最新刊期
期 6 ， 2019
- 摘要：<正>脾胃病是公认的中医治疗优势、特色病种,每年都有许多临床和基础论文发表,繁荣了中医脾胃病学研究。本期登载的5篇文章,虽然篇幅不大,但内容既有脾胃病提纲挈领的辨治方法论述,又有临床经验挖掘总结;既有内服中药汤药和膏方治疗的研究,也有外治方药的运用,且着重临床和创新,皆为治疗上的知常而达变,另辟蹊径,并取得了良好的临床效果。八纲辨证是指阴、阳、表、里、寒、热、虚、实八类证候的归纳方法,是中医各种辨证的总纲及基本方法。而各系统疾病特点不一,故在八纲辨证的临床运用中又各有偏重。脾胃病易发且易反复发作、慢性迁延,又与饮食、情志等多因素相关,
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发布时间：2023-04-10 - 摘要：脾胃病以易发和反复发作、慢性迁延等为特点,又多与饮食、情志等因素相关,与先、后天均有关系,病位在脾、胃、肠,与肝、肾、肺等脏亦关系密切。临床多见寒热错杂、虚实相兼、气血同病、湿浊侵犯,脏腑多易肝、脾同时受病。辨治脾胃病应首辨寒热、虚实,再辨气血、湿浊,总归于脏腑,并由此衍生出寒温并用、虚实相兼、调气行血、化湿祛浊、调肝理脾的治法治则。脾胃病寒热错杂证多见脾寒胃热、胆热脾寒、上热下寒、胃热肠寒、肝热胃寒;脾胃病虚实相兼多见脾虚气滞、脾虚湿蕴、脾虚痰阻、脾虚食滞;脾胃病气血病变多见气滞血瘀、气虚血瘀、久病入络;脾胃病又多兼夹湿浊,系统总结祛湿化浊之法,如健脾化湿、芳香化湿、温阳化湿、和胃化湿、化浊消积、清热燥湿、祛风化湿、利水渗湿、祛浊化毒;脾胃病脏腑辨治中强调调肝理脾法的运用,总结了疏肝健脾法、泄肝扶脾法、补脾泄肝法、补脾养肝法、清肝温胃法、柔肝滋脾法、暖肝温脾法、理气化瘀法、清利湿热法、清胆温脾法肝脾同治之十法。关键词：寒热;虚实;脏腑;辨证;十纲;脾胃病
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发布时间：2023-04-10 - 摘要：Objective To observe the clinical curative effect of Methods of invigorating spleen and harmonizing stomach with warming yang and dredging diaphragm in treating gastro-esophageal reflux disease（GERD）and explore the mechanism of action and advantages of targets.It has significant meaning for the prevention and treatment of GERD with effectiveness.Methods 80 patients were randomly divided into two groups in a single blind control study.The treatment group received the decoction of invigorating spleen and harmonizing stomach with warming yang and dredging diaphragm and the control group received the Omeprazole.The course of treatment was 6 weeks.The scores of symptoms were recorded before the treatment,2 weeks,4 weeks and 6 weeks after treatment.The score of SF-36 was recorded before the treatment and 6 weeks after the treatment.The treatment group checked the esophagus 24 hours pH monitoring and inspection.Results（1）Comprehensive evaluation showed that the treatment group was better than the control group in reflux,sleeping,taking the medicine and the total score of GerdQ 6 weeks after treatment（P<0.05）.（2）In aspects of syndromes of TCM:the effective rate of the treatment group was 94.7%,while the control group was 88.9%.The difference between two groups had statistical significance（P<0.05）.The treatment group was better than the control group in reflux,belching,pharyngeal tight adverse,chest pain and the total score 6 weeks after treatment（P<0.05）.（3）The esophagus 24 hours pH monitoring and inspection:the treatment group after the treatment was better than that before the treatment in the number of reflux,time of reflux,De Meester and so on（P<0.05）.（4）SF-36:the treatment group was better than the control group in the total score 6 weeks after treatment（P<0.05）.It showed that the treatment group was better than that of control group in patients’ physical and mental health.Conclusion The therapy of invigorating spleen and harmonizing stomach with warming yang and dredging diaphragm treating has good clinical curative effect on improving the level of reflux which contribute to the physical and mental health of patients with GERD.关键词：Gastro-esophageal Reflux Disease;invigorating spleen and harmonizing stomach with warming yang and dredging diaphragm;curative effect evaluation;esophagus 24 hours pH monitoring and inspection
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发布时间：2023-04-10 - 摘要：Objective To observe the effects of Liqi Tongbian Acupoint Plaster on the clinical symptoms and quality of life of patients with qi stagnation type of functional constipation.Methods A total of 60 patients were divided into treatment group and control group by random method with 30 patients each.The treatment group was treated with Liqi Tongbian Acupoint Plaster made from a basic prescription on Shénquè（神阙CV8）,and the control group was treated with 1/10 of the dose of the basic prescription of the Plaster on the same point.The treatment course was 4 weeks,and the changes of the overall symptom score,single symptom score and SF-36 life scale score of constipation before and after the treatment in two groups were observed.Results The improvement of overall and single symptom scores of constipation in the treatment group was significantly better than that in the control group,and the difference was statistically significant（P<0.05）.The VT,MH and PCS dimensions in the SF-36 scale were improved after the treatment in the treatment group,with statistically significant differences（P<0.05）.The improvement in the BP dimension after treatment in the treatment group was better than that in the control group,with statistically significant differences（P<0.05）.Conclusion The self-designed Liqi Tongbian Acupoint Plaster for the treatment of qi stagnation type of functional constipation disease can significantly relieve the clinical symptoms and improve quality of life.关键词：Functional constipation;qi stagnation type;Liqi Tongbian Acupoint Plaster;Shénquè（神阙CV8）
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发布时间：2023-04-10 - 摘要：Objective To explore the medication rules of TCM ointment in the treatment of functional constipation.Methods From 2016 to 2018,137 prescriptions for functional constipation were collected from Professor Cai Gan’s ointment outpatient department.The application frequency of commonly used herbal drugs was calculated and SPSS modeler 18.0 Apriori algorithm was used to analyze the usage of different drug combinations in the treatment of functional constipation.Results The most commonly used five Chinese herbs were:Radix Aucklandiae,Raw licorice,Poria cocos,Pseudostellaria principis,Orange peel;the most commonly used five groups of herbal medicines were Pinellia and Orange peel,Amomum villosum and Radix Aucklandiae,Amomum kravanh and Radix Aucklandiae,Amomum kravanh and Amomum villosu,Raw atractylodes and Licorice.Conclusion The ointment prescription in treating functional constipation attaches great importance to the care of the spleen and the stomach,strengthening spleen and helping transportation as the main method,and compatible with the Methods of moisturizing bowel,clearing heat and removing dampness,nourishing yin and fluid,promoting blood circulation and removing blood stasis,dissipating phlegm and removing stagnation,tonifying kidney and purgation.关键词：CAI Gan;TCM ointment;Functional constipation;data mining;medication rules
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发布时间：2023-04-10 - 摘要：目的观察化浊解毒方对慢性萎缩性胃炎（CAG）浊毒内蕴证患者血清胃蛋白酶原（PG）、胃泌素-17（G17）水平的影响,探讨临床作用机制。方法将176例CAG浊毒内蕴证患者随机分为2组,观察组89例口服化浊解毒方治疗,对照组87例口服胃复春片治疗,治疗均为3个月。比较2组治疗前后中医证候积分、胃镜下黏膜病变积分、病理组织学病变积分、PGⅠ、PGⅡ、PGR及G17改变情况。结果治疗后观察组的各项证候积分均较治疗前降低,差异有统计学意义（P<0.05）;与对照组比较,差异亦有统计学意义（P<0.05）。治疗后观察组各胃镜下黏膜病变积分均较治疗前下降,差异有统计学意义（P<0.05）;对照组变白/花斑、变薄血管透见、局部颗粒状、红斑、糜烂、出血点积分较治疗前降低,差异均有统计学意义（均P<0.05）;变白/花斑、变薄血管透见及结节样隆起积分治疗后观察组积分低于对照组,差异有统计学意义（P<0.05）。治疗后观察组各项病理组织学病变积分均低于治疗前,差异有统计学意义（P<0.05）;观察组腺体萎缩、肠上皮化生积分低于对照组,差异均有统计学意义（均P<0.05）。2组治疗后PGⅠ、PGR较治疗前升高,G17较治疗前下降,差异均有统计学意义（均P<0.05）;2组间差异亦有统计学意义（P<0.05）。结论化浊解毒方治疗CAG浊毒内蕴证,能改善患者中医症状、胃镜下黏膜病变及病理组织学病变情况,其机制可能与调节PGⅠ、PGR、G17水平有关。
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发布时间：2023-04-10 - 摘要：Objective To study TCM physical distribution features of autoimmune hepatitis（AIH）patients to provide guidance for TCM treatment and nursing.Methods 247 patients with AIH were analyzed,and according to gender,age and liver cirrhosis,the distribution of TCM constitution was observed.Results The AIH ratio of the distribution of TCM Constitution was in descending order:yin deficiency（25.1%）and qi stagnation（21.1%）,qi deficiency（15.0%）,balanced constitution（13%）,damp heat（10.5%）,phlegm and damp（8.1 %）,blood stasis（3.2%）and yang deficiency（3.2%）,the intrinsic constitution（0.8%）.Secondly,gender did not affect the distribution of TCM constitution type,but the age and liver cirrhosis could affect the distribution of TCM Constitution types.Conclusion The AIH patients are mainly manifested as the biased constitution,including yin deficiency,qi stagnation and qi deficiency;with the increase of age,the balanced body constitution become less,while yang deficiency and blood stasis gradually will increase;with the progression of the disease,qi stagnation,blood stasis,yin deficiency,yang deficiency constitution gradually increase,while balanced condition,qi deficiency,blood,phlegm dampness,damp heat constitution gradually reduce.关键词：Autoimmune hepatitis;TCM constitution;distribution;evolution
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发布时间：2023-04-10 - 摘要：Objective To evaluate the complete remission rates in elderly AML（M3 excluded）patients during peri-induction chemotherapy period after receiving one course of combined treatment of induction chemotherapy and Yiyiren Oil injection.Methods Elderly inpatients（≥60 years old） in Dongzhimen Hospital from January 2009 to January 2016 were the subjects,and based on whether Yiyiren Oil injection was incorporated in the patients’ treatment regimen or not during hospitalization,these cases were divided into two groups:those who received Yiyiren Oil injection were categorized into the combined treatment group,while those who did not were placed in the simple treatment group.The clinical remission rate,TCM symptoms,sign effect and drug safety between the two groups were compared.Results After one course of induction,complete remission was seen in 13 cases（40.6 %）and partly remission in 5 cases（15.6 %）in the treatment group,and complete remission was seen in 7 cases（30.4 %）and partly remission in 5 cases（21.8 %）in the control group,the differences between the two groups were not statistically significant（P>0.05）.Bone marrow blast percentages was 4.5 in the treatment group and 9.0 in the control group.The total effect rate of TCM syndrome was 77.2 % in the treatment group,and 20.0 % in the control group,and the difference between the two groups was not statistically significant（P>0.05）.The incidence of heart,liver,and kidney toxicity after one course of induction therapy was18.7 %,31.2 %,and 12.5 % in the treatment group and 34.8 %,21.7 %,and 8.7 % in the control group respectively.The differences between the two groups were not statistically significant（P>0.05）.Conclusion Combined treatment regimen with induction chemotherapy and Yiyiren Oil injection has the effects for elderly AML（M3 excluded）patients in increasing remission rate,lower bone marrow blast percentage,more prominently in refractory or relapsed AML.Yiyiren Oil Injection has the effect of reducing chemotherapy-related cardiotoxicity in elderly patients with AML without increasing liver and kidney toxicity.关键词：Acute myeloid leukemia;elderly;peri-induction chemotherapy period;Yiyiren Oil injection
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发布时间：2023-04-10 - 摘要：Objective To observe the clinical effect of modified Baihe Dihuang Decoction combined with auriculotherapy for the treatment of type 2 diabetes accompanied by insomnia. Methods 56 patients were randomly divided into two groups: modified Baihe Dihuang Decoction combined with auriculotherapy group（treatment group） and Zopiclone Tablets group（control group）. Both groups were treated for 28 days. Pittsburgh sleep quality index（PSQI）, TCM symptom scores, Hamilton Anxiety Scale（HAMA） and Glycosylated serum protein（GSP） were observed before and after the treatment. Results Both two groups of patients were been improved in sleep quality（P<0.05）, and GSP and HAMA scores were lowered than that before the treatment（P<0.05）. Compared with the control group, the improvement of sleep quality, sleep efficiency, daytime dysfunction index, HAMA and TCM symptom scores in the treatment group were significantly improved（P<0.05）. Conclusion Chinese herbal medicine combined with auriculotherapy is more effective on type 2 diabetes with insomnia, and is worth popularizing.关键词：Type 2 diabetes;insomnia;modifed Baihe Dihuang Decoction;auriculotherapy
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发布时间：2023-04-10 - 摘要：Objective To study the protective effect of schisandrin B on myocardial cells with hypoxia/reoxygenation-induced injury in neonatal rats,and observe its inhibitory role in endoplasmic reticulum stress.Methods Cardiac myocytes from neonatal SD rats were cultured and pretreated with schisandrin B with low-（10 mg/L）,medium-（100 mg/L）,high-（200 mg/L）concentration and SIRT1 inhibitor（Ex-527）,before exposure to hypoxia（95 %N2-5 %CO2）for 3 h and reoxygenation（95 % air-5 %CO2）for 3 h to create cell model of hypoxia/reoxygenation.The effect of schisandrin B on the relative survival rate of cardiac myocyte was detected.The lactate dehydrogenase（ LDH）level,methylenediox yamphetamine（MDA）level and superoxide dismutase（SOD）activity were investigated.Western Blot was used to determine the expression levels of GRP78,CHOP,Cleaved caspase12,SIRT1 and PGC-1α protein.Results Compared with the control group,the relative survive rate of cardiac myocyte in H/R group was significantly decreased（P <0.05）,the LDH and MDA levels in I/R group were highly increased（P<0.05）,SOD activity was sharply decreased（P<0.05）,the expression levels of GRP78,CHOP,Cleaved caspase12 in I/R group were significantly increased（P<0.05）,and the expression levels of SIRT1 and PGC-1α were greatly decreased（P<0.05）.Compared with I/R group,the relative survival rate of cardiac myocyte in schisandrin B groups were significantly increased（P<0.05）,the LDH and MDA levels in schisandrin B groups highly were decreased（P<0.05）,SOD activity was sharply increased,the expression levels of GRP78,CHOP,Cleaved caspase12 in schisandrin B were significantly decreased（P<0.05）,and the expression levels of SIRT1 and PGC-1α were greatly increased（P<0.05）.However,the effect of Ex-527 on cardiac myocyte was opposite to schisandrin B.Conclusion Schisandrin B has a protective effect on cardiac myocyte injury caused by hypoxia/reoxygenation,which is partially via suppressing the endoplasmic reticulum stress.关键词：Schisandrin B;endoplasmic reticulum stress;hypoxia/reoxygenation;cardiac myocyte
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of modified Xiaoyao San on the balance of helper T cell 1（Th1） and helper T cell 2（Th2） on allergic conjunctivitis. Methods Mice model with allergic conjunctivitis induced by ovalbumin（OVA） were randomly divided into model group, modified Xiaoyao San group（including high, medium and low dose group）, positive drug control group（cromolyn sodium eye drops）, another normal group as a blank control, each group had 10 mice so a total of 60, and intervention was given for 2 weeks. Eye signs were observed and serum levels of IFN-γ and IL-4 detected by ELISA. Results Each dose of modified Xiaoyao San could alleviate eye symptoms. The model group had the highest mean sign score, significantly higher than that in the blank control group（P<0.01）, the scores of signs in Xiaoyao San group with different dose were lower than of in the model group（P<0.01）. There was no significant difference between the mean scores of Xiaoyao San group and the scores were closer to that of the Cromolyn sodium eye drops group（P> 0.05）.2. Serum IL-4, IL-4/IFN-γcontent in each dose of Xiaoyao San group and cromolyn sodium eye drops group were lower than that of model group（P<0.01）, but IFN-γwere higher than that of model group; there was no significant difference among high, medium and low dose of Xiaoyao San groups（P>0.05）. Conclusion Modified Xiaoyao San may ease the eye signs in mice with allergic conjunctivitis, and possibly regulate Th1 and Th2 balance.关键词：Modified Xiaoyao San;allergic conjunctivitis;Th1/Th2 balance
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发布时间：2023-04-10 - 摘要：功能性不射精症病因不明,病理不清,西医尚无一种FDA认可的治疗方法,中医整体观念和辨证论治仍是治疗此类疾病的重要选择。李曰庆教授对于功能性不射精症的治疗有独特的经验,认为可从精窍的开阖功能入手,把握其与脏腑经络的关系,兼顾外邪的影响,身心同治,损益结合,以恢复精液的正常排泄。关键词：李曰庆;功能性不射精;精窍;开阖
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发布时间：2023-04-10 - 摘要：郭军教授认为男性不育症是脏腑、气血、津液功能失调共同作用的结果,特发性弱精子症是男性不育症的重要原因之一,多由痰湿引起,导致脏腑阴阳失调,气血津液不能布化而致病。以"先驱邪,后扶正"为治疗思路,初期在患者肾精不亏的前提下以二陈汤为基础方,以理气祛痰、健脾化湿为法,后期辅以补肾强精治疗。关键词：特发性弱精子症;痰湿;二陈汤;郭军
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发布时间：2023-04-10 - 摘要：翁维良教授擅长运用自拟方"疏肝活血方"治疗冠心病冠状动脉介入治疗（PCI）术后合并焦虑患者,翁老认为心脉瘀阻、肝郁气滞为冠心病PCI术后病机关键,治疗上主张"双心"同调,心肝同治,尤其强调治肝,即疏肝理气、养血安神与活血化瘀并进。关键词：翁维良;冠心病;PCI术后;焦虑;老中医经验
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发布时间：2023-04-10 - 摘要：外阴白色病变常伴随的瘙痒干涩,迁延难愈,为患者带去极大烦苦。由于病因并不明确,现代医学仅能对症止痒或手术处理,症状时常反复。金哲教授创立"一源三岐"学术思想,将中医利湿、养血、祛风的诊疗思路,与西医改善外阴营养、减轻炎性渗出、治疗毒菌感染相结合,以中医药治疗为主,现代医学为指导,使用归根膏"养血气、祛风燥、利湿毒",当外阴得到滋养,肌肉得充实,腠理更加致密,则瘙痒可以消散,外阴色泽恢复如常。同时也为中医药治疗外阴白色病变,提供了新的治疗思路,也为广大外阴白色病变的患者带去福音。关键词：外阴白色病变;一源三岐;归根膏;养血祛风法;金哲
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发布时间：2023-04-10 - 摘要：《医学心悟》为清代名医程国彭所著,在书中不乏记载一些内科急诊重症的资料,为后世医家辨治内科急诊重症起了指导作用。通过研读《医学心悟》,从内科急诊重症的急诊危重症的临床特点、急诊重症的鉴别诊断、急诊重症的病因病机、急诊危重症的辨证要领等方面,梳理了《医学心悟》其对中医急诊重症学科的贡献。关键词：《医学心悟》;内科急诊重症;学科建设
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发布时间：2023-04-10 - 摘要：临床治疗火证,实火以苦寒清热为主,虚火以滋阴降火为主,然补土伏火亦是治疗火证的重要方法。分析历代医家相关论述及临床运用经验,总结"补土伏火"有两层含义,一是补中焦脾胃而助生理之真火;二是补中焦脾胃而能够潜降上越的虚火。对脾虚脉弱兼有虚火上冲症状者,可选择应用。关键词：补土伏火;阴火;封髓丹
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发布时间：2023-04-10 - 摘要：目的分析高血压病胰岛素抵抗（IR）中医内治法及用药配伍特点,以期为高血压病临床治疗和研究提供参考。方法纳入中国知网、万方数据知识服务平台、维普数据库收录的中医药治疗高血压病IR的临床研究文献,提取内治法和用药信息建立处方数据库,对数据进行频次、频率的统计、聚类,并分析药物配伍如药对、角药。结果共纳入高血压病IR文献78篇,涉及中医治则13种,其中高血压病IR中医内治法频次在前6位的分别是化痰降浊（11频次）、活血（7频次）、平肝潜阳（6频次）、滋养肝肾（6频次）、养阴（5频次）、清肝泻火（5频次）。治疗高血压病IR方剂57首,涉及中药84味,使用频次居前12位的药物从高到低依次是牛膝、丹参、钩藤、大黄、菊花、石决明、泽泻、茯苓、山楂、桑寄生、天麻、黄芩。聚类分析结果显示,治疗高血压病IR用药的4个核心药物群:牛膝、丹参、钩藤;大黄、石决明、菊花、茯苓、泽泻;桑寄生、山楂、黄芩、天麻、黄芪、生地黄、葛根、甘草、桃仁;黄连、地龙、山药、决明子、杜仲、陈皮、白芍、半夏、牡蛎、当归、何首乌、龙胆。使用频数居前5位的药对:牛膝+钩藤（8频数）,牛膝+石决明（6频次）,牛膝+丹参（6频次）,牛膝+桑寄生（6频次）,丹参+桑寄生（6频次）;常使用的角药:牛膝+丹参+桑寄生（6频次）;牛膝+石决明+钩藤（6频次）。结论高血压病IR的内治法以化痰降浊、活血养阴为主,兼顾平肝潜阳、育阴息风、解毒利湿、调肝健脾益肾。关键词：高血压病;胰岛素抵抗;用药配伍;特点;中医内治法
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发布时间：2023-04-10 - 摘要：目的观察自拟清火散结汤口服结合药液熏蒸双目治疗表层巩膜炎的效果。方法选择2016年12月—2018年12月于作者所在医院就诊的表层巩膜炎患者43例（60只眼）,采用随机数字表法将其分为中药组22例（30只眼）与对照组21例（30只眼）。中药组给予清火散结汤口服结合药液熏蒸双目,对照组给予局部冰袋冷敷,每次10～15 min,每日3次、患眼局部点普南扑灵滴眼液,2组均治疗4周。比较2组有效率、复发率及主观症状、巩膜充血评分。结果中药治疗组治愈8只眼（26.67%）,好转17只眼（56.67%）,无效5只眼（6.67%）,总有效率83.3%。对照组治愈5只眼（16.67%）,好转17只眼（56.67%）,无效8只眼（16.67%）,总有效率73.3%,前者的疗效好于后者,但是差异不显著（χ2=0.884,P=0.347）。对治愈患者分别3个月后随访,中药治疗组复发1只眼,复发率12.5%,对照组复发4只眼,复发率80.0%,2组有差异但无明显统计学意义（Fisher精确检验,P=0.532）。单纯性巩膜炎患者治疗后2组主观症状、巩膜充血评分均较治疗前明显改善（P<0.05）;治疗组主观症状、巩膜充血评分优于对照组,但无显著统计学差异（P>0.05）;结节性表层巩膜炎患者中药治疗后主观症状、巩膜充血评分均较前明显改善（P<0.05）,对照组与治疗前比较差异无统计学意义（P>0.05）;治疗后中药组主观症状评分、巩膜充血评分均优于对照组,差异有显著统计学意义（P<0.05）。根据修改后的正文补充2组有效率、复发率及主观症状、巩膜充血评分统计分析结果。结论自拟清火散结汤口服结合药液熏蒸双目治疗表层巩膜炎,对于结节性表层巩膜炎,治疗有明显优势,对于单纯性巩膜炎,中药或西药治疗均有改善,西医冷敷和非甾体类消炎药对症使用也有一定价值,中药组较对照组有治疗优势,但没有表现出显著统计学差异。关键词：表层巩膜炎;清火散结汤;熏蒸;复发
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发布时间：2023-04-10 - 摘要：目的观察不同运动方式下12周前后2型糖尿病患者糖脂代谢、生存质量的变化。方法 60例2型糖尿病患者分别进行为期12周的改良八段锦锻炼、快走及对照,12周训练前后所有患者检测空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、血脂（TC、TG、HDL-C、LDL-C）,并采用WHOQOL-BREF量表对其生存质量进行评估,观察不同运动方式对2型糖尿病患者糖脂代谢、生存质量的影响。结果改良八段锦可以降低2型糖尿病患者HbA1c水平,减少降糖药物使用;患者WHOQOL-BREF量表总分干预前后差异有统计学意义（P<0.01）;在生理领域方面,干预前后差异有统计学意义（P<0.05）。结论改良八段锦与快走运动相比,可降低2型糖尿病患者平均血糖水平,改善患者生存质量。关键词：改良八段锦;2型糖尿病;糖脂代谢;生存质量
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发布时间：2023-04-10 - 摘要：目的借助数据挖掘的方法,对刘清泉教授治疗危重症患者的用药规律进行研究,发掘其常用的药物及其配伍规律。方法 （1）病历检索与筛选:通过医院信息系统调取2016年1月—2018年4月ICU的全部中药汤剂处方,筛选其中由刘清泉教授开出或指导开出的处方,剔除外用处方、灌肠处方和口护处方,抓取系统里的字段,包括患者姓名、年龄、性别、科室、医师、药物、剂量、用法、医嘱时间。（2）纳入及排除标准:收集2016年1月—2018年4月北京中医医院ICU住院患者所有中药处方,纳入口服或鼻饲中药汤剂处方,排除住院患者外用处方、灌肠处方和口护处方;借助SAS 8.1软件和SQL语句完成数据变化工作,完成数据录入与清洗工作,采用SAS 8.1和SPSS Clementine 17.0软件从频数分析、广义规则归纳算法（Generalizedrule induction,GRI）的关联规则、聚类分析等角度进行分析。结果共统计3256首处方,剔除口护方、灌肠方、外用方后口服方剂共2 723首,涉及中药400味,通过频数分析筛选出常用药物84味,得出配伍规律关联规则30条,通过聚类分析得出处方15首。结论应用多种数据挖掘方法,系统总结了刘清泉教授危重病论治的用药规律,为临床用药和进一步研究学习刘清泉教授的学术经验提供了基础。关键词：危重症;刘清泉;用药经验;数据挖掘
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发布时间：2023-04-10 - 摘要：目的观察在常规护理基础上应用中药穴位贴敷技术改善危重症患者早期肠内营养导致腹胀的效果。方法采用随机对照方法,将120例患者分成对照组和观察组2组,各60例,分别给予常规护理和常规护理+中药穴位贴敷技术。比较2组干预7日后肠鸣音、腹围和腹腔压,并评价腹胀程度变化。结果干预后,观察组肠鸣音、腹腔压、腹围均较干预前改善,差异均有统计学意义（均P<0.01）;对照组肠鸣音、腹腔压较干预前改善,差异有统计学意义（P<0.05,P<0.01）。2组间比较,观察组肠鸣音、腹腔压和腹围改善程度优于对照组,差异均有统计学意义（均P<0.01）。结论中药穴位贴敷对危重症患者肠内营养所致腹胀具有一定改善作用。关键词：危重患者;肠内营养;腹胀;穴位贴敷
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发布时间：2023-04-10 - 摘要：目的观察益气养阴、活血化瘀法治疗老年2型糖尿病肾病（Ⅲ、Ⅳ期）的临床疗效。方法将70例糖尿病肾病（DN）患者按年龄分成2组,比例约为1∶1,A组年龄<60岁,B组年龄≥60岁。均给予益气养阴、活血化瘀法为主治疗12周,观察2组疗效及治疗前后中医证候积分、空腹血糖（FBG）、餐后2小时血糖（2 hPG）、糖化血红蛋白、24h尿蛋白定量、肝肾功能指标、血脂指标等变化情况。结果服药12周后,A组总有效率82.35%,B组为77.78%,但2组间差异无统计学意义（P>0.05）。治疗后,A组中医症候积分及尿白蛋白排泄率、HDL-C、TG均较治疗前改善（P<0.05）;B组中医症候积分及尿白蛋白排泄率均较治疗前改善（P<0.05）。治疗后2组间比较,尿微量白蛋白排泄率差异有统计学意义（P<0.05）。结论对Ⅲ、Ⅳ期的老年2型DN患者使用益气养阴、活血化瘀法能够有效的改善临床症状,但控制蛋白尿改善肾小球滤过率方面效果不及非老年患者。关键词：糖尿病肾病;气阴两虚夹瘀;益气养阴;活血化瘀;老年
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发布时间：2023-04-10 - 摘要：目的观察养阴益气合剂联合醋酸泼尼松治疗结缔组织病继发间质性肺病（CTD-ILD）的临床效果。方法选取2016年1月—2017年8月CTD-ILD患者59例,随机分为观察组30例,对照组29例,对照组采用醋酸泼尼松片进行治疗,观察组在对照组治疗基础上加养阴益气合剂治疗。比较2组的总有效率、不良反应发生率以及治疗前后症状积分、圣乔治医院呼吸调查问卷（SGRQ）评分、影像评分等。结果观察组总有效率高于对照组（P<0.05）。治疗后观察组症状积分、SGRQ评分、影像评分均低于治疗前（P<0.05）;且均低于对照组（均P<0.05）;对照组症状积分、影像评分低于治疗前（P<0.05）,SGRQ评分与治疗前比较,差异无统计学意义（P>0.05）。观察组不良反应发生率低于对照组（P<0.05）。结论养阴益气合剂联合醋酸泼尼松可显著改善CTD-ILD患者的临床症状,效果与安全性优于单纯醋酸泼尼松治疗。关键词：结缔组织病继发间质性肺病;养阴益气合剂;醋酸泼尼松
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发布时间：2023-04-10 - 摘要：目的观察二仙止遗散敷脐治疗遗尿症的疗效。方法选择2014年12月—2017年6月门诊收治的遗尿症患者63例,分为观察组32例,对照组31例。观察组给予二仙止遗散敷脐治疗,做成直径1 cm、厚0.5 cm的药饼,睡前以医用胶布固定于神阙穴（肚脐）,晨起取下,每6天休息1天。对照组给予口服醋酸去氨加压素,睡前1 h服用,根据患儿年龄、病情轻重及效果调整剂量,最大剂量不超过0.6 mg/天,服药后严格限水。2组均连续治疗1个月为1疗程。对比2组疗效,统计2组治疗期间发生的不良反应及随访6个月的复发情况。结果观察组总有效率高于对照组（P<0.05）。结论二仙止遗散敷脐治疗遗尿症效果醋酸去氨加压素治疗。关键词：遗尿症;二仙止遗散;中医外治法
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发布时间：2023-04-10 - 摘要：目的观察摩腹法加穴位点按治疗血液透析患者功能性便秘的临床疗效。方法第一阶段:将入选患者随机分为治疗组及对照组各30例。对照组给予常规血液透析治疗,治疗组常规血液透析的同时给予顺时针按摩腹部加穴位点按治疗。第二阶段:将对照组患者随机分为单纯摩腹法和单纯穴位点按2组,各15例,观察并比较3种方法的治疗效果。结果治疗组痊愈3例,有效21例,总有效率为80.0%;对照组痊愈0例,有效8例,总有效率为26.67%,2组间差异有统计学意义（P<0.05）。单纯摩腹组总有效率62.3%,单纯穴位点按组为49.1%,2组疗效基本相当,治疗后症状均较治疗前明显改善,治疗前后比较差异有统计学意义（P<0.05）。结论摩腹法加穴位点按可有效缓解维持性血液透析患者便秘症状,提高患者生活质量。关键词：血液透析;便秘;摩腹法;穴位点按
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发布时间：2023-04-10 - 摘要：<正>刘殿池主任医师,师从名医王大经,从医40余年,精通内科杂病,尤擅于治疗内分泌系统、风湿免疫疾病等,对于疑难杂症及危重病证辨别精准,遣方用药轻灵。结合脏腑六经辨证,以少阴虚寒为基础,应用麻黄附子细辛汤或麻黄附子甘草汤治疗糖尿病。1 少阴证与糖尿病《伤寒论》曰:"少阴病,脉微细,但欲寐。少阴病,始得之,反发热,脉沉者,麻黄细辛附子汤主之……少阴病,得之二三日,麻黄附子甘草汤微发汗,以二三日无里证,故微发汗也。"三阴病[1],因其阳气关键词：少阴证;麻黄附子细辛汤;麻黄附子甘草汤;糖尿病
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发布时间：2023-04-10 - 摘要：<正>当前中医药多应用于治疗慢性疾病,较少应用于急重症的治疗。而历代中医医家在临床中不乏遇到各种急重病情,来势急、变化快、病情重,故也积累了丰富的临床经验,有其独到之处。1 龙胆泻肝汤治疗急性视神经炎龙胆泻肝汤以龙胆草为君,泻肝胆实火,利肝胆湿热;柴胡、黄芩、栀子助以泻火;车前子、木通、泽泻辅以利湿;佐以生地、当归滋阴养血,顾护根本;甘草调和诸药,使全方具有清泻肝胆实火上炎和清利肝胆湿热下注的功效。肝开窍于目,肝胆实火循经上炎可引起目关键词：眼科;急重症;医案;中医药疗法
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发布时间：2023-04-10 - 摘要：<正>"上焦宣痹汤",原方名"宣痹汤",因见于《温病条辨·上焦》,故后世便有称其为"上焦宣痹汤"者。此方由枇杷叶、郁金、射干、通草、豆豉组成,以清宣肺痹为主,宣气分阻滞以除呃。五味共达宣透上焦湿痹、清解上焦郁热之功。1 病案举例1.1 支气管炎患儿,男,7岁,2017年5月23日初诊。3周前感凉后出现咽痛咽干,家长自行予银黄颗粒、蒲地蓝消炎片等清热、解毒、利咽中成药,用药后咽痛减轻但出现咳嗽,且迁延不愈。于外院查血常规均正常,胸片关键词：上焦宣痹汤;感冒后咳嗽;慢性咽炎;过敏性鼻炎;辨证论治
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发布时间：2023-04-10 - 摘要：<正>皮肌炎（dermatomyositis,DM）是一组病因不明、以横纹肌为主要病变的非化脓性炎症性疾病,常以亚急性发作的对称性四肢近端肌痛、肌无力及特征性皮疹为主要表现,同时可累及肺、食管等多个脏器[1]。DM病情多为进行性,5年病死率接近50%[2],中医药治疗优势的发挥显得尤为重要。冯兴华教授是国家级名老中医,首都国医名师,从医五十余载理验俱丰,治学严谨,在中医风湿病诊疗中积累了大量经验,在干燥综合征、强直性脊柱炎、类风湿性关节炎等多关键词：皮肌炎;发热;医案;冯兴华
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发布时间：2023-04-10 - 摘要：<正>"发热待查"是内科医生常见的临床问题,发热是由于各种致热源导致前列腺素（E2）释放,作用于下丘脑,使体温调定点升高,从而出现产热效应。经典型发热待查是指发热持续3周以上,口腔测体温至少3次>38.3℃（或至少3次体温1 d内波动>1.2℃）,经过至少1周在门诊或住院的系统全面的检查仍不能确诊的一组疾病[1]。导致经典发热的病因有200余种,可以归纳为感染性疾病、肿瘤性疾病、非感染性炎症性疾病、其他疾病4类[2]。临床需要详细询问病史,精关键词：发热待查;幼年特发性关节炎;成人斯蒂尔病;ANCA相关性小血管炎;青少年
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发布时间：2023-04-10 - 摘要：<正>清代著名医学家黄元御创立了"一气周流""六气治法"和"中气升降"等理论,在治疗上重视中气升降,以扶阳抑阴、厚培中气原则,被后世称为"医门大宗""一代之大医"。《四圣心源》是其将理论与临床紧密结合的代表作,现将其学术思想在难治性皮肤病治疗中应用阐释如下。1 黄元御主要学术思想黄元御依据《内经》天人相应思想,提出"一气周流,土枢四象"的学术思想。四象即阴阳之升降,阴阳即中气之浮沉。分而名之,则曰四象,合而言之,不过阴阳。分而言之,则关键词：《四圣心源》;银屑病;慢性荨麻疹;带状疱疹后遗神经痛
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发布时间：2023-04-10
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