最新刊期

    11 2019
    • ZHANG Cang
      Vol. 38, Issue 11, Pages: 1059-1062(2019) DOI: 10.16025/j.1674-1307.2019.11.001
      摘要:皮肤湿病是指以湿为核心病机,以湿象为主要临床表现的皮肤疾患。皮肤湿病发生之前必有蕴湿藏于皮之下肌之外。蕴湿或被六淫邪气诱发,或被体内伏火蒸腾,造成皮肤湿病的急性发作,前者轻,后者重。皮肤湿病急性发作之后会有多种转归,若湿邪滞表,形成湿痹,则会变为皮肤顽症。针对皮肤湿病的不同发作状态可以选用疏风除湿汤、除湿胃苓汤、清热除湿汤、清脾除湿饮等治疗。针对湿痹,搜风除湿汤全面反映了赵老的治疗思路。  
      关键词:赵炳南;皮肤湿病;疏风除湿汤;除湿胃苓汤;清热除湿汤;清脾除湿饮;搜风除湿汤   
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      发布时间:2023-05-12
    • JIANG Xi,LI Nan,JIANG Ya-nan
      Vol. 38, Issue 11, Pages: 1062-1065(2019) DOI: 10.16025/j.1674-1307.2019.11.002
      摘要:陈彤云教授在损美性皮肤病方面有丰富的临床经验,她认为疣类疾病的病因病机为风、热、毒、瘀之邪凝聚肌肤,治疗以调和气血、解毒散瘀为原则,以中药紫蓝方为基础随证加减,同时配合其自创的特色中药外用方,在临床实践中取得了良好效果。  
      关键词:陈彤云;疣类疾病;辨证论治;老中医经验   
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      发布时间:2023-05-12
    • XU Yue,ZHU Hui-ting
      Vol. 38, Issue 11, Pages: 1065-1067(2019) DOI: 10.16025/j.1674-1307.2019.11.003
      摘要:慢性荨麻疹是临床中常见的皮肤病,因其病因复杂,病程较长且易反复,临床治愈较为困难。蔡念宁教授提出慢性荨麻疹治以祛风渗湿、调和阴阳、中和气血,采用赵炳南经验方多皮饮治疗时应明辨虚实两端。属于慢性荨麻疹实证者,注重清热凉血、解毒疏风;虚证当辨气血之不足,血虚风燥者养血和血,佐以养血活血之品,肺脾不足者常佐以健脾益气固表升阳之品。  
      关键词:慢性荨麻疹;赵炳南;蔡念宁;多皮饮;中医药疗法;名中医经验   
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      发布时间:2023-05-12
    • ZHU Hui-ting,YANG Li-yun
      Vol. 38, Issue 11, Pages: 1068-1071(2019) DOI: 10.16025/j.1674-1307.2019.11.004
      摘要:慢性荨麻疹是皮肤科常见病,部分患者顽固难愈。王萍教授在长期临床实践中,继承赵炳南教授、张志礼教授学术思想,结合自身体会,总结出以中医理论辨治顽固性荨麻疹的独特经验。王教授善用赵老四藤方和秦艽以除湿疏风清热、调和阴阳气血,重视柴胡剂的应用,重视对"三因制宜""治病必求于本"的实践。  
      关键词:王萍;慢性荨麻疹;秦艽;柴胡;中医药疗法;名中医经验   
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      发布时间:2023-05-12
    • YANG Lan,LI Bo-hua,ZHOU Dong-mei
      Vol. 38, Issue 11, Pages: 1071-1073(2019) DOI: 10.16025/j.1674-1307.2019.11.005
      摘要:通过分析《赵炳南临床经验集》中荆防方的具体应用,传承名老中医的临床经验。荆防方具有疏风解表、清热止痒的作用,对于风热型荨麻疹有较好的临床疗效。深入了解荆防方组方的涵义、临床适应证并加以灵活运用,可以更好地发挥传统方剂的特色,为患者解决病痛。  
      关键词:赵炳南;荆防方;荨麻疹;风热证;辨证治疗   
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      发布时间:2023-05-12
    • WANG Si-yi,LI Guan-ru,SUN Li-yun
      Vol. 38, Issue 11, Pages: 1074-1077(2019) DOI: 10.16025/j.1674-1307.2019.11.006
      摘要:<正>清热除湿汤是现代中医皮外科创始人赵炳南先生根据龙胆泻肝汤化裁而来的临床经验方,在临床诊疗中常应用于急性湿热性皮肤病和湿热蕴结型皮肤病的热重于湿证,对于急性湿疹、皮炎、痤疮、带状疱疹等多种皮肤病的治疗具有较好疗效。许多学者通过临床疗效观察,对其药理、药性、组方思路进行阐释,并附临床典型病例显示其临床有效性。笔者对清热除湿汤的证治研究综述如下。1 湿热性皮肤病临床治疗思路湿热之邪是最为多见的皮肤疾病致病因素,其原因在于皮肤的生理特点  
      关键词:清热除湿汤;证治研究;湿热性皮肤病;文献综述   
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      发布时间:2023-05-12
    • Professional Committee of Peripheral Vascular Disease of Traditional Chineseand Western Medicine Association
      Vol. 38, Issue 11, Pages: 1078-1087(2019) DOI: 10.16025/j.1674-1307.2019.11.007
      摘要:<正>糖尿病在我国有巨大的人口基数,而糖尿病足溃疡(diabetic foot ulcer, DFU)是导致糖尿病患者截肢的主要原因,也是造成社会、家庭沉重负担的重大公共卫生问题。我国糖尿病患者1年内新发溃疡的发生率为8.1%,愈合的DFU患者1年内再发溃疡发生率为31.6%。2004 年的多中心调查显示,我国DFU以神经缺血性为主,其中合并感染的溃疡占67.9%。近期调查结果显示,总截肢率为19.03%,其中大截肢占2.14%,  
      关键词:糖尿病足;中西医结合;专家共识   
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      发布时间:2023-05-12
    • LIAN Xiao-tong,LI Qian,HUANG Tian-yi,WANG Gang,LI Chuang,Deng Li-juan,YANG Guang-yao,GUO Xian,ZHANG Long,LI Da-yong,YANG Bao-zhong,ZHUANG Bai-xi,HE Li-gang,HE Chun-hong,XU Jin,WANG Wan-chun,YANG Bo-hua,LIU Sheng-nan,LI Wei-hong,JU Shang
      Vol. 38, Issue 11, Pages: 1088-1092(2019) DOI: 10.16025/j.1674-1307.2019.11.008
      摘要:Objective To observe the clinical effect of elephant skin powder in treatment of diabetic foot ulcer.Methods Patients with diabetic foot who were hospitalized in the Department of Peripheral Vascular Diseases of Dongzhimen Hospital and other 9 hospitals from June 2018 to June 2019 and met the inclusion criteria were divided into the experimental group and the control group.Both groups were treated with standardized internal medicine and wound dressing.On this basis,the experimental group and the control group were treated with elephant skin powder and epidermal growth factor respectively for 1 time/d,and observed for 14 days.Results A total of 180 patients completed the trial,90 in the experimental group and 90 in the control group,and the total effective rate was 95.5% and 84.4% respectively.After treatment,the experimental group was superior to the control group in the comparison of the reduction of wound area,the reduction of TCM syndrome scores and total cost(P<0.05).Conclusion Elephant skin powder treatment has a good effect on diabetic foot ulcer with deficiency syndrome.  
      关键词:diabetic foot ulcer;deficiency syndrome;elephant skin powder;traditional Chinese medicine   
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      发布时间:2023-05-12
    • GUO Xian,LIU Chun-yan,SUN Jian-jian
      Vol. 38, Issue 11, Pages: 1092-1095(2019) DOI: 10.16025/j.1674-1307.2019.11.009
      摘要:目的评价外用珍珠烫伤膏蚕食清创法联合超声清创法治疗糖尿病足溃疡的临床疗效。方法将90例糖尿病足溃疡患者,按不平衡指数最小分配原则进行随机化分组,分为治疗1组、2组、3组各30例。均给予常规降糖、改善循环、抗感染等基础治疗,治疗1组外用珍珠烫伤膏换药+蚕食清创+超声清创治疗,治疗2组外用凡士林油纱换药+蚕食清创+超声清创治疗,治疗3组外用珍珠烫伤膏换药+蚕食清创+模拟超声清创治疗。3组均以14天为1个疗程。结果治疗7~14天,治疗1组的临床疗效、溃疡愈合率、抑菌率均优于其他2组(P<0.05,P<0.01)。结论采用解毒生肌法联合超声清创治疗糖尿病足溃疡,疗效明显,值得临床推广运用。  
      关键词:糖尿病足溃疡;解毒生肌;超声清创;蚕食法;珍珠烫伤膏   
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      发布时间:2023-05-12
    • XIA Lian-heng,ZHANG Jia-yuan,WANG Jia-xin
      Vol. 38, Issue 11, Pages: 1096-1098(2019) DOI: 10.16025/j.1674-1307.2019.11.010
      摘要:慢性皮肤溃疡又称难治性溃疡,由于局部组织营养状态差,血液循环障碍及抵抗力低下,在此基础上出现反复感染形成恶性循环。李令根教授根据多年临床经验,提出下肢慢性溃疡多为"毒""瘀""虚"夹杂的病机,故治以活血化瘀、益气敛疮,研制出院内中药外用制剂壳聚糖复合药膜,用于慢性难愈性创面后期,脓腐已去而肌难生者,临床疗效显著。壳聚糖复合膜的自然成膜性能使创面保持持久湿润,有利于溃疡"煨脓长肉",药膜中所含中药能通气血、补正气,共奏补虚祛瘀之效。  
      关键词:李令根;中药壳聚糖复合药膜;下肢慢性溃疡;老中医经验   
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      发布时间:2023-05-12
    • WANG Xia,ZHANG Jing-yun
      Vol. 38, Issue 11, Pages: 1098-1100(2019) DOI: 10.16025/j.1674-1307.2019.11.011
      摘要:何春红教授治疗糖尿病足坏疽重视整体辨证与局部辨证,审因测机,据证选法,首辨阴阳,外用生肌玉红膏治疗糖尿病足坏疽余邪未清、正气已虚阶段,可以攻补兼施,祛邪不伤正,扶正不滞邪,祛瘀化腐、活血生肌合用,共奏促阴转阳、腐祛肌生之效。治疗疮疡关键在于察其病势,准确把握用药时机。  
      关键词:何春红;糖尿病足;坏疽;生肌玉红膏;用药时机;名中医经验   
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      发布时间:2023-05-12
    • ZHANG Hui-na,LI Ping,WANG Ju-sheng
      Vol. 38, Issue 11, Pages: 1101-1105(2019) DOI: 10.16025/j.1674-1307.2019.11.012
      摘要:Objective To explore the regulation of drugs for nourishing the liver and kidney,activating blood circulation,eliminating wind as well as the whole prescription for melanocyte activity and apoptosis rate,mitochondrial membrane potential and release of apoptosis protein induced by oxidative damage and discuss the action mechanism.Methods B16 melanocytes were used as the subject and oxidative damage model of melanocytes induced by hydrogen peroxide stimulation,then protective effect on melanocytes were observed.The prescription for nourishing liver and kidney were divided intothe following groups:group of nourishing liver and kidney,group of activating blood,group of eliminating wind,and freeze-dried powder solution was adopted to act on cells.MTT colorimetry was used to observe the growth inhibition of melanocytes in each group;flow cytometry was used to analyze DNA content and determine the proportion of apoptotic cells.Mitochondrial membrane potential detection kit(JC-1 method)was used to detect mitochondrial membrane potential changes.Western blot method was used to detect apoptosis protein.Results In the experiments,the whole prescription group of nourishing liver and kidney(200 μg/mL、100 μg/mL)and the group of activating blood(100 μg/mL)can increase the cell activityafter oxidative damage,the whole prescription group is the most obviously seen.The apoptosis rate of cells in the whole prescription group was the lowest,it is more effective than other groups in protecting melanocytes from oxidative damage.Compared with the control group,there was a significant difference between the 50 μg/mL whole prescription group,200 μg/mL group of nourishing liver and kidney,the 50 μg/mL group of nourishing liver and kidney group,and the protein expression of Bcl-2 were increased(P<0.05) and it indicated that the anti-apoptosis effect was more obvious in whole prescription group and group of nourishing liver and kidney.Capase 9,capase3,and CytC models groups had notsignificant statistical differencewith other groups in protein expression.AIF protein in 25 μg/mL group of eliminating wind,12.5 μg/mL group of eliminating wind had statistical significancewith the model group(P<0.05).50 μg/mL whole prescription group,50 μg/mL group of nourishing liver and kidney group,50 μg/mL group of activating blood,25 μg/mL group of dispelling wind,12.5 μg/mL group of dispelling wind had statistical significance in Bax protein compared with the model group.Except the whole prescription group and group of nourishing kidney and liver,there was statistical significance in Smac protein expression compared between the drug groups and model group(P<0.05).Conclusion The nourishing liver and kidney recipe and its component recipes can inhibit melanocyte oxidative damage,which may occur through mitochondrial pathway,suggesting that clinical treatment of vitiligo should be combined with enriching blood and promoting blood circulation,nourishing liver and kidney,and dispelling pathogenic wind.  
      关键词:Nourishing liver and kidney prescription;component prescription;nourishing liver and kidney;promoting blood circulation;dispel pathogenic wind;melanocytes;oxidative damage;apoptosis   
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      发布时间:2023-05-12
    • ZHANG Wu-feng,WANG Fang,WU Yi-ni,WU Xue-mei,JI Lu,HAN Zhi-hua
      Vol. 38, Issue 11, Pages: 1106-1108(2019) DOI: 10.16025/j.1674-1307.2019.11.013
      摘要:Objective To observe the effect of ligustrazine injection on apoptosis of human lens epithelial cells stimulated by high glucose.Methods The HLEs(human lens epithelial cells,HLEs)were cultured in vitro and the subcultured cell were divided into three groups,namely the normal glucose group(5.5 mmol/L glucose,N),the high glucose group(25 mmol/L glucose,H),and high glucose + ligustrazine group(including 0.2 μg/mL of ligustrazine medium,H+L).Apoptosis rate of lens epithelial cells in 3 groups was detected by TUNEL staining.The proteins expression levels of apoptosis-promoting protein Caspase-3 and inhibition of apoptosis protein Bcl-2 in three groups were detected by Western blot.Results The apoptosis rate of lens epithelial cells was higher in the high glucose group than in the normal control group and the ligustrazine group(P<0.05),and the difference was not statistically significant between the ligustrazine group and in the normal control group(P>0.05).The expression of caspase-3 was higher in the high-glucose group than in the normal control group(P< 0.05),while the expression of caspase-3 was not significantly changed in the ligustrazine group(P>0.05).The expression of Bcl-2 was down-regulated in the high glucose group(P<0.05)compared with normal control group,and the difference was not statistically significant between the ligustrazine group and the normal control group(P>0.05).Conclusion Ligustrazine can inhibitthe apoptosis of humman lens epithelial cells induced by high glucose.  
      关键词:Ligustrazine;human lens epithelial cell;high glucose;apoptosis   
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    • WU Qun-li,YANG Dan
      Vol. 38, Issue 11, Pages: 1109-1111(2019) DOI: 10.16025/j.1674-1307.2019.11.014
      摘要:梁晓春教授认为,失眠症虽然病因复杂,但精神心理因素最关键;在脏腑功能失调中,以肝居主导地位,主张从肝论治失眠;肝气郁结是脏腑功能失调的始动因素,肝血亏虚是阴阳气血失和的病理基础,而病程中产生的郁火、痰阻和血瘀可加重失眠。初期以肝气郁结为主;中期可出现肝郁化火、痰热上扰、肝血亏虚、肝肾阴虚;后期可出现肝阳上亢及肝郁血瘀。治疗时依据失眠的病程长短和病情轻重,辨别脏腑之阴阳和气血之虚实的不同,采用疏肝、清肝、养肝、柔肝及平肝五法,根据兼证灵活配伍安神药,或酌情配合化痰和活血之品,使肝之气血调和,肝之阴阳平秘,失眠得以治愈。  
      关键词:梁晓春;失眠;从肝论治;名中医经验   
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      发布时间:2023-05-12
    • YU Fang,SONG Jin
      Vol. 38, Issue 11, Pages: 1111-1113(2019) DOI: 10.16025/j.1674-1307.2019.11.015
      摘要:脾胃病是临床常见病,中医药治疗具有一定疗效,临床可见寒热错杂证为其常见证型。张声生教授认为脾胃病以脾虚为本,治疗应在健脾的基础上,根据寒热错杂病机的标本先后、轻重缓急进行调治,辨证为胃热脾寒、胃热肠寒、胃寒肠热、肝热脾寒等,其治法分别为温脾清胃、清胃温肠、温胃清肠、清肝温脾。  
      关键词:张声生;脾胃病;寒热错杂证;名中医经验   
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      发布时间:2023-05-12
    • ZHENG Ai-jun
      Vol. 38, Issue 11, Pages: 1114-1117(2019) DOI: 10.16025/j.1674-1307.2019.11.016
      摘要:针灸治痰是周德安教授"针灸六治"学术思想之一。周氏"针灸六治"包括针灸治神、治痰、治风、治痛、治聋、治动。针灸治痰方法有化痰、豁痰、涤痰、消痰法。针灸治痰处方包括针灸化痰方、针灸豁痰方、针灸涤痰方、针灸消痰方。周德安教授针灸治痰学术思想有完备的理、法、方、穴、术,为痰证的治疗提供很好的临床思路,广泛用于多种疑难杂症的治疗中。  
      关键词:周德安;针灸治痰;学术思想;临床应用;老中医经验   
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      发布时间:2023-05-12
    • WANG Shi-qi,WEI Shan-shan,CHEN Wen-hui
      Vol. 38, Issue 11, Pages: 1118-1120(2019) DOI: 10.16025/j.1674-1307.2019.11.017
      摘要:"脉象模糊"是指脉形模糊不清,其记载见于明清以来医家著作。"脉象模糊"涉及的具体脉象为微涩细散四脉,可见于多种病证中。"脉象模糊"的形成机理有多种因素:湿邪弥漫黏滞,郁阻脉气;温邪热盛伤阴,逆传心包;寒食痰浊固结,阻塞脉气;气血阳气衰微,元阳欲脱。此四类因素均可导致"脉象模糊"。医者临证中见"脉象模糊",细查明辨,可有效指导临床。  
      关键词:脉象模糊;沿革;机理   
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    • SUN Yu-nan,HAN Song-xue,JIN Yu-an
      Vol. 38, Issue 11, Pages: 1121-1125(2019) DOI: 10.16025/j.1674-1307.2019.11.018
      摘要:中医古籍记载了康复医学的理论与思想,包涵了理、法、方、药及物理自然疗法,其中以顺应自然、调畅情志、起居有常、饮食有节为规矩准绳。康复方法或施以方药,或针刺艾灸,或导引吐纳,或杂合以治,目的使经络疏通,气血流行,调理人体阴阳恢复平衡协调状态,是中医康复之道。回顾经典,探求理论,以中医学独特的哲学思想及辨治方法指导临床,为康复医学的发展奠定坚实基础。  
      关键词:中医古籍;中医理论;康复;辨证论治;针灸导引   
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    • LI Li,SHI Qing-sheng,LI Hong-yang
      Vol. 38, Issue 11, Pages: 1126-1128(2019) DOI: 10.16025/j.1674-1307.2019.11.019
      摘要:目的观察中药"喷灌疗法"(儿童型开喉剑喷雾剂口腔喷雾联合清热解毒中药灌肠)治疗普通型手足口病的临床疗效。方法选择2017年7—10月诊断为普通型手足口病的患儿70例,其中来自北京佑安医院36例,来自河北省邯郸市妇幼保健院34例。采用随机数字表法将患儿分为对照组和治疗组各35例。对照组给予西医对症处理。治疗组采用开喉剑喷雾剂(儿童型)口腔喷雾治疗,每日6~8次,每次6喷;用清热解毒方灌肠,每日1次。2组均治疗3~7天,随访3天。对比2组退热时间、口腔黏膜病变消失时间、皮疹/疱疹消失时间,记录继发肺部或其他部位感染情况、重症转化情况、不良事件发生情况。结果发热但体温≤38.5℃、未应用退热西药治疗的患儿21例,治疗组13例、对照组8例,2组退热时间分别为(1.77±0.60)、(2.66±0.52)天,治疗组退热时间短于对照组,2组比较差异无统计学意义(P=0.31);体温≥38.5℃患儿8例,治疗组3例,对照组5例,均接受了药物(百服宁)治疗,由于例数较少,未做分层比较。出现咽部明显充血、口腔黏膜疱疹或溃疡等病变的患儿66例,治疗组、对照组分别31例、35例,2组口腔黏膜病变消失时间分别为(3.84±1.46)、(4.80±1.21)天,差异有统计学意义(P=0.005)。2组皮疹/疱疹消失时间分别为(5.21±1.34)、(6.11±1.18)天,治疗组皮疹/疱疹消失时间短于对照组(P=0.004)。2组治疗期间均未发生其他部位继发感染、重症转化及不良事件。结论中药"喷灌疗法"可有效缩短普通型手足口病的患儿的口腔黏膜病变消失时间、皮疹/疱疹消失时间,明显改善症状,且安全性高。  
      关键词:普通型手足口病;开喉剑喷雾剂;口腔喷雾;中药灌肠;喷灌疗法;儿童   
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    • LI Cui-jing,CHANG Hong,WEI Na
      Vol. 38, Issue 11, Pages: 1129-1131(2019) DOI: 10.16025/j.1674-1307.2019.11.020
      摘要:目的通过中医八段锦气功运动疗法对帕金森病合并轻中度抑郁患者的干预,探讨八段锦练习对患者心理状态及生活质量改善的效果。方法选取2018年1—10月笔者所在医院神经内科病房收治的帕金森病合并轻中度抑郁患者66例,随机分为药物联合八段锦练习组(观察组)33例,和单纯药物组(对照组)33例。比较2组患者的汉密尔顿抑郁量表评分(HAMD)及日常生活能力评定指数(Barthel指数)。结果观察组HAMD量表及Barthel指数干预7天后及干预1个月后均较干预前有所改善,观察组较对照组改善明显,差异有统计学意义(P<0.05)。结论八段锦可改善帕金森病患者合并轻中度抑郁的状态,减轻负性情绪的影响,提高患者生活质量。  
      关键词:帕金森病;抑郁;八段锦;生活质量   
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    • LV Zhi-chao,LIU Xiao-jing,LI Jing
      Vol. 38, Issue 11, Pages: 1132-1134(2019) DOI: 10.16025/j.1674-1307.2019.11.021
      摘要:目的观察清热宣肺法对肺部细菌性感染患者白细胞及炎性因子的影响。方法选取2017年1月—2018年7月唐山市中医医院肺病科诊治的肺部细菌性感染患者116例,采用随机数字表法将患者分为对照组、治疗组各58例。对照组给予内科常规治疗,治疗组在对照组基础上给予清热宣肺法治疗。2组均治疗7天。2组治疗前后分别用全自动血液流变仪检测白细胞(WBC)、中性粒细胞(NE)水平,ELISA法检测超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平,对比2组疗效、未愈患者病情严重程度。结果治疗后2组hs-CRP、WBC、NE均较治疗前降低(P<0.05),且治疗组hs-CRP、WBC、NE低于对照组(P<0.05)。治疗后2组血清IL-6、IL-8、TNF-α水平均较治疗前降低(P<0.05),且治疗组IL-6、IL-8、TNF-α低于对照组(P<0.05)。治疗组总有效率高于对照组(P<0.05)。2组未愈患者病情严重程度比较差异有统计学意义(Z=-2.070,P=0.038)。结论清热宣肺法能够降低肺部细菌性感染患者白细胞及炎性因子水平,减轻炎症反应程度,提高临床疗效。  
      关键词:清热宣肺法;肺部细菌性感染;白细胞;炎性因子   
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    • WU Shan-shan,LI Jun-xiang,LI Wen-yan
      Vol. 38, Issue 11, Pages: 1135-1138(2019) DOI: 10.16025/j.1674-1307.2019.11.022
      摘要:目的探讨非酒精性脂肪性肝炎(NASH)肝郁脾虚证与湿热内蕴证患者肠道菌群的结构特征。方法选择北京中医健康乡村(社区)项目方庄试点2017年1—10月确诊为肝郁脾虚型NASH患者10例(肝郁脾虚组)、湿热内蕴型NASH患者24例(湿热内蕴组)及健康体检者26例(正常对照组)。用Illumina Hiseq 2500高通量测序手段,对通过16 s rDNA技术提取的新鲜粪便样本总DNA进行测序。通过设定相似度聚类成可操作分类单元(OTU)并完成物种注释,从而评价各组肠道菌群结构差异。结果与正常对照组比较,肝郁脾虚组、湿热内蕴组OTU少(P<0.05),肝郁脾虚组、湿热内蕴组OTU比较差异无统计学意义(P>0.05)。在"门"水平,正常对照组中拟杆菌门的菌群丰度高于肝郁脾虚组、湿热内蕴组(P<0.05),但肝郁脾虚组、湿热内蕴组比较差异无统计学意义(P>0.05)。肝郁脾虚组、湿热内蕴组酸杆菌门的菌群丰度分别与正常对照组相比,差异无统计学意义(P>0.05);而肝郁脾虚组该菌群丰度高于湿热内蕴组(P<0.05)。在"纲"水平,肝郁脾虚组腐生螺旋菌纲、酸杆菌纲的菌群丰度高于其他2组(P<0.05)。在"目"水平,肝郁脾虚组红螺菌目、腐生螺旋体菌目及酸杆菌目的菌群丰度高于其他2组(P<0.05)。在"科"水平,肝郁脾虚组葡萄球菌科、红螺菌科、Koribacteraceae、Chitinophagaceae的菌群丰度高于其他2组(P<0.05)。在"属"水平,肝郁脾虚组葡萄球菌属(Staphylococcus)的菌群丰度高于其他2组(P<0.05)。结论 NASH患者存在肠道菌群失调现象,且肝郁脾虚证与湿热内蕴证患者菌群结构也存在差异。  
      关键词:非酒精性脂肪性肝炎;肝郁脾虚证;湿热内蕴证;肠道菌群   
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    • GAO Shan-shan,Guo Lin-tao,BAO Shen-tao
      Vol. 38, Issue 11, Pages: 1139-1141(2019) DOI: 10.16025/j.1674-1307.2019.11.023
      摘要:目的观察传统经典方剂消风散加减治疗特应性皮炎风湿蕴肤证的效果。方法选择2017年6月—2018年12月作者所在医院皮肤科门诊收治的特应性皮炎患者61例,采取随机、平行、对照法分为治疗组31例和对照组30例。治疗组给予消风散加减口服治疗,对照组给予盐酸西替利嗪片口服治疗,2组均治疗4周。治疗前后采用特应性皮炎评分指数(SCORAD评分)进行疗效评价。结果治疗4周后,2组SCORAD评分均较治疗前有所降低,且治疗组评分均低于对照组(P<0.05);皮损程度、瘙痒和睡眠缓解方面均明显改善,治疗组较对照组改善更明显;治疗组有效率87.1%,对照组有效率70.0%,治疗组明显高于对照组,差异有统计学意义(P<0.05)。结论消风散加减治疗特应性皮炎,可明显改善患者临床症状,有效率高于盐酸西替利嗪片治疗。  
      关键词:特应性皮炎;风湿蕴肤证;消风散;盐酸西替利嗪片   
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    • LI Hai-tian,MA Jian-qiang,ZHANG Man
      Vol. 38, Issue 11, Pages: 1141-1143(2019) DOI: 10.16025/j.1674-1307.2019.11.024
      摘要:目的观察透刺法辅助治疗小儿周围性面瘫口角歪斜的疗效。方法选择2017年10月—2018年11月作者所在医院康复科门诊收治的周围性面瘫口角歪斜患儿100例,采用随机数字表法分为治疗组和对照组各50例。对照组给予单纯针刺治疗;治疗组在对照组针刺疗法的基础上,给予患侧地仓透颊车穴针刺。2组均每日1次,6次为1个疗程,休息2天,进行下一疗程,共治疗4个疗程。治疗前后对2组患儿颊肌进行表面肌电检测,比较2组患侧颊肌肌电信号(患侧颊肌放松20 s、患侧颊肌微笑)以及2组患健侧颊肌肌电信号差异。参照改良Portmann评分标准,比较2组疗效。结果 2组治疗后患侧颊肌放松20 s的肌电信号、患侧颊肌微笑的肌电信号、患健侧颊肌的肌电信号差异与治疗前比较,差异均有统计学意义(P<0.05);治疗后治疗组患侧颊肌放松20 s的肌电信号、患侧颊肌微笑的肌电信号、患健侧颊肌的肌电信号差异与对照组比较,差异均有统计学意义(P<0.05)。治疗组疗效优于对照组(Z=-2.113,P<0.05)。结论透刺法对小儿周围性面瘫口角歪斜有明显改善作用,并可提高针刺治疗疗效。  
      关键词:周围性面瘫;儿童;口角歪斜;透刺法   
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    • WU Zhao-xu,JI Wei,WANG Yin
      Vol. 38, Issue 11, Pages: 1144-1147(2019) DOI: 10.16025/j.1674-1307.2019.11.025
      摘要:目的分析37例接受中医治疗的晚期胃癌死亡患者临床特征。方法选择2016年12月1日—2018年3月31日北京中医药大学东直门医院、北京桓兴肿瘤医院、北京三环肿瘤医院收治的晚期胃癌患者80例,其中死亡37例。根据Ⅳ期生存时间和TOGA研究初步定义"晚期胃癌中医优势人群",将死亡患者分为优势组14例,非优势组23例。收集并分析2组临床病理特征。结果优势组接受中西医综合治疗的比例明显高于非优势组(P<0.05),2组年龄、性别、BMI、KPS评分、病理类型、分化程度、HER-2基因、贫血程度、肿瘤手术史、肿瘤负荷、中医证型、中医临床症状积分的差异无统计学意义(P>0.05)。结论晚期胃癌中医优势人群可能的特征是KPS评分高、曾接受手术治疗及中西医综合治疗的比例高。  
      关键词:晚期胃癌;生存结局;中医优势人群   
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    • Vol. 38, Issue 11, Pages: 1148-1150(2019) DOI: 10.16025/j.1674-1307.2019.11.026
      摘要:<正>国医大师晁恩祥是中日友好医院中医内科首席专家,从医60余载,勤求古训,治学严谨,临证精于辨治,处方用药考究,对中医内科疾病,尤其是中医肺系病的治疗与研究积累了丰富的经验。晁恩祥教授治疗肺系病,注重抓主症,看兼证,抓主要病机,注重疾病演变规律;治疗分清主次;注重"风邪"在肺系疾病发病过程中的重要性;注重通过提高患者自身的抗病能力来治病。晁教授临床上对支气管哮喘、咳嗽变异性哮喘、慢性阻塞性肺疾病、间质性肺病、支气管扩张等疾病的治疗,形成了独  
      关键词:晁恩祥;疏风宣肺;Kartagener综合征;医案   
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    • Vol. 38, Issue 11, Pages: 1150-1151(2019) DOI: 10.16025/j.1674-1307.2019.11.027
      摘要:<正>凉血五花汤是赵炳南先生在几十年的临床实践中总结出的一首有效的经验方[1],全方由凌霄花、玫瑰花、鸡冠花、红花、野菊花5种花类药物组成,方中凌霄花凉血活血泻热为君药,玫瑰花、红花理气活血化瘀,鸡冠花疏风活血,野菊花清热解毒。全方功在凉血活血,疏风解毒。凉血五花汤本方可用于血热发斑、热毒阻络所致的皮肤病,因花类药具有轻清上浮之性,所以本方尤其善治病变在上半身或全身散发的红斑性皮肤病。临床多应用于偏上半身红斑皮肤病初期,如盘状红斑狼疮、玫瑰糠  
      关键词:凉血五花汤;酒渣鼻;药毒病   
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