最新刊期
期 10 ， 2021
- 摘要：当前临床对痴呆症的研究主要集中在阿尔茨海默病（Alzheimer′s disease, AD）上,而对血管性认知障碍（vascular cognitive impairment, VCI）的研究较少,近年来,VCI的防治研究虽有一定的成果,但仍没有突破性进展,缺乏特效药。VCI属于中医学"痴呆""呆病""善忘"等范畴,中医治疗VCI具有一定的优势。本文基于"肾通于脑"的理论,通过文献研究,分析探究从肾论治VCI的可行性与科学性,为补肾类中药治疗肾虚型VCI提供依据。关键词：肾通于脑;血管性认知障碍;从肾论治;述评
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发布时间：2023-04-10 - 摘要：Objective To explore the effect of an agreement prescription Tongnao Decoction on the severity, recurrence rate and mortality of patients with acute cerebral infarction of phlegm and blood stasis blocking collaterals after treatment.Methods A total of 370 patients with acute cerebral infarction of phlegm and blood stasis blocking collaterals were enrolled.On the basis of routine treatment in the guideline for acute cerebral infarction, all patients in the study were divided into the control group and the observation group according to whether they took Tongnao Decoction or not, and followed up for 9 months.There were 197 cases in the control group and 148 cases in the observation group except the lost to follow-up.The results of the scale of NIHSS,mRS,Barthel were used to evaluate the neurological function of the two groups before the treatment, at the time of discharge, 3 months and 9 months of follow-up, and the recurrence rate and mortality were also evaluated.Results Main indexes: The mRS rating in the observation group was significantly better than that in the control group at the time of discharge, 3 months and 9 months of follow-up（P<0.05）.The number of recurrence and death in the observation group was significantly less than that in the control group during their duration of hospital stay and follow-up, with the difference statistically significant（P<0.01）.Secondary observation indexes: The NIHSS in the observation group were significantly better than the control group at the time of discharge, 3 months and 9 months of follow-up（P<0.05）.The Barthel in the observation group was better than that in the control group at the time of discharge, and 3 months of follow-up（P<0.05）.Conclusion Tongnao Decoction has significant effects on improving neurological deficit, enhancing activities of daily living, reducing the degree of illness, and the recurrence rate and mortality of cerebral infarction in patients with acute cerebral infarction.关键词：Acute cerebral infarction;Tongnao Decoction;syndrome of phlegm and blood stasis blocking collaterals
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of Panax notoginseng saponins on cGAS/STING/NF-κB pathway and anti-inflammatory action in rats with acute cerebral infarction.Methods 30 rats were randomly divided into three groups: sham operation group, MCAO model group, and Panax notoginseng saponins treatment group（PNS,0.15 g/kg）.There were 10 rats in each group.Except for the sham operation group, The middle cerebral artery ischemia（MCAO）model were established by using thread occlusion method in other three groups, in which Panax notoginseng saponins treatment group were given Panax notoginseng saponins after established MCAO model.After 1.5 h of ischemia and 24 h of reperfusion, the Garcia JH score was carried out to observe the degree of neurological deficit.The rats were sacrificed, and the peripheral cortex was collected.The protein expression of cGAS,STING,NF-κB phosphorylation and NF-κB were detected by Western Blot.The gene expression of iNOS was measured by RT-PCR,and the levels of TNF-α and IL-6 were detected by ELISA.Results Compared with the sham operation group, the Garcia JH neurological function scores were obviously reduced in the MCAO model group（P<0.01）; the protein expression levels of cGAS,STING,and p-NF-κB/NF-κB and the levels of TNF-α and IL-6 and the gene expression level of iNOS were all significantly increased（P<0.01）.Compared with the model group, the Garcia JH neurological function scores was increased in the Panax notoginseng saponins treatment group（P<0.05）; the protein expression levels of cGAS,STING,p-NF-κB/NF-κB and the levels of TNF-α and IL-6 and the gene expression level of iNOS were all reduced（P<0.05）.Conclusion Panax notoginseng saponins may inhibit NF-κB-induced inflammatory response by regulating the cGAS/STING signaling pathway and alleviate brain damage to play a protective effect.关键词：Acute cerebral infarction;acute cerebral ischemia reperfusion;cGAS/STING/NF-κB pathway;inflammatory response;Panax notoginseng saponins;rats
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发布时间：2023-04-10 - 摘要：Objective To explore the effect of methods for activating blood circulation and removing blood stasis on autophagy and Aβ42 in hippocampus tissue of rats with chronic cerebral hypoperfusion.Methods The rat models of chronic cerebral hypoperfusion were made by two-step bilateral common carotid artery occlusion（BCCAO）.SD rats were randomly divided into 3 groups: sham group, model group, and NDS group.Cognition（spatial memory）were evaluated by Morris water maze test.The protein expression of Beclin-1,LC3-Ⅱ,p62 and amyloid precursor protein（APP）were detected by Western Blot.Aβ42 level in hippocampus tissue were detected by ELISA.Results Compared with the sham group, the impairment of spatial memory appeared remarkably, the protein expression of Beclin-1,LC3-Ⅱ,p62 were all increased（P<0.05,P<0.01）,while the expression of APP did not change（P>0.05）in model group, and the expression level of Aβ42 was increased in model group（P<0.01）.Compared with the model group, the cognitive impairment in the NDS group was mildly damaged, the protein expression of Beclin-1,LC3-Ⅱ,p62 were all decreased（P<0.01,P<0.05）,and the expression level of Aβ42 was decreased in NDS group（P<0.05）.Conclusion The methods for activating blood circulation and removing blood stasis could decrease Aβ42 by inhibiting neuron autophagy, to improve cognitive impairment induced by chronic cerebral hypoperfusion.关键词：Chronic cerebral hypoperfusion;methods for activating blood circulation and removing blood stasis;Naodesheng Pills;autophagy;neuron;Aβ42;rats
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发布时间：2023-04-10 - 摘要：卒中后认知障碍是卒中后常见的并发症之一,属中医学"善忘""呆病"的范畴。通过阐述从脾肾论治卒中后认知障碍的理论基础和治则治法,认为脾肾与卒中后认知障碍关系密切,其中脾肾亏虚、痰瘀内阻是本病的主要病因病机,健脾益肾、活血化痰法治疗能够有效改善患者症状,从脾肾论治卒中后认知障碍具有重要的临床意义。关键词：卒中后认知障碍;健脾益肾;活血化痰;名中医经验
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发布时间：2023-04-10 - 摘要："痰瘀同源、痰瘀同病、痰瘀同治"学说是国医大师沈宝藩在几十年的临床实践中形成的独特理论体系和辨证论治方法,在治疗老年病、心脑血管疾病和其他杂症中广泛应用,尤其在疑难病的诊治中颇获良效。本文从1例嗜酸性粒细胞增多综合征导致的脑梗死的诊治,探讨痰瘀同治理论在神经系统疑难病中的应用。关键词：脑梗死;痰瘀同治;嗜酸性粒细胞增多综合征
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发布时间：2023-04-10 - 摘要：<正>在2021服贸会中医药主题日暨海外华侨华人中医药大会及中医药创新中心共建共享发布会上,北京中医药国际服务指导与评价中心（TCMGEC）发布了《国际患者北京中医就诊指南》（A 7-Ten Rapid Advice Guideline for International Patient Care ofTraditional Chinese Medicine in Beijing）, TCMGEC主任崔永强向海外消费者及患者介绍了如何快速了解北京的医疗资源、中医有关信息,并在恰当的时间、地点得到优质的中医服务,为患者提供切实可行的帮助。
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发布时间：2023-04-10 - 摘要：Objective To observe the therapeutic effect and action mechanism of Shugan Granule on mice with mammary gland hyperplasia caused by liver qi stagnation, and explore its neuroendocrinology regulation mechanism for this disease. Methods Female mice were divided into blank group, model group, traditional Chinese medicine group and western medicine group. In the experiment, the blank group had no intervention, the other three groups were given chronic compound stress for 10 weeks. From the 11 th to 14 th week, the blank group and model group were given distilled water by gavage, while the traditional Chinese medicine group and western medicine group were given Shugan Granule and tamoxifen by gavage respectively. The biological characteristics of mice were observed and recorded after 0, 10 and 14 weeks. At the end of the experiment, the mice were killed, and the hypothalamus was stripped to detect neurotransmitters; the blood was taken to detect serum hormones; the mammary gland and its surrounding skin were taken under aseptic conditions for pathological observation. Results At the end of modeling, except the blank group, the other three groups of mice showed a series of desperate behavioral changes, such as fatigue, hair removal, weight loss, immobility time growth and so on. Compared with the other groups, hyperplasia of mammary glands was decreased, the secretion of hypothalamic neurotransmitters NE and 5-HT was inhibited, and the serum hormones CRH and ACTH were increased in the Chinese medicine group. Conclusion Shugan Granule can regulate the neuroendocrine system and reduce the degree of mammary gland hyperplasia in mice effectively.关键词：Mammary gland hyperplasia;chronic psychological stress;Shugan Granule;emotional disease;mice
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发布时间：2023-04-10 - 摘要：Objective To investigate the anti-leukemia mechanism of Zhebei Huangqin Decoction in NOD/SCID subcutaneous tumor-bearing mice.Methods Twenty NOD/SCID mice were injected subcutaneously with kasumi-1 cell, then divided randomly into model group, chemotherapy group, CSFD group and DA+CSFD group.The tumor-bearing mice were intervened by distilled water, daunorubicin+cytarabine, Zhebei Huangqin Decoction and Chinese and Western medicine.The living state, body weight, transplanted tumor volume and weight, and blood routine changes of mice in each group were observed.The expression levels of wip1 mRNA and p53 mRNA in transplanted tumor cells were detected by RT-PCR.The expression level of wiP1 and p53 were detected by real-time PCR.Results The volume of subcutaneous transplanted tumor in each group increased gradually, of them the DA+CSFD group had the smallest tumor volume and weight（P<0.05）;the platelets in DA+CSFD group were lower than before（P>0.05）,and that in the other three groups were significantly higher than before（P<0.05）;compared with the model group, the expression of wip1 mRNA in the CSFD group was decreased, and the expression of p53 mRNA in the CSFD group was significantly up-regulated（P<0.01）,that in the DA group was down-regulated and that in the DA+CSFD group was the same as the model group.Conclusion CSFD could reduce the expression of wip1,and promote the recovery of p53 transcription regulation function, inhibit the proliferation of leukemia cells and reverse part of drug resistance.关键词：Acute myeloid leukemia;kasumi-1;wip1;p53;Zhebei Huangqin Decoction;mice
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发布时间：2023-04-10 - 摘要：膏方作为中医传统剂型,以其润泽滋补之功效、宜于久服之特点而适于病情缠绵、日久难愈之脾胃病的调治。秦伯未先生临证善用膏方治疗脾胃病,重视脾胃的生理、病理特点及与其他脏腑的五行生克关系。研究发现,秦老调治脾胃病的膏方中,尤为注重肝脾、肝胃关系的调和,并依病机不同而有针对性地选取补肝、和肝、疏肝、清肝、温肝、镇肝等法。对于痞满、腹痛、便秘、泄泻等常见脾胃病证,秦老蕴调肝之法于理脾和胃之膏方中,或为其应用膏方调治脾胃病收效之关键。关键词：秦伯未;膏方;脾胃病;调肝
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发布时间：2023-04-10 - 摘要：国医大师路志正认为,痛风多因脾肾亏虚、饮食不节及外邪侵袭所致,常见水湿内停、湿热痹阻、浊瘀互结等病机,临床诊治时,路志正教授强调应重视脾肾在痛风发病中的作用,从先后天之本入手,分期而论,重视内服与外洗并用。在痛风急性期以清肺理脾、祛湿化浊、凉血消肿为主,辅以补肾通络、疏风定痛等法,达到标本兼治效果。痛风慢性期则以健脾化湿、补肾通络、疏风定痛为主要治法,并重视患者生活调理,防止复发。关键词：痛风;调理脾肾;路志正;国医大师
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发布时间：2023-04-10 - 摘要：胃脘痛是临床常见病症,常伴有上腹胀、纳呆、恶心、呕吐、嘈杂、反酸、嗳气等症状,多因外邪袭胃、饮食伤胃、恼怒忧思、久病虚损、劳累过度、虫积扰胃等损伤脾胃,导致脏腑气血紊乱,血脉涩凝不通而导致胃痛。胃痛症状多见于西医学的慢性胃炎、消化性溃疡、胃下垂、功能性消化不良等,具有病程长、反复发作、缠绵难愈的特点。李乾构教授根据多年临床经验,认为脾气虚贯穿于胃脘痛病程的始终,因此在治疗胃脘痛过程当中,根据不同疾病和患者的个体差异,灵活运用四君子汤加减化裁,在健脾和胃的基础上加用通降胃腑、活血化瘀药,注重气血双调,辨明寒热,分清虚实,取得了令人满意的临床疗效。关键词：胃脘痛;李乾构;名中医
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发布时间：2023-04-10 - 摘要：多皮饮源自《三因方》中五皮饮,是名老中医赵炳南教授的经验方,王莒生教授作为赵氏皮科流派的主要传承人之一,对于多皮饮的应用有自己独到的心得,在充分分析多皮饮功能主治的基础上,提出多皮饮具有健脾清热除湿作用,所治主症热多寒少,临床上用于治疗慢性荨麻疹可虚可实,可寒可热。关键词：慢性荨麻疹;赵炳南;王莒生;多皮饮;名中医经验
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发布时间：2023-04-10 - 摘要：阳痿是男科门诊中较为常见的性功能障碍,既可单独发病,也可合并糖尿病、心血管疾病等基础性疾病,使其病因病机趋于复杂化,不再以单一的肾虚、肝郁、血瘀为主。而肾虚血瘀等复合证型逐渐被众多医家重视,并以此为立法,遣方用药,收效显著。此型患者在肾虚的同时伴有血瘀的相关症状,如唇暗、舌有瘀点瘀斑、小腹时有刺痛感,或脉见结代,或合并心血管等疾病。治疗上明辨精、气、阴、阳之不足,施以对应的补益方法,并稍加活血化瘀药以通阳道,使宗筋得血液之荣,精微之养。基于补肾活血为主要治则,探讨肾虚血瘀型阳痿的诊治思路,以提高临床疗效。关键词：阳痿;补肾活血;肾虚血瘀
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发布时间：2023-04-10 - 摘要：难治性眩晕反复发作,严重影响患者的生活质量。病邪久病入络成瘀,痰瘀互结是反复发作、难以治愈的关键。风痰阻络是难治性眩晕发作期的主要病机,发作期治疗以健脾祛湿、化痰息风为主,并关注是否有"新病入络"瘀血与风痰互结的现象,治疗以半夏白术天麻汤为基础,重用天麻并加用钩藤、石决明、丹参、川芎等;缓解期治疗"以通为用",以活血化瘀、化痰通络为主,兼顾培元固本,使血脉气机通畅,临证常用丹参、赤芍、川芎、鳖甲、夏枯草、芒硝等。关键词：眩晕;风痰阻络;痰瘀互结;息风化痰;活血化瘀;化痰通络
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发布时间：2023-04-10 - 摘要：高血压性眩晕是指由于血压增高而引起的头目昏眩不适等症状。西医学常通过降压、改善循环、营养神经,以达到缓解眩晕症状的目的,然效果不尽相同。中医对于此病的治疗,讲求从整体的角度考虑其统一性和联系性,并以五脏为基,探求其本。本病病机繁杂,非单一致病因素所致,且五脏六腑皆令人眩,因此在治疗时应注重本病与各脏腑的关系,切勿顾此失彼。关键词：整体观;眩晕;高血压;五脏
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发布时间：2023-04-10 - 摘要：真性红细胞增多症（PV）因红细胞大量克隆性增殖,可导致血液黏性增大和血栓形成风险增加,晚期部分可进展为骨髓纤维化或急性髓细胞性白血病。治疗主要以降低血细胞比容和血小板计数为主,目前仍然无法治愈。中医将其归属于"血积（髓癥）"范畴,中医药在改善PV患者临床症状以及降低血细胞比容和血小板计数方面疗效明显,而且不良反应少。PV病机主要为中土湿寒、乙木瘀滞,肾阳不足、肝血瘀滞,肝血不足、血行瘀滞。在治疗上分别予以温中祛湿、养血活血,方选当归四逆加吴茱萸生姜汤或温经汤;温肾补阳、活血散瘀,方选桂附地黄丸加减;养血活血通经,方选胶艾汤加桃仁红花加减。关键词：真性红细胞增多症;肝血瘀滞;中医药
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发布时间：2023-04-10 - 摘要：中医学认为不全流产以胎毒蕴热证、瘀热互结证、湿热瘀滞证为主,中医治疗应突出清热解毒,同时采用养血化瘀,或兼以利湿的方法,祛邪又兼顾流产后气血不足。通过病案举例观察血HCG下降至正常,及B超宫内残留物消失情况,说明清热解毒、养血化瘀法治疗有效,可以有效去除宫腔内残留的蜕膜和人绒毛膜组织,避免刮宫手术带来的损伤。关键词：不全流产;人工流产;清热解毒;养血化瘀
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发布时间：2023-04-10 - 摘要：目的观察抗白延年汤联合小剂量化疗治疗老年急性髓系白血病（AML）的效果。方法采用多中心、随机对照、前瞻性、竞争入组的模式,纳入2013年1月—2015年12月期间全国6家医院的AML患者。按照是否给予中药一次分组,继而根据给予的化疗方案（小剂量HAA或DA方案）分组进行亚组分析。系统评估中药联合化疗在化疗通过率、疾病缓解率、总生存期、免疫指标、化疗并发症、患者临床证候等方面的作用。结果小剂量化疗联合中药较单纯小剂量化疗组能显著提高患者第一次诱导化疗的通过率（85.7%Vs 62.2%）。无论是否联合中药,小剂量HAA方案（高三尖杉酯碱+阿糖胞苷+阿克拉霉素）在疾病完全缓解率（CR率）、总有效率方面均高于小剂量DA方案（柔红霉素+阿糖胞苷）,早期死亡率低于小剂量DA方案,联合中药治疗能一定程度上提高单纯小剂量化疗的总有效率,但差异均无统计学意义（P>0.05）。第一次化疗后,单纯小剂量化疗组与联合中药组在CR率上无显著差异（24.3%Vs 25.7%,P>0.05）,但在总有效率上,联合中药组更高（71.4%Vs 48.6%,P<0.05）。联合中药组在一定程度上显示了缩短患者中性粒细胞恢复时间（14 d Vs 16.7 d）,降低患者中医证候评分的趋势,但差异无统计学意义（P>0.05）。同时,与单纯HAA组比较,HAA+中药组的RBC输注量明显减少,差异有统计学意义（P=0.041）。结论小剂量化疗联合抗白延年汤能有效提高老年AML患者的化疗通过率,并提高首次诱导化疗的有效率,继而有助于延长患者的总体生存期。关键词：急性髓系白血病;抗白延年汤;化疗;小剂量;老年人
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发布时间：2023-04-10 - 摘要：目的观察艾灸联合针刺治疗缺血性卒中后肩手综合征（SHS）Ⅰ期的临床疗效。方法选取2018年12月—2020年7月北京中医药大学附属护国寺中医医院针灸科及北京小汤山医院中西医结合康复科住院的120例缺血性率中后SHSⅠ期患者,采用随机数字表法分为对照组、无烟艾灸组和艾灸组,各40例。对照组采用常规体针治疗;无烟艾灸组在对照组治疗基础上加无烟艾灸治疗;艾灸组在对照组治疗基础上加正常艾灸治疗。3组治疗周期均为3周,结束后对比3组临床疗效,治疗前后及治疗后4周随访时视觉模拟评分（VAS）、上肢Fugl-Meyer评分（FMA）及Barthel指数（BI）。结果 3组总有效率中艾灸组最高为85.7%,对照组最低为78.8%,但3组间差异无统计学意义（P>0.05）。治疗后各组VAS评分均较治疗前降低（P<0.05）,FMA及BI评分均较治疗前升高（P<0.05）;艾灸组治疗后BI及4周随访时VAS、FMA、BI评分与对照组、无烟艾灸组比较,差异均有统计学意义（P<0.05）。结论艾灸联合针刺治疗可减轻缺血性卒中后SHSⅠ期患者疼痛,改善局部运动功能,提高生活质量。关键词：艾灸;针刺;艾烟;缺血性卒中;肩手综合征
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发布时间：2023-04-10 - 摘要：目的观察电针夹脊穴联合芪参通脉饮1号治疗FontaineⅡ期下肢动脉硬化闭塞症（ASO）的临床效果。方法选择2019年1月—2020年1月于黑龙江中医药大学附属第一医院周围血管病科就诊的90例FontaineⅡ期ASO患者,随机分为对照组、试验1组、试验2组,每组各30例。对照组在常规治疗基础上予以电针夹脊穴治疗,试验1组在对照组的基础上联合应用通塞脉片口服治疗,试验2组在对照组的基础上联合应用芪参通脉饮1号口服治疗,3组均以7 d为1个疗程,共观察4个疗程。4个疗程后,观察3组患者的临床症状和体征（包括肢体冷感、下肢间歇性跛行、踝肱指数）及微循环血流状态（包括足部温度、温控血流）,对比分析3组之间的差异性。结果试验1组总有效率为86.67%,试验2组总有效率为93.33%,对照组总有效率为83.33%,3组疗效差异有统计学意义（P<0.05）。治疗后3组临床症状和体征、微循环血流状态均较治疗前有不同程度改善（P<0.05）,试验1组、试验2组改善程度均明显优于对照组,且试验2组优于试验1组（P<0.05）。结论电针夹脊穴联合芪参通脉饮1号能够改善FontaineⅡ期ASO患者的下肢缺血情况,缓解下肢发凉及疼痛症状,改善微循环血流,且安全有效。关键词：下肢动脉硬化闭塞症;电针;夹脊穴;芪参通脉饮1号;微循环
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发布时间：2023-04-10 - 摘要：目的分析益肾祛浊方治疗多囊卵巢综合征-胰岛素抵抗（PCOS-IR）的临床疗效。方法选择2017年1月—2021年4月就诊于首都医科大学附属北京中医医院许昕专家门诊的PCOS-IR患者43例,分析益肾祛浊方治疗PCOS-IR的疗效。结果 43例患者中月经异常41例,治疗后月经复常29例,月经周期恢复率为70.7%;妊娠率16.7%。41例月经异常患者治疗前基础体温单相36例,非典型双相4例,双相1例,治疗后单相13例,非典型双相13例,双相15例,改善率为63.9%。治疗后卵巢体积变化不大（P>0.05）,卵巢内卵泡数减少（P<0.05）,最大卵泡直径增大,但差异无统计学意义（P>0.05）,LH/FSH、T变化不大（P>0.05）,FINS、HOMA-IR降低（P<0.05）。治愈7例,显效8例,有效23例,无效5例,愈显率为34.9%,总有效率为88.37%。结论益肾祛浊方加减治疗PCOS-IR,以健脾益肾、清利阳明浊热为法,配合疏肝理气、调和冲任,重启天癸之机,效果显著。关键词：多囊卵巢综合征;胰岛素抵抗;益肾祛浊;临床疗效
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发布时间：2023-04-10 - 摘要：目的系统分析联合中成药对盆腔炎症性疾病（PID）抗生素使用的影响。方法系统检索知网、万方、维普、PubMed、Cochrane library数据库以及国内外临床试验注册库,日期截至2020年5月17日。纳入中成药联合抗生素对照单用抗生素治疗PID,且结局指标包含对抗生素使用影响的随机与半随机对照试验。由2名研究者独立对纳入文献进行资料提取,并采用ROB 2.0工具与RevMan 5.4分别进行质量评价与数据分析。结果最终纳入15篇文献,涉及1 608例受试者,包括6篇半随机试验、9篇随机对照试验。11篇文献报告了联合中成药可缩短抗生素使用时间,其中7篇联合中成药组的抗生素使用时间短于我国PID西医指南推荐疗程。这11篇文献共涉及5种中成药及3种抗生素方案,对具有相同干预的4篇文献进行Meta分析,结果显示相比单用莫西沙星治疗慢性PID,联合康妇消炎栓组抗生素使用时间缩短（356例患者,MD=-5.73 d, 95%CI[-6.32,-5.14]）;其他抗生素方案均仅有1篇文献,未进行Meta分析。2篇文献报告了联合中成药可减少抗生素使用剂量,2篇文献报告了联合中成药可减少抗生素使用种类。每项原始研究结果均显示联合中成药组取得了不劣于单用抗生素组的治愈率与复发率。15篇文献均存在高偏倚风险。结论联合中成药可能会缩短抗生素单用治疗PID的所需时间,但目前证据质量较差,尚不足以证明,未来仍需更多严格设计、足够样本量的研究进一步得出结论。关键词：盆腔炎症性疾病;抗生素;中成药;Meta分析
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发布时间：2023-04-10 - 摘要：目的评价中药对子宫内膜异位症患者体外受精-胚胎移植（IVF-ET）结局的改善作用。方法应用计算机检索CNKI、维普、万方、PubMed、Ovid、Cochrane Library和Web of Science等数据库,纳入中药联合IVF-ET治疗子宫内膜异位症不孕的随机对照试验（RCT）,由2名研究者按照Cochrane Handbook Version 5.1.0标准对文献质量进行独立评价,并对数据进行提取并交叉检验,通过RevMan 5.3软件进行Meta分析。结果共纳入10个研究,合计953例患者,文献整体质量一般。Meta分析结果显示中药联合IVF-ET可提高子宫内膜异位症患者临床妊娠率[RR=1.59,95%CI（1.37,1.84）]、取卵数[MD=1.71,95%CI（0.38,3.05）]、受精率[MD=0.11,95%CI（0.07,0.14）]、优质胚胎率[MD=0.13,95%CI（0.11,0.15）]。结论中药联合IVF-ET能有效提高子宫内膜异位症患者的临床妊娠率和胚胎质量。限于纳入文献的质量及数量,上述结论仍需开展更多高质量的研究进一步验证。关键词：子宫内膜异位症;体外受精-胚胎移植;中药;临床妊娠率;Meta分析
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发布时间：2023-04-10 - 摘要：目的系统分析半夏泻心汤治疗幽门螺杆菌（Hp）相关性慢性萎缩性胃炎（CAG）的有效性和安全性。方法检索中国知网（CNKI）、维普数据库（VIP）、万方数据库（WanFang）、PubMed等,收集半夏泻心汤加减治疗Hp相关性CAG的随机对照试验（RCT）。检索时限从建库至2020年6月26日。由2位研究员按照纳入和排除标准进行文献筛选,运用Cochrane协作网推荐的偏倚风险评价表（risk of bias, ROB）对每项纳入试验进行偏倚风险和质量评估,并采用Revman5.3软件进行Meta分析。结果共纳入23篇中文RCT研究,合计2 080例患者。结果显示,与常规西药抗Hp治疗比较,单用半夏泻心汤或联合抗Hp治疗在改善临床综合疗效[RR=1.23,95%CI（1.18,1.28）,P<0.000 01]、胃镜及组织病理检查有效率[RR=1.26,95%CI（1.15,1.37）,P<0.000 01]、幽门螺杆菌转阴率[RR=1.24,95%CI（1.16,1.32）,P<0.000 01]、临床症状积分等方面具有一定优势,且能降低不良反应发生率,差异均有统计学意义。结论半夏泻心汤联合西药组治疗Hp相关性CAG疗效优于常规西药抗Hp治疗,可提高临床综合疗效、胃镜下及胃黏膜病理疗效、幽门螺杆菌转阴率,改善临床症状,降低不良反应发生率。但纳入文献存在一定发表偏倚且方法学质量有限。关键词：半夏泻心汤;慢性萎缩性胃炎;幽门螺杆菌;随机对照试验;Meta分析
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发布时间：2023-04-10 -
Exploration of medication rules of ZHANG Zhi-li in treating allergic dermatosis based on data mining
摘要：目的应用中医传承辅助系统（V2.5）分析张志礼先生治疗变态反应性皮肤病的用药规律。方法选取《张志礼皮肤病医案选萃》《张志礼皮肤病临床经验辑要》《张志礼皮肤病临证笔谈》及《精诚大医张志礼》四本书籍收录的治疗变态反应性皮肤病的验案处方62首,录入中医传承辅助系统（V2.5）以分析张老治疗变态反应性皮肤病的用药规律。结果通过对验案中所载62首处方进行分析,筛选用药频次≥14次的药味共20味,药物关联分析显示置信度较高的药物组合包括"苦参-白鲜皮""黄芩-生地黄""白术-薏苡仁"等,熵聚类分析显示的高频药物组合包括"石膏-白茅根""当归-首乌藤"等,复杂网络分析显示的核心处方可分为清热解毒、健脾除湿、养血疏风3大类。结论张老用药常以攻补兼施、气血并治为特点,形成了独特的气血津液辨证体系。关键词：张志礼;变态反应性皮肤病;用药规律;数据挖掘;关联规则;熵聚类- 2
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发布时间：2023-04-10 - 摘要：目的探讨孔伯华治疗眩晕的思路及用药规律。方法运用古今医案云平台（V2.2.3）收集整理《孔伯华医集》《孔伯华医案存真》中治疗眩晕的有效验案,通过数据筛选及标准化处理建立医案数据库,利用频次统计、关联分析等数据挖掘方法,对症状、舌脉、证候、治法、方药等进行统计分析。结果共纳入118诊次病案,常见症状有头晕、失眠、心悸等148种;舌象有腻、白、厚、黄等11种;脉象有弦、滑、数、大等26种;证型包括肝热脾湿、肝阳上亢等74种;治法有清柔、清平、和化等81种;共计处方118张,药物199味,其中高频药物为石决明、旋覆花、赭石、荷叶、知母、桑寄生等,药性以苦寒为主,归胃肝经,常用药对有石决明-赭石-旋覆花。结论孔伯华先生认为肝热脾湿、痰火上扰、血虚精亏、水不涵木为眩晕病基本病机;清热平肝、健脾和胃、育阴潜阳、活血通经为主要治法。处方用药切合病机。关键词：孔伯华;眩晕;用药规律;古今医案云平台;数据挖掘
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发布时间：2023-04-10 - 摘要：目的通过检测石膏生品和不同条件下煅制品的水化能力,为石膏煅制条件的确定和质量评价提供参考。方法采用低场核磁共振技术测试生石膏及不同条件煅制品的水化过程,利用T2谱分析样品中不同状态水分的变化,判断生石膏及其煅制品的水化能力的强弱。结果生石膏、150℃煅制品（CG150）和350℃煅制品（CG350）的早期水化过程都是在20 min内完成,750℃煅制品（CG750）的早期水化过程是在50 min内完成。在早期水化过程中,CG150和CG350会产生4种不同状态水,分别为化学结合水、吸附水、孔隙水和自由水。生石膏和CG750会产生3种不同状态水,分别为化学结合水、孔隙水和自由水。生石膏、CG150、CG350、CG750的水化能力强弱顺序为CG150>CG350>CG750≈生石膏。结论利用低场核磁共振技术分析石膏及其煅制品的水化过程,可揭示不同条件的煅制品的水化能力,为煅石膏煅制工艺优化提供依据。关键词：石膏;煅石膏;水化反应;低场核磁共振
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发布时间：2023-04-10 - 摘要：中医学认为肾虚、冲任失和与乳腺增生症的形成及发展关系密切,在中医治则治法中重视补肾调冲法。查阅相关中医内治法、外治法、联合应用、心理疗法等中医药补肾调冲法治疗乳腺增生症的文献,对中医药补肾调冲法治疗乳腺增生症的现状进行评述,为临床运用补肾调冲法治疗乳腺增生症提供依据。关键词：乳腺增生症;补肾调冲法;中医药;文献综述
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发布时间：2023-04-10 - 摘要：从《阴阳脉死候》《黄帝内经》《金匮要略》《小儿药证直诀》等古代文献可见,历代医家从中医整体观念出发,开创并丰富了目诊这一具体诊法,从望目之神、色、态等诸多方面获悉五脏六腑的气血盛衰,以诊察全身疾病,确定病位、揭示病机、鉴别病证、判断病势,有着重要的理论价值和临床启示意义。与现代医学理论结合,并借助现代诊查设备,在临床实践中观察患者的眼象特征,着眼于目诊与西医疾病的联系,在总结内外妇儿部分疾病的眼象特征、利用目诊协助诊断、研发眼象特征采集与分析技术等方面取得了一定的进展。未来对目诊理论的研究应以中医基础理论为指导,结合临床实践,借助现代科学技术,使目诊客观化、信息化、精确化,以诊察全身的健康状况,发挥中医药特色优势,以更好地发挥目诊功能,对目诊理论的继承、应用、发展有着更深远的意义。关键词：中医望诊;目诊;理论发展;临床应用
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发布时间：2023-04-10 - 摘要：随着我国骨质疏松症发病率的增加,其防治已成为重大的公共卫生问题。中医对骨质疏松症的发病机制有独特的认识,认为其发病虚中有实、多虚多瘀,涉及多脏腑,中医治疗原则以补肾为主,补肝脾、行气活血化瘀为辅。结合传统中医药理论和现代药理学研究,从补肾壮阳、补气健脾、滋补肝肾、行气活血和化瘀止痛等方面综述中药复方防治骨质疏松症的临床及实验研究进展,为临床选择骨质疏松症的中药治疗方案提供理论参考。关键词：骨质疏松症;中药;防治;文献综述
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发布时间：2023-04-10 - 摘要：生血宁片来源于中药蚕砂提取物,主要成分为铁叶绿酸钠和叶绿素衍生物,能够有效补充合成血红蛋白所需要的铁元素,直接参与人体血红蛋白的合成,其治疗癌性贫血的作用机制可能与抑制白细胞介素-6、肿瘤坏死因子-α、C-反应蛋白等炎性介质的产生,抑制铁调素的高表达,调节铁代谢紊乱及抑制氧化应激反应等有关。对生血宁片治疗癌性贫血的研究进行概述,临床和实验研究证实了生血宁片治疗癌性贫血的有效性和科学性,为中医药防治癌性贫血提供了新思路。关键词：生血宁片;癌性贫血;机制;应用;文献综述
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发布时间：2023-04-10
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