介绍。     

Relationships between psychological variables relevant to asthma and patients' quality of life

The relationships between health-related quality of life and various psychological variables relevant to the clinical evolution of bronchial asthma were evaluated for 101 asthma patients ages 14 to 72 years. Scores on quality of life exhibited a significant negative correlation with perceived vulnerability, panic-fear personality, and irritability, fatigue, airway obstruction, hyperventilation, and panic-fear during attacks but was not significantly correlated with preventive behaviour, attack-related behaviour, recognition, and control of respiratory function, or quality of care. These results imply that the effects of the former group of variables should be taken into account when assessing asthmatic patients' quality of life.