最新刊期
期 7 ， 2020
- 摘要：<正>当前,全球新型冠状病毒肺炎（以下简称"新冠肺炎"）疫情形势仍很严重,近期北京市又出现本地病例,为进一步加强新冠肺炎中医药救治工作的精准性和规范性,推进中西医协同治疗以提高治愈率、降低病死率,在总结先期中医药治疗新冠肺炎经验的基础上,对《北京市新型冠状病毒肺炎中医药防治方案（试行第四版）》进行修订,形成了本方案。各医疗机构可参照本方案确定的原则进行辨证论治及预防。1 中医病因病机本病属于中医学"疫病"范畴,湿毒疫疠之气,自口鼻而入关键词：新型冠状病毒肺炎;中医药;防治方案;北京市
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发布时间：2023-04-11 - 摘要：<正>2019年12月以来,湖北省武汉市陆续发现新型冠状病毒肺炎（corona virus disease 2019,COVID-19,简称"新冠肺炎"）病例,并迅速蔓延至全国。国家卫生健康委员会、国家中医药管理局陆续下发了6版《新型冠状病毒肺炎诊疗方案（试行）》,从第三版开始推荐中医药治疗,但自该方案下发以来,临床对中药的合理使用可能存在一些不足,例如中药饮片炮制规格的选择、特殊注意事项等。中药的临床药学服务可以从处方审核、合理用药指导关键词：新型冠状病毒肺炎;中药;临床药学;合理用药;共识
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发布时间：2023-04-11 - 摘要：为建立新型冠状病毒肺炎（COVID-19,简称"新冠肺炎"）疫情期间肿瘤患者中西医结合临床管理策略,根据近期发表的有关新冠肺炎流行病学特征、临床特点的文献及国家卫健委下发的有关新冠肺炎的防控文件,结合全国多家中西医结合肿瘤防治单位临床实践,经中国中西医结合学会肿瘤专业委员会专家组充分讨论形成共识性文件。该共识提出了新冠肺炎疫情期间基于肿瘤患者病情与所处治疗阶段的分类管理建议、肿瘤患者入院诊疗管理,提出了普通肿瘤患者、新冠肺炎疑似肿瘤患者、新冠肺炎确诊肿瘤患者中西医结合诊疗与调护方案。在遵守国家及地方相关管理政策的前提下,推荐基于本共识开展肿瘤患者的管理。关键词：新型冠状病毒肺炎;中西医结合肿瘤治疗;临床管理;专家共识
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发布时间：2023-04-11 - 摘要：Objective To discuss the rules of acupoint selection and compatibility in Tuina manipulation for lung rehabilitation based on data mining technique. Methods Acupoints prescriptions of Tuina manipulation for pulmonary rehabilitation released from the establishment of these database to March 1, 2020 by online databases such as CNKI, Wanfang medical network and VIP database were collected and sorted.The frequency of used acupoints, the association rules between the acupoints as well as the new prescriptions for the massage were determined through the Chinese Medicine inheritance system V2.5. Results A total of 17 articles were included with 22 effective prescriptions, in which acupoints mainly belong to Conception Vessel（CV）, Bladder Meridian of Foot-Taiyang（BL）, Lung Meridian of Hand-Taiyin（LU）, Governance Vessel（GV）and Stomach Meridian of Foot-Yangming. The used acupoints with the highest frequency were Fèishū（肺俞BL13）, Shènshū（肾俞BL23）, Dìngchuǎn（定喘EX-B1）, etc. The combinations of acupoints with the highest frequency were Fèishū（肺俞BL13）with Shènshū（肾俞BL23）, and Fèishū（肺俞BL13）with Dìngchuǎn（定喘EX-B1）,etc. The core combinations were Yīngǔ（阴谷KI10）-Dìngchuǎn（定喘EX-B1）-Tiāntū（天突CV22）, Yīngǔ（阴谷KI10）-Dìngchuǎn（定喘EX-B1）-Géshū（膈俞BL17）, etc. New prescriptions were formed including Yīngǔ（阴谷KI10）, Dìngchuǎn（定喘EX-B1）, Tiāntū（天突CV22）,Tàixī（太溪KI3）, Fèishū（肺俞BL13）and Géshū（膈俞BL17）, etc. Conclusion It can be seen from the data mining analysis techniquethat Tuina manipulationcan could strengthen the antipathogenic qi and improve pulmonary function in lung rehabilitation. It provides a treatment idea for early lung rehabilitation in COVID-19 convalescent patients.关键词：corona virus disease,COVID-19;pulmonary rehabilitation;Tuina;data mining;association rules;clustering algorithm
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发布时间：2023-04-11 - 摘要：Objective To observe the effect of Qiting Lishui Prescription on the clinical efficacy, quality of life and serum levels of matrix metalloproteinase-2（MMP-2）and matrix metalloproteinase-9（MMP-9）in patients with heart failure of coronary heart disease. Methods 60 patients diagnosed with heart failure of coronary heart disease with Qi deficiency and water retention from September 2018 to September 2019 in cardiovascular department, Beijing Hospital of Traditional Chinese Medicine were randomly divided into control group and treatment group. Both two groups were given standardized treatment by western medicine, the treatment group were treated with extra Qiting Lishui Prescription. The NT-proBNP levels, TCM syndrome score, living quality score and level of MMP-2 and MMP-9 were compared between the two groups of patients.Results The difference of NT-proBNP level before the therapy between the two groups was no significant（P>0.05）. After treatment, the NT-proBNP level of two groups was decreased, the difference was statistically significant（P<0.01）, the NT-proBNP level of the treatment group was much lower than that of the control group, the difference has statistical significance（P<0.05）, and the NT-proBNP decline rate of treatment group was higher than that of the control group, the difference was statistically significant（P<0.01）.There was no significant difference in TCM syndrome score between the two groups before treatment（P>0.05）, while the TCM syndrome score of the two groups after treatment were decreased compared with that before treatment（P<0.05）, and the TCM syndrome score of the treatment group was much lower than that of control group with statistically significant difference（P<0.05）.There was no significant difference in the scores of quality of life before treatment between the two groups（P>0.05）, and the scores of quality of life after treatment were improved compared with that before treatment, with statistically significant difference（P<0.05）. Besides, the scores of quality of life after treatment in the treatment group were higher than those in the control group, with statistically significant difference（P<0.01）. Before treatment, there was no significant difference in MMP-2 and MMP-9 levels between the two groups（P>0.05）. After treatment, MMP-2 and MMP-9 levels of two groups were lower than those before treatment, with statistically significant difference（P<0.05）. After treatment, MMP-2 and MMP-9 levels of the treatment group were lower than that of the control group, with statistically significant difference（P<0.01）.Conclusion Qiting Lishu Prescription can effectively improve the clinical symptoms and quality of life of patients with heart failure of coronary heart disease due to Qi deficiency and water retention, and reduce the levels of NT-proBNP, MMP-2 and MMP-9, suggesting that this prescription may improve the outcomes by alleviating cell matrix damage and myocardial remodeling.关键词：Qiting Lishui Prescription;coronary heart disease;heart failure;Qi deficiency and water retention;quality of life;serum matrix metalloproteinase
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发布时间：2023-04-11 - 摘要：Objective To observe the efficacy and safety of Biyukang Mixture Ⅰ on rheumatoidarthritis（RA）.Methods A total of 120 RA with cold-dampness obstruction syndrome inpatients and outpatients received from January 2017 to May 2019 by the Department of Rheumatology,Beijing Hospital of TCM Affiliated to the Capital Medical University were randomly divided into treatment group and control group with randomized, controlled, double-blind, double simulation method, with 60 cases in each group.The treatment group was given Biyukang Mixture Ⅰ, Tripterygium wilfordii polyglycoside tablets placebo and nonsteroidal anti-inflammatory Drugs（NSAⅠDs）, the control group was given Tripterygium wilfordii polyglycoside tablets, Biyukang Mixture Ⅰ placebo and NSAⅠDs both for 12 weeks.A 28-joint Disease Activity Score（DAS28）, health assessment questionnaire（HAQ）and TCM syndrome scores were administered to both two groups at week 2, week 4, week 6, week 8 and week 12. Results At week 12, the total effectiveness of treatment group was 93.3%, that of control group was 90%, the treatment group was better than the control group, but the difference was not statistically significant（P>0.05）;with the treatment getting longer, the effectiveness was increased in TCM syndrome（P<0.05）. The ACR20 patients in treatment group was 93.3%, while that in the control group was 90%. The treatment group was superior to the control group, but the difference was not statistically significant（P>0.05）, with the treatment getting longer, the patients reaching ACR20 became more and more compared with that before the treatment（P<0.05）.Serious adverse events was not found in both groups. Conclusion Biyukang Mixture Ⅰ has similar effect as Tripterygium wilfordii polyglycoside tablets on cold-dampness obstruction syndrome of RA with high safety.关键词：Biyukang Mixture Ⅰ;rheumatoid arthritis;cold-dampness obstruction syndrome
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发布时间：2023-04-11 - 摘要：Objective To observe the effect of Renzhu Jianpi Liqi Granules on gastric accommodation of rats with functional dyspepsia（FD）and explore its mechanism. Methods In vivo experiment: 75 SD rats were randomly divided into normal group, model group, as well as high-dose group, medium-dose group and low-dose group of Renzhu JianpiLiqi Granules. Rats with FD were developed by combining neonatal iodoacetamide-treatment and adult tail-damping. The normal group and the model group were given normal saline by gastric lavage, and the high, medium and low dose groups of Renzhu Jianpi Liqi Granules were given corresponding doses of Renzhu Jianpi Liqi Granules by gastric lavage respectively. After the detection of 3-hour food intake, the gastric accommodation of rats in each group was measured by electronic constant voltage device. In vitro experiment: The proximal gastric muscle strips of rats were prepared in order to detect the effects of Renzhu Jianpi Liqi Granules on the tension ofstrips of rats. Results In vivo experiment showed that the 3-hour food intake in the model group was significantly lower than that in the normal group（P<0.01）; the 3-hour food intake of the high and medium dose groups of Renzhu Jianpi Liqi Granules was significantly higher than that of the model group（P<0.01）; the gastric accommodation of rats in the model group was significantly lower than that of in the normal group（P<0.05）; the gastric accommodation of rats in the high, middle and low dose groups of Renzhu Jianpi Liqi Granules was higher than that in the model group（P<0.05）. In vitro experiment showed that Renzhu Jianpi Liqi Granules（300, 3 000 and 6 000 μg/mL）could significantly reduce the tension of proximal gastric muscle strips of rats; L-NAME could partially inhibit the effect of Renzhu Jianpi Liqi Granules on the reduction of smooth muscle tension. Conclusion Renzhu Jianpi Liqi Granules can improve gastric accommodation in FD rats. Its action mechanism may be related to regulating the synthesis and release of NO and reducing the tension of proximal gastric smooth muscle.关键词：functional dyspepsia;Renzhu Jianpi Liqi Granules;gastric accommodation;tension of isolated proximal gastric muscle strips;rats
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发布时间：2023-04-11 - 摘要：Objective To observe the effect of Shufeng Jiedu Capsules（SFJDC）on the expression of serumCD3+, CD4+/CD8+ of rats with acute pharyngitis（AP）. Methods Seventy rats were randomly divided into seven groups, 10 rats in each group（half male and half female）, including blank control group, model group, placebo group, clarithromycin sustained-release tablet group, SFJDC high, medium and low dose groups. AP rat model was prepared with the method of pharyngeal spray and ammonia modeling. After the success of 3-day modeling, from the fourth days on, SFJDC was given intragastric administration of 2.2, 1.1 and 0.55 g/（kg·d）respectively. The clarithromycin sustained release tablets group was given clarithromycin sustained release tablets 20 mg/（kg·d）, and the placebo group was given the same amount of distilled water with intragastric administration twice a day, all continuously for 5 days. The general situation of rats in each group was observed, and the expression of CD3+, CD4+/CD8+ in serum T lymphocyte subsets was detected. Results By observing the changes of rats’ behavior and pathological sections comparison score, there was found a significant statistical difference between the model group and the blank control group（P<0.05）, which indicated a successful modelling of AP rats. Compared with the placebo group, there were no differences in the mean CD3+ of the SFJDC high, medium and low dose group and the clarithromycin sustained-release tablet group（P>0.05）; the mean CD4+ of the SFJDC high, medium and low dose group and clarithromycin sustained-release tablet group decreased, but the differences were not statistically significant（P>0.05）; the average CD8+ of the SFJDC high, medium, and low dose groups and the clarithromycin sustained-release tablet group increased, however, only SFJDC high dose group had significant difference（P<0.01）; the CD4+/CD8+ mean values of the SFJDC high,medium dose groups and the clarithromycin sustained-release tablet group decreased, and there were significant differences（P<0.05,P<0.01）. Compared with the clarithromycin sustained-release tablet group, the CD3+ and CD8+ of the SFJDC high dose group were better than the clarithromycin sustained-release tablet group, and the differences were statistically significant（P<0.05）.Conclusion SFJDC has a better therapeutic effect on AP rats. The mechanism of SFJDC in treating AP may be that it has immunity-regulating effect by adjusting the ratio of CD3+, CD4+/CD8+ of serum T lymphocyte subsets.关键词：Acute pharyngitis;T cell subsets;immunoregulation;ShuFeng Jiedu Capsules;rats
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发布时间：2023-04-11 - 摘要：李佩文教授认为肿瘤性发热的热型特点为午后发热、五心烦热、骨蒸潮热,以阴虚内热为主要病机,兼以气虚、血瘀、精亏之证。受"清骨散"启发,以清虚热、消骨蒸之法,拟清热消蒸汤,治疗肿瘤性发热。体现了中医治病求本、标本同治的特色。关键词：李佩文;清热消蒸汤;肿瘤性发热;老中医经验;中医药疗法
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发布时间：2023-04-11 - 摘要：仝小林教授临床擅用经方桃核承气汤治疗流行性出血热（epidemic hemorrhagic fever,EHF）,其认为血瘀尿闭是膀胱蓄血证的核心病机;结合临床,提出逐瘀通下是EHF无尿期治疗的关键环节。仝教授运用桃核承气汤治疗EHF的3大辨治要点:①辨有无表证;②辨膀胱蓄血与类膀胱蓄水;③辨痛吐胀闭。治疗时紧扣"以通为用"的要点,剂量选择上常用桃仁30～60 g、生大黄30～60 g、芒硝15～30 g、加用厚朴30 g、枳实30 g等,促进胃肠动力,增强以通为用功效。关键词：仝小林;流行性出血热;桃核承气汤;以通为用;名中医经验
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发布时间：2023-04-11 - 摘要：王麟鹏教授根据多年中医针灸临床经验,结合现代医学,治疗面瘫疗效确切。王教授在诊断面瘫同时注意明确西医诊断,避免延误病情,并提出以追求最完整的功能恢复为目标。根据面瘫不同时期的病机特点,提出急性期逐邪、缓解期祛邪通经、恢复期扶正逐邪的治疗原则,并指明具体的针药治疗及调护方法,另外治疗全程需注重调神。关键词：王麟鹏;面瘫;针灸;治疗;名中医经验
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发布时间：2023-04-11 - 摘要：糖尿病肾病是糖尿病最常见的微血管并发症之一。冯兴中教授认为糖尿病肾病是糖尿病之坏证,糖尿病日久阴伤气耗,气血津液运行失常,变生湿、痰、瘀等病理产物,壅滞体内、郁积不解而成浊毒,毒邪流注肾脏,损伤肾络,其病位主要在肾,与脾、肝密切相关,病性为本虚标实,本虚以气虚、阴虚、阳虚为主,标实以湿、痰、瘀、热、毒、气滞为主,核心病机为"气虚生毒";冯兴中教授在临床治疗上针对该核心病机,以"益气固肾解毒"为主要治疗原则,随症进行辨证治疗,加用滋阴、温阳、健脾化湿、祛痰、活血化瘀、清热、疏肝理气等药物,取得了很好的临床疗效。关键词：冯兴中;糖尿病肾病;益气;解毒;固肾;名医经验
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发布时间：2023-04-11 - 摘要：肛周湿疹是肛肠科常见病,主要临床表现为瘙痒、肛门潮湿等,常反复发作,肛门局部可见丘疹、结痂、脱屑等皮损表现,严重影响患者的生活质量。肛周湿疹多以风湿挟热、脉络瘀阻为主,风湿热互结、气血不畅是其核心病机。贾小强教授认为治疗肛周湿疹应审证求因,明辨病机,治病求本,祛风、活血、胜湿三法合用。祛风胜湿是治疗本病的常法,活血化瘀法是提高疗效、缩短病程、减少复发的关键。关键词：贾小强;肛周湿疹;辨证论治;名医经验
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发布时间：2023-04-11 - 摘要：鲍身涛教授认为湿疹的中医病机以肝脾失调为本,而以"湿""热""毒"为标。故治疗应重视疏理肝气、健运脾胃,同时兼顾清热、利湿、解毒等以祛除病邪,临床采用中药内服配合中医外治法,达到标本兼治的目的。关键词：鲍身涛;湿疹;从肝脾论治;名医经验
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发布时间：2023-04-11 - 摘要：冠心病是全球死亡率最高的疾病之一,不能进行血运重建的冠心病是一类特殊的冠心病,通常合并多种慢性疾病,具有十分严重和复杂的冠状动脉病变或是存在手术治疗的禁忌证而无法实施血运重建治疗。阳虚血瘀贯穿冠心病发展始终,为不能进行血运重建的冠心病的基本证型。而扶阳活血法以扶助心、脾、肾三焦阳气,活血化瘀同时兼顾疏理气机,为运用中西医结合的方法治疗不能进行血运重建的冠心病提供了新的策略。关键词：扶阳活血法;不能进行血运重建;冠心病
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发布时间：2023-04-11 - 摘要：徐旭英教授认为乳腺癌术后上肢淋巴水肿的病机为气血亏虚、水湿停聚、血络瘀阻、气机不畅。辨证时首辨阴阳,治法分内外。内治:阳证治法为利湿活血通络,阴证治法为益气温通,后期注意顾护脾肾;外治:溻渍法,以煎药后残渣兑适量温水浸泡患肢,直达病灶。内外合治,促进病情恢复。关键词：乳腺癌术后上肢淋巴水肿;内外合治;中医药疗法
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发布时间：2023-04-11 - 摘要：肿瘤中医病证范畴广泛,病因病机复杂,临床症状与证候特点呈现多样化,标本缓急各异,多有从化、易于传变。因此临证辨别标本、虚实、缓急、顺逆裁定治则是肿瘤防治的重要临床思维方法,辨标本虚实思维,即思维学中理论思维和关系概念在中医临床思维中的具体体现。具体包括辨本虚、标实证,急则治标、缓则治本,基于治病求本与扶正培本治则、病因辨证与祛邪解毒治则、攻补兼施治则等多种思维方法,临证应依据实际需求,将辨标本虚实论治肿瘤临床思维方法与辨病思维、辨证思维、治未病思维、三因制宜思维、杂合以治思维、中西医汇通思维融会贯通,随证立法,灵活运用。关键词：肿瘤;辨证论治;标本;虚实;思维方法
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发布时间：2023-04-11 - 摘要：小细胞肺癌是肺癌中恶性程度极高的一种,其预后极差,生存期短。张培彤主任认为小细胞肺癌以肺、脾、肾脏气亏虚为本,痰、瘀、毒邪气炽盛为标。局限期的治疗需辨病辨证相结合,分为化疗期、放疗期、维持治疗期3阶段论治,以益气养阴、健脾益肾、清热解毒、活血化瘀、化痰散结、解毒抗癌等法灵活组合运用。强调用药剂量大,治疗时间长,方可收到满意的疗效。关键词：小细胞肺癌;局限期;中医辨治;张培彤
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发布时间：2023-04-11 - 摘要：目的系统评价生脉散联合常规西药治疗病毒性心肌炎的疗效及安全性。方法检索CNKI、WANFANG Data、VIP、SinoMed、PubMed、Cochrane Library、Web of science数据库自建库以来至2020年2月26日公开发表的与生脉散治疗病毒性心肌炎相关的随机对照试验。由2名研究者根据纳入排除标准筛选文献,运用Revman 5.3软件进行临床疗效和安全性评价。结果共纳入26篇文献,共计2 144例患者,文献质量一般。Meta分析结果显示:与对照组比较,试验组总有效率高（P<0.01）,治疗后试验组乳酸脱氢酶（LDH）、肌酸激酶（CK）及肌酸激酶同工酶（CK-MB）水平降低,心电图异常改善明显（P<0.01）;但2组天门冬氨酸氨基转移酶（AST）水平及不良事件发生率比较,差异无统计学意义（P>0.05）。结论生脉散联合常规西药治疗病毒性心肌炎可提高临床疗效,降低LDH、CK、CK-MB水平,改善心电图,且安全性较好;但本研究文献存在一定偏倚。关键词：病毒性心肌炎;生脉散;疗效;安全性;Meta分析
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发布时间：2023-04-11 - 摘要：目的观察心衰合剂对射血分数保留的心力衰竭患者心肌纤维化的影响。方法选择2017年3月—2018年3月在北京中医医院顺义医院心血管内科住院的慢性心力衰竭患者77例,用随机数字表法将患者分为治疗组39例、对照组38例。对照组给予西医常规治疗,治疗组在西医常规治疗基础上给予心衰合剂,疗程2周。对比2组疗效,治疗前后检测2组心肌纤维化标志物血清可溶性基质裂解素2（sST2）、半乳糖凝集素-3（Gal-3）及N-末端脑钠肽前体（NT-proBNP）水平。结果 2组总有效率比较,差异无统计学意义（P>0.05）。与治疗前比较,治疗组患者sST2水平降低,差异有统计学意义（P<0.01）;治疗后治疗组较对照组血清sST2水平降低（P<0.05）。与治疗前比较,2组患者Gal-3水平均无明显变化,差异无统计学意义（P>0.05）;治疗后2组患者Gol-3水平比较差异无统计学意义（P>0.05）。与治疗前比较,治疗组NT-proBNP降低明显（P<0.05）,而对照组有轻微升高趋势（P>0.05）;治疗后治疗组患者NT-proBNP明显低于对照组（P<0.05）。结论心衰合剂可改善甚至逆转射血分数保留的心衰患者心肌纤维化进程。关键词：慢性心力衰竭;射血分数保留;心衰合剂;心肌纤维化
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发布时间：2023-04-11 - 摘要：目的观察化瘀通络中药熏洗方在全膝关节置换术（total knee arthroplasty,TKA）后早期康复中的应用效果。方法选择2019年3—9月作者所在医院住院的TKA术后康复患者80例,采用随机数字表法分为试验组与对照组各40例。对照组给予常规康复训练,试验组在常规康复训练基础上加用中药熏洗治疗,干预时间均为2周。比较2组治疗前后膝关节功能评分、优良率及不良反应。结果干预2周后,试验组膝关节功能评分表（KSS评分）、膝关节功能优良率高于对照组（P<0.05）,2组均未发生严重不良反应。结论化瘀通络中药熏洗方可增强TKA患者早期功能锻炼效果,改善膝关节功能。关键词：中药熏洗;全膝关节置换术;康复
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发布时间：2023-04-11 - 摘要：目的观察夏枯草颗粒合丹栀逍遥散颗粒联合西药治疗桥本氏甲状腺炎甲状腺功能减退的临床疗效。方法选择2017年6月—2018年6月就诊于烟台市中医医院内分泌科门诊的桥本氏甲状腺炎甲状腺功能减退患者60例,采用随机数字表法将患者分为治疗组、对照组各30例。2组均给予低碘饮食,对照组给予左甲状腺素钠片口服治疗,治疗组在对照组基础上加夏枯草颗粒及丹栀逍遥散颗粒口服。4周为1个疗程,2组均治疗3个疗程。对比2组疗效、临床症状体征评分、甲状腺左右叶及峡部前后径变化、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）、甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPO-Ab）,观察治疗期间患者的不良反应及心电图、肝肾功能变化。结果治疗组总有效率90%,高于对照组（P<0.05）;治疗组临床症状体征评分、甲状腺大小、TSH水平、甲状腺抗体滴度均优于对照组（P<0.05,P<0.01）。2组治疗过程中均无明显不良反应。结论夏枯草颗粒合丹栀逍遥散颗粒联合西药治疗甲状腺功能减退的桥本氏甲状腺炎安全有效。关键词：桥本氏甲状腺炎;甲状腺功能减退;夏枯草颗粒;丹栀逍遥散颗粒
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发布时间：2023-04-11 - 摘要：目的观察化痰调脂汤辅助治疗冠心病伴血脂异常患者临床疗效及对血清同型半胱氨酸（Hcy）和血脂指标的影响。方法选择2018年1月—2019年1月作者所在医院收治的冠心病伴血脂异常患者68例,用随机数字表法将其分为观察组和对照组各34例。2组均给予调脂、扩血管、抗血小板聚集、拮抗神经内分泌等冠心病基础用药,治疗组在此基础上加服化痰调脂汤,2组均治疗8周。对比2组疗效及治疗前后脂蛋白a、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、Hcy、心绞痛疗效、心电图疗效及中医证候积分等。结果观察组心绞痛疗效、心电图疗效及中医证候疗效总有效率优于对照组,差异有统计学意义（P<0.05）;2组治疗后脂蛋白a、TC、TG、LDL-C、HDL-C及Hcy水平均优于治疗前（P<0.05）,且观察组各指标水平均优于对照组（P<0.05）。结论在西医治疗基础上联用化痰调脂汤能有效调节冠心病伴血脂异常患者的血脂水平及血清Hcy水平,提高临床疗效,值得临床借鉴。关键词：冠心病;化痰调脂汤;脂蛋白a;同型半胱氨酸
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发布时间：2023-04-11 - 摘要：目的评价夏荔芪胶囊治疗良性前列腺增生的有效性及安全性。方法采用多中心、随机、双盲、双模拟、阳性药对照临床试验设计。将440例脾肾气虚兼痰瘀型良性前列腺增生患者按3∶1的比例随机分为治疗组、对照组。治疗组口服夏荔芪胶囊（每粒0.45 g）,3粒/次,3次/d;同时口服前列舒乐颗粒模拟剂（每袋4 g）,1袋/次,3次/d。对照组口服前列舒乐颗粒（每袋4 g）,1袋/次,3次/d;同时口服夏荔芪胶囊模拟剂（每粒0.45 g）,3粒/次,3次/d。2组均治疗4周。比较2组治疗前后国际前列腺症状评分（I-PSS）及中医证候评分、泌尿症状困扰评分（BS）、最大尿流率、前列腺体积、残余尿量,评价2组药物的疗效和安全性。结果治疗组总有效率高于对照组（P<0.01）。2组单项主要症状疗效比较,对排尿无力、滴沥不尽、夜尿频多的改善,治疗组疗效优于对照组（P<0.05）;对小腹坠胀、腰膝酸软、倦怠乏力的改善,2组疗效相当（P>0.05）。治疗后2组I-PSS评分、中医证候评分均较治疗前降低（P<0.05）,且治疗组I-PSS评分、中医证候评分低于对照组（P<0.05）。治疗后2组BS评分、前列腺体积、残尿量均较治疗前降低,最大尿流率较治疗前升高,差异有统计学意义（P<0.05）;且治疗后治疗组BS评分较对照组低,最大尿流率较对照组高,差异有统计学意义（P<0.05）。2组在缩小前列腺体积、减少残尿量方面的疗效相当（P>0.05）。治疗组1例、对照组2例发生与治疗药物相关的不良事件。结论夏荔芪胶囊治疗良性前列腺增生有效,且安全性较高。关键词：良性前列腺增生;夏荔芪胶囊;临床疗效评价;中医证候评分
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发布时间：2023-04-11 - 摘要：目的观察益气生津袋泡茶在气阴两虚型糖尿病前期患者中的应用效果。方法选择2016年6月—2019年8月于作者所在医院就诊的气阴两虚型糖尿病前期患者72例,用随机数字表法将患者分为治疗组和对照组各36例,治疗组失访2例,最终入组34例;对照组失访4例,最终入组32例。对照组给予基础治疗,治疗组给予基础治疗及益气生津袋泡茶治疗。疗程均为16周。对比2组疗效,2组治疗前后空腹血糖（FBG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、总胆固醇（TCHO）、甘油三酯（TG）、中医证候积分,记录治疗组治疗期间发生的不良反应。结果治疗后2组FBG、2 hPG、HbA1c、TCHO、TG与治疗前比较差异有统计学意义（P<0.05）,且治疗组FBG、2 hPG、HbA1c低于对照组（P<0.05）;治疗组中医证候改善优于对照组（P<0.05）;治疗组总有效率高于对照组（P<0.05）;治疗组未发生明显不良反应。结论益气生津袋泡茶可有效改善气阴两虚型糖尿病前期患者症状,降低血糖及相关生化指标,且无明显不良反应。关键词：益气生津;袋泡茶;糖尿病前期;气阴两虚
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发布时间：2023-04-11 - 摘要：目的对2004—2018年推拿治疗小儿腹泻的临床文献进行特征现状的计量学分析,为临床实践和科研提供参考。方法检索中国知网（CNKI）、万方（Wanfang）、重庆维普中文科技期刊（VIP）、中国生物医学文献数据库（Sinomed）及PubMed、EMBASE、Cochrane Library,纳入运用推拿治疗小儿腹泻、肠炎、肠道功能紊乱的临床研究及其系统综述文献。检索时间:2004年1月—2018年12月。采用SPSS 22.0对相关文献的发表年代分布、研究类型、文献来源、基金资助、推拿流派等文献特征进行分析。结果共纳入符合条件的文献560篇,包括系统综述5篇、随机对照试验209篇、队列研究1篇、非随机对照试验69篇、病例系列232篇、病例报告44篇;在对照设计的试验中有159篇文献的干预措施是单用推拿疗法,120篇文献的干预措施是推拿联合其他疗法,对照组疗法包括蒙脱石散、益生菌类、西医其他对症治疗及中药等其他疗法。纳入文献主要以中文形式发表在181种杂志上,发表文献数量排名前3位的期刊为《按摩与导引》《按摩与康复医学》《中国民间疗法杂志》;仅有4.82%文章标注基金资助;排名前3位的特色推拿流派是山东三字经流派、捏脊（积）流派、湖南湘西流派等。结论 2004—2018年推拿治疗小儿腹泻的临床研究有较快发展,其证据的等级和效力不断提高,发文期刊的分布较为分散,特色推拿流派发表的相关临床文献偏少。关键词：推拿;小儿腹泻;文献计量学;文献特征;推拿流派
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发布时间：2023-04-11 - 摘要：目的建立子宫锭的质量控制标准。方法采用薄层色谱法对处方中的血竭、蛇床子进行定性鉴别研究;分别采用高效液相色谱法和气相色谱法对子宫锭中的儿茶素和麝香酮进行含量测定。结果薄层色谱可检出血竭、蛇床子的特征斑点;儿茶素在0.632 5～1.265 0μg范围呈良好的线性关系（r=0.999 9）,平均回收率为98.71%,RSD=1.56%;麝香酮在0.134 4～0.302 4μg范围呈良好的线性关系（r=0.999 8）,平均回收率为98.36%,RSD=1.82%。结论本方法准确、灵敏、重复性好,为子宫锭的质量控制提供了依据。关键词：子宫锭;儿茶素;麝香酮;薄层色谱法;高效液相色谱法;气相色谱法
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发布时间：2023-04-11 - 摘要：目的建立高效液相色谱法（HPLC）测定香苏正胃丸中新橙皮苷的含量方法。方法色谱柱:Hypersil ODS2柱（250 mm×4.6 mm,5μm）;以乙腈-水（20∶80）（用磷酸调节pH值至3.0）为流动相;检测波长:283 nm;柱温:30℃;流速:1.0 mL/min;进样量:20μL。结果新橙皮苷在10.01～320.4 mg/L的浓度范围内线性良好,平均加样回收率分别为99.8%（RSD=1.06%）。结论该测定方法灵敏度高、准确、可靠、重现性良好,可作为香苏正胃丸的定量分析方法。关键词：香苏正胃丸;新橙皮苷;高效液相色谱法;含量测定
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发布时间：2023-04-11 - 摘要：<正>抗中性粒细胞胞浆抗体（antineutrophil cytoplastic antibody,ANCA）相关性血管炎（ANCA-associated vasculitis,AAV）是一种可累及多系统的自身免疫性疾病,病理特点是小血管壁炎症和纤维素样坏死,血清中伴有ANCA存在的系统性血管炎。本文回顾分析1例中西医结合治疗AAV累及肺脏、影像表现为肺部占位性病变,临床反复高热并出现指趾坏疽的病案资料。1 病案介绍患者,男,55岁,关键词：抗中性粒细胞胞浆抗体;血管炎;肺部占位;坏疽;四妙勇安汤
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发布时间：2023-04-11 - 摘要：<正>随着经济的迅速发展,人民生活水平迅速提高,多种因素导致肥胖人数日益增多,阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hyponea syndrome,OSAHS）已逐渐成为全球范围内的公共卫生问题[1]。目前,西医治疗主要分为非手术治疗和手术治疗,非手术治疗主要包括一般性治疗、气道正压通气治疗、安装口腔矫正器、药物治疗等,但其临床疗效有待提高,治疗后不良反应尚需进一步研究。中医推拿治疗可以通过缓解肌肉关键词：阻塞性睡眠呼吸暂停低通气综合征;推拿;拨筋疗法;医案
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发布时间：2023-04-11 - 摘要：<正>复发性流产（recurrent spontaneous abortion,RSA）属于病理性妊娠,指在同一配偶情况下连续遭受2次或2次以上的早期妊娠胚胎停育或自然流产[1]。近年,该病发病率呈上升趋势,占育龄女性的1%～5%。有报道,RSA患者再次妊娠,妊娠早期发生胚胎停育或自然流产风险的可能性高达70%～80%,严重危害育龄期女性的身心健康及社会和谐。RSA病因复杂多样,包括生殖道解剖结构异常、病原微生物感染、自身免疫性疾病、遗传因素关键词：不明原因复发性流产;中西医;研究进展;文献综述
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发布时间：2023-04-11
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