最新刊期
期 4 ， 2021
- 摘要：<正>风湿性疾病是一种自身免疫性疾病,多因患者体内的免疫功能过强或免疫刹车机制缺失导致,当免疫系统错误地对自身组织发起攻击,如不及时治疗,其结果将十分危险。目前,被证明与自身免疫相关的疾病已有近200种,可影响包括骨骼、大脑、心脏、神经、血管、眼睛、肺、肾脏、腺体、消化道、关节、肌肉及皮肤等多种器官组织。自身免疫性疾病已被世界卫生组织（WHO）列为继心血管疾病和癌症后,威胁人类健康的第三大杀手。我国目前风湿性疾病的患者有2亿多,其中类风湿关节炎患者500多万、强直性脊柱炎患者约500万、干燥综合征患者约500万、红斑狼疮患者120多万;我国高血压患病2亿人、高脂血症患病3亿人,而高尿酸血症（痛风）全国发病率13.3%,约有1.7亿人患病,超过了糖尿病的1.14亿人,是一个非常庞大的人群。
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发布时间：2023-04-10 - 摘要：李济仁教授认为痛风性关节炎的病因病机为湿热浊瘀痹阻经络,内因为过食肥甘厚味,脾胃运化失司,化生痰浊湿热;外因多为感受外邪,使水湿凝滞,痹阻经络。李教授化用经方,拟"消肿汤""通经丸"化瘀清热、活血通痹。张华东教授在李教授学术思想的基础上将病因进一步总结为毒、热、湿、痰、瘀、虚,认为六者由内伤外感所致,不仅互为因果,且相互夹杂。张教授提出细分内外、明辨六因互结是辨证施治的关键,并合"消肿汤""通经丸"为"消肿通经方"应用于临床,增进了临床疗效。关键词：李济仁;痛风性关节炎;痛风病;消肿汤;通经丸
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发布时间：2023-04-10 - 摘要：Objective To investigate the correlation between CYP3 A4 gene polymorphism and individual differences in the therapeutic effect of Tripterygium wilfordii on rheumatoid arthritis（RA）.Methods 58 RA patients taking tripterygium glycosides tablets orally were selected and CYP3 A4 single nucleotide polymorphism（SNP） were detected by SnaPshotmethod.Hardy-Weinberg equilibrium verification and correlation test were performed using Pearson Chi-Square test.The relationship between CYP3 A4 genotype and the therapeutic effect of tripterygium wilfordii in patients with rheumatoid arthritis was analyzed by binary Logistic regression model to see the individual differences between CYP3 A4 gene polymorphism and the therapeutic effect of Tripterygium wilfordii on rheumatoid arthritis.Results Genotype to Hardy-Weinberg genetic balance was reached in 58 patients with（P>0.05）,the three genotypes（GG,GA,AA） efficient difference was statistically significant; when comparing in pair, there was no statistically significant difference in the effective rate between GG and AA type（P>0.05）,and but was statistically significant difference between GA and AA type efficient difference（P<0.05）.Conclusion The individual difference in therapeutic effect of tripterygium wilfordii in patients with rheumatoid arthritis was related to SNP polymorphism of CYP3 A4 gene.It was most effective to in AA type of patient taking Tripterygium wilfordii,then less in GA type, and lest in GG type.关键词：rheumatoid arthritis;Tripterygium wilfordii;CYP3A4;Gene polymorphism
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发布时间：2023-04-10 -
Efficacy of Zaoshu Decoction combined with hydroxychloroquine in treating primary Sj?gren’s syndrome
摘要：目的评价燥漱方联合羟氯喹治疗原发性干燥综合征（pSS）的临床疗效与安全性。方法采用前瞻性自身对照病例研究方法,纳入2018年9月—2019年12月就诊的pSS患者60例,给予燥漱方含漱联合硫酸羟氯喹口服治疗,疗程12周。采用视觉模拟量表（VAS）及欧洲抗风湿联盟干燥综合征患者报告指数（ESSPRI）评价口干、眼干、疲乏、肢体痛等症状改善情况,并记录药物相关不良反应。结果治疗后患者口干、眼干、干燥症状、疲乏、肢体痛等症状VAS评分、ESSPRI均较治疗前明显改善,差异有统计学意义（P<0.01）,且未见不良反应。结论燥漱方联合羟氯喹能有效改善pSS患者症状,且安全性较好。关键词：原发性干燥综合征;燥漱方;中医外治;羟氯喹;中西医结合治疗- 2
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发布时间：2023-04-10 - 摘要：目的调查类风湿关节炎（RA）患者伴随消化道症状的现状。方法从类风湿关节炎中医数据中心（CRDC-TCM）调取全国多家三甲中医院中的RA患者1 623例,并从中筛选出合并消化道症状的患者805例,提取性别、年龄、病程长短、疾病活动度、用药情况、地域及饮食特征等信息,进行统计分析。结果符合本次研究纳入标准的患者805例,其中男106例（13.17%）,女699例（86.83%）,男女比为1∶6.5。不同地域分布的RA患者的消化道症状不适程度比较,差异有统计学意义（P<0.05）,患者多分布在华东地区207例（25.71%）。不同病程RA患者的消化道症状不适程度比较,差异无统计学意义（P>0.05）,平均病程10.75年,病程15年以上最多278例（34.53%）。中、高疾病活动度患者占比大（93.70%）,差异有统计学意义（P<0.05）。服用过或正在服用不同药物的RA患者的消化道症状不适程度比较,差异有统计学意义（P<0.05）,其中DMARDs 800例（99.38%）、NSAIDS 522例（65.25%）,使用率最高。结论 RA患者伴消化道症状程度与地域分布、疾病活动度、用药情况相关。关键词：类风湿关节炎;消化道症状;临床特征;疾病活动度;用药情况
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发布时间：2023-04-10 - 摘要：目的采用Meta分析的方法,评价中药复方治疗对强直性脊柱炎疾病活动度的影响,同时与慢作用抗风湿药物（DMARDs）进行疗效对比。方法检索CNKI、维普、万方、PubMed、Cochrane Library、Embase等中英文数据库,检索时限为建库至2020年10月1日。纳入中药治疗强直性脊柱炎的随机对照试验（RCT）并进行资料提取,采用Cochrane协作网推荐的"偏倚风险"评估工具进行方法学质量评价,采用RevMan 5.4软件进行Meta分析。结果纳入20项研究,共计1 885例患者,试验组1 030例,对照组855例。Meta分析结果显示:中药复方治疗强直性脊柱炎在BASDAI[MD=-1.03,95%CI（-1.33,-0.74）,P<0.000 01]、BASFI[MD=-0.98,95%CI（-1.29,-0.66）,P<0.000 01]改善程度方面均优于DMARDs治疗。结论中药复方治疗强直性脊柱炎对疾病活动度有所改善,且较DMARDs效果显著。关键词：强直性脊柱炎;疾病活动度;中药;Meta分析
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发布时间：2023-04-10 - 摘要：Objective To observe the effect of Qingfei Jiangzhuo Prescription on inflammatory response and organ protection in patients with severe pneumonia of obstruction of phlegm heat in the lung.Methods A total of 68 cases of severe pneumonia with phlegm heat obstructing lung syndrome treated in Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from September 2017 to September 2019 were randomly divided into combined Chinese and western medicine treatment group and western medicine treatment group with 34 cases in each group.The western medicine group was treated by routine western medicine.On the basis of the routine treatment, the Chinese and western medicine group was also given Qingfei Jiangzhuo Prescription, one bag each day and for 7 days as one course.The clinical efficacy, pneumonia severity index（PSI）,acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）,C-reactive protein（CRP）,procalcitonin（PCT）,interleukin-6（IL-6）,oxygenation index（PaO2/FiO2）,carbon dioxide（PaCO2）,systolic blood pressure（SBP）,lactic acid（Lac）,fibrinogen（FBG） and D-Dimer（D-D） were compared between the two groups before and after the treatment.Results The effective rate of the Chinese and western medicine group was higher than that of the western medicine group, but the difference was not statistically significant（P>0.05）.The scores of PSI and APACHE Ⅱ in both two groups were significantly lowered than those before the treatment（P<0.05）,and the decline in the Chinese and western medicine group was more pronounced than the western medicine（P<0.05）.The same change happened with the levels of CRP,PCT,IL-6,Lac in the two groups.After treatment the oxygenation indexes（PaO2/FiO2） in the two groups were higher than those before treatment; And the change was more obliviously in the Chinese and western medicine group（P<0.05）.The levels of SBP and PaCO2 were normal before and after the treatment.Conclusion Qingfei Jiangzhuo Prescription combined with western medicine can reduce the severity of the disease, and that may be the Results of its reducing inflammatory reaction, improving respiratory and circulatory function capability.关键词：severe pneumonia;obstruction of phlegm heat in the lung;Qingfe Jiangzhuo Prescription;inflammatory response;multiple organ dysfunction
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发布时间：2023-04-10 - 摘要：目的观察储药罐改善稳定型心绞痛（气虚血瘀型）患者胸闷胸痛症状的护理效果。方法选取2018年10月—2019年12月北京中医医院顺义医院心血管科诊治的稳定型心绞痛（气虚血瘀型）患者120例,采用区组随机法分为对照组和观察组,各60例。对照组予以规范治疗和常规护理,观察组在此基础上予以储药罐技术干预,14 d后,比较2组胸闷和（或）胸痛的发作次数、发作持续时间、疼痛视觉模拟评分（VAS）,采用西雅图心绞痛调查量表（SAQ）评估2组治疗前后的胸闷胸痛症状等。结果 2组患者基线资料比较,差异无统计学意义（P>0.05）。观察组总有效率为96.49%,对照组为83.33%,2组间差异有统计学意义（P<0.05）。观察组心绞痛发作次数随时间的变化趋势明显低于对照组（P<0.05）;观察组心绞痛发作持续时间均低于对照组（P<0.05）;观察组心绞痛发作VAS评分低于对照组（P<0.05）;观察组干预14 d SAQ评分高于对照组（P<0.05）。结论储药罐可改善稳定型心绞痛（气虚血瘀型）患者胸闷胸痛发作次数、发作持续时间、VAS评分、SAQ评分,提高生存质量。关键词：储药罐技术;稳定型心绞痛;气虚血瘀证;胸闷胸痛
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发布时间：2023-04-10 - 摘要：Objective To investigate the clinical effect of modified Zishui Qinggan Decoction combined with Estradiol Tablets/Estradiol and Dydrogesterone Tablets for patients with menopausal syndrome of kidney deficiency and liver stagnation.Methods 80 cases of postmenopausal syndrome with kidney deficiency and liver stagnation were randomly divided into two groups.The control group was treated with Estradiol Tablets/Estradiol Didroxyprogesterone Tablets composite packaging（Femoston）.The observation group was treated with Zishui Qinggan Decoction on the basis of the control group.The treatment lasted for 3 months.The clinical effect, Kupperman score, Menqol score, serum follicle stimulating hormone（FSH）,estrogen（E2） levels and adverse reactions were observed before and after the treatment in both two groups.Results After 3 months, the total effective rate of the observation group was significantly higher than that of the control group（P<0.05）.The TCM symptom score, Kupperman score, Menqol score, serum FSH and E2 levels of the observation group were better than those of the control group（P<0.05）; the incidence of adverse reactions in the observation group was lower than that in the control group, but the difference was not statistically significant（P>0.05）.Conclusion Modified Zishui Qinggan Decoction combined with Fenmatong is more effective than single use of western medicine in the treatment of menopausal syndrome with kidney deficiency and liver stagnation because it can effectively regulate the level of endocrine hormones and improve the quality of life with safety.关键词：Zishui Qinggan Decoction;menopausal syndrome;kidney deficiency and liver stagnation;Estradiol Tablets/Estradiol and Dydrogesterone Tablets
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发布时间：2023-04-10 -
Clinical application of Sinew knife in the treatment of the third lumbar transverse process syndrome
摘要：Objective To study the clinical application of Sinew knife in the treatment of the third lumbar transverse process syndrome.Methods 80 patients with the third lumbar transverse process syndrome, who visited the Department of Orthopaedics, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University from March 2016 to February 2017,were selected as the research subject, and divided into two groups by random number table.The control group was treated with small needle knife.The observation group was treated with Sinew knife.The therapeutic effect of the two groups was observed, the JOA scores and VAS scores were compared between the two groups before and after treatment, and the levels of related oxygen free radical metabolism indexes were detected in the two groups.Results The total effective rate of the observation group was 97.50%,which was significantly higher than that of the control group（82.50%）（P<0.05）.After treatment, JOA scores of two groups were increased significantly, VAS scores decreased significantly, the difference was statistically significant（P<0.05）;VAS score of the observation group after treatment was significantly lower than that of the control group, JOA score was significantly higher than that of the control group（P<0.05）.Conclusion The treatment of the third lumbar transverse process syndrome with Sinew knife has definite curative effect.关键词：Sinew knife;third lumbar transverse process syndrome;low back pain- 2
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发布时间：2023-04-10 - 摘要：Objective To observe the effect of Jianpi Qinghua Decoction on the growth of metronidazole resistant Helicobacter pylori（HP） in vitro and the change of metronidazole content in vivo, and to explore the possible mechanism of Jianpi Qinghua Decoction.Methods Clinical strains of metronidazole resistant HP were selected.In experimental group, 1,1/2,1/4,1/8,1/16,1/32 times of Jianpi Qinghua Decoction was used to intervene the growth and activity of HP.In control group, normal saline was used for comparison.The growth of metronidazole resistant HP in vitro and the change of metronidazole content in bacteria were observed by agar dilution method and ELISA method.Results Antibacterial test in vitro showed that 1,1/2,1/4 times of Jianpi Qinghua Decoction had inhibitory effect on the growth of metronidazole resistant HP,and its minimum inhibitory concentration was 1/4 times of concentration; ELISA Results showed that Jianpi Qinghua Decoction was more effective compared with the control group.The contents of metronidazole in drug-resistant HP in each group were increased significantly, showing a gradient change, and the difference between each group was statistically significant（P<0.05）.Conclusion 1,1/2,1/4 times of Jianpi Qinghua Decoction can inhibit the growth of metronidazole resistant HP.At the same time, different concentrations of Jianpi Qinghua Decoction can change the content of metronidazole in bacteria.The mechanism may be related to the influence of HP efflux pump.关键词：Jianpi Qinghua Decoction;metronidazole;drug resistance;helicobacter pylori;growth in vitro
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发布时间：2023-04-10 - 摘要：Objective To study the antibacterial effect of Reduning combined with imipenem sitastatin sodium, cefoperazone sodium and sulbactam sodium, piperacillin sodium and ceftazidime on acinetobacter baumannii resistant to carbapenem in vitro.Methods The minimum inhibitory concentration（MIC） of Reduning and four antibiotics against 30 strains of carbapenem resistant acinetobacter baumannii was determined by broth dilution method, and the partial inhibitory concentration（FIC） index was calculated to evaluate the antibacterial effect of the drugs in combination.Results The MIC value range, MIC50 %(MIC50),and MIC90 %(MIC90) of the four antibiotics were significantly lower than that of the single drug.With Reduning 125μl/ml, cefoperazone sodium and sulbacartan sodium 32μg/ml, the number of strains was the highest and the bacteriostatic effect was the most obvious.With Reduning 250μl/ml, imipenem Cistantin sodium 64μg/ml had the largest number of strains and the most obvious bacteriostatic effect.The FIC index of ceftazidime combined with imipenemen Cistantin sodium ≤0.5 was 3.3%,0.6～0.9 was 93.3%,1～2 was 3.3%,and>2 was 0.The FIC index of cefoperazone sodium and sulbactam sodium FIC≤0.5 was 6.7%,0.6～0.9 was 93.3%,1～< 2 was 0,and >2 is 0.The FIC index of piperacillin sodium≤0.5 was 13.3%,0.6～0.9 was 76.7%,1～2 was 10.0%,and >2 was 0.The FIC of ceftazidime sodium index≤0.5 was 13.3%,0.6～0.9 was 80.0%,1～2 was 6.7%,and > 2 was 0.Conclusion The effects of Reduning combined with four antibiotics against acinetobacter baumannii were synergistic and additive, without antagonism.Cefoperazone sodium and sulbactam sodium and imipenem Cistantin sodium had the best effect in vitro.关键词：Reduning;antibiotics;ICU;acinetobacter baumannii resistant to carbapenem;bacteriostatic action
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发布时间：2023-04-10 - 摘要：糖尿病患者机体高血糖水平可引发一系列内环境改变,并导致多种生理结构及功能损害,从而促发抑郁,其发生、发展及转归具有鲜明特点,在治疗中有别于原发性抑郁症。高彦彬教授在形神学说、络病理论指导下,从络病论治本病,注重糖尿病与抑郁症二者的内在联系,在辨明虚实病性的基础上,提出络气郁滞、络脉瘀阻、络气虚滞、络脉失荣的基本病机,以通络为治疗大法,注重形神并调。络气郁滞、络脉瘀阻者当祛邪通络;络气虚滞、络脉失荣者当扶正通络、通补兼施。关键词：糖尿病;抑郁症;络病;通络
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发布时间：2023-04-10 - 摘要：地中海贫血是单基因遗传病,发病率高、危害性大、致残率高,至今尚无特效疗法。中国中医科学院广安门医院吴志奎教授根据中医"肾藏精、生髓"及"精血同源"理论结合现代医学研究,提出"肾藏精"→"精生髓"→"髓生血"理论,并始终坚持运用"补肾益髓生血"法治疗地中海贫血。研究证实益髓生血颗粒可通过改善患者造血功能、减轻红细胞损伤与破坏等发挥治疗作用,可减轻患者贫血症状,提高生活质量并延长寿命。关键词：吴志奎;地中海贫血;遗传病;溶血性贫血;益髓生血
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发布时间：2023-04-10 - 摘要：声带白斑临床表现以波动性嘶哑为主,是喉科常见难治性病变,目前临床对该病缺少特效非手术治疗方法。刘大新教授根据多年临床经验认为本病与肝脏疏泄功能密切相关,治疗上要求审证求因、从肝论治,明确病机、综合治疗,"健脾气-化瘀血-清虚热"之法联合应用,强调宜用"轻降"之品。关键词：刘大新;声带白斑;从肝论治;健脾气;化瘀血;清虚热
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发布时间：2023-04-10 - 摘要：耳鸣患病率高,梁晓春教授认为,其发生责之肾、肝、脾三脏,痰、瘀两端,治疗强调补肾为根本、调肝为关键、健脾为枢机,根据兼症,或清火化痰,或燥湿化痰,或祛瘀活血,以开耳窍,方随法定,疗效显著。补肾分阴虚、阳虚,肾阴虚方用耳聋左慈丸,常加二至丸或五子衍宗丸;肾阳虚方用金匮肾气丸,常加菟丝子、桑寄生、牛膝、杜仲、补骨脂或益智仁。调肝分气郁、肝火、阴虚及阳亢,气郁方用逍遥散,常加蔓荆子、石菖蒲和香附;肝火方用龙胆泻肝汤;阴虚常加二至丸或枸杞子、桑椹或菊花;阳亢方用天麻钩藤饮,常加龙骨、牡蛎、灵磁石、石决明或珍珠母。健脾分脾胃虚弱及清阳不振,前者方用益气聪明汤,后者方用补中益气汤。关键词：梁晓春;耳鸣;补肾;调肝;健脾;化痰祛瘀;经验
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发布时间：2023-04-10 - 摘要：房定亚教授提出尿道综合征以肝经湿热、气机不畅为核心病机,在疾病的发展过程中可以出现耗气伤阴、阴虚内热的症状;由于久病入络,病程较长的患者可以出现血行不畅、经脉瘀阻的症状;病久伤及中气,导致脾肾不足,出现膀胱失约的表现。治疗中房定亚教授选用四逆散合八正散化裁进行治疗,早期以清利湿热、理气止痛为主;阴虚内热辅以益气清热;对于血行不畅、经脉瘀阻的患者在治疗中辅以理气活血通络;对于疾病日久损伤中气的患者在治疗中注意温补脾肾以调畅气机贯穿治疗始终,取得良好的临床疗效。关键词：房定亚;尿道综合征;八正散;四逆散
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发布时间：2023-04-10 - 摘要：阳痿是男性常见的性功能障碍,其发病率逐年上升,西医治疗阳痿的一线药物仍为5型磷酸二酯酶抑制剂,兼有手术、物理治疗等多种治疗方式,大部分患者可从中受益,但对患者的整体状态关注不足,难以满足标本兼治需求。中医多从肝、肾为中心论治本病,阳痿亦与宗气密切相关。宗气为"气之宗主",具有"贯心肺,行呼吸"及"资养先天元气"的生理功能,能够调节人体气血、脏腑、经络、形神,在维持阴茎的正常勃起上起着重要作用。因此从"调补宗气"论治阳痿可丰富中医治疗阳痿的理论,并为临床辨治提供新策略。关键词：阳痿;调补宗气;病机
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发布时间：2023-04-10 - 摘要：《伤寒论》中"阴阳自和"是概括人体生理状态的纲领性条文,本文从阴阳的本义为切入点,强调阴阳二者矛盾统一运动的性质,从动态视角解读《伤寒论》中"阴阳自和"含义。阐述了生理情况下,阴指气和津在人体正常的蓄积过程,阳指热和水向外排泄的过程,阴阳自和则说明两者相互配合得当,气机通畅;病理情况下,阴盛阳衰,则无力外出,阳强阴弱,则无以外出,两者均会导致内蓄成邪。而疾病向愈的关键是"汗出",其本质则为阴阳自和,治疗的关键则为调和阴阳的过程,且一旦阴阳自和便需停止用药。关键词：伤寒论;阴阳自和;动态观
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发布时间：2023-04-10 - 摘要：气机郁滞可致气血阴阳运行失常,引起各种病症。气滞与肝胆密切相关,疏理郁滞之气机多以疏肝理气、疏肝利胆为法。肝胆气机畅达需要阳气的推动,"木……其候温和",胆经子时当值,"子时一刻,乃一阳之生";肝升胆降,需相火伴行。肝胆经气郁滞不行时,宜温通肝胆,忌一味泻肝利胆,恐杀伐阳气。毫火针刺足少阳胆经之阳陵泉、丘墟二穴,可以激发胆经原气、温补胆经之初生少阳,温通肝胆经气。关键词：毫火针;气滞;足少阳胆经;温通肝胆
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发布时间：2023-04-10 - 摘要：孔嗣伯先生秉承家学,熟悟经旨,临床辨证提纲挈领,认为女性不孕症应首重冲任,冲任二脉欠和是主因。临床治以调和冲任收到较好效果,对湿邪下注、痰湿瘀滞、胞络欠通的患者,治以温阳化湿、通调醒塞,选药茯苓、薏苡仁、芡实、陈皮、小青皮、细辛、川椒目、乌药、橘核、沉香、小茴香、竹叶卷心、车前子;对肾阴不足、封藏失职、冲任失养、难以固胎者,柔肝益肾、滋养冲任以养胎元,选药生牡蛎、生海蛤、炒杜仲、桑寄生、山茱萸、墨旱莲、当归、花蕊石、红白鸡冠花、丹参、鸡血藤、益母草等。孔先生还认为不孕症患者常有冲任血瘀络阻,在温阳理气、柔肝益肾的同时,配合使用活血药可获奇效。关键词：孔嗣伯;不孕症;经验
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发布时间：2023-04-10 - 摘要：通过对《针灸大成》中太渊穴相关条文进行整理,并结合现代研究,对太渊穴的腧穴定位、穴性、刺灸方法、配穴规律、临床应用等进行分析、归纳与总结。太渊穴定位:在腕掌侧横纹桡侧,距离桡动脉约1 cm处。其治疗方法有刺法及灸法。其穴性为肺之原穴、脉会、五输之俞土穴。其配穴主要有列缺、太溪、足三里、合谷、人中、曲池、肺俞、三阴交、鱼际、颊车。其主要治疗痛症、肺系疾病、鼻目疾病。对痛症的治疗,以头痛、肢体痛、心胸痛、胃腹部疼痛及牙痛为主,可治疗风痰咳嗽、久嗽不愈、咳唾血痰、寒痰咳嗽、干咳、喘、肺胀等肺系疾病及鼻流清涕、喷嚏不止、鼻窒、鼻痔、眼痛及目赤肤翳等鼻目之疾。但还需要进一步加强基础研究及总结临床证据。关键词：太渊穴;针灸大成;穴位配伍;临床应用
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发布时间：2023-04-10 - 摘要：喉痹是耳鼻喉科常见病、多发病,随着中医学的发展进步,对喉痹的认识从广义之咽喉病统称发展到狭义之咽喉肿痛及不适症状,相当于现代医学的急慢性咽炎,多由于外邪侵袭,邪滞于咽,或脏腑虚损,咽喉失养,或虚火上灼所致咽部红肿疼痛,或以干燥、异物感、咽痒不适为主要临床表现的咽部疾病。喉痹病邪以火邪多见,涉及五脏六腑,又以肺胃为主,治疗当清利咽喉。润喉清咽合剂是首都医科大学附属北京中医医院的院内制剂,由寒水石、竹叶、儿茶组成,具有清热泻火解毒、润喉利咽止痛之功效,主治咽干咽痛、反复口腔溃疡、干咳等肺胃热盛之喉痹,对于"虚火"喉痹亦可随症加减使用,经数十年临床验证,安全可靠,效果显著,值得临床进一步借鉴。关键词：润喉清咽合剂;喉痹;咽炎;肺胃热盛;清热解毒
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发布时间：2023-04-10 - 摘要：根据《黄帝内经》"五阳已布,疏涤五脏"的思想,认为五脏阳虚、瘀滞不通是肿瘤发病的重要因素。在肿瘤患者的中医临床治疗中,运用开胃进食汤加减温补五脏阳气,开鬼门、洁净府,通利三焦、六腑,疏涤以使五脏安和。调理肿瘤患者体质,可使肿瘤得到控制,提高患者生活质量,并延长其生存期。关键词：肿瘤;阳虚;五阳已布;疏涤五脏;开胃进食汤
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发布时间：2023-04-10 - 摘要：目的基于数据挖掘分析庞鹤教授治疗下肢静脉溃疡的用药经验,为治疗提供临床思路。方法收集庞教授2016年9月—2019年9月于东直门医院周围血管科治疗有效的下肢静脉溃疡门诊处方132首,录入中医传承辅助系统,进行频次统计、关联规则、复杂系统熵聚类以及无监督熵层次聚类提取关联系数、置信度、核心药物组合以及新处方。结果单味药物频次统计得到出现频次≥30次的药物有27味,频次最高的分别为黄芪、当归、赤芍、川芎、丹参、地龙。应用关联规则挖掘数据,得到置信度≥0.75的药物组合28对;基于熵聚类分析,得到关联系数≥0.06的药物组合30对,核心的组合共17组,新处方9首。结论数据挖掘分析显示庞鹤治疗下肢静脉溃疡以活血化瘀法贯穿始终,兼以益气、去湿、化浊。关键词：数据挖掘;名老中医;下肢静脉溃疡;用药规律
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发布时间：2023-04-10 - 摘要：目的分析、总结明清时期（1551—1911年）治疗以鼻塞、黄涕为主要表现的鼻渊的中医用药规律。方法检索《中华医典》中文数据库中的明清医案,应用中医传承辅助平台（V2.0）统计所有以鼻塞、黄涕为主要表现的鼻渊相关资料,分析其高频药物及常用药物组合。结果 96篇医案中口服中医方剂共80首,涉及药物162味,清热解毒药物使用频次最高为73次,药物组合辛夷-苍耳子使用频次最高为20次。结论明清时期治疗以鼻塞、黄涕为主要表现的鼻渊首重专方专药,其次注重脾胃肺肝的气机升降及"消""托""补"3法的运用。关键词：鼻渊;中医药;医案;明清时期;组方规律
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发布时间：2023-04-10 - 摘要：目的基于Meta分析探究类风湿关节炎（RA）寒证与热证患者临床特点的差异,为RA的寒热辨证提供循证依据。方法通过检索中国学术期刊全文数据库、万方数据库、维普中文期刊数据库、PubMed平台中与类风湿关节炎寒热证候相关的文献,并按照纳入和排除标准进行筛选,使用美国医疗保健研究与质量局横断面研究质量评价条目对文献质量进行评估并提取相关临床特征数据,使用RevMan 5.3软件对相关数据进行Meta分析。结果共纳入11篇文献,对文献进行质量评价,评分8分的文献9篇,评分7分的有2篇。Meta分析结果显示,寒证组与热证组红细胞沉降率（ESR）比较,寒证组明显低于热证组[SD（Random）=-16.62,95%CI（-24.98,-8.25）],差异有统计学意义（Z=3.89,P<0.000 1）;寒证组与热证组C反应蛋白（CRP）比较,寒证组明显低于热证组[SD（Fixed）=-1.80,95%CI（-2.21,-1.40）],差异有统计学意义（Z=8.67,P<0.000 01）;寒证组与热证组28关节疾病活动度（DAS28）比较,寒证组明显低于热证组[SD（Random）=-0.92,95%CI（-1.25,-0.58）],差异有统计学意义（Z=5.38,P<0.000 01）;寒证组与热证组类风湿因子（RF）比较,寒证组与热证组之间差异未见统计学意义[SD（Random）=-11.89,95%CI（-26.68,-2.89）,Z=1.58,P=0.11]。结论 RA热证患者疾病活动相关指标明显高于寒证患者,提示热证患者处于一个较强的疾病活动状态,在临床上可为RA寒热证候辨证提供一定的参考。关键词：类风湿关节炎;寒证;热证;Meta分析
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发布时间：2023-04-10 - 摘要：目的运用网络药理学方法筛选"土茯苓-金银花"药对治疗类风湿关节炎（RA）的有效成分和作用靶点,探究其主要成分-核心靶点-疾病的复杂网络关系。方法通过中药系统药理学平台（TCMSP）收集"土茯苓-金银花"药对的活性成分及作用靶点;通过GeneCards及OMIM、Drugbank数据库收集RA的疾病相关基因,构建"核心成分-核心靶点-核心通路"网络并筛选出"土茯苓-金银花"药对治疗RA的核心靶点,然后进一步行蛋白互作网络分析（PPI）、GO生物功能注释、KEGG通路富集分析。结果 （1）在TCMSP数据库初步提取土茯苓化学成分75种,金银花化学成分240种,经ADME筛选后共获得土茯苓15种,金银花23种活性成分,包括紫杉酚、槲皮素、山萘酚、香茅醇、豆甾醇等。土茯苓主要成分作用靶点基因252个,金银花主要成分作用靶点基因352个。（2）在GeneCards数据库、OMIM的两个数据库、Drugbank数据库检索得到671个RA靶点。（3）土茯苓、金银花与RA的共同靶点基因55个。PPI网络分析发现JUN、AKT1、IL-10、VEGFA、TNF等可能是"土茯苓-金银花"药对治疗RA的关键靶点。（4）在DAVID数据库提交基因序列,得到富集分析结果KEGG Pathway 96条信号通路,"土茯苓-金银花"药对治疗RA主要参与的信号通路包括TNF信号通路、Toll样受体信号通路、HIF-1信号通路、NOD样受体信号通路、破骨细胞分化、雌激素信号通路、T细胞受体信号通路等。GO富集分析包括生物过程（BP）355条结果,涉及RNA聚合酶Ⅱ启动子转录的正调控、一氧化氮生物合成过程的正调控、炎症反应、对脂多糖的反应、脂多糖介导的信号通路、平滑肌细胞增殖的正调控、血管生成、细胞对脂多糖的反应、血管新生的正调控、以DNA为模板的转录正调控等;细胞成分（CC）27条结果,分子功能（MF）50条结果,主要涉及酶结合、细胞因子活性、转录因子结合、相同的蛋白质结合、蛋白质结合、序列特异性DNA结合、类固醇激素受体活性、蛋白磷酸酶2A结合、转录激活子活性,RNA聚合酶Ⅱ核心启动子近端区域序列特异性结合、肿瘤坏死因子受体结合等。结论 "土茯苓-金银花"药对的主要活性成分通过TNF信号通路、Toll样受体信号通路、HIF-1信号通路、NOD样受体信号通路、破骨细胞分化、雌激素信号通路、T细胞受体信号通路等信号通过参与RA发病的炎症反应,从而发挥了缓解RA病情的临床作用。本研究初步探究了"土茯苓-金银花"药对治疗RA的作用靶点和作用通路,为进一步更深入地挖掘其治疗RA的作用机制奠定了基础。关键词：网络药理学;土茯苓-金银花药对;RA;机制
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发布时间：2023-04-10 - 摘要：目的采用网络药理学方法研究补肾强脊颗粒治疗强直性脊柱炎的机制。方法利用中药系统药理学数据库与分析平台（TCMSP）收集补肾强脊颗粒的主要化学成分及靶点,通过Genecards, Disgenet, TTD数据库获取强直性脊柱炎的主要靶点,并借助STRING平台构建蛋白互作网络;采用Metascape平台进行GO功能富集分析和KEGG信号通路分析,明确补肾强脊颗粒治疗强直性脊柱炎的核心靶点及作用机制。结果补肾强脊颗粒有58个活性成分,核心活性成分为槲皮素（quercetin）、山奈酚（kaempferol）、豆甾醇（stigmasterol）,核心靶点有IL-6、CXCL8、RELA、IL-1B、CCL2、IL-10、IL-4、IFENG、CXCL10、IL-2等,补肾强脊颗粒治疗强直性脊柱炎的生物学通路主要作用于IL-17信号通路、AGE-RAGE信号通路、流体剪切应力和动脉粥样硬化等通路。结论研究初步揭示了补肾强脊颗粒治疗强直性脊柱炎的多成分、多靶点、多通路的作用机制,为进一步治疗强直性脊柱炎提供思路。关键词：补肾强脊颗粒;强直性脊柱炎;网络药理学
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发布时间：2023-04-10 - 摘要：高血压靶器官损害危及心、脑、肾等多个器官的功能,给高血压的控制和管理带来了新的挑战。目前预防和治疗高血压靶器官损害是临床研究重点和难点,中医药由于多靶点、多系统、整体治疗等独特优势得到较多重视。中医治则主要包括温阳活血、化瘀止痛、健脾益气、补肾祛湿。其机制可能与抑制肾素-血管紧张素-醛固酮系统激活、炎性反应、抑制神经细胞凋亡等方面有关。本文通过梳理文献,总结中医药在治疗高血压靶器官损害方面的独特经验,期望为临床治疗提供一定的参考。关键词：高血压;靶器官损害;中医药;综述
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发布时间：2023-04-10 - 摘要：针刺能够通过激活人体的穴位来减轻疼痛,因穴位包含肥大细胞、神经纤维等特殊成分,故有利于针刺信号的激活。在脊髓中电针可以通过下调趋化因子并增加抗炎细胞因子来抑制神经胶质细胞活化,从而减少肿瘤坏死因子α、白介素1β、白介素6、前列腺素E2等释放参与即时与长期镇痛。即时镇痛通过抑制P38丝裂原激活蛋白激酶（p38MAPK）和细胞外信号调节激酶途径（ERK）来抑制小胶质细胞激活;长期镇痛则是阻断CJunN末端激酶（JNK）信号通路抑制星形胶质细胞激活。此外,针刺镇痛涉及多种递质,如内源性阿片类药物、5羟色胺、谷氨酸、去甲肾上腺素、多巴胺、γ氨基丁酸、乙酰胆碱等。期待将来采用全身视角的基础研究,探索针刺镇痛机制。关键词：针刺;镇痛;机制研究;综述
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发布时间：2023-04-10
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