最新刊期
期 1 ， 2019
- 摘要：病机是决定病情变化的关键,针对糖尿病的中医核心病机,专家或强调虚,或强调瘀,或认为糖尿病可划分为郁热虚损不同阶段,更有提出糖尿病贯穿"壮火食气"热伤气阴病机者。针对糖尿病基本治法,专家或强调健脾补肾、益气养阴;或强调活血化瘀;或强调分"脾瘅"和"消瘅",分别给予消中满、清内热与清胃健脾治法。更有认为应以清热为基本治法,并针对胃肠结热、肝经郁热、脾胃湿热以及痰火、瘀热等,具体选用清泄、清解、清化以及清补治法者。其实,糖尿病不同阶段,证候表现与病机特点有所不同,临床上应该紧抓糖尿病不同阶段的病机,选用针对性的治法,如此才能反映出中医药防治糖尿病及其并发症的丰富多彩。关键词：糖尿病;消渴病;病机;治法;燕京医学
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发布时间：2023-04-10 - 摘要：Objective To analyze TCM syndrome characteristics of 61 patients with acute exacerbation of diffuse parenchymal lung diseases（AE-DPLD）.Methods From January 2013 to May 2017,the characteristics of TCM syndromes and the correlation between TCM syndromes and the clinical features of western medicine in 61 hospitalized patients with AE-DPLD in our hospital were analyzed. Results The first five types of TCM syndromes with higher proportion were: spleen-lung qi deficiency syndrome,interior obstruction of phlegm-damp syndrome,Qi-Yin deficiency syndrome,interior obstruction of dampness-heat syndrome,middle Qi collapse syndrome,cold syndrome and deficiency syndrome occupied the highest proportion,the disease location in lung and spleen were higher. 60 cases were treated with internally taking Chinese herbal medicine with a total of 38 prescriptions involved. Tonifying Qi and nourishing Yin,warming yang and drying dampness were mostly used. Among those with fever,deficiency of qi and yin were seen most. Heat syndrome and exterior syndrome were most found in OP patient in image more than that in UIP an NSIP patient. Among the patients with hypoxemia,spleen-lung qi deficiency syndrome were most found. Kidney was most involved among the patients with use of mechanical ventilation more than without use of mechanical ventilation. Prognosis was poorer in deficiency syndrome. Conclusion Qi deficiency and phlegm-damp syndrome are dominant pathogenic manifestation among 61 cases of AE-DPLD.Lung and spleen are major disease locations.The mainly therapeutic methods are tonifying Qi nourishing Yin,and warming yang and dry dampness.关键词：Diffuse parenchymal lung diseases;acute exacerbation;TCM syndrome characteristics
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发布时间：2023-04-10 - 摘要：Objective To discuss TCM syndrome type distribution,composition ratio and features,and clinical symptoms of bipolar affective disorder and provide evidence for establishing common TCM syndrome standards of this disorder. Methods Four TCM diagnostic methods were used to differentiate TCM syndromes and investigate syndrome index in 482 patients with bipolar affective disorder in the Department of Psychiatry,Beijing Anding Hospital. Meanwhile,Yong’s manic depression self rating scale（USES）and SDS scale were used to assess their manic and depressive condition. Results Bipolar manic episode（hereinafter referred to as bipolar mania）and bipolar depressive episode（hereinafter referred to as bipolar depression）patients’ number in six types of interior disturbance of phlegm fire,disharmony of heart and kidney,damp-heat of liver and gallbladder,and liver and kidney Yin deficiency had no significant differences（P>0.05）. The number of patients diagnosed with interior disturbance of phlegm fire in bipolar mania and bipolar disorder was the highest. The patients with interior disturbance of phlegm fire got the highest scores in the number of sub-scales like sexual interest,irritability,speaking speed and sum. Those with qi stagnation and blood stasis got the highest score in thinking disorder. Those with damp-heat of liver and gallbladder scored the highest in destructive aggression.The above three had significant differences with other 5 kinds of syndrome types（P<0.01）. Conclusion Interior disturbance of phlegm fire is the main pathogenesis of bipolar affective disorder. The patients with interior disturbance of phlegm fire,liver stagnation and blood stasis,and damp-heat of liver and gallbladder have their own manifestations. Various types of patients with bipolar depression get similarities in sub-scales like depressive mood,somatic manifestations and cognitive behavioral disorder.关键词：Bipolar affective disorder;bipolar manic episode;bipolar depressive episode;TCM syndromes
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发布时间：2023-04-10 - 摘要：Objective To study the effect of Changpu Yujin Decoction on liver tissue pathology,insulin resistance（IR）and expression of liver sterol regulatory element binding protein-1 c（SREBP-1 c）of rats with type 2 diabetes mellitus（T2 DM）complicated with nonalcoholic fatty liver disease（NAFLD）. Methods A total of 32 SD rats were randomized into two groups: the control group of 8 and the model group of 24. The model group were induced T2 DM with NAFLD by streptozotocin（STZ）and high-fat diet. After successfully establishing the models,they were randomly divided into Chinese herbal medicine group,Metformin group and model group of 8 each. The Chinese herbal medicine group was given Changpu Yujin Decoction solution. The Metformin group was given the metformin powder suspension. The control group and the model group were given an equal volume of 0.9% sodium chloride aqueous solution. Eight weeks later,the rats were given anesthetic death for sampling. The pathological changes of liver in each group were observed by HE staining. The fasting blood glucose（FBG）and insulin content（INS）of each group were measured and the insulin resistance index（HOMA-IR）calculated. The level of expression of liver SREBP-1 c was determined by RT-PCR. Results Compared with the model group,Changpu Yujin Decoction could significantly alleviate the liver steatosis of T2 DM with NAFLD,reduce the levels of INS and HOMA-IR（P<0.05 or P<0.01）,and decrease the the level of SREBP-1 c expression in the liver. Conclusion Changpu Yujin Decoction has a significant therapeutic effect on T2 DM with NAFLD in rats. The mechanism may be related to the reduction of SREBP-1 c expression,thereby reducing liver fat deposition,cell degeneration and alleviate IR.关键词：Type 2 diabetes mellitus;nonalcoholic fatty liver disease;insulin resistance;SREBP-1c
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发布时间：2023-04-10 - 摘要：Objective To study the effects and the mechanism of Qiwei Granules on the expression of renal function in KK-Ay mice with spontaneous type 2 diabetes. Methods 8-week-old male KK-Ay mice were fed by research forage for 12 weeks to establish model with diabetic nephropathy,the model mice were randomly divided into model group,Valsartan group,Qi-wei Granules group,PERK inhibitor group with 8 mice in each group. 8 C57 BL/6 J mice were set up as the control group. All the mice received daily gavage administration with corresponding medicines. Fasting plasma glucose（FBG）,24 h urinary excretion（UAER）were examined. At age of 20 weeks,bloody urine and kidney tissue were obtained after anaesthetic death to examine the renal function（BUN,SCr）. The pathological morphology of renal tissue were observed by hemmatoxylin eosin（HE）stain,while the protein expressions of GRP78 and PERK were measured by western blot. Results Compared with the model group,albuminuria and renal function were alleviated in Qiwei Granules group（P<0.05）,the protein level of GRP78 and PERK were significantly decreased（P<0.05）. The pathological changes of kidney tissue were obviously improved. Conclusion QWG could reduce albuminuria and improve renal function in KK-Ay mice with spontaneous type 2 diabetes. The protective effect may be associated with inhibition of PERK signaling pathways.关键词：Qiwei Granules;diabetic nephropathy;endoplasmic reticulum stress;mice
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发布时间：2023-04-10 - 摘要：Objective To study the effects of Huanpifang I on glucose and lipid metabolism in STZ-induced diabetic rats and the study on the mechanism.Methods 60 male SD rats were randomly divided into 6 groups of 10 rats in each group,including blank group,model group,pioglitazone group,low dose group,middle dose group and high dose of Huanpifang I group. Except the blank group,other groups were fed with high glucose and high fat diet combined with intraperitoneal injection of STC to establish diabetic rat model.Pioglitazone group was taken Pioglitazone 17.5 mg/（kg·d）,the low-dose,middle-dose and high-dose groups were respectively given Huanpifang 10.3,0.7 and 1.4 g/（kg·d）respectively, while equal volume of normal saline was given once a day in blank group and model group. After 4 weeks,blood samples were taken to detect fasting plasma glucose（FPG）,oral glucose tolerance test（OGTT）,serum free fatty acid（FFA）,total cholesterol（TC）,triglycerides（TG）,and low density lipoprotein cholesterol（LDL）.ELISA was used to detect the activity of SOD and the content of MDA in liver. Liver histopathologic evaluation was performed by hermatoxylin-eosin staining.Results Compared with the model group,the level of OGTT was decreased significantly at fasting 30 minutes,60 minutes and 120 minutes in high dose group（P<0.01,P<0.05）.The level of FFA,TC,TG and LDL was decreased significantly in high dose group and middle dose group（P<0.01,P<0.05）. The activity of SOD was increased,and the content of MDA reduced in all dose groups（P<0.01,P<0.05）. Conclusion Huanpifang I can improve the glyeolipid metabolism disorder in STZ-induced diabetic rats,which maybe due to anti-oxidative stress.关键词：Huanpifang I;diabetes;glucose and lipid metabolism;oxidative stress;rats
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发布时间：2023-04-10 -
Effects of Jin Li Da Granules on mitochondrial biogenesis and insulin sensitivity in skeletal muscle
摘要：Objective To investigate the effects of Jin Li Da（JLD）on mitochondrial biogenesis and insulin sensitivity of skeletal muscle. Methods Male SD rats were randomly divided into two groups（12 in normal feeding group and 24 in high fat feeding group）. After six weeks of feeding,6 rats in each group were selected for the high insulin-positive glucose clamp test.After the model were established successfully,the body weight,HOMA-IR,intraperitoneal glucose tolerance test（IPGTT）,glucose infusion rate,GIR and so on were measured.The rest 18 rats of model group were randomly divided into model group,pioglitazone intervention group and JLD intervention group,and continued to be fed for 8 weeks,the body weight,blood fat,intraperitoneal glucose tolerance test,glucose infusion rate,GIR,etc. were measured.The expression levels of TLR2 and the mitochondrial biogenesis index PGC1α,MFN2,NRF-1 and insulin signaling pathway PI3 K,P-AKT and GLUT4 protein levels in skeletal muscle were detected by Western blot.Results ①After 6 weeks of feeding:compared with the normal group,the body weight and HOMA-IR of the model group were significantly increased;The glucose tolerance test（IPGTT）0,5,10,30,60,120 were significantly increased in the model group,and the glucose of model group was increased;in the high insulin-positive glucose clamp test,the glucose infusion rate of GIR was decreased significantly,the difference was statistically significant（P<0.05）,which indicated that the rats in the model group had obvious insulin resistance.②After 14 weeks of feeding:compared with the model group,the weight and blood fat were decreased in pioglitazone intervention group and the JLD intervention group,the blood sugar in IPGTT 0,5,10,30,60,120 respectively decreased,and the GIR increased significantly,and the differences were statistically significant（P<0.05）,suggesting that JLD and pioglitazone can improve insulin sensitivity in hyperlipidemic rats.③After 14 weeks of feeding:compared with the model group,the mitochondrial biogenesis indexes,PGC1α,MFN2,NRF-1 and the level of insulin signaling pathway PI3 K,P-AKT and GLUT4 were increased,and the expression level of TLR2 protein in skeletal muscle was decreased in the JLD intervention group and pioglitazone intervention group,and the differences were statistically significant（P<0.05）. Conclusion JLD and pioglitazone could promote skeletal muscle mitochondrial biogenesis and improve insulin sensitivity.关键词：Jinlida Granules;Pioglitazone;skeletal muscle;mitochondrial biogenesis;insulin resistance;insulin sensitivity;rats- 2
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发布时间：2023-04-10 - 摘要：Objective To study the antibacterial effect of Reduning herbal injection in vitro on carbapenem-resistant acinetobacter baumannii-resistant drugs.Methods Using the broth dilution method,Reduning injection,antimicrobial tests in vitro of Reduning injection combined with ceftazidime,Imipenem-Cilastatin sodium hydrate for the carbapenem-resistant acinetobacter baumannii were conducted.Results Reduning MIC for carbapenem-resistant acinetobacter baumannii was400 l/mL,effects of Reduning combined with,Imipenem-Cilastatin sodium hydrate on carbapenem-resistant acinetobacter baumannii greatly were reduced compared with single Reduning or ceftazidime,Imipenem-Cilastatin sodium hydrate. Conclusion Reduning for carbapenem-resistant acinetobacter baumannii has inhibitory effect,the application of traditional Chinese medicine combined with antibiotics have best coordinate effects as they can reduce the mount of antibiotic and also help solve the problem of drug resistant bacteria.关键词：Reduning injection;Ceftazidime;Imipenem-Cilastatin sodium hydrate;carbapenem-resistant acinetobacter baumannii;antibacterial effect
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发布时间：2023-04-10 - 摘要：国医大师晁恩祥教授以中医温病学理论为指导,采用卫气营血辨证与六经辨证、脏腑辨证等相结合的方法,以透邪外出为根本治疗大法,重视扶正祛邪,及后期整体调理,临床辨治乙型流感病毒肺炎,效如桴鼓。并分析晁老采用中药汤剂联合西医机械通气、综合支持治疗等措施,成功救治危重症乙型流感病毒肺炎致重症肺炎急性呼吸窘迫综合征患者1例的临床过程,阐述晁老辨治乙型流感病毒肺炎的经验,为中西医结合治疗乙型流感重症肺炎提供思路。关键词：晁恩祥;乙型流感;重症肺炎;ARDS;国医大师;老中医经验
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发布时间：2023-04-10 - 摘要：变应性鼻炎是机体暴露于变应原后主要由IgE介导的鼻黏膜非感染性慢性炎性疾病。临床上主要表现为阵发性喷嚏、清水样涕、鼻痒和鼻塞等,可伴有眼部症状,包括眼痒、流泪、眼红和灼热感等,多见于花粉过敏患者。黄飞剑主任医师根据仝小林教授的"脏腑风湿"理论,明确提出变应性鼻炎是呼吸系统的风湿病,并在"脏腑风湿"理论指导下,应用独活寄生汤、阳和汤及其自创的气血双调汤、化气汤、健脾渗湿汤、开心汤治疗鼻炎,取得了显著的疗效。关键词：脏腑风湿;变应性鼻炎;黄飞剑;仝小林
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发布时间：2023-04-10 - 摘要：消化膏为北京中医医院院内处方,是赵炳南、王玉章老先生治疗乳腺增生症、乳痛症常用方,具有温筋通络、活血化痰、散寒止痛等作用,临床应用数十年,疗效肯定。湿热敷是古代热熨法的延伸,主要作用是"中药+透热",对改良消化膏有较好渗透作用。二者合用,相得益彰。该技术方法临床推广使用到数十家医疗机构,治愈大量中重度乳痛症患者。对改良消化膏湿热敷法治疗中重度乳痛症的理论基础、操作方法、注意事项等进行简述,以便临床更好地推广使用此种中医特色技法。关键词：乳痛症;湿热敷;消化膏;操作规程
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发布时间：2023-04-10 - 摘要：耳石症患者复位治疗后仍有残余头晕,根据残余头晕临床表现,结合古代医籍,可将其归属于中医学"眩晕"范畴。笔者认为"肾精不足、督阳不升"是其发病机制,据此提出"补肾调督"针刺治疗取穴思路,以肾俞、命门、百会、神庭、印堂为主穴,同时临证治疗时随患者病因病症灵活配穴,可荣养肾气,疏通头部经脉,使得清阳得升,脑海得充,眩晕立止。关键词：耳石症;中老年;复位;头晕;调督升阳;针刺疗法
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发布时间：2023-04-10 - 摘要：目的探讨慢性萎缩性胃炎从无萎缩向萎缩及肠化、异型增生转化过程中的证候演变规律。方法收集2012年11月—2014年11月就诊于中国中医科学院广安门医院,接受胃镜检查及病理组织活检确诊为慢性胃炎患者307例。以面对面访谈为调查方法,对研究对象进行四诊及主要项目检查,收集临床资料,确定临床证候,对得出的结果进行统计分析。结果从非萎缩性胃炎→轻度萎缩→中度萎缩→重度萎缩,胃阴不足证及胃络瘀阻证逐渐增多（P<0.01）;从无肠化→轻度肠化→中度肠化→重度肠化,胃阴不足证及胃络瘀阻证逐渐增多（P<0.01）;异型增生患者以胃络瘀阻证和寒热错杂证居多（P<0.05）。结论慢性萎缩性胃炎从无萎缩向萎缩及肠化、异型增生转化过程中存在由实至虚,渐见阴虚、血瘀的证候演变规律。关键词：慢性萎缩性胃炎;肠上皮化生;异型增生;证候;演变规律
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发布时间：2023-04-10 - 摘要：目的观察孙氏降糖饮治疗气阴两虚型2型糖尿病的临床疗效。方法将入选的90例气阴两虚型2型糖尿病患者随机分为2组,各45例,均给予基础治疗,对照组予二甲双胍治疗,治疗组加用孙氏降糖饮中药治疗。比较治疗12周后患者空腹（FPG）及餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、胰岛素敏感指数（ISI）、体质指数（BMI）、中医证候积分及血常规、肝肾功的变化情况。结果治疗12周后,治疗组与对照组FPG、2hPG、HbA1c、FINS均有明显下降,治疗组较对照组下降显著,差异有统计学意义（均P<0.05）;ISI均较治疗前明显升高,治疗组较对照组升高显著,差异有统计学意义（P<0.05）;BMI均较治疗前降低,但2组差异无统计学意义（P>0.05）。治疗组中医证候疗效显著优于对照组,差异有统计学意义（P<0.05）;2组血常规、肝肾功均无明显变化。结论孙氏降糖饮配合二甲双胍治疗2型糖尿病,能够显著降低患者的血糖指标,减轻胰岛素抵抗,缓解临床不适症状,安全有效。关键词：孙氏降糖饮;气阴两虚;胰岛素抵抗;2型糖尿病
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发布时间：2023-04-10 - 摘要：目的分析目前临床针刀治疗屈指肌腱狭窄性腱鞘炎的临床观察文献报道情况。方法检索2000—2017年发表的针刀治疗屈指肌腱狭窄性腱鞘炎的临床随机对照文献,采用Jadad评分及随机化隐藏评级对文献方法学质量进行评价,应用RevMan 5.0统计软件对数据进行Meta分析。结果最终共纳入23篇文献收集24份数据报告,针刀组（治疗组）与单纯封闭对照组（对照组）在性别、年龄、病程基线水平上均保持均衡性。2组治疗前疼痛VAS评分均衡,治疗后治疗组疼痛VAS评分优于对照组。治疗组末次随访治疗治愈率优于对照组。结论目前临床针刀治疗屈指肌腱狭窄性腱鞘炎,总体疗效优于单纯封闭治疗,而且该方法远期随访的复发率低于对照组。关键词：针刀;封闭;屈指肌腱腱鞘炎;Meta分析
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发布时间：2023-04-10 - 摘要：目的通过文献研究确定同型半胱氨酸（homocysteine,Hcy）的中医临床意义;规范检验前中后过程,探讨Hcy适合应用于中医诊治的检测流程,建立其中医临床应用的统一标准。方法检索近20年Hcy相关中医研究文献,按照纳入标准、排除标准,选择目标文献进行阅读整理。结果高Hcy与中医证型存在内在关系;高蛋白饮食可能导致Hcy升高,应空腹采血并避免中医药补品的影响;Hcy用于中医证型诊断,应提高检测质量、提高精密度;提供中医临床意义咨询服务应接受过系统中医培训并有相应资质。结论 Hcy是心脑血管疾病、糖尿病、肾病等的危险因素,各疾病中医证型与其水平之间存在内在关系。开展Hcy中医临床应用标准化工作,对疾病的诊治有着积极的作用。关键词：同型半胱氨酸;中医临床应用;标准化
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发布时间：2023-04-10 - 摘要：目的观察并分析针刺治疗对硝酸酯类头痛的即时止痛效果。方法将70例使用硝酸酯类药物出现头痛的冠心病患者,随机分为针刺组和对照组,每组35例。对照组口服布洛芬缓释胶囊,针刺组给予针刺治疗。比较2组患者治疗前即时及治疗后10 min、30 min、1 h、2 h疼痛视觉模拟评分法（VAS）评分值。结果针刺组止痛作用迅速产生,进针10 min时头痛VAS评分已明显减低（P<0.05）,并在留针30 min期间止痛作用持续加强,且起针后止痛效果仍存在。治疗30 min时,对照组药物开始起效,直至2 h二者效果基本相同。结论针刺治疗对硝酸酯类头痛有明显即时止痛作用,并且最终止痛程度与口服布洛芬缓释胶囊等同。关键词：针刺;头痛;硝酸酯类药物
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发布时间：2023-04-10 - 摘要：产地加工方法与中药材形色嗅味特征的形成关系密切。国医大师金世元从业70余年,形成了从产地加工方法入手鉴别道地药材的形状、颜色、质地和气味等性状特征的技术专长,分析金老"循象溯源,由源寻征"的鉴别思维,为中药人员学习金老中药传统鉴定技术提供途径。关键词：金世元;产地加工;道地药材;中药鉴定
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发布时间：2023-04-10 - 摘要：小蓟饮子为治疗下焦结热血淋尿血之代表方,出自《严氏济生方》。由于原书久已散佚,今人已无法窥其原貌,而后世历代医家对其转录有异,从而引发了君药之争等一系列争议。通过对小蓟饮子方源的考证,分析其主治病证及组方原则,探讨其君药、药量、药味及用法之争,以便更好地发挥古方固有疗效,同时灵活加减变通运用于当今临床。关键词：小蓟饮子;济生方;君药;小蓟;木通
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发布时间：2023-04-10 - 摘要：目的探讨基于药材质量优劣数字化方法在蒲公英药材质量评价中的应用。方法以蒲公英药材为研究对象,采用高效液相色谱法构建12批次蒲公英药材的指纹图谱,通过二甲苯致小鼠耳肿胀法评价蒲公英的抗炎活性,由此构建活性成分数据库;利用偏最小二乘法（PLS）对药材指纹图谱与抗炎活性的相关性进行分析;对分析得到的YZL值（正、负系数相关峰峰面积和之比值）进行正态拟合,并界定判定药材质量优劣的YZL值区间。结果从12批蒲公英药材指纹图谱中标定了18个共有峰的共有模式,以PLS法建立了药材共有峰峰面积与抗炎活性间的回归模型,得到相应的标准化回归系数,基于回归模型相应标准化回归系数的正负性,经多重综合分析,提炼出YZL值;通过对YZL值进行正态拟合并界定,评价蒲公英药材质量的优劣。结论基于药材质量优劣数字化方法准确可靠,可用于评价蒲公英的药材质量。关键词：蒲公英;数字化;指纹图谱;抗炎活性;药材质量
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发布时间：2023-04-10 - 摘要：金银花和山银花都属忍冬科,其几个原植物都是近缘植物,在生物学特征上十分相近,用肉眼不容易鉴别,但是两者在某些方面存在细微差别。通过考察金银花和山银花的鉴别要点,结合参考文献,先从金银花和山银花外观性状进行初步鉴别,再从显微结构和化学成分对两者进行比较,探讨两者之间的差异区别,构建一套比较合理的质量标准来鉴别金银花和山银花。金银花和山银花的成分相似,功效相近,但功效偏重不同,使用中应该扬长避短,尽量发挥2种药物的优势,使临床用药更准确,达到金银花药材"真实、优质、稳定、可控"的目的。关键词：金银花;山银花;鉴别;差异;质量标准
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发布时间：2023-04-10 - 摘要：目的探析生白术治疗便秘的机制和临床用药及用量规律。方法对北京医院2014年1月—2017年12月门诊中药饮片处方生白术的使用特点进行总结分析。结果含中药生白术饮片处方共计16 172张,其中使用生白术治疗便秘处方中,老年人所占比例最大,其次是中年人,青年人较少。在使用剂量上老年人最大。由于药典规定其剂量为6～12 g,分析发现生白术的使用90%以上超量,30～60 g最多。结论生白术治疗便秘疗效确切,多用于治疗中老年便秘,且剂量30～60 g为宜。关键词：便秘;处方分析;生白术;用药剂量
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发布时间：2023-04-10 - 摘要：临床带教是针对医学专业的学生开展的一系列教学活动,是帮助医学生将自身学到的理论知识和操作技术运用到临床工作中,使之获得应有的专业技能、态度和行为的教学组织形式。自临床医学专业学位研究生（专硕）教育与住院医师规范化培训（规培）实行"双轨合一"以来,专硕具有研究生与规培生双重身份,其培养主要依靠于医院转科期间的学习,因此临床带教作为影响规培生临床能力的重要环节显得尤为重要。通过创新临床带教方式,提高规培质量,具体方法包括:入科教育,教学组长自担纲;常规教学,试用践行导师制;教学细节,恰当利用早交班;教学实践,中医为主也参西;教学方式,教学手段灵活化;教学考核,寓于日常工作中;因材施教,出科水平目标化;师生关系,教学相长是真理;教师队伍,考核奖惩相结合。通过以上带教方法,旨在培养高素质、高水平的临床人才。关键词：临床带教;住院医师;规范化培训;教学方法;专业学位研究生
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发布时间：2023-04-10 - 摘要：阐述现代医学及中医学理论下的儿科学及儿童用药特点,探讨中医药在儿科领域应用的特殊性,指出儿科专业中药临床药师的培养势在必行。为此需要整合优势资源、开创联合培养模式;夯实西药基础、重视兼容并包;立足中药特色、突出儿科特点。关键词：儿科;中药;临床药学
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发布时间：2023-04-10 - 摘要：<正>奇经八脉是十二正经以外的冲、任、督、带、阴维、阳维、阴跷、阳跷八条经脉,属于中医经络系统的重要组成部分。奇经错综分布,深入浅出,虽不直接络属脏腑,但通过与十二正经的广泛联系,具有溢蓄气血、维系营卫、统调阴阳、平衡脏腑等功能,在中医脏腑经络辨治体系中具有重要地位。谢鸣教授不仅熟谙脏腑辨治,对奇经辨治也颇有研究,著有《奇经辨治与方药运用》。其临证常从奇经切入,辨治疑难杂症,多获良效。本文兹就临床侍诊所见,选其脏腑辨证结合奇经理论辨治验案数则关键词：谢鸣;脏腑辨证;奇经;内科杂病
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发布时间：2023-04-10 - 摘要：<正>淋巴结反应性增生为各种损伤和刺激引起淋巴结内的淋巴细胞和组织细胞反应性增生而致淋巴结肿大的疾病,以出现颈部肿块多见。该病原因复杂,可由细菌或病毒感染、接触有害化学物、环境污染、药物中毒等引起,呈现出急性炎症或慢性免疫反应,或急慢反应同时存在[1]。患者在淋巴结肿大的前期或早期常有反复低热史,淋巴结缓慢增大,全身脏器检查未见明显异常,血常规白细胞计数基本正常。西医治疗一般采取保守治疗、对症处理,目前认为外科手术治疗为其根治办法[2]。由于关键词：三仁汤;淋巴结反应性增生;低热;医案
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发布时间：2023-04-10 - 摘要：<正>冠心病（CHD）是临床常见的心血管疾病,其发病率和死亡率在我国呈逐年上升趋势,是引起死亡的主要疾病之一[1]。冠心病中医学属"胸痹""心痛"范畴,张仲景在《金匮要略》中指出:"夫脉当取太过不及,阳微阴弦,即胸痹而痛,所以然者,责其极虚也。今阳虚知在上焦,所以胸痹、心痛者,以其阴弦故也",认为"阳微阴弦"为其基本病机。而祛瘀生新法是中医治疗冠心病的基本治则。活血温通法结合了"阳微阴弦"基本病机和祛瘀生新治则,是治疗冠心病的常用治法,临床上关键词：活血温通;冠心病;中医药;文献综述
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发布时间：2023-04-10
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