在中医学理论体系中,痹、痿两种疾病在病因病机、辨证论治方面均不相同,但痹病可以导致痿病的发生.类风湿关节炎主要影响肢体关节,亦可影响筋脉肌肉,从而形成痹痿并存的症状."脾虚"在痹与痿的发病、发展以及演变中具有重要作用.脾虚为本,营卫失和,外湿引动内湿,湿邪困脾,加重脾虚,影响五脏,故外及肢体,内及脏腑.病情进一步发展,脾虚失养,或脾虚湿阻,因痹致痿,故出现肉痿筋弛,肺痿咳喘.据此提出:健脾化湿,以调营卫、滋气血、利关节、濡肌肉、强筋骨,同时兼顾补脾养五脏,通五脏痹,养五脏痿.故从脾论治类风湿关节炎,可以涵盖类风湿关节炎各个病理阶段,实现痹与痿同治.
Double heart disease is a general term for a group of cardiovascular diseases combined with psychosomatic problems,which is a common disease in cardiology,but there are no effective cures"and"methods at present.In view of double heart disease,combining with the physiological function of"heart governs blood and heart governs Shen"in traditional Chinese medicine and the living characteristics of modern people,Professor Liu Hongxu believes that the pathological characteristics of double heart disease are liver excess and spleen deficiency,Yang excess and Yin deficiency,and the imbalance of the liver and the spleen is the important mechanism of the disease,so the general principle is to adjust the liver and the spleen together.Symptoms manifestation focuses on the emotional disturbances,poor appetite and fatigue,red tongue and stringy pulse,the treatment adopts the method which relieves the depression and clears away the heat,strengthens the spleen and nourishes the heart,the dispatch prescription uses the medicine to Danzhi Xiaoyao powder to add the subtraction,with the symptom to be tailored.This paper summarizes Professor Liu Hongxu based on the liver and spleen same adjustment theory of treatment of double heart disease ideas and experience with medicine,and attached to a medical case,to support the description.
Peroxisome proliferator-activated receptor(PPAR)is a kind of transcription factor that is involved in sugar and lipid metabolism,inflammatory response and cell proliferation,differentiation,and apoptosis.In recent years,an increasing number of studies have been conducted on the related pathways of the three subtypes of PPAR,and it has been found that PPAR played an important role in the transformation process of non-alcoholic fatty liver disease.From monomer and compound Chinese medicine to patent Chinese medicine and external treatment of traditional Chinese medicine(TCM),all of which showed that TCM intervention had a good clinical effect on the treatment of non-alcoholic fatty liver disease(NAFLD).The number of fundamental experiment studies to elucidate the mechanism of TCM in the prevention and treatment of NAFLD based on PPAR pathways is increasing.This article will review the experimental studies on the mechanism of TCM prevention and treatment of NAFLD in recent years from the perspective of PPAR pathways.
腹型过敏性紫癜是以腹部疼痛为主要表现的免疫紊乱性小血管炎性疾病,甚者可并发急腹症,严重危害患儿身心健康,目前认为其发病机制与"肠道微生态-免疫炎症"失调有关.糖皮质激素是西医推荐的首选用药.近年来中医药治疗本病疗效日渐显著,但具体机制不明.故本文从中医"阳明"为切入点,阐释肠道"微生态-免疫炎症"失衡与"阳明有余"二者之间的联系与内涵,为中医药靶向"微生态-免疫炎症"治疗和预防腹型过敏性紫癜提供新的研究思路.
Objective This study aims to examine the utilization of Elemene Emulsion Injection in combination with other drugs for the treatment of esophageal cancer.Method From 21 tertiary hospitals across the country,clinical records of 310 patients,who received Elemene Emulsion Injection for esophageal cancer,were retrieved from the Hospital Information System(HIS).These patient data were subjected to descriptive analysis focusing on their diagnostic and medication details.Applying the modularity optimization feature of the Louvain algorithm for multi-level networks,an exploration into the key medication regimens for the most effectively treated patient group was conducted.Results Among esophageal cancer patients treated with Elemene Emulsion Injection,hypertension,diabetes,coronary heart disease,and lung infection frequently co-occur.The predominant mode of administration is via intravenous drip.The range of dosage per administration is between 20 mL and 200 mL;most patients are treated with a course lasting no more than three days.Concomitant Western medicines primarily encompass nutritional supplements,vitamins,insulin injections,and their respective analogs.Additionally,co-administered Chinese Patent Medicine often include Xiaoaiping Injection,Yadanzi Oil Emulsion Injection,and Compound Bitter Sophora Injection.Moreover,Elemene Emulsion Injection is regularly paired with potassium chloride,heparins,thymopeptide,dexamethasone,vitamins,and furosemide.Conclusion The integration of Elemene Emulsion Injection in the clinical management of esophageal cancer adheres to pertinent clinical guidelines.The collaborative application of Chinese Patent Medicine and modern Western Medicine primarily addresses the nutritional status of patients,adverse reactions following surgery or radiation and chemotherapy,overlapping conditions,complications,and supportive treatment for symptoms.This offers a valuable reference point for esophageal cancer treatment strategies.
汗证是心系病极为多见的并发病证.第三批全国老中医药专家学术经验继承工作指导老师董其美以《黄帝内经》"汗为心之液""心为汗之枢"思想为指导,认为汗出异常是心之体用失常、阴阳失衡的结果,见微知著,以象窥脏,循因求本,临证心系疾病思辨过程中注重"汗"的证机内涵,提出"心病见汗之证,可辨汗而治"的学术思想,从汗辨治心系病,临床疗效显著.本文从辨汗论治心病的理论渊源、方法与要点等方面系统介绍了该学术思想,以及董老在这一学术思想指导下的运用经典方剂化裁临证遣方选药经验.
支气管扩张症是以咳嗽、咯痰或咯脓痰等为主要表现的一种难治性肺疾病,中医外治法与中药联合使用可增加疗效,在该病治疗中具有一定的优势,文章通过整理近10 年来的相关文献资料,综述了常见的中医外治法在该病中的应用和研究现状,总结提炼了以下选穴规律和治法治则:常用的腧穴以手太阴肺经、足太阳膀胱经和手、足阳明经穴位为主,急性期祛风散邪、理肺清热,常用风门、肺俞、厥阴俞、膻中、合谷、孔最、涌泉等穴;稳定期健脾化痰、补肺益肾,常用肺俞、脾俞、肾俞、丰隆、足三里、定喘等穴;其中,常使用穴位贴敷孔最和涌泉来治疗咯血.并针对中医外治法治疗该病的研究提出展望,旨在为后来研究者提供参考.
带下病为中医常见的四大妇科疾病之一,该病可见于现代医学的闭经性阴道炎、卵巢早衰、子宫颈炎、不孕、妇科肿瘤等疾病,临床上呈现发病率高、复发率高的趋势,严重影响女性身心健康.目前西医多以抗生素治疗,疗效有限.自清代傅青主起,诸位医家多从湿辨带.现代医家对带下病的认识有诸多发挥,认为带下病多湿邪化热、夹痰、结瘀,而脏腑功能失调是导致带下病产生的重要因素.本文着重探讨现代中医治疗带下病的诊疗特点,从对带下病的病名认识出发,结合历代古籍文献,旨在为现代中医诊治"带下病"临床实践提供借鉴.
老年健忘主要表现为记忆力减退、遇事易忘,中医也称"喜忘""善忘"等,属老年群体的常见病、多发病.有些患者还可能发展为阿尔茨海默病,严重影响患者的健康及生活质量.中医药在老年健忘的防治方面具有丰富的临床经验,值得深入探讨.王平教授从事老年病、老年脑病相关工作多年,对老年健忘的认识深刻、见解独到,常从元气理论出发探讨老年健忘的病因病机及防治措施.王平教授认为老年健忘的病理基础为脾肾亏虚,元气不足;发病的重要因素为元气亏虚,因虚致实,痰阻瘀停;防治方面,认为未病时需培元保元、重在预防,既病则应养元复元、培元健脑.
Objective To establish an animal model of blood stasis syndrome and to construct a more systematic and comprehensive evaluation system for animal models of blood stasis syndrome.Methods SPF male SD rats were randomly divided into normal group and carrageenan(Ca)low,medium,and high dose(5,10,20 mg/kg)model group;the model group was injected with the corresponding dose of carrageenan in the peritoneum and the normal control group was injected with 0.9%sodium chloride solution.At 24 h and 48 h after injection,the general condition,black tail length,caudal blood perfusion,tongue,blood rheology,and platelet aggregation rate were observed and detected in each group of rats,and the tail tissues of each group of rats were retained for pathological section analysis.Results Rats in the medium and high-dose groups showed signs such as decreased activity,decreased eating,loose and dull fur,erect hair,and purple and dark auricular veins at 24 and 48 hours after molding.24 h after molding,the model low,medium,and high-dose groups all showed off black tails,and the length of the black tail in the high-dose group increased significantly compared with the low-dose group(P<0.01);48 h after molding,compared with the low-dose group,the length of the black tail in the medium-dose and high-dose groups increased significantly(P<0.01 or P<0.05).24 h and 48 h after molding,the tail-end blood flow of each dose group of the model group was significantly reduced compared with the normal group(P<0.01),and no significant difference was found between the model groups.In the medium-dose group and high-dose group of the model,the values of tongue images R,G,and B decreased significantly compared with the normal group 24h and 48h after molding(P<0.01 or P<0.05).The whole blood viscosity(low,medium,and high cut)was significantly increased in the medium-and high-dose groups at 24 and 48 hours after molding(P<0.01 or P<0.05).At 24 and 48 h after molding,the maximum aggregation rate of platelets in the medium-dose and high-dose groups was significantly higher than that in the normal group(P<0.01 or P<0.05).The result of tail histopathology showed that a small number of inflammatory cells were visible in low-dose groups.A large number of inflammatory cell infiltrates,interstitial edema,thin tube walls,and erythrocyte spillage could be seen in the medium-and high-dose groups.Conclusions The medium-dose(10 mg/kg)and high-dose(20 mg/kg)carrageenan-induced rat blood stasis model showed more stable and typical blood stasis symptoms at 24 h and 48 h after molding,and a model evaluation system involving macroscopic characterization of blood stasis syndrome,modern medical microscopic indicators and histopathological morphology of TCM was constructed in this study.
By analyzing the classical and modern studies related to pancreatic cancer,we realize that the pancreatic cancer is located in the spleen,which is related to the liver.The pathogenesis is summarized as deficiency of the original.The specific interpretation is based on spleen deficiency,coupled with Qi stagnation,endogenous dampness-heat phlegm and blood stasis,and repeatedly invasion by cancer poison.Based on the understanding of etiology and pathogenesis,the basic treatment of pancreatic cancer should be based on supplementing the deficiency and strengthening the spleen,regulating Qi,dampness removal,heat clear,phlegm dissolve,stasis disperse,and external cancer toxin,while not forgetting to regulate the liver.We also summarize the modern TCM treatment of pancreatic cancer in terms of modern Chinese medicine formulas,Chinese medicine injections,acupoint dressing,acupuncture,electroacupuncture,percutaneous nerve stimulation,ear pressure pills,and moxibustion,and realize that in modern Chinese medicine treatment,the principles of prescription medicine and acupoint selection are mostly based on strengthening the spleen and regulate the liver,which is consistent with the basic treatment principles.Further studies have found that modern traditional Chinese medicine treatment can inhibit the growth of pancreatic cancer cells,prolong the survival of patients,reduce tumor indicators,alleviate the adverse reactions of radiotherapy and chemotherapy,and improve the general conditions of patients such as cancer pain,hiccups,nausea and vomiting,postoperative gastric paralysis,depression,insomnia.
"心肾相交"作为中医学的重要理论,起源于《周易》,明清时期日趋完善.傅青主多从心肾立论,认为"心肾不交"是多种疾病的发病基础,故常用"交通心肾"法愈诸疾,而远志正是"交通心肾"的代表药.本文基于《傅青主医学全书》,结合"心肾相交"理论,探析傅青主运用远志特色,以期更好地传承傅青主学术思想,指导临床诊疗.
Objective To analyze the medication rules of Professor Zhu Wenzeng in the treatment of myasthenia gravis(MG)by data mining.Methods The medical records of newly-diagnosed MG patients who visited professor Zhu Wenzeng's clinic from January 2017 to December 2021 were collected.The Chinese herbal medicine prescriptions for first visit were included and a database was established.The frequency of each herbal medicine used,four Qi,five flavors,meridians,and efficacy categories were calculated.Association rules analysis and cluster analysis were carried out to explore the characteristics of herbal medicine used.Results A total of 212 prescriptions were included,involving 126 herbal medicines.All herbal medicines were used 5 320 times in total.The top 5 herbal medicines used were astragalus membranaceus(Huangqi,212 times),Nux vomica(Maqianzi,212 times),dried human placenta(Ziheche,212 times),Codonopsis pilosula(Dangshen,211 times),and Licorice(Gancao,211 times).Warm(2 645 times)and sweet herbs(3 492 times)were used the most in the aspect of Qi and flavor.Most of the herbal medicines belong to liver meridian(2 927 times),lung meridian(2 581 times),spleen meridian(2 534 times),and kidney meridian(1 624 times).The top 5 efficacy categories applied were tonifying deficiency drugs(2 215 times),relieving exterior drugs(1 036 times),blood activating drugs(438 times),liver calming and wind calming drugs(418 times),and heat clearing drugs(114 times).The results of association rules analysis showed that Astragalus membranaceus,Nux vomica,Codonopsis pilosula,Radix Bupleuri(Chaihu)and cimicifugae foetidae(Shengma)were the core drugs,among which Huangqi-Maqianzi-Ziheche were the essential drugs for prescription.The drugs can be divided into 9 categories by cluster analysis.Conclusion Professor Zhu Wenzeng takes supplementing Qi and warming Yang as the basic principle in the treatment of MG,and attaches importance to the combined application of methods such as activating blood circulation and dredging collaterals,consolidating exterior and expelling wind,drying dampness,and removing phlegm.
Spindle medicine(pastille)is a distinctive type of traditional Chinese medicine medication that can be taken orally or used externally.This article presents the appearance of spindle medicine in the history of Chinese medicine development by organizing the naming origin and functional evolution of spindle medicine,and explores its unique medical value and cultural attributes in the history of traditional Chinese medicine.Research has found that the Ting shaped substance in Han and Tang literature is the predecessor of spindle medicine,with"Ding"borrowed from"Ding",and"Ding""Sting",and"Ting"are interchangeable characters;From the Song dynasty to the Yuan dynasty,spindle medicine was widely spread due to its flexible usage,and its gradually fixed naming may be related to the social background of silver monetization;After the Ming and Qing dynasties,due to its clear and prominent therapeutic effect,spindle medicine was widely used in various social settings.In the continuous development and evolution of various dynasties,the medicinal functions of pastille drugs have evolved from external use to oral and external use.The treatment scope includes the treatment of constipation,ear diseases,eye diseases,etc.At the same time,it also derived its function as a gift(health product)and was recorded as a military item in historical records for a period of time.
中医药诊治妇科疾病具有独特的优势,"洛阳象庄秦氏妇科"代表性传承人秦月好在治疗妇科疾病方面积累了丰富的临证经验,形成了独到的学术见解.独创"荡胞六法"治疗妇科疾病之实证,对妇科虚证重视补肾;创建辨证-辨病-辨期多元化诊疗模式;提出妇科特有的中西医结合周期疗法;重视中医外治法;善用经方、习用药对、巧用虫药;并且强调中医妇科临床治疗优势在于止血、止痛、促孕.本文系统阐释秦月好治疗妇科疾病的学术思想及临证经验,以期为名老中医经验传承和中医药防治妇科疾病提供有益借鉴.
Objective Taking patients with non-small cell lung cancer(NSCLC)and patients with tiny pulmonary nodules as research subjects,we studied the facial,tongue,and pulse characteristics of NSCLC and their correlation with tumor markers.Then explore the role of facial,tongue,and pulse data in the diagnosis of NSCLC.Methods We collected 377 patients with NSCLC and 368 patients with tiny pulmonary nodules,then analyzed and extracted their facial,tongue,and pulse data.We used Wilcoxon rank-sum test to analyze the difference in facial,tongue,and pulse data between the two groups.We used the Spearman's rank correlation coefficient to represent the correlation between facial,tongue,pulse data and tumor markers.Results The tongue image parameters Per-all,TC-L,TB-CON,TB-ENT,TB-MEAN,and TB-L in the NSCLC group were lower than those in the tiny pulmonary nodules(P<0.05),while TC-a,TC-b,TB-ASM,TB-a,and TB-b were higher than those in the tiny pulmonary nodules group(P<0.05).The facial tongue image parameters F-ASM,F-IDM,and F-L in the NSCLC group were lower than those in the tiny pulmonary nodules group(P<0.05),while F-CON,F-ENT,F-a,and F-b were higher than those in the tiny pulmonary nodules group(P<0.05).The pulsogram parameters h4/h1,h5 and t in the NSCLC group were smaller than those in the tiny pulmonary nodules group(P<0.05);h3/h1,h1/t1,t1/t,t4/t5,w1/t,w2/t,h1,h3,h4,t4 were higher than those in the tiny pulmonary nodules group(P<0.05).All the serum tumor markers included in the study were correlated with facial,tongue,and pulse data.Conclusion There were significant differences in facial,tongue and pulse characteristics between NSCLC patients and patients with tiny pulmonary nodules.And there was a correlation between facial,tongue,pulse parameters and various tumor markers.So we can use facial,tongue,pulse data to assist in the diagnosis of benign and malignant pulmonary nodules in clinical practice.
元旦饮屠苏酒,是中华民族传承已久的新年习俗.本文根据历代医书古籍及清宫档案记载,对清宫屠苏酒进行溯源,考证其组方、制法,厘清历代屠苏酒的传承关系.研究表明,此酒由华佗创制,现存医籍的最早记载见于《肘后备急方》.历代屠苏酒方大致有两种,一方首药为大黄,继收载于《肘后备急方》后经孙思邈《备急千金要方》流传甚广;一方用"赤术",经《本草纲目》流传,可能是华佗原方.清宫现存可见两种配方基本传承于孙思邈方,制法与民间应用粮食酿造酒不同的是清宫所用为木瓜酒,以增效并调和酒味甘醇.
对于《伤寒论》"但见一证便是,不必悉具",后世医家的见解莫衷一是,见仁见智.本文介绍张雪亮教授对《伤寒论》第101 条的独到见解.通过梳理原文,前后对比、论证,此句并非辨柴胡证的要点,其核心为抓主证."伤寒中风,有柴胡证",是指柴胡证和其他方证同时并存,他证轻微."一证"是指柴胡证,并非临证时某个单一症状,以柴胡证为主证,他证为次证时,用小柴胡汤就可解决问题.因小柴胡汤外可解表,内可扶正,调达气机又可辅助解决里实问题,故能"不必悉具".
By combing the description of the seven kinds of hernias(Shan)in Zhu Bing Yuan Hou Lun,it is considered that the naming of the seven kinds of hernias has three modes.First,the name of the hernias is composed of two disease names,and has the symptoms of two diseases,such as Jueshan,Zhengshan and Fushan.The description of the symptoms of Jueshan and Zhengshan has their own characteristics.Second,they are named after etiology,such as Hanshan and Qishan.Third,they are named by characteristics of disease,such as Panshan.Fourth,the name of the disease was miswritten in the transcription,such as Fushan and Langshan.Some of them no longer seen later with the same names and symptoms.The reasons why its name and connotation are unknown are that there is a different description.Another contributing factor is that they had a broader description or lacked description.
产后抑郁症是一种常见的心理健康问题,发病率高,若不加重视及治疗,或可给产妇及其家庭、社会带来极大危害.中医治疗产后抑郁症疗效确切,优势显著.文章首次总结了全国名老中医姚乃礼教授治疗产后抑郁症的经验,他擅长从心肝脾三脏论治.姚教授认为产后抑郁症的产生主要以产后多虚多瘀为病理基础,与脾思过度、肝魂不藏、心神不安相关,辨证主要分为以下五种类型:心血亏虚,脾气虚弱;心肝血虚,神魂不安;肝气郁结,脾失健运;肝失条达,心神不宁;痰瘀互结,浊邪扰神.临证中善安心神,重视睡眠;顾护脾胃,调畅气机;改易心志,施药扶持,往往取得较好疗效.文末附验案一则加以佐证,以飨读者.
