1.
[Treatment of albuminuria in gestational hypertension puerpera in the severe preeclampeia stage by TCM therapy for stasis-removing and diuresis].
Liu, Z, Wang, XY, Yan, NN
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine. 2009;(3):222-4
Abstract
OBJECTIVE To explore the TCM therapy for puerperal albuminuria (PA) in patients with gestational hypertension syndrome (GHS). METHODS Seventy-two GHS patients with PA in the severe preeclampsia stage were assigned to the treated group (38 cases) and the control group (34 cases). They were treated, starting from the postpartum second day, with Nifedipine 10 mg three times per day, but to the treated group, Shenkangbao (SKB, a TCM patent drug for stasis resolving and dinresis) was given additionally at the dose of 10 g twice a day, 3 weeks as one therapeutic course for all. Changes of urinary albumin quality and quantity, plasma total protein and albumin, as well as renal function and blood pressure before and after treatment were observed. RESULTS Significant difference after treatment between the two groups was shown in terms of percentage of cases with positive albuminuria (0.7 +/- 0.8 vs. 1.5 +/- 0.9), 24-h urinary albumin (520 +/- 480 mg vs. 1352 +/- 861 mg), plasma total protein (74.5 +/- 6.3 g/L vs. 67.8 +/- 6.2 g/L), and plasma albumin (39.4 +/- 4.5 g/L vs. 34.6 +/- 4.3 g/L, all P < 0.01); also in urinary albumin negative inversion rate (92.1% vs. 67.6%, P < 0.01). No significant difference of renal function between groups, and between pre- and post-treatment was found (P > 0.05), as for the blood pressure, it showed a significant difference between pre- and post-treatment in both groups (P < 0.01), but with no difference between groups (P > 0.05). CONCLUSION TCM therapy for stasis-resolving and diuresis with SKB can promote the eliminating of albuminuria in puerpera in the severe preeclampsia stage.
2.
Efficacy of expulsive therapy using nifedipine or tamsulosin, both associated with ketoprofene, after shock wave lithotripsy of ureteral stones.
Micali, S, Grande, M, Sighinolfi, MC, De Stefani, S, Bianchi, G
Urological research. 2007;(3):133-7
Abstract
Extracorporeal shock wave lithotripsy (ESWL) is currently considered one of the main treatments for ureteral stones. Some studies have reported the effectiveness of pharmacologic therapies (calcium antagonists or alpha-blockers) in facilitating ureteral stone expulsion after ESWL. We prospectively evaluated the efficacy, after ESWL, of nifedipine on upper-middle ureteral stones, and tamsulosin on lower ureteral stones, both associated to ketoprofene as anti-edema agent. From January 2003 to March 2005 we prospectively evaluated 113 patients affected by radiopaque or radiolucent ureteral stones. Average stone size was 10.16 +/- 2.00 mm (range 6-14 mm). Thirty-seven stones were located in the upper ureter, 27 in the middle ureter, and 49 in the lower ureter. All patients received a single session of ESWL (mean number of shock waves: 3,500) by means of a Dornier Lithotripter S (mean energy power for each treatment: 84%). Both ultrasound and X-ray were used for stone scanning. After treatment, 63 of 113 patients were submitted to medical therapy to aid stone expulsion: nifedipine 30 mg/day for 14 days administered to 35 patients with upper-middle ureteral stones (group A1) and tamsulosin 0.4 mg/day for 14 days administered to 28 patients with stones located in the distal ureter (group A2). The remaining 50 patients were used as a control group (29 upper-middle ureteral stones-B1-and 21 lower ureteral stones-B2-), receiving only pain-relieving therapy. No significant difference in stone size between the groups defined was observed. Stone clearance was assessed 1 and 2 months after ESWL by means of KUB, ultrasound scan and/or excretory urography. A stone-free condition was defined as complete stone clearance or the presence of residual fragments smaller than 3 mm in diameter. The stone-free rates in the expulsive medical therapy group were 85.7 and 82.1% for the nifedipine (A1) and tamsulosin (A2) groups respectively; stone-free rates in the control groups were 51.7 and 57.1% (B1 and B2, respectively). Five patients (14.3%) in group A1, 5 (17.8%) in group A2, 14 (48.3%) in group B1 and 9 (42.8%) in group B2 were not stone-free after a single ESWL session and required ESWL re-treatment or an endoscopic treatment. Medical therapy following ESWL to facilitate ureteral stone expulsion results in increased 1- and 2-month stone-free rates and in a lower percentage of those needing re-treatment. The efficacy of nifedipine for the upper-mid ureteral tract associated with ketoprofene makes expulsive medical therapy suitable for improving overall outcomes of ESWL treatment for ureteral stones.
3.
Effect of nifedipine on endothelial function in normotensive smokers: potential contribution of increase in circulating hepatocyte growth factor.
Yamasaki, K, Aoki, M, Makino, H, Hashiya, N, Shimizu, H, Ohishi, M, Ogihara, T, Morishita, R
Journal of human hypertension. 2004;(10):701-5
Abstract
Calcium antagonists are reported to have protective effects on the endothelium in vitro and in vivo. Especially, nifedipine, among many calcium antagonists, was shown to improve endothelial dysfunction in patients with hypertension. However, no report has determined whether the improvement of endothelial dysfunction by nifedipine is due to direct effects or indirect effects such as its hypotensive effect. Thus, in this study, we evaluated the direct effects of nifedipine on smoking-induced endothelial dysfunction, since cigarette smoking itself is a major factor in damage of endothelial cells, as well as hypertension. We examined whether nifedipine improves endothelial function in 10 normotensive smokers without any risk factors for atherosclerosis. The subjects were treated with 20 mg nifedipine monotherapy (n = 10) or placebo (n = 10) for 4 weeks. Nifedipine did not affect blood pressure and heart rate of normotensive smokers. We measured forearm blood flow (FBF) by strain-gauge plethysmography after 2 and 4 weeks of treatment. Changes in vasodilator response to reactive hyperaemia were significantly improved in nifedipine-treated subjects (P < 0.05), while there was no significant change in FBP response in control subjects. Response to nitroglycerin was not changed in either group. Moreover, to evaluate the mechanisms of the direct effects of nifedipine on the endothelium, we focused on hepatocyte growth factor (HGF), which is a novel angiogenic growth factor with an antiapoptotic action on endothelial cells. Interestingly, serum HGF concentration in smokers treated with nifedipine was significantly elevated both at 2 and 4 weeks (P < 0.05). Overall, these results demonstrated direct effects of nifedipine in the improvement of endothelial dysfunction in normotensive smokers. The increase in serum HGF concentration by nifedipine might contribute to the improvement of endothelial dysfunction.