最新刊期

    11 2018
    • FENG Xing-zhong
      Vol. 37, Issue 11, Pages: 1007-1010(2018) DOI: 10.16025/j.1674-1307.2018.11.001
      摘要:糖尿病与恶性肿瘤存在相关性,糖尿病合并恶性肿瘤具有"虚气流滞,气虚生毒"的病机特征,中医药治疗抓住病机关键,根据正气与毒邪消长变化,在控制血糖、辨证与辨病相结合的基础上,根据标本缓急分阶段采用补虚扶正、祛实通滞、攻毒解毒的扶正祛邪方法治疗糖尿病合并恶性肿瘤,可获良效。  
      关键词:糖尿病;恶性肿瘤;气虚生毒;扶正祛邪;中医药治疗   
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      发布时间:2023-04-10
    • ZHAO Jin-xi,WANG Shi-dong,HUANG Wei-jun
      Vol. 37, Issue 11, Pages: 1010-1013(2018) DOI: 10.16025/j.1674-1307.2018.11.002
      摘要:"证"的本意为证据,包括了症、证候、病证3个方面的含义,"症"为症状和体征,"证候"为疾病某一阶段的病理概括,而"病证"为具有特定的发生、发展规律的病理生理变化过程。中医辨证论治,不仅应该重视辨证候和辨病,同时还应该重视辨体质,辨体质、辨病、辨证候"三位一体"的诊疗模式应该被倡导。研究证候与肠道菌群的相关性,需基于体质和临床,且必须注意肠道菌群不是证候形成的唯一环节,应该重视中医理论的创新,单单研究中药单体或某一有效组分对肠道菌群的影响,虽然有一定意义,但对中医学术本身作用有限。  
      关键词:证候;体质;病证;肠道菌群;糖尿病   
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      发布时间:2023-04-10
    • ZHANG Wei-hua,FENG Xing-zhong
      Vol. 37, Issue 11, Pages: 1014-1018(2018) DOI: 10.16025/j.1674-1307.2018.11.003
      摘要:目的评价疏肝健脾法治疗2型糖尿病合并非酒精性脂肪肝主要生化学指标的疗效。方法计算机检索及手工检索2010年1月1日—2018年7月1日文献,按Cochrane协作网质量评价标准评价,提取有效数据并采用Revman 5. 1软件进行分析。结果共纳入10项随机对照试验,包括1 213例糖尿病合并非酒精性脂肪肝患者,但方法学质量评价显示纳入研究质量不高,均为C级。Meta分析结果显示:与对照组比较,疏肝健脾法治疗能降低FPG、2hPG、HbA1C、胰岛素抵抗指数(IRI)水平,但降低FPG、2hPG、HbA1C不明显;降低ALT、AST、GGT水平;降低TG、TC、LDL-C水平,提高HDL-C水平,但改善作用不明显。结论疏肝健脾法治疗糖尿病合并非酒精性脂肪肝在改善肝功能、IRI方面作用较明显,对血糖、血脂、HbA1C等指标具有一定的改善作用。  
      关键词:疏肝健脾法;糖尿病;非酒精性脂肪肝;肝功能;血糖;血脂;Meta分析   
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      发布时间:2023-04-10
    • GUO Yu-xin,WANG Li-ying,LI Yi-xiao,LIU Qin,CHEN Feng,ZHANG Tao-jing
      Vol. 37, Issue 11, Pages: 1018-1021(2018) DOI: 10.16025/j.1674-1307.2018.11.004
      摘要:Objective To observe the regulating effect of Tangluoning (TLN) on MAPKs pathway and NF-κB pathway in sciatic nerve of diabetic peripheral neuropathy (DPN) rats. Methods 8 weeks old Sprague Dawley (SD) male rats of pathogen-free were selected. All the rats were fed adaptively for two weeks with routine diet firs before experiment. The rat model with hyperglycemia leading to DPN was induced by intraperitoneal injected with streptozocin (STZ) 60 mg/kg except the blank control group. Those with hyperglycemia were randomly divided into normal control group,model control group,positive control (a-lipoic acid) group,and TLN group,and then successively administrated for 8 weeks. TLN group were given by gavage once a day with TLN powder dissolved in distilled water 5 g/kg,positive control group were given by gavage once a day with a-lipoic acid 20 mg/kg,model control group were given by gavage once a day with equal amount of distilled water. During administration,blood glucose was dynamically monitored to ensure the success of diabetes model. After 8 weeks,Western Blot method was used to measure the expression of p-JNK,p-ERK1/2,NFκB,p-NFκB in sciatic nerve. Results The expression of p-p38,p46 JNK、ERK1/2 were similar in all groups. And the difference had no statistical significance (P > 0. 05); compared with normal group,the expressions of p-p38 MAPK,p-p46 JNK,p-ERK1/2,and p-NFκB were increased in model control group (P < 0. 01). Compared with model group,the expressions of p-p38 MAPK,p-p46 JNK,p-ERK1/2,p-NFκB of a-lipoic acid group and TLN group were decreased (P < 0. 05). Compared with normal group,the expressions of p-NFκB of model group were increased (P < 0. 01); compared with model group,the expressions of p-NFκB of a-lipoic acid group and TLN group were decreased (P < 0. 05). Conclusion Tangluoning can regulate MAPKS signaling pathway and NFκB signaling pathway so as to improve oxidative stress and avoid nerve injury.  
      关键词:Tangluoning;oxidative stress;diabetic peripheral neuropathy;rat   
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      发布时间:2023-04-10
    • ZOU Ben-liang,CHEN Zhu-hong,ZHANG Guang-de
      Vol. 37, Issue 11, Pages: 1022-1024(2018) DOI: 10.16025/j.1674-1307.2018.11.005
      摘要:魏子孝教授认为"和其阴阳"是中医治疗的核心思想,而和法是表现形式之一。和法涵盖的内容广泛,其中对药这一形式浓缩了和法的精髓,如寒热共用、攻补兼施、动静结合等,药简力强,值得总结继承。  
      关键词:和法;对药;魏子孝;老中医经验   
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      发布时间:2023-04-10
    • GAO Hui-juan,WANG Ya-fei
      Vol. 37, Issue 11, Pages: 1024-1026(2018) DOI: 10.16025/j.1674-1307.2018.11.006
      摘要:冯兴中教授认为糖尿病周围神经病变(DPN)的病机具有动态演变的特点,随病程的进展,初期阴虚燥热,逐渐进入气阴两虚阶段,最后出现阴阳两虚的变化。肝、脾、肾三脏在DPN的发生发展中起重要作用,故治疗应健脾固肾疏肝;同时,在脏腑功能失调、气血阴阳亏虚的基础上,痰浊、瘀血等病理产物生成,停滞于络脉,导致络脉不通,加重病情,故治疗须不忘活血化痰通络。  
      关键词:糖尿病周围神经病变;脾;肾;肝;络脉瘀阻   
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      发布时间:2023-04-10
    • LIU Zhi-qiang,MENG Yan,WANG Yu-feng
      Vol. 37, Issue 11, Pages: 1027-1030(2018) DOI: 10.16025/j.1674-1307.2018.11.007
      摘要:2型糖尿病肾病(DN)Ⅲ-Ⅳ期是疾病的快速进展阶段,通过中医药治疗可以有效延缓疾病进展,改善临床症状。赵文景教授认为DNⅢ-Ⅳ期的病机特点为"本虚标实",早期为因实致虚,后期因虚致实。本虚,即消渴期多为气阴两虚,并发症期则阴损及阳,出现脾肾阳虚;标实,即早期为湿热毒邪,后期则血瘀水饮浊毒为患。因此DN属于中医学"肾燥"范畴,即阴精亏虚与阳不化精同时存在,以"肾苦燥,急食辛以润之"为指导原则,在继承首都国医名师张炳厚教授"重视滋补肾阴,喜用熟地"的学术思想基础上,加强温补肾阳之力,常用经验方"加味四君地龟汤",以"辛润温阳"法阴阳并补,辛散气化以消水肿,固肾摄精以降蛋白,三法共用,达到标本同治的目的。  
      关键词:糖尿病肾病;辛润温阳;蛋白尿;水肿   
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      发布时间:2023-04-10
    • WANG Jian-wei,JIE Chuan-hong
      Vol. 37, Issue 11, Pages: 1031-1033(2018) DOI: 10.16025/j.1674-1307.2018.11.008
      摘要:接传红教授认为增生性糖尿病视网膜病变(PDR)玻璃体切除术后早期出血,是由于阴虚火热上扰迫血妄行所致,宜采用凉血止血散瘀法。故将生蒲黄汤加减应用于PDR玻璃体切除围手术期,并且强调辨病(中西医)-辨证(全身)-辨症(眼部)相结合,以"急则治标,缓则治本"的原则,在玻璃体切除围手术期使用滋阴降火、凉血止血散血的生蒲黄汤加减方,可取得良好的临床疗效。  
      关键词:糖尿病视网膜病变;生蒲黄汤;玻璃体切除术;围手术期   
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      发布时间:2023-04-10
    • LI Guo-jing,QUAN Hong,FENG Xing-zhong
      Vol. 37, Issue 11, Pages: 1034-1035(2018) DOI: 10.16025/j.1674-1307.2018.11.009
      摘要:通过解读黄芪桂枝五物汤及相关仲景论述,明确与糖尿病周围神经病变(DPN)相关的"血痹""痿症"和坏疽的基本病机为气血津液亏虚。通过与相关方剂进行比较,加深对仲景关于血痹的发生、诊断依据和组方用药原则的理解,从而指导DPN的中医临床治疗。  
      关键词:糖尿病周围神经病变;黄芪桂枝五物汤;气血津液亏虚   
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      发布时间:2023-04-10
    • WANG Bei,GU Wen,MA Cong
      Vol. 37, Issue 11, Pages: 1036-1038(2018) DOI: 10.16025/j.1674-1307.2018.11.010
      摘要:目的观察益气生津散治疗干燥综合征气阴两虚证的临床效果。方法将干燥综合征气阴两虚证患者92例,随机分为益气生津散组和羟氯喹组,分别给予益气生津散、硫酸羟氯喹治疗,疗程均为12周。分别于治疗前及治疗4、12周用欧洲风湿病联盟干燥综合征患者自评指数(ESSPRI)评分评价患者干燥、肢体疼痛、身体疲劳。治疗前后检测2组免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、类风湿因子(RF)及红细胞沉降率(ESR)等血清免疫学指标变化。结果治疗4、12周益气生津散组干燥、疲劳、ESSPRI评分均较治疗前有明显降低,与羟氯喹组差异有统计学意义(P <0. 05)。治疗12周益气生津散组IgG、IgA、RF、ESR均较治疗前下降(P <0. 05),组间比较IgG较羟氯喹组低(P <0. 05),其余指标2组比较差异无统计学意义(P> 0. 05)。结论益气生津散可改善干燥综合征气阴两虚证患者的临床症状和部分免疫学指标。  
      关键词:干燥综合征;益气生津散;气阴两虚;羟氯喹   
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      发布时间:2023-04-10
    • GAN Xiao-wei,TAO Qing-wen,WANG Jian-ming
      Vol. 37, Issue 11, Pages: 1039-1042(2018) DOI: 10.16025/j.1674-1307.2018.11.011
      摘要:目的探讨阎小萍教授治疗强直性脊柱炎(AS)髋关节受累的中药用药规律。方法 144例AS患者均来自2011年1月—2017年12月中日友好医院中医风湿病科阎小萍门诊,均为阎小萍教授首诊。根据髋关节CT的疾病影像指数(BASRI)评分[10]分为髋关节受累组46例(一侧或双侧髋关节BASRI评分≥2分)、髋关节未受累组98例(双侧髋关节BASRI评分<2分)。收集阎小萍教授首次门诊处方,使用非参数检验分析其中药处方组成、高频使用药物、高频使用药对。结果髋关节受累组中片姜黄、续断、桑寄生、独活、防风、青风藤、元胡、徐长卿的使用率较髋关节未受累组高(P <0. 05)。2组的共有药对为桂枝、赤芍,续断、桑寄生,盐补骨脂、骨碎补,香附、茯苓,青风藤、郁金。髋关节受累组独有药对为千年健、海风藤,桑枝、徐长卿。结论阎小萍教授辨治AS髋关节受累以"补肾强督"为本,注重循经辨证,善于使用引经药物,注重补肾壮骨、通络止痛。  
      关键词:强直性脊柱炎;髋关节受累;阎小萍;用药规律   
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      发布时间:2023-04-10
    • MA Di,WU Shan-shan,MA Gui-qin
      Vol. 37, Issue 11, Pages: 1043-1047(2018) DOI: 10.16025/j.1674-1307.2018.11.012
      摘要:目的系统评价中药口服治疗活动期类风湿关节炎(RA)不同治法的疗效。方法检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(维普)、万方医学数据库(WANFANG MED)、PubMed数据库,收集中药口服治疗活动期RA的随机对照试验(RCT),同时手工检索相关期刊。由专人对检索到的文献信息进行数据提取和统计分析。用Stata软件做网状Meta分析。结果共纳入22篇研究进行综合分析,共涉及1 752例患者,所纳入研究质量一般。网状Meta分析结果表明不同治法中药口服治疗活动期RA能够提高患者总有效率。治疗方案排序为:活血化瘀通络法>清热利湿通络法>温阳补肾解毒通络法>祛风利湿解郁通络法>祛风散寒通络法。结论不同治法中药口服能够提高活动期RA患者治疗的总有效率,但因为纳入的大部分文献的质量不高,故该结论仍需开展多中心、大样本、双盲随机试验加以论证。  
      关键词:类风湿关节炎;系统评价;网状Meta分析;中医治法   
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      发布时间:2023-04-10
    • HUANG Fang-fang,ZHAO Zhe,FENG Xing-hua
      Vol. 37, Issue 11, Pages: 1048-1051(2018) DOI: 10.16025/j.1674-1307.2018.11.013
      摘要:目的评价三九穴位贴敷联合中药内服治疗强直性脊柱炎(AS)的临床疗效。方法采用随机、对照、前瞻性研究,将145例活动期AS患者随机分为合治组75例与对照组70例,合治组给予清热强脊汤或补肾强脊汤口服,并配合三九穴位贴敷;对照组给予清热强脊汤或补肾强脊汤口服。疗程均为30天。采用国际ASAS20、BASDAI50评价标准,结合中医证候疗效评价、生活质量评价等多维疗效评价体系,比较2组疗效。结果治疗后,合治组ASAS20达标率33. 3%,2组BASDAI50达标率、BASDAI评分、BASFI评分、BASMI评分、脊柱痛评分、脊柱炎症评分、夜间痛评分、患者总体评价及主要临床测量体征均有改善,患者的疾病活动度降低,功能状况得到改善,2组各项指标比较差异均无统计学意义(P> 0. 05)。合治组的中医证候疗效总有效率为66. 0%,对照组为33. 3%,2组差异有统计学意义(P <0. 05); HAQ健康评估问卷评价结果表明,2组治疗均有效,其中HAQ总分和HAQ不适指数合治组疗效优于对照组(P <0. 05)。结论三九穴位贴敷联合中药内服治疗AS疗效较好。  
      关键词:强直性脊柱炎;三九穴位贴敷;内外合治;增效研究   
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      发布时间:2023-04-10
    • SONG Chen-hui,HOU Xiu-juan,ZHANG Hua-dong,WANG Hai-yu,QIAN Tang-liang,ZHU Yue-lan,XU Xiang-qing
      Vol. 37, Issue 11, Pages: 1052-1055(2018) DOI: 10.16025/j.1674-1307.2018.11.014
      摘要:Objective To observe the effect of Huoxue Jiedu Formula on the expression of LincR-Ccr2-5’AS in submandibular gland of non-obese diabetic (NOD) mice with Sj?gren’s syndrome (SS). Methods 34 NOD/Ltj mice were randomly divided into model group,control group and Chinese medicine group,and 12 C57BL/6J mice were used as normal group. The normal group and the model group were given distilled water at 10 mL/kg. The control group was given total glucosides of paeony at 234 mg/kg. The Chinese medicine group was treated with Huoxue Jiedu Formula at 28 g/kg,all for 8 weeks. The eyeballs of mice of each group were taken for blood and serum CCL5 levels were detected by ELISA. The submandibular gland tissues were stained by HE,and observed under the microscope and scored. The expressions of LincR-Ccr2-5’AS,CCR5 mRNA and CCL5 mRNA in the submandibular gland were detected by RT-q PCR. Results Serum CCL5 in the model group was higher than that in the normal group (P < 0. 01). The serum CCL5 level of the control group and Chinese medicine group was lower than that of the model group (P < 0. 01). The serum CCL5 level of Chinese medicine group was lower than that of the control group (P < 0. 01). The histological scores of the normal group were lower than those of NOD mice of other groups (P < 0. 01). There was no significant difference in the histological scores between the groups of NOD mice (P > 0. 05). The expression of LincR-Ccr2-5’AS in the submandibular gland of Chinese medicine group was lower than that of the model group (P < 0. 01). The expression of CCL5 mRNA in the submandibular gland of the control group was lower than that of the model group (P < 0. 01). There was no significant difference in the expression of CCR5 mRNA in the submandibular glands between the two groups (P > 0. 05). There was a positive correlation between CCR5 mRNA expression and CCL5 mRNA expression in submandibular gland tissue (r = 0. 512,P < 0. 01). CCR5 mRNA was positively correlated with serum CCL5 level (r = 0. 413,P < 0. 05). CCL5 mRNA was positively correlated with serum CCL5 (r = 0. 377,P < 0. 05). Conclusion Huoxue Jiedu Formula can down-regulate the serum CCL5 level in NOD mice and the expression of LincR-Ccr2-5’AS in submandibular gland tissue,and has no significant effect on the expression of CCR5 and CCL5 in submandibular gland.  
      关键词:Sj?gren’s syndrome;Huoxue Jiedu Formula;long noncoding RNA;chemokine receptor 5;chemokine ligand 5;NOD mice   
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    • LIU YANG,DENG Jun-hua,ZHAO Rui-ying
      Vol. 37, Issue 11, Pages: 1056-1058(2018) DOI: 10.16025/j.1674-1307.2018.11.015
      摘要:姜经过炮制后功效各异。姜药常见生姜、干姜、炮姜、煨姜、生姜皮、生姜汁。张炳厚教授临床巧妙应用姜药入方辨证施治,疗效显著。干姜辛温大热,善驱散三焦及经络之阴寒;生姜辛散之力较强,善走中上二焦,能散寒解表,也能温中止呕;炮姜苦温,可温中下二焦,化血中寒气,常用于温经止血;煨姜温热平和,不散不燥,守于中焦,温煦脾阳,健脾止泻;生姜皮辛凉,可健脾利水,尤善散皮肤之水气;生姜汁温润浓稠,辛而不燥,温而不热,可化痰止呕,通络开窍等。张炳厚教授辨证施药,以达到更好的疗效。  
      关键词:张炳厚;姜药;老中医经验   
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    • LI Shi-yu,WANG Xin
      Vol. 37, Issue 11, Pages: 1059-1061(2018) DOI: 10.16025/j.1674-1307.2018.11.016
      摘要:纤维肌痛综合征(FMS)是一种以弥漫性对称性疼痛、特殊部位压痛点为主证的功能性风湿病。周彩云教授认为,肝之阴血不足为本病发生的主要病机,脾胃亏虚为发病的重要因素。周师在中医五行理论指导下,总结出本病的治疗规律:即以滋水涵木、调补中土为主,佐金平木、潜阳归元为辅,自拟水木归元汤治疗本病,在临证中取得了较为满意的效果。  
      关键词:周彩云;纤维肌痛综合征;五行理论;水木归元汤;名中医经验   
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    • ZHAO Zhe,ZHAO Ya-nan,WU Dong-mei
      Vol. 37, Issue 11, Pages: 1062-1064(2018) DOI: 10.16025/j.1674-1307.2018.11.017
      摘要:中医学认为强直性脊柱炎发病以禀赋不足、肾气亏虚为根本原因。肾藏先天之精,是人体生命之源,为"先天之本"。肾之元气属人体正气范畴,中医肾藏象与免疫之间存在密切联系,"肾生髓"包括其对免疫细胞的调节作用。补肾法可在细胞、分子等多水平对体内T细胞亚群失衡及炎性细胞因子分泌进行调控,从而维持机体免疫自稳态。从中医肾藏象与现代免疫学的角度,将现代医学"神经-内分泌-免疫"网络以及T淋巴细胞亚群紊乱与肾精亏虚本质相结合,探讨强直性脊柱炎的可能机制,为中医药治疗提供思路。  
      关键词:强直性脊柱炎;肾虚;免疫失衡   
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    • WEN Jian-min,TONG Yun,ZHANG Shuai
      Vol. 37, Issue 11, Pages: 1065-1068(2018) DOI: 10.16025/j.1674-1307.2018.11.018
      摘要:中西医结合微创治疗拇外翻技术(温氏微创技术)是我国原创,是在中医理论指导下,结合现代科学技术治疗足拇外翻的一种方法。该技术秉承阴阳平衡理论,依据"骨离缝、筋出槽"理念,借鉴"小夹板、纸压垫"治疗方法,通过4项核心技术:微创截骨手法整复术、"裹帘"法外固定、围手术期用药、术后康复,恢复和保持第一跖趾关节的阴阳平衡,达到"骨正筋柔"的良好临床效果。从病因病机、辨证分型、核心技术、治未病方面对拇外翻的诊断、治疗、预防进行全面、系统的论述。  
      关键词:拇外翻;微创疗法;温氏微创技术;中西医结合疗法   
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    • XU Cheng-yong,XU Ran,WANG Yu-guo,DOU Yong-qi
      Vol. 37, Issue 11, Pages: 1069-1072(2018) DOI: 10.16025/j.1674-1307.2018.11.019
      摘要:Objective To study the anti-tumor effects of different dosage ratio between Astragali Radix and Curcumae and difference in mechanism of antitumor angiogenesis. Methods C57BL/6 mice with Lewis lung cancer were established by injecting tumor cells subcutaneously and then randomly divided into model group,cisplatin (DDP) group,and four proportion groups with Astragali Radix and Curcumae Rhizoma in ratio of 0∶1,1∶1,2∶1,and 3∶1 respectively. All groups were given intragastric administration with different drugs or normal saline (NS) for 15 days and then intraperitoneally injected with cisplatin or NS at day 1,3,5,7,9,11,13 and 15. At day 16,after the mice were put to death,the tumor tissue was dissected,tumor weight index and tumor inhibition rate were measured. H-E staining was used to analyze histopathological changes of tumor tissues,Western blot to confirm the protein expression of TGF-β1 and HIF-1α. Results Compared with the model group,tumor weight,tumor weight index and the number of lung surface metastases of different groups of Curcumae Rhizoma and with different proportion of Astragali Radix were much lowered (P < 0. 05). The groups of tumor inhibition rates with different proportion of Astragali Radix and Curcumae Rhizoma at 0∶1,1∶1,2∶1 and 3∶1 were 21. 91%,23. 89%,37. 70% and 43. 22% respectively. The tumor weight of herbal medicine groups was heavier than that of cisplatin group (P < 0. 05),but the difference of tumor weight had no statistical significance between 3∶1,2∶1 proportion groups and cisplatin group (P > 0. 05),and the inhibitory effect of 3∶1 group on tumor weight was better than that of other proportion groups (P < 0. 05). Compared with the model group,TGF-β1 protein expression of 3∶1 and 2∶1 groups were significantly decreased (P < 0. 01),and the difference was not statistically significant (P > 0. 05); compared with the model group,HIF-1α protein expressions in all proportion groups were significantly decreased (P < 0. 01),3∶1 proportion group was the most similarly decreased with cisplatin group,and lower than that of other proportion groups (P < 0. 01). Conclusion The high proportion of Astragali Radix has more significantly effects on anti-tumor and anti-metastasis of Curcumae Rhizoma. The mechanism may be related to Astragali Radix’s action of enhancing the inhibition of protein expression of TGF-β1 and HIF-1α of Curcumae Rhizoma.  
      关键词:Astragali Radix;Curcumae Rhizoma;dosage ratio;Lewis lung cancer;transforming growth factor-β1;hypoxia inducible factor-1α   
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    • KONG Xiang-wen,SUN Wen-jun,CAI Yue-ping
      Vol. 37, Issue 11, Pages: 1073-1075(2018) DOI: 10.16025/j.1674-1307.2018.11.020
      摘要:传统中药炮制技艺遵循古代中医药学思想,符合临床辨证论治要求,使中药饮片增效、减毒,以满足临床用药需求,意义重大。从国医大师金世元教授对于传承传统中药"少泡多润""质坚宜薄,质松宜厚""逢子必炒""炒炭存性"和"以药制药"等炮制技艺的实践角度出发,分析传统炮制关于切制、炮制的意义及方法,以总结、探索金老传承传统中药炮制技艺的宝贵经验。  
      关键词:金世元;中药;炮制;老中医经验   
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    • DING Qi-you,WANG Yi-tian,YANG Ying-ying
      Vol. 37, Issue 11, Pages: 1076-1078(2018) DOI: 10.16025/j.1674-1307.2018.11.021
      摘要:张寅医师在临床实践过程中针对一些特定类型的自身免疫性肝病,通过运用脏腑风湿理论,认为自身免疫性肝病的病因病机为:外邪侵袭,他病内传,络闭不通,浊毒内生,寒邪伤阳。临证治疗宜"和"疏结合,散肝透邪;散寒除湿,调理脾胃;养血祛瘀,全程通络;肝肾同调,顾护阳气。以不换金正气散、独活寄生汤、柴胡疏肝合真武汤等方药治疗取得了很好的疗效。  
      关键词:自身免疫性肝病;脏腑风湿;中医药疗法;仝小林;临床经验   
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    • WANG Qing,LIU Yan-wen,SONG Qing-qiao
      Vol. 37, Issue 11, Pages: 1079-1081(2018) DOI: 10.16025/j.1674-1307.2018.11.022
      摘要:仝小林教授根据脏腑风湿理论,提出寒凝经脉型高血压病的新治法,指出此类高血压病与感受风寒湿邪关系密切,病机要点在于风寒湿等外邪内侵机体,治疗重点在于透邪外出,且兼顾伏邪内藏的重要病机;临床常采用散寒解肌、通阳舒筋,温阳驱寒、软脉活血,温经通脉、化瘀通络等法;常用方药为葛根汤、当归四逆汤、吴茱萸汤、阳和汤、桃红四物汤、大黄虫丸等,临床效果良好。  
      关键词:脏腑风湿;高血压;中医药疗法;仝小林;临床经验   
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    • LIU Ye,CHE Nian-cong,TIAN Tian
      Vol. 37, Issue 11, Pages: 1082-1083(2018) DOI: 10.16025/j.1674-1307.2018.11.023
      摘要:原发性胆汁性肝硬化属于病因不明的慢性胆汁淤积性肝病,此病缠绵难愈,易发展为其他肝脏疾病。车念聪教授认为原发性胆汁性肝硬化多病程日久,正气渐虚,虚实交杂,治疗时应重视肝体用同调,即滋肝阴、养肝血、去湿热、通肝络,同时中药与西药联合使用,预防肝病进一步发展,可显著提高疗效。  
      关键词:肝硬化;体用同调;中医证治;诊疗思路   
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    • YI Jing-hong
      Vol. 37, Issue 11, Pages: 1084-1085(2018) DOI: 10.16025/j.1674-1307.2018.11.024
      摘要:甲状腺相关性眼病(TAO)的中医辨证分型,国内专家大多认为其病位在肝、脾、肾,与痰凝、血瘀、气滞、火、脾虚相关。本病常因情志不畅、肝郁化火伤及肝肾之阴,虚火上炎,上冲二目而发病,当以柔润滋水为主,采用滋阴平肝清热法治疗,为TAO辨证治疗提供思路。  
      关键词:甲状腺相关性眼病;鹘眼凝睛;滋阴平肝清热法   
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    • WANG Liang-min,SHAN Chen-xi,MA Jian-ling
      Vol. 37, Issue 11, Pages: 1086-1088(2018) DOI: 10.16025/j.1674-1307.2018.11.025
      摘要:目的观察五音疗法联合穴位按摩在慢性阻塞性肺疾病(COPD)患者情志护理中的应用效果。方法选择伴焦虑症状的COPD患者60例,根据随机数字表法分为试验组和对照组,各30例。2组均给予常规情志护理,试验组在此基础上应用五音疗法联合穴位按摩治疗。比较2组呼吸困难量表(mMRC)评分、汉密尔顿焦虑量表评分及患者满意度。结果 2组出院时mMRC评分、汉密尔顿焦虑量表评分均较入院时低(P <0. 05),且出院时试验组mMRC评分、汉密尔顿焦虑量表评分低于对照组(P <0. 05)。试验组出院满意度评分高于对照组(P <0. 05),满意度等级优于对照组(P <0. 05)。结论五音疗法联合穴位按摩可以有效缓解COPD患者的呼吸困难及焦虑症状,提高患者的满意度。  
      关键词:慢性阻塞性肺疾病;五音疗法;穴位按摩;情志护理   
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    • Vol. 37, Issue 11, Pages: 1089-1091(2018) DOI: 10.16025/j.1674-1307.2018.11.026
      摘要:目的探讨稳心颗粒对持续性心房颤动射频消融术后患者心律失常的治疗效果。方法将104例持续性心房颤动且行射频消融治疗的患者,随机分为治疗组和对照组,各52例。对照组给予盐酸胺碘酮及抗凝常规治疗,治疗组在对照组治疗的基础上加用稳心颗粒。对比2组治疗后3个月、1年随访时动态心电图及临床疗效的差异。结果 2组临床疗效对比,3个月、1年随访时治疗组总有效率高于对照组,差异有统计学意义(P <0. 05);治疗组各种房性心律失常及心房颤动复发例数较对照组明显减少,差异有统计学意义(P <0. 05)。结论持续性心房颤动射频消融术后,常规治疗基础上加用稳心颗粒,可明显提高临床疗效,降低持续性心房颤动复发率。  
      关键词:稳心颗粒;持续性心房颤动;射频消融术   
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    • Vol. 37, Issue 11, Pages: 1092-1094(2018) DOI: 10.16025/j.1674-1307.2018.11.027
      摘要:目的观察康艾注射液联合经动脉导管化疗栓塞术(TACE)对中晚期肝癌患者肝功能及甲胎蛋白(AFP)的影响。方法选择明确诊断为乙肝相关性原发性肝癌患者80例,分为治疗组和对照组,各40例。2组均进行TACE治疗及基础治疗,治疗组加用康艾注射液。比较2组在介入术前及术后2、7、14天肝功能(ALT、AST、TBil、TBA、ALB)及凝血酶原活动度(PTA)的变化;观察2组术前、术后14天血WBC、PLT、AFP的变化。结果 2组在介入术后2天肝功能均明显异常,PTA下降;治疗组术后14天肝功能明显好转,AFP明显下降,与对照组比较差异有统计学意义(P <0. 05)。结论康艾注射液对中晚期肝癌患者介入术后肝功能有恢复作用,并一定程度上增强抗肿瘤作用。  
      关键词:康艾注射液;TACE术;肝癌;乙肝   
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    • Vol. 37, Issue 11, Pages: 1095-1096(2018) DOI: 10.16025/j.1674-1307.2018.11.028
      摘要:目的观察420 nm脉冲激光联合化痰除瘀汤内服加中药面膜治疗囊肿结节型痤疮的临床疗效。方法将2017年1—12月在中国中医科学院西苑医院痤疮专病门诊就诊的60例囊肿结节性痤疮患者随机分为试验组和对照组,各30例。试验组采用化痰除瘀汤内服、中药面膜外用联合420脉冲激光治疗;对照组仅给予化痰除瘀汤内服、中药面膜外用治疗。均治疗6周,分别于治疗4、6周对比2组临床疗效,比较治疗前后2组皮损变化,随访2个月观察复发情况。结果治疗4、6周试验组总有效率均高于对照组(P <0. 05);试验组治疗后总皮损、炎性皮损、非炎性皮损均减少(P <0. 05);试验组复发率低于对照组(P <0. 05)。结论 420 nm脉冲激光联合化痰除瘀汤加中药面膜外用的综合疗法对囊肿结节性痤疮患者起效快,复发率低,有较好的临床疗效。  
      关键词:囊肿结节性痤疮;化痰除瘀汤;脉冲激光   
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    • Vol. 37, Issue 11, Pages: 1097-1099(2018) DOI: 10.16025/j.1674-1307.2018.11.029
      摘要:目的探讨在中医皮肤性病学临床实习中引入以案例为基础的教学法(CBL)联合应用以问题为基础的教学法(PBL)的教学效果。方法选取皮肤科实习生40人,随机分为试验组和对照组各20人。试验组采用CBL+PBL双轨教学法,对照组采用传统的讲授教学法(LBL)。采用理论考试和问卷调查的方法评价教学效果。结果试验组理论考试主观题得分和总成绩均显著高于对照组(P <0. 05)。试验组对问卷调查的各项内容的评价均优于对照组(P <0. 05)。结论 CBL和PBL两种教学模式形成优势互补,有利于培养学生的临床思维能力,提高学生自主学习、综合分析、合作学习的能力。  
      关键词:以案例为基础的教学法;以问题为基础的教学法;中医皮肤性病学;实习教学   
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