最新刊期
期 7 ， 2021
- 摘要：Objective To analyze the TCM syndromes and syndrome characteristics of patients with pulmonary injury of antineutrophil cytoplasmic antibody（ANCA）-associated vasculitis（AAV）,and explore its etiology and pathogenesis.Methods The four-diagnosis information and syndrome differentiation data of the hospitalized patients diagnosed with lung injury due to AAV for the first time,were collected from May 2014 to October 2019,and retrospectively analyzed.Results In this study,the high frequency of pulmonary symptoms was cough（21/21,100%）,expectoration（19/21,90.5%）and shortness of breath（17/21,81.0%）; the main extrapulmonary symptoms were fever（13/21,61.9%）,muscle and joint pain（12/21,57.1%）,fatigue（10/21,47.6%）and anorexia（10/21,47.6%）.The incidence of muscle and joint pain in the active period（10/13,76.9%）was higher than that in the stable period（2/8,25%）,with a statistical difference（P<0.05）. The top 5 most high frequent types of syndromes were dampness invasion（52.4%）,lung-qi deficiency（47.6%）,internal phlegm dampness accumulation（38.1%）,spleen-qi deficiency（33.3%）and kidney-qi deficiency（33.3%）.The frequency of dampness syndrome（11/13,84.6%）was higher in the active period,and the frequency of blood stasis syndrome（4/8,50.0%）was higher in the stable period（P<0.05）.Among them,dampness invasion syndrome was related to the increase of Birmingham Vasculitis Activity Score（BVAS）and erythrocyte sedimentation rate（ESR）,and the difference was statistically significant（P<0.05）.The main causes were dampness,phlegm,heat and blood stasis.The basic pathogenesis is rightness deficiency and evil excess.The deficiency of lung,spleen and kidney is the root,and phlegm,dampness,heat and blood stasis are the branches.Lung,spleen and kidney are the main regions of the disease.Conclusion The clinical symptoms of lung injury due to AAV are complex and diverse,mixed with deficiency and excess.The basic pathogenesis is deficiency and excess.Lung,spleen and kidney are the mainly affected regions.关键词：ANCA-associated vasculitis;pulmonary injury;syndromes;syndrome characteristics;etiology and pathogenesis
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发布时间：2023-04-10 - 摘要：Objective To observe the therapeutic effect of electroacupuncture of auricular concha on reflux esophagitis（RE）.Methods A total of 62 patients with RE admitted to Beijing Tongren Hospital in January 2018 to December 2019 were randomly divided into two groups, 31 cases in each group. The observation group was treated with auricular concha electroacupuncture, while the control group was treated with auricular electroacupuncture. The patients in both group were all treated 30 min each time, 3 times a week, for 4 weeks totally. Before and after treatment,the severity of symptoms and clinical outcomes were assessed with the reflux disease questionnaire（RDQ）, the symptom scale for RE, the Pittsburgh sleep quality index（PSQI）, and the SF-36 quality of life scale. Results Compared with before treatment, the scores of RDQ, RE symptom and PSQI of the auricular concha electroacupuncture group after treatment were significantly lower than those before treatment（P<0.05）. Except the score of physiological function was lower than that before treatment, all other dimensions of SF-36 were higher than that before treatment（P<0.05）. Compared with the control group, the scores of RDQ, RE symptom and PSQI in the auricular concha electroacupuncture group were significantly lower, and the scores of SF-36 quality of life scale were significantly improved（all P<0.05）.The total effective rate of auricular concha electroacupuncture group was 90.32%, and the total effective rate of inflammation under gastroscope was 74.19%, both higher than the control group, the difference was statistically significant（P<0.05）. Conclusion Auricular concha electroacupuncture can be used to treat RE and improve sleep and quality of life.关键词：Reflux esophagitis;auricular concha electroacupuncture;PSQI;SF-36
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发布时间：2023-04-10 - 摘要：Objective To observe the clinical effect of Tongqiao Decoction combined with acupuncture on sphenopalatine ganglion in the treatment of chronic sinusitis with allergic rhinitis.Methods 100 patients with chronic sinusitis with allergic rhinitis due to lung-qi coldness and deficiency were randomly divided into two groups,one treated by Tongqiao Decoction combined with acupuncture at sphenopalatine ganglion（treatment group）and the other treated by Western medicine（control group）.50 patients in each group were treated for 4 weeks.The visual analogue scale（VAS）and nasal endoscopy were adopted to evaluate the efficiency.Results After treatment,the scores of VAS and endoscopic examination in the two groups were significantly lower than those before treatment（P<0.05）,but there was no significant difference in VAS, endoscopic examination and total effective rate between the two groups（P>0.05）.Conclusion Tongqiao Decoction combined with acupuncture of sphenopalatine ganglion is effective in the treatment of sinusitis complicated with allergic rhinitis.关键词：Chronic sinusitis;Allergic rhinitis;Tongqiao Decoction;sphenopalatine ganglion;acupuncture
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发布时间：2023-04-10 - 摘要：Objective To investigate the clinical effect of Anshen Xingnao（ASXN）Decoction on the treatment of HIV/AIDS patients with insomnia induced by efevirenz.Methods From May 2016 to September 2018,in the AIDS outpatient department of Beijing Ditan Hospital,Capital Medical University,108 HIV/AIDS patients with insomnia induced by efevirenz,syndrome characterized by liver depression transforming fire combined with phlegm-heat internally disturbing,were selected and divided into observation group and control group by using random number table methods.54 participants were in each group and respectively treated with ASXN Decoction and estazolam tablets for 8 weeks.The clinical efficacy was assessed and compared according to the evaluation criteria of TCM insomnia efficacy,Pittsburgh sleep quality index（PSQI）score and TCM syndrome score between the two groups before and after treatment.Results After 4 and 8 weeks of treatment,compared with before treatment,PSQI score and TCM syndrome score were significantly reduced with a remarkably statistical significance（P<0.01）in two groups,respectively.After 4 weeks of treatment,the PSQI scores had no statistical significance（P>0.05）,and the difference of TCM syndrome scores were statistically significant（P<0.05）between two groups.After 8 weeks of treatment,the PSQI scores and the difference of TCM syndrome scores were statistically significant（P<0.01）,between two groups.8 weeks after treatment,the total effective rate of the observation group was remarkably better than the control group（P<0.01）.Conclusion ASXN Decoction could effectively improve the insomnia of HIV/AIDS patients induced by efevirenz.关键词：Insomnia;Anshen Xingnao Decoction;acquired immune deficiency syndrome;efavirenz
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of Bushen Huoxue Recipe on the expression of CD34,integrin ανβ3 and leukocyte inhibitory factor（ LIF） in endometrium of rats with thin endometrium treated by bone marrow mesenchymal stem cells（ BMSCs）transplantation. Methods BMSCs were isolated from femur bone marrow of male SD rats aged 6 ～ 8 weeks. BMSCs were purified by whole bone marrow adherent method. The cells of passage 3 with high purity were transplanted into the experimental rats by tail vein（ IV） and intrauterine（ IU） injection respectively. Female SD rats were perfused with 95% absolute ethanol and intrauterine injection of hydroxyurea plus high molecular dextran via tail vein to establish the model of kidney deficiency and blood stasis. The experimental rats were divided into control group,model group,positive control group,BMSCs + IV group,BMSCs + IU group,BMSCs + IV +traditional Chinese medicine group and BMSCs + IU + traditional Chinese medicine group; each group was intervened by corresponding Methods,and then the rats were sacrificed after three estrous cycles. The expression of vascular endothelial cell marker protein CD34,endometrial receptive marker integrin ανβ3 and LIF were detected by immunohistochemistry and Western blot. Results BMSCs + IV group,BMSCs + IU group,BMSCs + IV + traditional Chinese medicine group and BMSCs + IU + traditional Chinese medicine group could all increase the expression of CD34,integrin ανβ3 and LIF in endometrium to a certain extent（ P < 0. 05）; the expression of integrin ανβ3 in the tail vein injection group was significantly higher than that in the intrauterine injection group（ P < 0. 01）. There were significant differences in the expression of CD34,integrin ανβ3 by immunohistochemistry and the expression of integrin ανβ3 and LIF detected by Western blot among BMSCs + IV group,BMSCs + IU group,BMSCs + IV + traditional Chinese medicine groupand BMSCs + IU + traditional Chinese medicine group（ P < 0. 05）. Conclusion The expression of integrin ανβ3 increased by tail vein injection was higher than that by intrauterine injection; combined with Bushen Huoxue Decoction,the expression of integrin ανβ3 and LIF showed a better efficacy.关键词：Bushen Huoxue Recipe;thin endometrium;BMSCs;CD34;integrin ανβ3;LIF
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发布时间：2023-04-10 - 摘要：Objective To investigate the pharmacological effects of Qingzi Xiaoban Granule（QXG）on acute dermal inflammation and allergic reaction.Methods The experimental mice were divided into control group,model group,QXG with low dosage group,QXG with medium dosage group,QXG with high dosage group and positive control group.Croton oil-induced ear inflammation mouse model was established to access the inhibition rate of the drug on ear swelling.Delayed type hypersensitivity（DTH）mouse model was established to evaluate the QXG effect on ear swelling and the immune organ index.Passive cutaneous anaphylaxis（PCA）rats model was established to examine the QXG effect on the diameter and absorbance values of the skin blue spot.Results The high-dose QXG group inhibited mouse ear swelling induced by croton oil at a rate of 15.8%,which was significantly different from that in model group（P<0.01）.The inhibition rate on DTH model ear swelling was 17.5%,the thymus index and spleen index were（1.35±0.22）mg/g and（4.40±0.47）mg/g,respectively,which were significantly different from those in model group（P<0.01）.The final size of the PCA model skin blue spot was（12.5±2.0）mm,statistically significant with the model group（P<0.05）.Conclusion QXG has a certain inhibitory effect on local acute inflammatory reaction and dermal hypersensitive reaction.关键词：Qingzi Xiaoban granule;dermal inflammation;delayed type hypersensitivity;passive cutaneous anaphylaxis
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发布时间：2023-04-10 - 摘要：Objective To observe the effect of electroacupuncture at Shuigou point,which intervention on cerebral infarction volume in stroke rats at different therapeutic time windows in early stage of ischemic stroke.Methods SD rats were randomly divided into 5 groups（sham operation group,model group,5 min group,30 min group and 60 min group）.Rat model of middle cerebral artery occlusion was made by suture method.The rats in the three electroacupuncture groups were treated with electroacupuncture at 5 min,30 min and 60 min after successful modeling.Every rat received electroacupuncture once every day at a fixed time（Frequency:30 Hz,intensity: 1-3 mA,duration: 30 min）.Eight rats in each group were taken for index observation,and the neurological deficit score（NDS）was evaluated after the rats woke up and before execution.The rats were over anesthetized 72 h after modeling and TTC staining was performed to calculate the infarct volume of rats before harvest.Results The neurobehavioral scores were significantly reduced in 30 min group（P< 0.05）.The cerebral infarction volume of the model group rats was significantly increased compared with the sham operation group（P < 0.01）.Compared with the model group,the volume of cerebral infarction in the three electroacupuncture group was significantly lower than that in the model group（P<0.01）.There was no difference in the cerebral infarction volume between three electroacupuncture groups（P > 0.05）.Conclusion Electroacupuncture in the early stage after ischemic stroke in rats could effectively reduce the volume of cerebral infarction in rats,and electroacupuncture at 30 min after stroke could effectively improve the neurological function of rats.关键词：electroacupuncture;cerebral ischemia;cerebral infarction volume;different therapeutic time windows;rat
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发布时间：2023-04-10 - 摘要：关幼波教授是现代杰出的中医药名家,一直致力于肝病的诊治,丰富和发展了痰瘀学说,认为痰瘀相互助长,胶固不化,可致诸多病理变化的发生。在慢性乙型肝炎肝硬化的病理过程中,痰瘀互结是余邪稽留、脏腑虚损、气血失调共同作用的结果,贯穿疾病发生发展的始终。治疗上,关教授重视调畅气机,倡导痰瘀同治,凝练出活血化痰一法,并将该法贯穿于慢性乙型肝炎肝硬化治疗的全程,提高了临床疗效和患者生活质量。关键词：关幼波;痰瘀学说;活血化痰法;慢性乙型肝炎;肝硬化;老中医经验
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发布时间：2023-04-10 - 摘要：病态窦房结综合征（sick sinus syndrome,SSS）是目前医学界公认的难治性心律失常疾病,由窦房结功能受损和搏动异常引起。国医大师刘志明教授认为SSS的病机为"阳郁血瘀"。从中西医结合的角度,以刘志明治疗SSS的学术思想为切入点,阐释SSS的病理机制。关键词：阳郁血瘀;病态窦房结综合征;β-tubulin微管蛋白;能量代谢;线粒体;刘志明
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发布时间：2023-04-10 - 摘要：动物类药物在男科疾病中应用丰富,李曰庆教授从医四十余年,总结前人经验,在临床上活用动物类药物治疗阳痿,积累了丰富的临证经验。李曰庆教授治疗阳痿时,善用的动物药可分为活血化瘀类（蜈蚣、水蛭）、补肾固本类（蛤蚧、黑蚂蚁）、疏肝解郁类（蜈蚣、蝉蜕）3种,并针对瘀血阻络、湿热血瘀、肝郁血瘀、肾虚血瘀等不同证型,归纳了动物药的适用证型。关键词：阳痿;中药;动物药;李曰庆
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发布时间：2023-04-10 - 摘要：悬饮常见于慢性疾病的终末阶段或急性加重期。李国勤教授认为悬饮的病机本在肺脾肾气虚,水液失于运化,聚而形成痰、饮、水、湿之邪;疾病日久成瘀,而痰、饮、水、湿、瘀之邪相互兼夹,停滞于肺、胸胁,从而形成悬饮之病。悬饮病因以正气亏虚为根本,痰、饮、水、湿、瘀为病理产物,治疗以益气温阳、泻饮逐水、活血化瘀、祛痰利湿为主,同时注意宽胸理气,顾护阴津。关键词：悬饮;胸腔积液;中医药疗法;李国勤
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发布时间：2023-04-10 - 摘要：再生障碍性贫血是由于脏腑受损而致气血亏虚,导致虚劳血虚,属中医学"虚劳"范畴。其临床症状以贫血、感染、出血为特点,目前移植性治疗是治愈此病的唯一方法。中医治疗时常以肾、脾为中心,加以补气血之品,疗效满意。对"补肾健脾、益气补血"思路辨治慢性再生障碍性贫血的临床经验进行总结。关键词：中西医结合治疗;再生障碍性贫血;虚劳
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发布时间：2023-04-10 - 摘要：《卫生家宝方》是一部仅存抄本残卷、而近年来被"国家中医药管理局中医药古籍保护与利用能力建设项目"挖掘整理的南宋中医临床方书著作。该书首次明确记载了"痟渴者""疾之久"会出现"足膝发恶疮、漏疮"这些糖尿病足的临床表现,同时还记载了与当代糖尿病认识极为吻合的有关消渴病的病因认识、临床表现、诊断依据、其他并发症、药物和服用法及禁忌等内容,所载方剂选药及倡导的"益气养阴"法在临床被广泛应用。关键词：《卫生家宝方》;消渴病;糖尿病足;理论研究;文献整理
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发布时间：2023-04-10 - 摘要：肺气宣发肃降有常推动腑气通降、脾气健运生化有源推动大肠运转是糟粕下行畅通的前提。反之肺脾气虚可致肠道推动无力,糟粕内结,排便不畅。故从肺脾论治便秘是常用的治疗便秘的思路。补肺脾之气,助大肠推导之功,以疗便秘,临床收效甚佳。关键词：便秘;补肺脾;临床疗效
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发布时间：2023-04-10 - 摘要：紧张型头痛是最常见的原发性头痛,一定程度上影响患者的日常生活及工作。紧张型头痛根据其主诉症状应归属于中医学"头痛"范畴,且多属"内伤头痛"。王麟鹏教授总结多年临床经验,认为紧张型头痛发病与气关系密切,情志失调为其常见诱因,临床治疗多从神、气论治,辨经与辨证相结合,针刺灵活选穴,针对中医证候明显者,辅以汤药治疗,针药并用,脏腑经络同调,临床疗效显著。关键词：紧张型头痛;针刺;汤药;针药结合
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发布时间：2023-04-10 - 摘要：《温病条辨》制方以药物性味配伍为特色,将药物的四气五味与辨证理论相结合,灵活应用于温热类疾病的治疗。其中苦辛合用法应用最为广泛,具有良好的调畅气机及促进脏腑运化功用,尤适用于甲状腺疾病的治疗,临床中通过运用辛微苦微寒法、苦甘酸寒微辛法、苦辛温法、苦辛温复咸寒法等,启发了中医学临床思维,使"论治"更加灵活,为甲状腺结节的治疗提供更多新的角度。关键词：甲状腺结节;苦辛法;四气五味;瘿病;温病条辨
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发布时间：2023-04-10 - 摘要：不寐的病因病机主要是脏腑功能失调,核心在肝,由肝及肾,心肾不交、饮食不节、思虑太过、久病血虚而发病。其辨证主要有肝气郁结、胃失和降、心脾两虚、心肾不交4型。结合病因与证型,不寐的治法可归纳为安神志、疏肝郁、调阴阳、养心神、健脾胃、祛邪气。关键词：失眠;不寐;脏腑
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发布时间：2023-04-10 - 摘要：目的观察芪胶升白胶囊对结直肠癌术后化疗所致骨髓抑制的预防效果。方法选取2016年1月—2018年6月河南中医药大学第一附属医院普外科收治的结直肠癌患者132例,按照随机数字表法将其分为对照组、治疗1组、治疗2组,各44例。3组均行开放或腹腔镜下结直肠癌根治术,术后2～3周采用mFOLFOX6方案序贯化疗,共8个周期。对照组仅采用上述治疗方案;治疗1组于首次化疗开始加服地榆升白片4片/次,3次/d;治疗2组于首次化疗开始加服芪胶升白胶囊4粒/次,3次/d。各组连续治疗至化疗周期结束。如出现严重骨髓抑制,可酌情选用人重组粒细胞集落刺激因子（rhG-CSF）。比较治疗前后各组骨髓抑制分级、中医证候评分、Karnofsky（KPS）评分及rhG-CSF用量。结果化疗结束后,两治疗组的骨髓抑制分级程度明显低于对照组（P<0.05）,KPS评分的改善、稳定病例数均优于对照组（P<0.05）,rhG-CSF使用量均少于对照组（P<0.05）,治疗2组中医证候评分低于对照组（P<0.01）。以上指标改善治疗2组均优于治疗1组（P<0.01,P<0.05）。结论芪胶升白胶囊可有效预防结直肠癌术后化疗骨髓抑制,减少rhG-CSF用量。关键词：芪胶升白胶囊;结直肠癌;化疗;骨髓抑制
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发布时间：2023-04-10 - 摘要：目的探讨运用"排痰清肺"外治法治疗小儿急性支气管炎痰热型的临床效果。方法选取2018年9月—2019年6月于北京市门头沟区中医医院儿科门诊就诊的急性支气管炎痰热型患儿120例,采用随机数字表法分为观察组与对照组各60例。对照组接受基础治疗,观察组在对照组治疗基础上加"排痰清肺"外治法,每日1次。2组疗程均为5 d。对比2组治疗前后咳嗽症状积分、疗效及咳痰症状消失时间。结果 2组治疗后咳嗽症状积分比较,差异有统计学意义（P=0.006）;治疗效果比较,观察组愈显率为76.7%,对照组为50.0%,2组比较差异有统计学差异（χ2=9.187,P=0.002）;观察组咳痰症状消失时间为（2.43±0.95）d,对照组为（3.95±0.63）d,2组差异有统计学意义（P<0.05）。结论在常规治疗基础上应用"排痰清肺"外治法治疗小儿急性支气管炎痰热型疗效显著,可明显改善咳嗽症状,缩短症状消失时间。关键词：排痰清肺;外治法;儿童;急性支气管炎;痰热型
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发布时间：2023-04-10 - 摘要：目的观察清肝安神汤治疗肝火亢盛型失眠的有效性和安全性。方法将124例肝火亢盛型失眠患者随机分为治疗组和对照组各62例,其中治疗组给予清肝安神汤治疗,对照组给予艾司唑仑片治疗,疗程均为4周。对比治疗结束后2组患者总有效率、匹兹堡睡眠质量指数（PSQI）及中医证候积分的改善情况,观察并记录不良反应。结果治疗组总有效率为85.48%,显著优于对照组的56.45%（P<0.01）;治疗组PSQI四个因子（睡眠质量、入睡时间、催眠药物和日间功能障碍）改善情况均优于对照组（P<0.01,P<0.05）;治疗组中医证候总有效率显著优于对照组（P<0.01）,不寐多梦、急躁易怒、头晕头胀等症状显著改善。结论清肝安神汤能提高肝火亢盛型失眠患者的整体睡眠质量,且能改善不寐多梦、急躁易怒、头晕头胀等临床症状,安全性好。关键词：失眠;从肝论治;清肝安神汤;肝火亢盛
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发布时间：2023-04-10 - 摘要：目的探讨血府逐瘀汤合越鞠丸加减治疗气滞血瘀型冠心病稳定性心绞痛合并焦虑临床疗效。方法将84例气滞血瘀型冠心病稳定性心绞痛伴焦虑患者随机分为观察组和对照组各42例。2组同时给予冠心病西医基础治疗,观察组予血府逐瘀汤合越鞠丸加减治疗,对照组给予西药劳拉西泮口服,比较2组患者治疗前后中医证候积分、心绞痛疗效、心电图疗效、西雅图心绞痛量表（SAQ）评分及汉密尔顿焦虑量表（HAMA）评分疗效。结果治疗后观察组中医证候积分低于对照组,差异有统计学意义（P<0.05）;观察组心绞痛及心电图疗效均高于对照组,差异均有统计学意义（P<0.05）;观察组SAQ各项评分均高于对照组,差异有统计学意义（P<0.05）;观察组HAMA评分总有效率高于对照组,差异有统计学意义（P<0.05）。结论血府逐瘀汤合越鞠丸加减治疗气滞血瘀型冠心病稳定性心绞痛合并焦虑,可提高患者心绞痛及心电图疗效,提高生存质量,改善焦虑状态及中医证候。关键词：血府逐瘀汤;越鞠丸;气滞血瘀;冠心病稳定性心绞痛;焦虑
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发布时间：2023-04-10 - 摘要：目的观察分析学龄儿童鼻窦炎患者的舌象规律。方法选择2019年10月—2020年6月天长市中医院中医耳鼻咽喉科门诊就诊的学龄儿童发作期鼻窦炎患者,采集患儿不同维度舌象特征;应用Excel 2013进行频数、舌色、舌形、苔色、苔质分析;应用IBM SPSS Modeler 18.0进行舌象因素间网络化关联展示以及关联规则分析。结果频数≥100次的舌象因素有6个,为淡红舌、点刺、白苔、薄苔、厚苔、腻苔,累计出现906频次,贡献百分比为72.60%。关联规则以腻苔-厚苔、腻苔-点刺,腻苔-厚苔and润苔,腻苔-点刺and白苔为主。结论学龄儿童鼻窦炎患者舌象常见腻苔,或伴点刺舌,说明湿、热为其主要病因病机。关键词：鼻窦炎;鼻渊;数据挖掘;腻苔;点刺舌;学龄儿童
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发布时间：2023-04-10 - 摘要：目的挖掘整理载有类抽动障碍表现疾病的古籍文献,为临床治疗抽动障碍提供参考。方法以关键词"瘛疭""慢惊风""抽搐""筋惕肉瞤""肝风",检索《中华医典》软件,将涉及病名、病因病机、方药、禁忌与预后的内容予以分类归纳。通过Excel 2007软件对药物性味及用药频率进行频数分析,使用SPSS 20.0软件对高频药物进行聚类分析。结果类似抽动障碍证候表现的疾病,其病因与患儿先天因素、外感寒热、饮食及母亲产后失血有关,病机以火热、津亏、血虚而致风动为主,亦与痰湿有关。共录入处方140张,药物169味,药物多数为补虚药、清热药、解表药,四气以寒、温、平为主,五味以辛、苦、甘为主,剂型多为丸散。其中使用频次≥10次的药物31味,共聚为4类。在阴液亏损的情况下不宜汗下,忌用温针。结论古代医家重视虚、风、痰在抽动类疾病中的作用,以补益中焦、祛风化痰、解表清热为核心治法,对药物的性味、剂型的选择颇有考究,值得借鉴。关键词：抽动障碍;古籍;文献研究
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发布时间：2023-04-10 - 摘要：目的探讨丁氏严系治疗胸痹的用药规律。方法选取四代代表性传承人丁甘仁（第一代）、严苍山（第二代）、严世芸（第三代）、潘华信（第三代）和徐燕（第四代）的胸痹治疗有效医案,包括丁甘仁医案9例,严世芸医案200例,潘华信医案125例,徐燕医案260例,严苍山病案主要通过其弟子潘华信提供伺诊病例及口述治疗经验,采用关联规则分析,寻找传承规律。结果诸位医家在治胸痹时紧抓"阳微阴弦"心脉痹阻的病机特点。丁甘仁善以"薤白-瓜蒌皮-半夏"为通阳散结的核心组合。严苍山善用甘药,温里通阳,煦养血气。严世芸强调益气活血、化瘀通络,多用桃仁、川芎,主用柴胡、桂枝、黄芪。潘华信治胸痹除擅用瓜蒌薤白外,主用附子,旨在逐瘀通络,配以薏苡仁化湿通痹下气。而第四代徐燕除益气活血通络治则之外,注重扶助中土,"劳则补其子",擅用山药、山楂、水蛭等以健脾养心、散瘀化结。结论丁氏严系门人遵仲景之道,紧抓胸痹病机特色;并且各承家技,在一定程度上丰富了丁氏内科治疗胸痹的学术经验。关键词：胸痹;丁氏内科;严苍山;严世芸;潘华信;徐燕;数据挖掘;关联规则分析
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发布时间：2023-04-10 - 摘要：目的系统评价肾康注射液联合前列地尔治疗糖尿病肾病（DN）的有效性和安全性。方法计算机检索国内外8个数据库,检索时间从建库至2020年3月16日。中文以"肾康""前列地尔""糖尿病肾病""糖尿病肾脏病"为检索词,检索CNKI、SinoMed、VIP、WanFang;英文检索以"diabetic nephropathy""diabetic nephrosis""shengkang injection""diabetic kidney disease""alprostadil"为检索词,检索Embase、PubMed、Wed of Science、Cochrane Library。收集肾康注射液联合前列地尔与仅用前列地尔对比治疗DN的随机对照试验。2名研究人员独立提取数据,并根据Cochrane系统评价手册对所纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入15个RCT,共1 130例患者,试验组572例,对照组558例。在总有效率、24小时尿蛋白方面,试验组疗效优于对照组;在血尿素氮（BUN）、总胆固醇（TC）、甘油三酯（TG）、血肌酐（SCr）、尿微量白蛋白方面,异质性明显,无法得出明确对比结果。不良反应主要为注射部位疼痛、潮红等,无严重不良反应报告。结论肾康注射液联合前列地尔治疗DN较仅用前列地尔疗效更佳,且相对安全。关键词：肾康注射液;前列地尔注射液;糖尿病肾病;Meta分析
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发布时间：2023-04-10 - 摘要：<正>因高热量饮食及体力活动不足,2型糖尿病（T2DM）近年来有发病年轻化倾向。据报道,儿童及青少年T2DM的患病率较30年前增加了2～3倍[1]。2002—2012年美国儿童青少年T2DM患病率的相对年度升幅为4.8%[2],2005—2010年我国儿童青少年T2DM的患病率为10/10万,北京地区6～18岁儿童青少年T2DM的患病率为0.6‰[3]。T2DM发病更早,胰岛β细胞功能衰减的速度也更快,若控制不及时更易出现并发症[4]。关键词：2型糖尿病;青少年;脾瘅;仝小林
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发布时间：2023-04-10 - 摘要：<正>喉乳头状瘤病（laryngeal papilloma,LP）又称复发性呼吸道乳头状瘤病（recurrent respiratory papillomatosis,RRP）,是由人乳头状瘤病毒（HPV）感染引起的喉部最常见的良性上皮性肿瘤。主要感染途径为患儿于母亲产道内吸入HPV颗粒,多发于14岁以下儿童,以6岁以下儿童为主[1],称为幼年型RRP（JORRP）。多数LP呈侵袭性病变[2],易阻塞气道,西医治疗以手术为主,关键词：喉乳头状瘤;儿童;名医验案;李淑良
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发布时间：2023-04-10 - 摘要：<正>小青龙汤为东汉时期张仲景所创,《伤寒论·辨太阳病脉证并治》云:"伤寒表不解,心下有水气,干呕,发热而咳,或渴,或利,或噎,或小便不利,少腹满,或喘者,小青龙汤主之。""伤寒表不解,心下有水气"点明本方治疗太阳伤寒兼水饮内停证,药用麻黄、桂枝、白芍、干姜、炙甘草、细辛、半夏、五味子,功在发汗解表、温化寒饮。方中麻黄、桂枝发汗解表,且麻黄兼能宣肺平喘,桂枝可化气行水;用干姜、细辛温肺化饮;佐以半夏辛温入里,可温化寒饮,降逆止呕;然恐麻黄、关键词：小青龙汤;胃痞;多涎;泄泻;痰饮;病案
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发布时间：2023-04-10 - 摘要：幽门螺杆菌被认为是消化性溃疡、胃癌等上消化道疾病重要的致病因子和危险因素。抗生素耐药成为制约根除疗效的最主要因素,不断升级的治疗方案使患者耐受性降低,尤其是存在根除治疗制衡因素的患者。包括益生菌、黏膜保护剂、中医药在内的非抗生素药物在提高根除率、减少不良反应中发挥了积极的作用。对以上药物在根除治疗中的效应、机制和存在的问题进行梳理和综述。关键词：幽门螺杆菌;非抗生素药物;根除治疗;益生菌;中医药;黏膜保护剂
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发布时间：2023-04-10 - 摘要：从椎间盘的不同结构:髓核、纤维环、终板三个方面,分别总结中医药对退行性椎间盘相关信号通路的影响。中医药治疗包括中药提取物、经典方剂、针刺、针刀等手段,在椎间盘退变过程中发挥减少细胞外基质降解、降低炎症反应、促进细胞增殖、抑制细胞凋亡,进而延缓椎间盘退变的作用,而在3种椎间盘结构中均参与调节的信号通路包括MAPK、Wnt/β-catenin、NF-κB等经典信号通路。从分子水平研究椎间盘退变的机制,为实现椎间盘退变的中医药精准医疗提供依据。关键词：中医药;信号通路;椎间盘退变;髓核;纤维环;终板
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发布时间：2023-04-10
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