最新刊期

    9 2020
    • NIU Zhu-zhu,RAO Xiang-rong
      Vol. 39, Issue 9, Pages: 901-905(2020) DOI: 10.16025/j.1674-1307.2020.09.001
      摘要:目前慢性肾脏病已成为我国重要的公共卫生问题,在临床实践中需要改进慢性肾脏病的防治,实施以人为本的诊断和管理计划。在诊疗过程中,应关注患者的健康相关生活质量,针对不同的症状进行辨证论治。关注认知障碍、虚弱综合征、肌少症等与健康相关生活质量密切相关的临床综合征的治疗,保护脏腑功能,祛除内生之邪,发挥中医药防治的优势,为患者提供更好的医疗服务体验,是未来努力的方向。  
      关键词:慢性肾脏病;健康相关生活质量;认知障碍;虚弱综合征;肌少症   
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      发布时间:2023-04-11
    • Vol. 39, Issue 9, Pages: 901(2020)
      摘要:<正>有数据显示,2017年全球慢性肾脏病(chronic kidney disease,CKD)患病率为9.1%,患者人数达6.975亿,导致全球当年约120万人死亡,其致残、致死率增幅排在所有慢病前列。与1990年数据相比,2017年接受透析和肾脏移植的患者分别上升43.1%和34.4%。全球疾病负担组织慢性肾脏病协作组明确指出:"CKD的防治成功与否关系到全球可持续发展目标的实现。"为了改进CKD的防治,国际肾脏病界正在经历从以疾病为中心的医疗服务转变为实施以人为本的综合防治理念,在防止终末期肾脏病发生和心血管死亡的同时,提倡关注患者的临床症状和对治疗的主观感受,以提高健康相关生活质量。同时,提出以人为本应结合不同国家社会发展水平和文化背景。毫无疑问,中医药是最具中国特色的CKD防治措施。  
        
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      发布时间:2023-04-11
    • XIONG Meng-ran,FANG Lv-gui,YUAN Bo,SHI Pei-qi,CUI Han-ming,ZHANG Run-shun,LI Shen,RAO Xiang-rong
      Vol. 39, Issue 9, Pages: 906-909(2020) DOI: 10.16025/j.1674-1307.2020.09.002
      摘要:Objective To explore the distribution rules of traditional Chinese medicine(TCM)syndromes in patients with chronic kidney disease(CKD)and mild cognitive impairment(MCI)and their relationship with various cognitive functions.Methods The clinical data of 139 outpatients and inpatients from the Department of Nephrology of Guang’anmen Hospital, China Academy of Chinese Medical Sciences from May 2017 to December 2018 and TCM syndromes of them were collected.And the Montreal Cognitive Assessment Scale(MoCA)Chinese version was used to assess the cognitive functions which were compared with TCM syndromes.Results The distribution of TCM syndromes: syndrome of qi and blood deficiency> syndrome of blood stasis obstructing collaterals of brain> syndrome of dampness and turbidity damaging clearness> deficiency of kidney essence.The abstract score and language score of patients with deficiency of qi and blood were the lowest(Z=-2.046, P=0.041; Z=-2.108, P=0.035).Conclusion CKD patients complicated with MCI have the highest proportion of deficiency of both qi and blood, and patients with this syndrome are more likely to suffer from impairment of abstract function and language function.  
      关键词:Chronic kidney disease;cognitive impairment;TCM syndromes   
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      发布时间:2023-04-11
    • GUO Chuan,SHEN Jia-chen,PIAO Yuan-lin,WANG Ya-rong,YIN De-hai
      Vol. 39, Issue 9, Pages: 910-915(2020) DOI: 10.16025/j.1674-1307.2020.09.003
      摘要:Objective To investigate the effects of Huangqi Tujian Mixture on the proliferation of glomerular mesangial cells in rats under high-glucose condition and its possible mechanism.Methods Male SD rats were randomly divided into two groups,which were respectively given Huangqi Tujian Mixture and distilled water of equal volume in order to prepare serum contained drug and normal rat serum.The glomerular mesangial(HBZY-1) cells of rats were randomly divided into four groups: 5 mmol/L glucose+normal serum group(control group), 25 mmol/L mannitol + normal serum group(D-mannitol group), 30 mmol/L glucose + normal serum group group(HG group) and 30 mmol/L glucose + drug-contained serum group(HG+HQTJM group).After 24 hours, 48 hours and 72 hours of intervention, CCK8 method was used to detect the proliferation activity and western blot method was used to detect the protein expression changes of collagen Ⅳ and fibronectin in HBZY-1 cells in each group.Meanwhile, the mRNA expressions of tumor necrosis factor-α,Interleukin-1β,phosphatase and tensin homologue deleted on chromosome 10 and protein kinase B in HBZY-1 cells were detected by real time PCR, the expression levels of TNF-α and IL-1 β in the supernatant were measured by Elisa.Results Compared with the control group, D-mannitol group had no significant effect on the proliferation of HBZY-1 cells and the expression of various molecules had no statistical significance(P>0.05), while in the HG group, the proliferation activity of HBZY-1 cells at 48 h and 72 h of intervention increased significantly, the protein expression of COLIV and FN increased, the gene expression of TNF-α, IL-1β and Akt increased significantly(P<0.05), and the mRNA expression of PTEN decreased with the difference not statistically significant(P>0.05), the expression of TNF-α and IL-1β protein in the supernatant of HG group significantly increased(P<0.05).Compared with the HG group, the HG+HQTJM group could significantly inhibit the proliferation of HBZY-1 cells(P<0.05)and the expression of COLIV and fibronectin in mesangial cells after 72 hours’ intervention;the mRNA expression of TNF-α in drug contained serum group was significantly lower than that in HG group after 24 hours’ intervention(P<0.05), and the mRNA expression of IL-1β was obviously lower than that of HG group after 48 hours’ and 72 hours’ intervention(P<0.05).In HBZY-1 cells, the PTEN gene expression significantly increased, Akt gene expression decreased, and TNF-α and IL-1β protein expression in cell culture supernatant increased at three time points of intervention(P<0.05).Conclusion Huangqi Tujian Mixture can significantly reduce the proliferation activity of HBZY-1 cells and down-regulate the protein expression of COLIV, FN in mesangial cells under high-glucose condition, which may be related to the activation of PTEN and the inhibition of inflammation mediated by PI3 K/AKT pathway.  
      关键词:Diabetic kidney disease;Huangqi Tujian Mixture;mesangial cell proliferation;PI3K/AKT;rat   
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      发布时间:2023-04-11
    • ZHANG Wen-lei,WANG Yao-guang
      Vol. 39, Issue 9, Pages: 916-921(2020) DOI: 10.16025/j.1674-1307.2020.09.004
      摘要:Objective To observe the effect of Yiqi Tongluo Formula on the protein expression of Wnt4, β-catenin, and Transforming Growth Factor-β1(TGF-β1) in rats’ kidney with unilateral ureteral obstruction(UUO).Methods Ninety six healthy adult SD rats were randomly divided into sham operation group, model group, low, medium and high dose Yiqi Tongluo Formula groups and losartan group respectively, with 16 rats in each group.Except the sham operation group, unilateral ureteral obstruction renal fibrosis model was established by ligating the left ureter.The sham operation group and model group were given normal saline by gavage, and the low, medium and high dose groups of traditional Chinese medicine and losartan group were given the medicines by gavage according to the corresponding drug concentration; 8 rats in each group were killed at random on the 7 th and 14 th day after modeling, and the blood samples were collected to detect the levels of serum creatinine(SCr) and blood urea nitrogen(BUN).The pathological changes of renal tissue were observed by HE staining and Masson staining, and the expression of Wnt4, β-catenin and TGF-β1 protein in renal tissues were detected by Western blot.Results The kidney tissue of the sham operation group was normal.Compared with the sham operation group at the same time point, renal interstitial fibrosis was found in the model group, SCr and BUN levels were increased, Wnt4, β-Catenin and TGF-β1 protein expression in renal tissues were significantly increased and the differences were statistically significant(P<0.05), and with the longer ureteral obstruction, the renal interstitial fibrosis got worse, the renal function reduced more, Wnt4, β-Catenin and TGF-β1 protein expression in renal tissues significantly increased.Compared with the model group at the same time point, the degree of renal interstitial fibrosis was alleviated, Wnt4, β-Catenin and TGF-β1 protein expression in renal tissues significantly decreased, and the differences were statistically significant(P<0.05) in low, medium an high-dose Yiqi Tongluo Decoction group and the Losartan group.Conclusion Wnt/β-catenin signaling pathway is activated in the renal tissues of UUO rats, which may mediate the transcription of TGF-β1.Yiqi Tongluo Formula may inhibit the activation of Wnt/β-catenin signaling pathway and down-regulate the expression of TGF-β1, thus playing an anti-renal fibrosis role.  
      关键词:Yiqi Tongluo Formula;UUO rats;renal interstitial fibrosis;Wnt/β-catenin pathway;TGF-β1;rat   
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      发布时间:2023-04-11
    • DENG Yan,YANG Jin-liang,SHI Jia-heng,QI Wen-sheng
      Vol. 39, Issue 9, Pages: 922-924(2020) DOI: 10.16025/j.1674-1307.2020.09.005
      摘要:从谈疫、论毒、解感冒、释膜原、议核心病机、评传入途径6个方面阐述齐文升教授对新型冠状病毒肺炎(简称"新冠肺炎")的认识。齐文升教授认为新冠肺炎属"湿疫""天行感冒",为"瘟疫"的一种,由"毒"引发,此种疫毒有类似"湿"的属性,而非湿邪。从膜原的角度概括新冠肺炎的复杂多变的临床现象及演变,总结为邪伏膜原证,病变部位为肺、脾(胃、肠),病变性质为湿毒、瘀闭、伤阳、耗血,疫毒闭肺为核心病机之一,疫毒主要从"窍"而入。  
      关键词:新型冠状病毒肺炎;天行感冒;湿疫;膜原   
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      发布时间:2023-04-11
    • ZOU Hao,KE Ying-shui,YAO Chen-si,WANG Yi-fei,XIONG Li-li,QIU Mo-yan
      Vol. 39, Issue 9, Pages: 925-926(2020) DOI: 10.16025/j.1674-1307.2020.09.006
      摘要:在新型冠状病毒肺炎的诊治过程中,越来越多的专家学者呼吁尽早关注血分病变。笔者结合邱模炎教授"湿热伤血"的学术思想,以湿热伤血为切入点,以既病防变为则,分析湿热伤血的各期表现,探讨以湿热为本的分期辅治方法,浅析新型冠状病毒肺炎的血分病变。  
      关键词:新型冠状病毒肺炎;湿热伤血;血分病变   
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      发布时间:2023-04-11
    • HUANG Fei,ZHANG Ya-qiang,LI Ye,LI Yi
      Vol. 39, Issue 9, Pages: 927-929(2020) DOI: 10.16025/j.1674-1307.2020.09.007
      摘要:新型冠状病毒肺炎属于中医学"疫"病范畴,病因为感受"疫戾"之气,尽管中医治疗已基本达成共识,"湿"性贯穿始终也得到普遍公认,但其核心病机和证型尚存争议。从致病特点似"湿"、证机百变非"湿"、古籍经典窥"湿"及似"湿"非"湿"之百家争鸣四个方面对新型冠状病毒肺炎的中医病机、证型进行初步探析,以期同道斧正。  
      关键词:新型冠状病毒肺炎;中医;湿;病因病机;证型   
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      发布时间:2023-04-11
    • GUO Song,MAO Xin-yong,CONG Yu,ZHANG Tao,DU Si-jing,LIU Qian,YANG Yang,SU Xiao-lan,WANG Xin,WEI Wei
      Vol. 39, Issue 9, Pages: 930-933(2020) DOI: 10.16025/j.1674-1307.2020.09.008
      摘要:新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)严重威胁全球人类的健康,细胞因子风暴可能是COVID-19重型化的主要原因。COVID-19的发病可能与中医学"湿邪致病"理论相关。外湿提供利于新型冠状病毒生存的环境,为细胞因子风暴的发生提供了外在条件;细胞因子风暴引起大量炎性渗出,生成内湿,影响器官功能;湿邪降低人体免疫功能,与细胞因子风暴后免疫抑制相关。针对COVID-19细胞因子风暴不同阶段的特征,采取相应祛除湿邪中医药干预,有利于防治COVID-19细胞因子风暴,降低病死率,增加患者获益。  
      关键词:新型冠状病毒肺炎;细胞因子风暴;中医;湿邪   
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      发布时间:2023-04-11
    • PANG Bo,JIANG Xiao-chen,LIU Rui-hong,QIAO Xi-jun,Hua Bao-jin
      Vol. 39, Issue 9, Pages: 934-939(2020) DOI: 10.16025/j.1674-1307.2020.09.009
      摘要:病证论治之法与方药配伍之法的关联是辨证论治的关键环节与核心思维方法。证之法当辨病五要素,方之法宜加减乘除四法。运用辨病五要素分析新型冠状病毒肺炎(corona virus disease 2019,COVID-19),其病位初起在膜原,病性具有"秽浊"和"火毒"之性,核心病机是秽浊闭阻气机、内热伤津耗气,重症存在毒邪败坏脏腑、气水血同病特点,病势有标本缓急、顺逆生死之异。并通过方法叠用、圆机化裁、对药配伍、一药多功的"方之法无尽"思维阐述COVID-19防治的具体思路与方法。  
      关键词:新型冠状病毒肺炎;思维方法;中医治法;方剂   
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      发布时间:2023-04-11
    • FU Kai-long,CAO Fang,LIU Zhao-heng,CAI Yao-dong,JIAO Yang
      Vol. 39, Issue 9, Pages: 939-942(2020) DOI: 10.16025/j.1674-1307.2020.09.010
      摘要:新型冠状病毒肺炎(简称"新冠肺炎")属于中医学"疫病"范畴,迄今为止,大量的临床实践证明,中医药对新冠肺炎的预防、治疗具有显著的作用。从中医药对新冠肺炎的认识、非特异性预防(避其毒气、逐其疫气、精神调护、饮食调护、运动调护、作息调护、脏腑预防、气候预防)、辨证施防、既病防变等方面对新冠肺炎的中医药防治手段及其现代医学原理进行探讨,以增进对中医药预防的认识和理解,提高对新冠肺炎的预防能力。  
      关键词:新型冠状病毒肺炎;中医药;预防   
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      发布时间:2023-04-11
    • HUANG Sheng-nan,SA Ri-na,CHU Meng-zhen,ZHANG Bing
      Vol. 39, Issue 9, Pages: 943-946(2020) DOI: 10.16025/j.1674-1307.2020.09.011
      摘要:新型冠状病毒肺炎(COVID-19,简称"新冠肺炎")疫情严重危害了人民的健康,临床上应用中西医结合治疗取得突出成效,但患者恢复期治疗仍是一项重要的医疗任务。通过分析我国及各地区新冠肺炎诊疗方案中恢复期患者药物应用,从指导新冠肺炎患者合理应用恢复期治疗药物(包括扶正类中药、祛痰药等)和合并慢性病用药(包括降压药、降糖药等)、追踪药品不良反应的转归、饮食调摄等方面探讨中药临床药师开展全程药学服务的策略,为中药临床药师指导新冠肺炎恢复期患者合理用药提供参考。  
      关键词:新型冠状病毒肺炎;恢复期;药学服务;中药临床药师   
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      发布时间:2023-04-11
    • ZHANG Dong-xiao,SUN Yu-jian,HUANG Qiao,ZHAO Wen-jie,FU Na,DONG Hao,LV Pei-wen
      Vol. 39, Issue 9, Pages: 947-949(2020) DOI: 10.16025/j.1674-1307.2020.09.012
      摘要:乳腺疾病常见的三大类疾患分别为乳腺炎症性疾患、增生性疾患、肿瘤性疾患,赵炳南老先生针对炎症性疾患,重视阴阳辨证,清热解毒法是基本法则,注重与凉血活血法配伍以增效;而针对乳腺增生和肿瘤性疾患,赵老多使用活血逐瘀药物,同时辅以温阳化痰软坚等药综合调治。内服药中赵老擅用对药和引经药;外用则剂型丰富,如芙蓉膏单独厚敷,而甘乳膏、京红粉软膏则薄涂于纱条上用药。赵老外治技法独具一格,药捻疗法用于窦道直达病所;引血疗法用于阴证、虚证、寒证,开刺络放血用于阴证、虚证先河。除整体观念、辨证论治、顾护脾胃外,"淘砌"理论用于疮面愈合、稳托疗法用于外科疑难杂症,均为赵老独创的学术理论。总结赵老学术思想在乳腺疾病的应用,以提升临床水平。  
      关键词:赵炳南;乳腺疾病;中医外科;治疗经验   
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      发布时间:2023-04-11
    • SHEN Zi-long,ZHAO Wen-jing,MENG Yuan,MENG Yan,ZHANG Bing-hou
      Vol. 39, Issue 9, Pages: 950-952(2020) DOI: 10.16025/j.1674-1307.2020.09.013
      摘要:复杂性尿路感染是指尿路感染同时伴有泌尿生殖道的结构或功能异常,或合并有糖尿病、慢性肾衰竭等疾病,病情容易反复,抗生素耐药现象突出,患者生活质量低下,临床治疗棘手。张炳厚教授认为本病的病机为肾阴亏虚、心肾失交,心火下移小肠,下焦湿热,病性为本虚标实,治疗强调扶正祛邪,治法重视滋阴补肾、清心火、清下焦湿热。导赤通淋汤是张炳厚教授治疗复杂性尿路感染经验方,本文介绍了张炳厚教授导赤通淋汤理法方药以及笔者运用本方治疗复杂性尿路感染经验。  
      关键词:张炳厚;导赤通淋汤;复杂性尿路感染;老中医经验   
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      发布时间:2023-04-11
    • LIU Da-peng,WANG Lin-peng,DING Hong-lei,LIU Tie-gang,HU Ke-xin,CUI Shu-sheng
      Vol. 39, Issue 9, Pages: 953-956(2020) DOI: 10.16025/j.1674-1307.2020.09.014
      摘要:椎动脉型颈椎病常以颈性眩晕、颈项酸痛不适及头枕部发作性跳痛或胀痛为主要症状,给患者工作和生活带来极大不便。崔述生教授从事颈椎病的研究与临床治疗工作近50年,总结临床经验提出手法治疗与药物治疗相结合,采用指针点穴、七线拨筋、拔伸牵引、旋转提扳、崔氏软伤洗剂外用的方法,"筋骨并重""标本兼治"治疗椎动脉型颈椎病,疗效显著。  
      关键词:崔述生;椎动脉型颈椎病;指针点穴;七线拨筋;软伤洗剂;老中医经验   
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    • LIU Xue,LI Guo-qin
      Vol. 39, Issue 9, Pages: 957-959(2020) DOI: 10.16025/j.1674-1307.2020.09.015
      摘要:肉芽肿性多血管炎是一种临床疑难罕见病,可累及全身多系统,早期症状缺乏特异性,部分患者抗中性粒细胞抗体检测阴性,易误诊、漏诊,延误治疗,糖皮质激素及免疫抑制剂虽疗效明显,但不良反应较多,且停药或药物减量后易复发。李国勤教授在治疗血管炎方面经验丰富,其认为肉芽肿性多血管炎中医属"血痹"范畴,需从急性发作期和缓解期分期论治,急性发作期以祛除外邪、化痰祛湿、祛瘀通络为治则,缓解期以补肺益肾治本为治则,从而达到辨病与分期辨证相结合的系统论治,最终可有效控制症状,防止复发。本文通过总结李国勤教授中医治疗肉芽肿性多血管炎的经验,有助于帮助临床医生提高对肉芽肿性多血管炎的中医认识及中医诊疗思路。  
      关键词:李国勤;肉芽肿性多血管炎;血痹;辨证论治;分期论治;老中医经验   
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    • HUANG Jing,ZHANG Bing
      Vol. 39, Issue 9, Pages: 960-961(2020) DOI: 10.16025/j.1674-1307.2020.09.016
      摘要:张冰教授基于临床中药学科特点及长期的临床实践,主张"立医选药、从药定效、医药融合"的诊疗思想。临床论治以药性理论为指导,关注中药的临床用药效益与风险;病证结合、应症组药,提出系列中药临床合理用药主张,力求精准用药。为保障患者用药安全和有效,提供参考。  
      关键词:张冰;临床中药;医药结合;用药实践   
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    • WANG Qing-ying,LANG Na,FU Zhong-xue,SHE Yuan-yao,YAO Chun-hai
      Vol. 39, Issue 9, Pages: 962-965(2020) DOI: 10.16025/j.1674-1307.2020.09.017
      摘要:麻黄连轺赤小豆汤是治疗阳明经变证湿热发黄的方剂之一,可外解在表之寒,内清经络、肌里之热,姚春海主任擅用其治疗多种皮肤科疾病,对原方用药用量加减化裁,根据风、湿、热(郁)各邪致病的不同侧重,以及病邪的相兼情况进行药味加减、合方应用。风邪致病明显者,重在通过疏散外风以缓解瘙痒,滋阴润肤减轻皮损的干燥程度;湿邪致病明显者,多在宣、利、温、化4种祛湿途径的基础上随证加减用药;热邪致病明显者,多兼顾血分,并根据病情深浅轻重程度选择用药。此外,本方所针对治疗的病证多伴有气机郁闭,故运用时常少佐行气、调血之品,以调畅气机,加强疗效。姚师对本方的应用尤为体现"异病同治"的诊治理念。  
      关键词:姚春海;麻黄连轺赤小豆汤;名医经验;皮肤病   
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    • ZHANG Jing-chun,LEI Shu-yan,QIAO Yu
      Vol. 39, Issue 9, Pages: 965-968(2020) DOI: 10.16025/j.1674-1307.2020.09.018
      摘要:清代宫廷医案是记录清代二百余年内帝后妃嫔、王公大臣等的原始诊疗档案,内容丰富。整理研究发现,在清代宫廷原始医药档案中从肝论治的应用颇为广泛,等级森严的宫廷之中,情志不遂、忧郁愤怒最为易见。中医认为肝主疏泄、调畅情志,从肝论治对情志因素诱发的各种疾病有着重要意义。本文对清宫医案中记载的从肝论治多系疾病的典型医案,加以整理并浅要分析。  
      关键词:清代宫廷医案;从肝论治;中医辨证   
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    • HUANG Pei-yi,LIANG Jing-rong,ZENG Tian-xiao,HAO Xiao-min,SUN Jiao,LIU Qing-guo
      Vol. 39, Issue 9, Pages: 969-971(2020) DOI: 10.16025/j.1674-1307.2020.09.019
      摘要:经筋痹是以活动受限伴随疼痛为主的临床常见病症,严重影响患者生活与工作。阳气在阴阳关系中起主导地位,本文通过对阳气与经筋生理、病理等研究,提出治疗经筋痹应以疏导阳气为切入点,以温阳除痹、疏通气机为原则,以扩大针刺面积、针刺关节左右为方法,为临床治疗提供了新思路。  
      关键词:经筋痹;阳气;内经;活动受限   
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    • LI Hui-juan,LI Hui
      Vol. 39, Issue 9, Pages: 972-974(2020) DOI: 10.16025/j.1674-1307.2020.09.020
      摘要:十枣汤是治疗胸腔积液的专方,由甘遂、芫花、大戟、大枣组成,其中甘遂、芫花、大戟均为有毒之品,临床应用较少。笔者采用根据十枣汤改良的甘遂大枣散(甘遂、大枣)治疗顽固性胸腔积液,根据患者体质将甘遂与大枣按一定比例同时打粉,并配以白粥送服,用量小、疗效肯定、安全性高。  
      关键词:顽固性胸腔积液;甘遂大枣散;十枣汤   
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    • CAO Yun,CHEN Jian-xin,FU Xin,HUANG Jia-qin,LIN Jia-ying,LI Zhi-hong
      Vol. 39, Issue 9, Pages: 975-979(2020) DOI: 10.16025/j.1674-1307.2020.09.021
      摘要:目的基于网络药理学探讨左金丸治疗反流性食管炎(reflux esophagitis,RE)多成分、多靶点、多通路的作用机制。方法以药物口服生物利用度(OB)和类药性(DL)为标准,借助中药系统药理学平台(TCMSP)、GeneCards和OMIM数据筛选并预测左金丸活性成分及治疗RE的作用靶标。基于Cytoscape 3.7.1软件构建"活性成分-靶标-疾病"复杂网络及拓扑学分析。借助STRING数据库构建靶蛋白相互作用(protein-protein interaction networks,PPI)网络;通过Uniprot数据库获取靶标蛋白的基因名称,利用DAVID在线工具进行潜在基因的基因本体(gene ontology,GO)分析及基因组百科全书(kyoto encyclopedia of genes and gnomes,KEGG)通路富集分析。结果从TCMSP数据库筛选出左金丸的41种活性成分;C-T-D网络中包含30个化合物,102个靶点。PPI网络中包含102个蛋白,涉及JUN、AKT1、IL6、MAPK1、RELA等关键蛋白。GO富集分析得到GO条目143个,以分子功能为主。KEGG通路富集分析得到132条信号通路,涉及PI3K-Akt信号通路、NF-κB信号通路、JAK-STAT信号通路等。结论左金丸主要通过参与调控炎症反应、细胞增殖和凋亡等途径发挥治疗RE的作用。  
      关键词:反流性食管炎;网络药理学;左金丸;作用机制   
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    • DAI Lu-lu,CAI Ting-ting,LIU Jing,LI Shu-liang
      Vol. 39, Issue 9, Pages: 980-983(2020) DOI: 10.16025/j.1674-1307.2020.09.022
      摘要:目的通过数据挖掘,探索李淑良教授治疗大前庭导水管综合征(large vestibular aqueduct syndrome,LVAS)的用药规律,为耳鼻喉科医师提供名老中医治疗LVAS的临床思路。方法收集李淑良教授门诊病例,应用中医传承辅助平台(V2.5)建立数据库,通过软件集成的关联规则分析等方法,分析其用药经验。结果共收集李淑良教授诊治的27例LVAS患者病历资料,通过软件分析得出高频用药包括生甘草、炒白术、茯苓、桂枝等17味,常用药物组合19条,强关联中药组合28个。结论李淑良教授治疗LVAS以温阳利水、健脾补肾为主,基本方为苓桂术甘汤,选用药物平和略偏温,在听力稳定期以扶正为主,在听力波动期以祛邪为主。  
      关键词:李淑良;大前庭导水管综合征;中医传承辅助平台;用药经验   
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    • YIN Wen-jun,FANG Wu-Jie
      Vol. 39, Issue 9, Pages: 984-987(2020) DOI: 10.16025/j.1674-1307.2020.09.023
      摘要:目的观察解郁清心汤联合耳穴治疗肝郁血虚型卒中后抑郁的临床疗效。方法选择2018年6月—2019年10月期间我院收治的103例卒中后抑郁患者,随机数字表法分为对照组51例和治疗组52例,2组均给予运动康复、心理治疗,对照组予口服盐酸帕罗西汀治疗,治疗组予口服解郁清心汤联合耳穴治疗,治疗30 d后对比2组的总有效率,汉密尔顿抑郁量表(HAMD)评分、神经功能缺失程度及Barthel指数(BI)的前后变化。结果治疗组总有效率高于对照组(P<0.05)。2组患者治疗前HAMD评分、神经功能缺失程度评分及BI评分对比,差异无统计学意义(P>0.05);2组患者治疗后的HAMD评分、神经功能缺失程度评分均低于治疗前,BI评分高于治疗前,且治疗组变化幅度均高于对照组,差异有统计学意义(P<0.05)。结论解郁清心汤联合耳穴治疗卒中后抑郁较对照组传统治疗方式更佳,能够一定程度缓解患者紧张抑郁的负面情绪,提高患者生存质量。  
      关键词:卒中;抑郁;肝郁血虚型;解郁清心汤;耳穴压豆   
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    • HUANG Xiao-tao,FANG Lue,ZHOU Jia-en,XIE Chang-fa,CHEN Yu-song,YAN Li-min
      Vol. 39, Issue 9, Pages: 987-991(2020) DOI: 10.16025/j.1674-1307.2020.09.024
      摘要:目的观察身痛逐瘀汤加减联合硬膜外冲击治疗血瘀型腰椎间盘突出症(LDH)的临床效果。方法选择2017年1—12月作者所在医院就诊的血瘀型LDH患者105例,根据随机数字表法将其分为对照1组、对照2组和观察组,每组各35例。对照1组给予硬膜外冲击治疗,对照2组口服中药身痛逐瘀汤加减治疗,观察组采用身痛逐瘀汤加减口服联合硬膜外冲击治疗,3组均治疗15 d。对比3组疗效及治疗前后中医证候积分、日本骨科协会评估治疗(JOA)评分与直观模拟评分表(VAS)评分、生活质量评价量表(SF-36)评分、血清炎症因子白细胞介素1(IL-1)、IL-6、IL-8及肿瘤坏死因子α(TNF-α)水平。结果治疗后,观察组总有效率(97.14%)高于对照1组(68.57%)、对照2组(71.43%),差异有统计学意义(P<0.05)。观察组腰腿痛、腰部板硬、下肢麻木、腰膝沉重评分均低于对照1组、对照2组(P<0.05),JOA评分、肢体功能、社会认知、躯体疼痛及精神健康评分均高于对照1组、对照2组(P<0.05),VAS评分、IL-1、IL-6、IL-8、TNF-α低于对照1组(P<0.05)。结论身痛逐瘀汤加减联合硬膜外冲击治疗血瘀型LDH较单用身痛逐瘀汤加减或硬膜外冲击治疗的临床效果更好,恢复更快,疼痛减轻更明显,炎性因子降低更多,预后效果更好。  
      关键词:腰椎间盘突出症;血瘀型;身痛逐瘀汤;硬膜外冲击疗法   
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    • ZENG Wei-ping,ZHANG Jun-han,LUO Yu
      Vol. 39, Issue 9, Pages: 992-994(2020) DOI: 10.16025/j.1674-1307.2020.09.025
      摘要:目的观察半夏泻心汤加减联合西医三联疗法对幽门螺杆菌的根治效果。方法选取2017年10月—2018年10月作者所在医院普通内科收治的幽门螺杆菌感染患者100例,随机将患者分为对照组(n=48)和试验组(n=52)。对照组给予西医三联疗法进行治疗,试验组在三联疗法基础上给予半夏泻心汤加减治疗。治疗后2周对比2组疗效、中医证候积分、幽门螺杆菌阳性率、复发率及不良反应。结果治疗后试验组总有效率(90.38%)高于对照组(75.00%)(P<0.05);治疗后2组中医证候积分均低于治疗前(P<0.05),且试验组中医证候积分低于对照组(P<0.05);治疗后2组幽门螺杆菌阳性率均低于治疗前(P<0.05),且试验组幽门螺杆菌阳性率低于对照组(P<0.05);治疗后6、12个月试验组幽门螺杆菌复发率低于对照组(P<0.05);试验组不良反应发生率低于对照组(P<0.05)。结论半夏泻心汤可提高西医三联疗法对幽门螺杆菌的根除率,降低复发率,减少不良反应。  
      关键词:消化性溃疡;半夏泻心汤;三联疗法;幽门螺杆菌   
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    • WANG Meng-chao,WANG Xin-qiu,CHAO En-xiang
      Vol. 39, Issue 9, Pages: 995-997(2020) DOI: 10.16025/j.1674-1307.2020.09.026
      摘要:<正>国医大师晁恩祥教授是中日友好医院中医内科首席专家,从事中医内科临床、科研、教学60余载,通过临床实践的探索总结,形成了独特的学术思想体系,尤其对中医肺系病的治疗与研究积累了丰富的经验。晁教授治疗肺系病,注重整体观念,从正邪之间消、长、进、退分析疾病,提出动态辨证,主张证变、法变,方药也随之而变;先辨证,后立法,法立则方出。在疾病的诊治过程中,强调要借鉴西医的诊疗技术为我所用,讲求中西医结合,更能全面认识疾病的病机实质。  
      关键词:晁恩祥;养阴益气;胸膜肺弹力纤维增生症;国医大师   
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    • JIANG Xiao-wei,ZHANG Yu-xin,ZHENG Feng-jie,LIU Jing-yuan
      Vol. 39, Issue 9, Pages: 998-1000(2020) DOI: 10.16025/j.1674-1307.2020.09.027
      摘要:<正>刘景源教授是第五、六批全国老中医专家学术经验继承工作指导老师、首都国医名师、著名温病学家,对分消走泄法见解独到。刘师认为,分消走泄法中的"消"与"泄"是指消除湿邪,使之泄出体外。"分"字,则是指出祛湿之法并非一法,而是要因势利导,从不同途径给湿邪以出路;"走"字,是行走之意,指用行气之品宣通气机,使气行则湿走,即《叶香岩外感温热》第11条所云"具有流动之品可耳"。可见,分消走泄法,是指用祛湿行气的药物,因势利导,使弥漫于三焦的湿邪分道而消,泄出体外[1]。  
      关键词:刘景源;分消走泄;湿热证;辛开苦降;老中医经验   
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    • LI Hao-yuan,MENG Ling-xin,WEN Yu-long,WANG Xu,GUO Li-ya,WANG Ya-nan,LIU Jian,WANG Yu-guang
      Vol. 39, Issue 9, Pages: 1001-1003(2020) DOI: 10.16025/j.1674-1307.2020.09.028
      摘要:<正>弥漫性肺间质疾病(interstitial lung disease,ILD)是一组涉及200余种疾病的异质性的呼吸系统疑难病症。ILD病因和病情复杂,目前国际呼吸学界推荐多学科(呼吸、影像、病理)参与的联合诊疗模式。临床上许多特发性间质性肺炎(idiopathic interstitial pneumonia,IIP)患者具有自身免疫特征。为深入研究该类患者,2015年"欧洲呼吸协会(European Respiratory Society,ERS)/美国胸科学会(American Thoracic Society,ATS)成立结缔组织病相关性间质性肺疾病特别工作组"经过研究和讨论,提出具有自身免疫特征的间质性肺炎(interstitial pneumonia with autoimmune features,IPAF)[1]的有关术语和分类标准,有助于临床医师早期识别此类患者,规范治疗和随访。  
      关键词:间质性肺炎;自身免疫;王玉光;验案   
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    • JIANG Xue-jiao,ZHANG Jing-yi,ZHANG Xu,SHEN Wen,SUN Chen-yao,ZHENG Shu-Yue,TAN Ke-xin,CUI Hui-juan
      Vol. 39, Issue 9, Pages: 1004-1005(2020) DOI: 10.16025/j.1674-1307.2020.09.029
      摘要:<正>发热是肺癌中晚期患者常见症状之一,严重影响患者的生存质量及生存期。癌症患者发热机制复杂,单纯用抗生素及非甾类退热药疗效欠佳,中医药对于肿瘤患者发热常可获效。近日崔慧娟主任治疗1例肺癌伴发热患者,采用中医辨证论治,效果显著,报告如下。  
      关键词:肺癌;反复发热;麻杏石甘汤   
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    • LI Meng-zhen,FENG Cui-ling
      Vol. 39, Issue 9, Pages: 1006-1008(2020) DOI: 10.16025/j.1674-1307.2020.09.030
      摘要:<正>蛤蚧定喘胶囊由古方蛤蚧定喘丸剂型改革而成,药物组成包括蛤蚧、鳖甲、紫菀等,有滋阴清肺化痰、平喘止咳等功效,常用来治疗肺系疾病肺肾两虚、阴虚肺热证。本文对蛤蚧定喘胶囊的组方特点、药理研究、适用证型、临床应用进行综述。  
      关键词:蛤蚧定喘胶囊;呼吸系统疾病;肺肾两虚;阴虚肺热;文献综述   
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