最新刊期
期 3 ， 2019
- 摘要：膜性肾病作为西医病理学名词,明晰其中医概念至关重要。专家们对本病的中医病名、病因、病机展开了讨论,认为本病是因病邪或由肺系入侵,或自脾胃入里,损伤肾脏而发病,并产生瘀血等诸多病理产物。因此在中医治疗上,主张从肺脾肾三脏入手,而具体用方用药各有不同。同时,对于本病的中医疗效评价标准及自发缓解现象,各位专家分别表达了自己的见解。关键词：膜性肾病;中医概念;病因病机;燕京医学
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发布时间：2023-04-10 - 摘要：<正>腰痛宁胶囊是颈复康药业集团有限公司生产的治疗腰腿痛药品。为了总结腰痛宁胶囊多年来研究及临床应用经验,更好地指导临床用药,颈复康药业集团有限公司特开展有奖征文活动,现将有关事项通知如下。一、征文内容1.腰痛宁胶囊治疗腰椎间盘突出症、坐骨神经痛、腰肌劳损、腰肌纤维炎、风湿性关节痛,症见腰腿痛、关节痛及肢体活动受限等病症的临床经验、体会与分析;2.腰痛宁胶囊临床用量、用法的研究与经验总结;3.腰痛宁胶囊组方研究、药理研究与探讨;4.腰
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发布时间：2023-04-10 - 摘要：<正>肝衰竭是临床常见的严重肝病症候群,病死率高。早在1970年,Trey等[1]首先提出爆发性肝衰竭（fulminant hepatic failure,FHF）的概念。1995年,日本学者Ohnishi等[2]提出慢加急性肝衰竭（acute-on-chronic liver failure,ACLF）命名。2009年和2014年亚太肝脏研究协会（APASL）分别发布和更新了《慢加急性肝衰竭共识》[3-4],2014年世界胃肠病组织关键词：慢加急性肝衰竭;中医内科;指南
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发布时间：2023-04-10 - 摘要：Objective To explore and screen out the biochemical indicators in relationship with the indexes of TCM deficiency and excess attributes in patients with acute-on-chronic acute-on-chronic liver failure（HBV-ACLF）,and evaluate their diagnostic value for predicting development of TCM deficiency and excess in order to provide assistance in making syndrome differentiation of TCM.Methods 130 patients with HBV-ACLF were included,and according to TCM syndrome differentiation criteria,they were divided into:blood stasis-heat jaundice,damp-heat jaundice,Qi-deficiency stasis jaundice,Yin-deficiency stasis jaundice and Yang-deficiency stasis jaundice.Blood stasis-heat jaundice and damp-heat jaundice were classified into excessive syndrome group with 90 cases.Qi-deficiency stasis jaundice,Yin-deficiency stasis jaundice and Yang-deficiency stasis jaundice were classified into deficiency syndrome group of 40 cases.Those index,including ALT,AST,TBiL,ALB,γ-GT,ALP,PA,CREA,PTA,INR,TC,TG,HDL-C,LDL-C,AFP,AFU,WBC,Hb and PLT Etc were screened out.The excess syndrome were taken as the positive trend prediction,the biochemical indicators of P<0.100 were included in the binomial logistic regression model for independent prediction analysis,and the threshold value,sensitivity and specificity of the prediction index were determined by the area under the receiver’s working curve（AUROC）.Results The indicators,such as AFU,PA,HDL-C and LDL-C excessive syndrome groups were higher than those of deficiency syndrome groups and the differences were statistically significant（P<0.05）.The rest indicators were not statistically significant（P>0.05）.To compare the excessive syndrome groups with the deficiency syndrome groups,the excessive syndrome trend prediction was used to compare the biochemical indicators including AFU,γ-GT,INR,PA,TC,TG,HDL-C,LDL-C and Hb of P<0.100 in Chinese medicine to the binomial logistic regression model.Indicators such as AFU,PA,and HDL-C were the excessive syndrome independent predictors.The empirical AUROC value of AFU level prediction was 0.706（95%CI 0.583～0.829）,and the threshold value was 39.20（U/L）.Above the threshold value,it was likely to be the excessive syndrome,with sensitivity of 78.20% and specificity of 47.60 %;PA level prediction the excessive syndrome AUROC value was 0.706（95%CI 0.587～0.826）,the threshold value was 37.60（mg/L）,above the threshold value was likely to be the excessive syndrome,the predicted trend sensitivity was 74.50%,and specificity 42.90%;the excessive syndrome AUROC value of HDL-C level was 0.711（95%CI 0.597～0.826）,and the threshold value was 0.36（mmol/L）.The fact that was above the threshold value suggest possibility of excessive syndrome,and the predicted trend sensitivity was 65.50 %,specificity was 38.10%.Conclusion AFU,PA and HDL-C can predict deficiency and excess syndromes in TCM with better sensitivity but less specificity,there is also a certain false positive,and the sample needs to be expanded.Multi-centered joint research can further screen out objective indicators that are more sensitive to predict TCM deficiency and excess attributes.关键词：Acute-on-chronic liver failure;hepatitis B;differentiation of syndromes in TCM;biochemical indicator;correlation analysis
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发布时间：2023-04-10 - 摘要：Objective To explore the clinical features,risk factors and TCM syndromes of mild hepatic encephalopathy. Methods The clinical data of 120 patients with liver cirrhosis admitted to the inpatient department,Center for Integrative Medicine,Beijing Ditan Hospital affiliated to the Capital Medical University from June 2017 to October 2018 were analyzed,and the characteristics of TCM syndromes of were studied. Results There were 52 cases of mild hepatic encephalopathy,accounting for 43. 3%,among which there were 32 cases of male and 20 cases of female. 68 patients did not have mild hepatic encephalopathy,accounted for 56. 7%,including 41 male and 27 female cases. The patients with decompensated cirrhosis in the mild hepatic encephalopathy group were obviously increased than those in the non mild hepatic encephalopathy group（ P < 0. 05）,the child classification significantly higher（ P < 0. 05）,and albumin significantly decreased. With logistic regression analysis,albumin and the child classification were risk factors for mild hepatic encephalopathy occurrence（ P < 0. 05）. The syndrome of liver and kidney Yin deficiency and the syndrome of blood stasis in the collateral were the most important syndrome features of patients with mild hepatic encephalopathy. Conclusion Mild hepatic encephalopathy is mostly found in the stage of decompensated cirrhosis. The more severe liver damage is,the higher the incidence of mild hepatic encephalopathy is.关键词：minimal hepatic encephalopathy;risk factor;TCM syndrome
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of Qinggan Huatan Huoxue Formula on fatty deposition in liver cell of rats with non-alcoholic fatty liver disease（NAFLD） and regulation of sterol regulatory element binding protein-1 c.Methods 60 SPF-class male SD rats were selected and divided into normal group,model group,treatment group with 20 in each group.Apart from the normal group,NAFLD rat model was replicated with high fat diet in other groups.After 8 weeks of modeling,10 rats were taken from each group randomly.After verifying the success of modeling,the treatment group was treated with Qinggan Huatan Huoxue Formula,and the model group and normal group were given saline.Serum ALT,AST,γ-GT,and TC,TG and FFA in liver tissue were tested to observe fatty degeneration in liver.The expression of SREBP-1 c mRNA was detected by real time quantitative PCR method.Results After 4 weeks of treatment,the liver tissue of normal group was normal.In the model group,fatty degeneration occurred in different degrees.Compared with the normal group,serum ALT,AST,and R-GGT in the model group were increased significantly with significant differences（P<0.05）;Compared with the model group,serum ALT,AST,γ-GT activity were decreased significantly in the treatment group（P< 0.05）;the levels of TC,TG,and FFA in liver tissue,were significantly lowered in the treatment group than that in the model group（P<0.01）;compared with the normal group,the expression of SREBP-1 c gene in hepatocytes in the model group was increased significantly（P<0.01）;compared with the model group,the level of expression in the treatment group was significantly reduced（P<0.01）.Conclusion Qinggan Huatan Huoxue Formula can improve liver inflammation by controlling liver cell SREBP-1 c to make it recover from fatty deposition in liver cells of rats with NAFLD.关键词：non-alcoholic fatty liver disease;Qinggan Huatan Huoxue Formula;liver cell;sterol regulatory element binding protein,SREBP-1c;rat
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of Qingchang Ligan Formula on hepatocyte autophagy in acute liver failure（ALF） of mice induced by D-galactosamine/lipopolysaccharide.Methods Wild type of healthy C57 BL/6 male mice were randomly divided into normal control group,ALF model group,Qingchang Ligan Formula intervention group,and 3-MA autophagy inhibitor intervention group.ALF model group:ALF model was induced by intraperitoneal injection with D-GalN/LPS;Qingchang Ligan Formula intervention group:3 days before D-GalN/LPS,Qingchang Ligan Formula was given with lavage,once a day;3-MA intervention group:3 days before D-GalN/LPS,Qingchang Ligan Formula was given with lavage,once a day;24 h before D-GalN/LPS,3-MA was given through caudal vein.6 h after D-GalN/LPS administration,the liver tissue and serum of each group were collected.Serum transaminase ALT and AST were assessed.Western blot and real-time fluorescent quantitative PCR were used to detect the expression of autophagy in liver tissue.The mortality and liver damage in mice were observed.Results Compared with the normal control group,the level of transaminase was increased and the level of autophagy decreased in the model group.In Qingchang Ligan Formula intervention group,the level of transaminase was significantly lowered than that of the model group,and the level of autophagy was increased,and the difference was statistically significant（P<0.05）.After inhibiting autophagy,the protective effect of Qingchang Ligan Formula was reversed,and the mortality of mice increased and liver damage aggravated.Conclusion Qingchang Ligan Formula can promote the autophagy level of hepatocytes in mice with acute liver failure caused by D-GalN/LPS,and reduce liver cell damage.关键词：Qingchang Ligan Formula;Acute liver failure;autophagy;liver damage;mice
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发布时间：2023-04-10 - 摘要："风疸"是一类具有"风邪特性"的黄疸,临床发病率低,易为医家所忽略。钱英教授认为风疸病因为"风",此风属"外风""实风",其发病乃由素体血虚,营卫失和,风邪直入脏腑,与热气相搏,阻滞于脾胃肝胆,导致脾胃运化功能失常,肝失疏泄,胆汁不循常道,溢于肌肤所致。病位在脾胃肝胆,病性属虚实夹杂,以实为主。本病与现代医学所述之"良性复发性肝内胆汁淤积"具有相通性。治疗当强调养血祛风,调和营卫,及重用秦艽、白鲜皮等祛风胜湿药。相较于其他病因所致之黄疸,风疸的病程较短,预后较好。关键词：钱英;风疸;老中医经验
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发布时间：2023-04-10 - 摘要：<正>近年来,肠道微生态成为众多学者研究的热点,很多常见疾病与肠道菌群失调有关,如慢性肾脏病[1]、2型糖尿病[2]、心血管疾病[3]等。肠道菌群失调与慢性肝病互为因果的关系得到了众多学者的认可。目前通过调节肠道微生态治疗慢性肝病已逐渐成为研究的新方向。中医药治疗肠道菌群失调有其独特优势,本文通过检索2008年1月—2018年12月中国期刊全文数据库（CNKI）中关于慢性肝病肠道微生态、中医药调节肠道微生态的文献,以"肝病肠道微生态"或"中药关键词：慢性肝病;肠道微生态;菌群失调;中医药
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发布时间：2023-04-10 - 摘要：Objective To observe the effect of Qizhu Granules on the expression of vWF and Caveolin-1 in sinusoidal endothelial cells of rats with hepatic fibrosis.Methods 24 Wister rats were randomly divided into normal group,model group,Qizhu Granules group and Compound Biejia Ruangan Tablets group with 6 in each group.Hepatic fibrosis model was established by intraperitoneal injection of 40% carbon tetrachloride（CCl4） dissolved in olive oil in model group,Qizhu Granules group and Compound Biejia Ruangan Tablets group,at the same time,Qizhu Granules was also given at a dosage of 1.25 g/（k·d） in the Qizhu Granules group,and Compound Biejia Ruangan Tablets given at a dosage of 0.625 g/（k·d） though lavage;the model group was given equal volume of intragastric aseptic water.The drugs were given continuously for 4 weeks.The normal group was raised under the same condition without modeling.vWF and Caveolin-1 in the hepatic tissues were tested with immunohistochemical method and Western blot.Results The expressions of vWF and Caveolin-1 in the hepatic sinusoidal endothelial cells were more strongly expressed in the model group compared with the normal group,but they were significantly weaker in the Qizhu Granules group and the Compound Biejia Ruangan Tablets group（P< 0.05）.Conclusion Qizhu Granules can reduce vWF and Caveolin-1 expression.关键词：hepatic fibrosis;Qizhu Granules;vWF;Caveolin-1;rat
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发布时间：2023-04-10 - 摘要：Objective To examine the action mechanism of Qishen Yiqi Dropping Pills（QYDP） on microcirculation disorder in diabetic rats with laser Doppler blood perfusion imaging techniques.Methods Streptozocin（STZ） intraperitoneal injection was used to establish a model of diabetic rats,then they were randomly divided into model group,treatment group and control group.At the same time,a normal control group was set up.The treatment group was medicated with QYDP（prepared into liquid）,while the control group with calcium dobesilate liquor（1 g/kg per day） both for 10 months.The blood flow of iris vessels,auricle and limb skin was monitored by laser Doppler blood perfusion image after drug intervention.Results The blood circulation in iris vessels,auricle and limb skin in model group were reduced,and compared with the treatment group and control group,the difference was statistically significant（P<0.05,P<0.01）.Conclusion QYDP can facilitate the peripheral microcirculation and promote the amount of blood perfusion per unit area so as to improve the ischemia of peripheral circulation.关键词：diabetes;Qishen Yiqi Dropping Pills;laser doppler blood perfusion imaging;microcirculation;rat
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发布时间：2023-04-10 - 摘要：从病因病机、辨病辨证、遣方用药等方面总结归纳肖淑琴老师从肝脾论治儿童神经性厌食的学术观点及临床经验。肖老师认为儿童神经性厌食病位主要在肝、脾,病机关键为肝郁气滞、脾胃失调,治疗上强调健脾疏肝、理气助运,予异功散合芍药甘草汤加味。关键词：肖淑琴;神经性厌食;儿童;肝;脾;老中医经验
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发布时间：2023-04-10 - 摘要：韦云教授独创"三分法",运用中医药治疗不寐病,临床疗效显著。通过理论梳理及病案总结,介绍"三分法"治疗不寐病的辨治思路,以更好地总结、继承、发扬韦云教授的学术思想和临床经验。关键词：韦云;不寐;三分法;中医药;名医经验
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发布时间：2023-04-10 - 摘要：痞满是临床常见病证,病因纷繁复杂。金宇安教授临证概括痞满为虚、湿、气三因致病,且相兼为患,致中州气机失调,而成本虚标实、虚实夹杂之证,脾胃升降失职、中焦气机不利为病机关键。诊病四诊合参,尤重舌脉。治疗时应抓住主要病因,切中要害,强调以脾胃为本,气机通畅为要,并根据虚、湿、气三因辨证论治,调畅气机,理气通滞,临床疗效显著。关键词：金宇安;痞满;本虚标实;三因辨治;调畅气机;名中医经验
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发布时间：2023-04-10 - 摘要：贾玉森教授提出生殖轴（肾及肾子、精室、精窍）、肝、脾胃、经络气血共同参与构成人体生殖环节的学术观点,并以此指导男性不育症的诊疗,取得疗效。推崇明代岳甫嘉的"生子专责在肾""种子兼顾脾胃""求嗣之道,贵在养精"及"毓麟用药,贵乎温和"等观点。在辨治不育症方面,精索静脉曲张性不育采用补益、活血、祛湿化瘀法治疗;免疫性不育采用滋补肾阴、活血化瘀、清解或清利法治疗;感染性不育,初期采用解毒利湿、活血泄浊法治疗,后期加用补肾益精药物;特发性不育以补肾生精及调和肝脾为主;精液不液化围绕"肾虚有湿"核心病机治疗。贾玉森教授认为补肾法应贯穿治疗不育症的全过程,临床上辨病与辨证相结合,治疗以补肾为主线,根据辨证辅以活血化瘀、清热解毒、利湿泄浊等治法,达到阴阳合（精卵）而受孕生子。关键词：贾玉森;男性不育症;名中医经验
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发布时间：2023-04-10 - 摘要：腹泻型肠易激综合征（IBS-D）是一种临床常见的功能性肠道疾病,以腹痛、腹泻为主要表现,其中有一类常见遇冷即发,其发病与寒湿内伏密切相关。以仝小林教授提出的脏腑风湿理论分析,该类IBS-D的病因病机为:寒湿之邪伏留胃肠,久伤中阳,遇寒引动,脾失健运,发为泄泻。治疗上,应给邪以出路为先,重散寒透邪,再攻补兼施,邪除而正气足,治以散寒温中健脾,以理中汤合小建中汤随症加减治疗。关键词：腹泻型肠易激综合征;寒湿内伏;脏腑风湿;散寒温中健脾;仝小林
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发布时间：2023-04-10 - 摘要：卵巢癌为妇科三大恶性肿瘤之一,早期多无症状,有症状时60%～70%已属晚期。该病的主要病机为正虚、寒凝、气滞、血瘀。其发病特点为伏邪稽留日久而渐成,有明显症状时已成顽疾恶候。其中一部分卵巢癌符合"脏腑风湿病"的发病特征,属于"胞宫风湿病"范畴。结合"脏腑风湿"的相关概念可将这类卵巢癌分为寒湿（早期）、寒湿瘀（中期）、寒湿瘀癥（晚期）三个阶段。治疗时温阳散寒法贯穿全程,早期兼以除湿,中期兼以化瘀,后期兼以消癥。同时结合名老中医经验及临床研究成果进一步完善"脏腑风湿"类卵巢癌的理论基础及治疗方案。关键词：脏腑风湿;仝小林;肿瘤;卵巢癌;中医药疗法
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发布时间：2023-04-10 - 摘要：中医药治疗老年皮肤瘙痒症有一定疗效,但部分患者仍效果不佳。从阴阳角度出发,提出老年皮肤瘙痒症的核心病机为阳虚络阻,将温阳通络法贯穿老年皮肤瘙痒症治疗过程中,为老年皮肤瘙痒症的临床治疗提供新的思路。关键词：老年皮肤瘙痒症;阳虚络阻;病络学说
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发布时间：2023-04-10 - 摘要：《伤寒论》全书条文398条,除太阴病外,其余各经共38条有关"烦躁"症状的条文。将这些条文分析辨别后,可归纳为:实热烦躁、阳虚烦躁、阴虚烦躁、心失所养烦躁、热扰胸膈烦躁、痰湿壅滞烦躁,及因呕吐、口渴、疼痛等引起的烦躁。在治疗方法上,给出了具体方药和治疗措施。《伤寒论》中对烦躁诊治的理法方药,对于当今临床者仍具有很大的实用意义。关键词：伤寒论;烦躁;辨证
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发布时间：2023-04-10 - 摘要：燮理肝肾法是指基于肝肾的功能特点以及肝肾同源共储阴血的关系,在滋补肝肾的同时,应用开合枢机、疏肝理气的药物,以补益肝肾、开郁疏肝、肝肾同治。燮理肝肾方由六味地黄汤、四逆散合方加苍术、牛膝组成,具有滋补肝肾、宣畅气机、疏肝理脾、燮理肝肾的功效,主治肝肾亏虚、肝气郁滞、枢机不利引起的糖尿病、肾病、更年期综合征、亚健康状态、代谢综合征等多种疾病。关键词：燮理肝肾方;名医经验;冯建春
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发布时间：2023-04-10 - 摘要：目的观察疏风解毒胶囊治疗北京地区季节性流行性感冒的临床疗效。方法选择2014年11月—2016年3月就诊于北京中医药大学东方医院发热门诊的流感患者220例,采用随机数字表法分为中成药组和西药组各110例。中成药组予疏风解毒胶囊治疗,西药组予磷酸奥斯他韦胶囊治疗。比较2组的退热起效时间、中医证候疗效、症状积分变化及安全性指标。结果中成药组退热中位起效时间为2 h,与西药组差异无统计学意义（P>0.05）。治疗5天后,2组中医证候疗效差异无统计学意义（P>0.05）。单项症状积分比较,2组均能有效改善流感患者症状,主症积分差异无统计学意义（P>0.05）,次症咽痛积分中成药组效果更佳（P=0.04）。2组并发症及不良反应比较,差异均无统计学意义（P>0.05）。结论疏风解毒胶囊治疗北京地区季节性流行性感冒安全有效,且对咽痛症状改善更佳。关键词：疏风解毒胶囊;流行性感冒;疗效
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发布时间：2023-04-10 - 摘要：目的探讨五点支撑功能锻炼对骨质疏松性椎体压缩性骨折经皮椎体后凸成形术（PKP）术后患者后凸畸形及功能恢复的影响。方法选择2015年1月—2016年6月收治的骨质疏松性椎体压缩性骨折患者96例,采用随机数字表法分为观察组和对照组各48例,对照组予PKP术,观察组PKP术后联合五点支撑功能锻炼。比较2组临床疗效、视觉模拟疼痛评分（VAS）、术后下床活动时间、椎体前缘高度、椎体后凸角度（Cobb角）、改良Obwestry功能障碍指数（ODI）、并发症等指标。结果治疗后观察组有效率95.83%,明显高于对照组（81.25%）（P<0.05）;VAS评分明显低于对照组（P<0.05）,术后下床活动时间明显短于对照组（P<0.01）。随访12个月,治疗组Cobb角、ODI明显低于对照组（P<0.05）,椎体前缘高度明显高于对照组（P<0.05）;2组并发症比较差异无统计学意义（P>0.05）。结论五点支撑功能锻炼有助于缓解骨质疏松性椎体压缩性骨折PKP术后患者疼痛程度,矫正后凸畸形,促进功能恢复,提高临床疗效。关键词：骨质疏松症;椎体骨折;经皮椎体后凸成形术;五点支撑功能锻炼
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发布时间：2023-04-10 - 摘要：目的观察颈椎旁神经阻滞配合易筋经功法治疗神经根型颈椎病的临床效果。方法将神经根型颈椎病患者68例随机分为观察组和对照组各34例。2组均用同息通（曲安奈德注射液）行责任椎体旁神经阻滞术。每周治疗1次,疗程4周。观察组在神经阻滞术后第2天开始每天2次练习易筋经第3势（韦驮献杵）及第7势（九鬼拔马刀）。比较2组治疗期间颈椎病疗效评分及疼痛视觉模拟（VAS）评分,并评价综合疗效,随访3个月。收集相关影像学资料及数据,采用Borden测量法测量2组治疗前及治疗结束3个月后颈椎生理曲度（颈椎弧弦距）变化。结果治疗4周,2组VAS及颈椎病疗效评分均较治疗前降低,且观察组低于对照组,差异均有统计学意义（P<0.05）。观察组治疗结束3个月后颈椎弧弦距较治疗前增加（P<0.05）,治疗前后差值大于对照组（P<0.01）,对照组治疗结束3个月后颈椎弧弦距较本组治疗前无明显增加（P>0.05）。观察组愈显率高于对照组（P<0.05）,2组总有效率比较差异无统计学意义（P>0.05）。结论颈椎旁神经阻滞配合易筋经功法治疗神经根型颈椎病疗效确切,可有效改善颈椎生理曲度,效果优于单纯颈椎旁神经阻滞。关键词：神经根型颈椎病;易筋经功法;颈椎旁神经阻滞;曲安奈德注射液
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发布时间：2023-04-10 - 摘要：目的观察并评价补肾活血颗粒缓解长期维持性血液透析的骨矿物质和骨代谢异常（CKD-MBD）患者骨痛症状及骨代谢指标异常的临床疗效。方法采用多中心、平行随机对照的前瞻性临床试验的设计方案,将177例行长期维持性血液透析的CKD-MBD患者随机分为对照组88例和中药组89例。对照组采用对症治疗方案,中药组在对照组基础上加用补肾活血颗粒,均治疗3个月。分别于治疗前后测定疼痛视觉模拟评分（VAS）,评价临床疗效;比较2组患者治疗前后血钙、磷、全段甲状旁腺激素（i-PTH）、血清骨特异性碱性磷酸酶（BAP）等钙磷代谢及骨转化指标的变化。结果治疗后,中药组和对照组疼痛VAS评分均下降,中药组评分下降程度显著大于对照组（P<0.01）,临床疗效显著优于对照组（P<0.01）。第3个月,中药组血钙上升（P<0.01）,血磷下降（P<0.05）。第3、6个月时,中药组血i-PTH有下降趋势,血BAP显著下降,与对照组比较差异有统计学意义（P<0.01）。结论补肾活血中药能够有效缓解长期维持性血液透析CKD-MBD患者的骨痛症状,并能改善其骨矿物质代谢,改善亢进的骨转换。关键词：慢性肾脏病-骨矿物质代谢异常;肾性骨病;补肾活血颗粒;血液透析;骨痛评分;中西医结合疗法
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发布时间：2023-04-10 - 摘要：目的观察中医扶正培本辅助伊立替康化疗对晚期结直肠癌患者血清CA19-9及MMP-7水平的影响。方法选取晚期结直肠癌患者80例,随机分为观察组及对照组各40例。对照组采用伊立替康化疗,观察组采用中医扶正培本辅助伊立替康化疗。观察短期疗效,并随访18个月评估远期疗效;比较治疗前后2组患者血清中CA19-9及MMP-7水平变化。结果治疗后观察组短期疗效为75.00%,显著高于对照组的42.50%（χ2=21.792,P<0.05）;治疗后观察组CA19-9为（11.47±4.39）kU/L,对照组为（22.84±4.39）kU/L,2组比较差异有统计学意义（t=10.313,P<0.05）;观察组MMP-7水平为（19.38±4.29）μg/L,对照组为（25.83±5.01）μg/L,2组比较差异有统计学意义（t=5.639,P<0.05）;随访18个月,观察组患者生存率显著高于对照组（P<0.05）;观察组不良反应总发生率为25.00%,显著低于对照组的70.00%（χ2=40.602,P<0.05）。结论采用中医扶正培本法辅助伊立替康化疗治疗晚期结直肠癌患者,可有效提高其临床疗效,并降低血清中CA19-9及MMP-7水平。关键词：结直肠癌;扶正培本;伊立替康;化疗;CA19-9;MMP-7
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发布时间：2023-04-10 - 摘要：目的观察运用经皮离子导入仪进行中药双侧肺俞、脾俞、肾俞穴位贴敷联合西医治疗,对慢性阻塞性肺疾病急性加重期（AECOPD）患者的临床疗效及对窖蛋白1（CAV1）、CAV2、水通道蛋白1（AQP1）、AQP5表达的影响。方法将60例AECOPD住院患者按照随机数字表法分为治疗组和对照组各30例。对照组采用西医常规治疗方法,治疗组在此基础上加用双侧肺俞、脾俞、肾俞穴中药离子导入,15天为1个疗程。疗程结束后比较2组临床疗效,比较2组治疗前后肺功能（FEV1、FVC、FEV1/FVC、FEV1/预计值）及血清可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）、CAV1、CAV2、AQP1、AQP5水平。结果治疗组总有效率93.3%,较对照组明显提高（P<0.05）。治疗后2组FEV1、FVC、FEV1/FVC、FEV1/预计值、CAV1、CAV2、AQP1、AQP5均较治疗前明显增加,sICAM-1、sVCAM-1均较治疗前明显减少（P<0.05或P<0.01）;治疗后治疗组各指标较对照组改善更明显（P<0.05或P<0.01）。2组患者治疗过程中无不良反应及并发症发生。结论中药经皮离子导入联合西医治疗可显著减轻AECOPD患者的临床症状,改善患者的肺功能,其机制可能与改善肺毛细血管渗透性及血管内皮炎症反应、调节血管内外平衡有关。关键词：慢性阻塞性肺疾病急性加重期;中药经皮离子导入;窖蛋白1;窖蛋白2;水通道蛋白1;水通道蛋白5
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发布时间：2023-04-10 - 摘要：目的对患者咨询三七的常见问题进行分析,为其合理应用提供参考。方法对首都医科大学宣武医院用药咨询系统中三七相关问题进行汇总,针对具体案例,结合文献报道,分析各类问题产生的原因和解决措施。结果用药咨询系统中记录三七相关问题69例,涉及三七的质量、炮制品、适应证、用法用量、不良反应等。三七的质量与三七大小、生长年限等诸多因素有关;三七生品、炮制品、不同药用部位功效不同,需区别应用;三七及其制剂可能引起皮疹、出血、过敏等不良反应。结论尽管三七作为临床常用中药或保健品可长期服用,仍需在医生或药师的指导下选用。关键词：三七;用药咨询;用药安全
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发布时间：2023-04-10 - 摘要：目的考证中医药书籍中记载的中药汤剂的煎煮次数,分析其变化规律。方法查阅《黄帝内经》《伤寒论》《肘后备急方》《备急千金要方》《太平惠民和剂局方》《新方八阵》《温病条辨》《医学衷中参西录》及现代《方剂学》教材,考证其中所载汤剂的煎煮次数。结果《黄帝内经》《伤寒论》中所载汤剂均为煎煮1次;检索《肘后备急方》100首汤剂,有1首煎煮2次;检索《备急千金要方》100首汤剂,均为煎煮1次;《太平惠民和剂局方》共载汤剂249首,有5首煎煮2次;《新方八阵》共载汤剂116首,有2首煎煮2次;《温病条辨》共载汤剂176首,有16首煎煮2次;《医学衷中参西录》上册共载汤剂132首,有3首煎煮2次;《方剂学》统编教材第2版中正式提出"一般一日一剂,分为头煎、二煎",第4、5、6、7版教材与第2版相同。结论秦汉时期汤剂俱为一煎,至《肘后备急方》二煎开始出现;宋、清之期二煎逐渐增多,但以一煎为主;目前则一般煎煮2次。关键词：中药汤剂;煎煮次数;黄帝内经;方剂学
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发布时间：2023-04-10 - 摘要：<正>1 病案介绍患者,男,29岁,主因"持续发热9天"由中国中医科学院广安门医院肾病科于2017年12月12日13∶30转入ICU。患者于12月4日夜间受凉后自觉发热,测体温 37.2℃,当时未予重视和处理,其后体温逐步升高。12月6日 10∶00于我院南区肾病科住院治疗,入院测体温38.5℃,急查胸部CT提示双肺间质弥漫性渗出,考虑肺部感染,先后予头孢哌酮舒巴坦钠、亚胺培南、美罗培南等药物抗感染治疗。12月11日 10∶00复查胸部C关键词：肺炎;卡氏肺孢子菌;发热;中西医疗法
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发布时间：2023-04-10 - 摘要：<正>急性胆囊炎属中医学"黄疸"范畴,临床多从胆腑瘀热或热毒炽盛辨证,治疗多用清热利湿、通腑利胆法[1]。然黄疸兼证变证良多,也可因血瘀而发,如某些需介入治疗的急性冠脉综合征患者,以胆系症状为首发表现,此时血瘀作为贯穿冠心病介入治疗（percutaneous coronary intervention,PCI）的主要证候要素[2]不应被忽视,辨证用药应灵活加减,并重视活血化瘀[3]。中国中医科学院望京医院急诊科以大柴胡汤为基础方,采用利湿退黄关键词：不稳定性心绞痛;冠脉支架术;黄疸;利湿退黄;化瘀通络
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发布时间：2023-04-10 - 摘要：<正>肠易激综合征（irritable bowel syndrome,IBS）是以腹痛、腹部不适,伴排便习惯及大便性状改变为主要临床症状的慢性功能性肠病,部分患者同时伴有失眠、焦虑、抑郁等神经精神症状。该病的发病机制目前尚未明确[1-4],多认为与肠黏膜屏障及肠道动力异常、内脏感知异常、肠道菌群失衡及精神心理障碍等因素有关,是多种因素和机制共同作用的结果。根据罗马Ⅲ标准,IBS可分为腹泻型（IBS-D）、便秘型（IBS-C）、混合型关键词：肠易激综合征;中医外治法;文献综述
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发布时间：2023-04-10 - 摘要：<正>连续发生2次或2次以上的自然流产,称为复发性流产。本病在育龄期女性中的发生率为1%～5%[1],且患者再次妊娠发生自然流产的机率高达70%～80%[2]。积极防治自然流产的反复发生,保护育龄期妇女生殖健康具有重要的临床意义和社会意义。西医学认为复发性流产病因复杂,可能与遗传因素、染色体异常、解剖因素、感染因素、免疫学因素、内分泌因素有关,亦有不明原因者。内分泌异常导致的复发性流产的发生率为10%～15%[3]。常见的内分泌因素有多囊卵巢关键词：多囊卵巢综合征;复发性流产;影响因素;高雄激素血症;高胰岛素血症;文献综述
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发布时间：2023-04-10
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