Objective To study the clinical efficacy on treatment of 179 diabetic peripheral neuropathy(DPN) with Taozhi Tongyu tablet.Methods A total of 179 cases were divide into control group(90 cases)and treatment group (89 cases)by adopting the methods of randomized,parallel and control study.Both groups of patients were given diabetes education,moderate exercise,diet control,maintaining the original hypoglycemic regimen.The treatment group received Taozhi Tongyu tablet,and the control group received Mecobalamin tablet.The items including effect indicator(TCM syn-drome score),Toronto clinical scoring system,Tumor Necrosis Factor-αand nerve conduction velocity of two groups were observed.Results After treatment,TCM syndrome score and Toronto clinical score were improved in both groups(P <0.05),and the Toronto clinical score of treatment group was better than the control group(P <0.05).After treatment,the common phrenic nerve motor conduction velocity was improved in both groups(P <0.05),and the treatment group was su-perior to the control group after treatment(P <0.01).The sensory conduction velocity of the left sural nerve before and af-ter treatment was significantly different between the two groups before and after treatment(P <0.01).There was no signifi-cant difference compared with the control group(P >0.05).The treatment group was superior to the control group after treatment(P <0.05).Before and after treatment,there was a statistically significant difference between the two groups in sensorimotor conduction velocity of the right sural nerve(P <0.01),but there was no significant difference between the two groups(P >0.05).The difference of TNF-α before and after treatment in the treatment group was statistically significant (P <0.05).There was no significant difference between the control group before and after treatment and the difference be-tween the two groups(P >0.05).Conclusion Taozhi Tongyu tablet can reduce the TCM syndrome score and Toronto clinical score of DPN,the effect on nerve conduction velocity and tumor necrosis factor-α is greater in treatment group.

Objective: To evaluate the efficacy and safety of Fuzheng Jiedu Huayu Decoction (FJHD) in treating pneumonia in the elderly. Methods: Adopting a multi-center, double-blind, parallel, randomized controlled trial, 284 elderly pneumonia patients were enrolled and randomly allocated to the standard treatment with FJHD (treatment group, TG) and the standard treatment with placebo group (control group, CG). Efficacy and safety was evaluated through mortality rate, curative rate, symptom improvement, chest X-ray (CXR) lesion absorption, arterial blood gas (ABG), peripheral blood leukocyte count (PBLC) and adverse events. Results: There was no significant difference in mortality rate between both groups (P > 0.05). TG significantly enhanced the curative rate of a 2-week treatment course (P < 0.05). Compared with CG, TG significantly decreased the expectoration score during the first and second week of treatment (P < 0.05). During the first week, improvement in expectoration was conducive to airway patency. During the second week, wheezing, shortness of breath and other symptoms were also significantly improved. During the third week, body temperature was stable. TG improved lesion absorption with Pneumonia Severity Index (PSI) class II (P < 0.05) and SMART-COP score 1 (P < 0.05). TG significantly decreased the arterial carbon dioxide partial pressure after a 1-week treatment. There were no serious adverse events in TG. Conclusion Standard anti-infection treatment with FJHD is a safe and reliable method of treating elderly patients with pneumonia, improving the curative effect after a 2-week treatment course, ameliorating expectoration and promoting the absorption of pneumonia lesions.

目前,Ⅱ型糖尿病(T2DM)已成為全球問題,而我國則可能已成為世界上糖尿病患病人數最多的國家.我國糖尿病的患病率為11.6％,其中Ⅱ型糖尿病佔90.0％以上,而胰島β細胞功能受損是T2DM發病的重要原因. 英國前瞻性糖尿病研究(UK Prospective Diabetes Study,UKPDS)的結果提示,在高血糖發生的7年之前與糖尿病相關的胰島β細胞功能受損就已存在,且隨著疾病的進展,以4.5％的速度逐年下降.Ⅱ型糖尿病不僅發病率高,同時伴有多種併發症,嚴重危害著人類的健康.

Objective: To summarize the research status of TCM intervening metabolic hypertension and various metabolic related factors. Methods: By consulting domestic and external related literature, research status of TCM intervening metabolic hypertension were summed up and concluded from lipid metabolism, glucose metabolism, uric acid and the other related factors. Results: Traditional Chinese medicine has obvious advantages in improving the symptoms of metabolic hypertension, lowering blood pressure and metabolic parameters. Conclusion:TCM intervening metabolic hypertension possesses the denifite effects and broad prospects.

Objective To explore the correlation among different constitutions of traditional Chinese medicine (TCM), blood pressure and blood lipid metabolism in metabolic hypertension.Methods 398 patients form physical examination center of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine were selected to classify into different TCM constitutions, analyzed the relationship among TCM constitution, blood pressure, body mass index (BMI) and blood lipid metabolism.Enumeration data was analyzed by Spearman rank correlation analysis,measurement data which accorded with the normal distribution was analyzed by One-way-ANOVA,and the other measurement data didn't accord with the normal distribution was analyzed by chi-square test.Results There was no statistical difference on the correlation between TCM constitution and BMI (P>0.05).The constitution of phlegm-dampness had negative correlation with systolic blood pressure (P<0.05).The normal constitution had positive correlation with diastolic blood pressure (P<0.05).The normal constitution had negative correlation with the cholesterol and high density lipoprotein (HDL) (P<0.05).The diastolic blood pressure had negative correlation with HDL (P<0.05).The systolic blood pressure and diastolic blood pressure had positive correlation with triglyceride in constitution of yin-deficiency and constitution of damp-heat (P<0.05).Conclusion The constitution of phlegm-dampness and normal constitution may be the influence factors of metabolic hypertension.The triglyceride and HDL may be risk factors of metabolic hypertension, and which in the people of constitutions of yin-deficiency and damp-heat are more prominent.

Objective:To explore the diagnostic significance of the 11 blood indicators to pneumonia with the syndrome of phlegmheat obstructing lung.Methods:The levels of white blood cell (WBC),neutrophil count (N#),C-reactive protein (CRP),platelet (PLT),partial pressure of oxygen (PO2),partial pressure of carbon dioxide (PCO2),prothrombin time (PT),activated partial thromboplastin time (APTT),hemoglobin (HGB),hematocrit (HCT) and albumin (ALB) were measured in 60 pneumonia patients with the syndrome of phlegm-heat obstructing lung.Then we explored the clinical value of the 11 blood examination indicators to the pneumonia patients with the syndrome of phlegm-heat obstructing lung by regression analysis method.Results:CRP played the best correlation with pneumonia patients with the syndrome of phlegm-heat obstructing lung,while N# was similar with WBC in indicators related to infection.The other indicators showed the positive rate from high to low on nutrition,respiratory failure and blood coagulation,respectively.Additionally,ALB showed more sensitive on nutrition aspect,while only ventilatory disorder on oxygenation aspect.However there is no obvious characteristic of dysfunctions of the blood clotting.Conclusions:The eleven indicators in this research showed a comprehensive evaluation significance from infection,nutrition,respiratory and blood coagulation to pneumonia with the syndrome of phlegm-heat obstructing lung.The positive rate of CRP,HGB,ALB and PO2 may had correlation with the syndrome.

代謝綜合徵(MS)是一組以肥胖、高血糖(糖尿病或糖調節受損)、血脂異常(高甘油三酯血症和/或低高密度脂蛋白膽固醇血症)以及高血壓等聚集發病、嚴重影響機體健康的臨床徵候群,是一組在代謝上相互關聯的危險因素的組合,這些因素直接促進了動脈粥樣硬化性心血管疾病的發生,也增加了發生Ⅱ型糖尿病的風險.

Objective To observe the clinical efficacy on treatment of Qi and Yin deficiency in Type 2 diabetes with modified Huangqizhuye decoction. Methods A randomized,parallel and control study was conducted. Sixty Type 2 Diabetes patients who were in accordance with the inclusive criteria were ran-domized into two groups. Patients in treatment group received modified Huangqizhuye decoction and original basic treatment,and control group applied only original basic treatment. The treatment lasted 8 weeks. Items include effect indicators(TCM syndrome score,FBG,PBG,FINS,2h - INS,Fasting C - peptide,Postprandial C - peptide,HbA1C,GA,HOMA - IR and HOMA - B)and safety indicators(liver and kidney function,blood routine,routine urine,electrocar diography)were observed. Results The TCM syndrome total integral drop in treatment group was significantly greater than the control group( P ﹤ 0. 05). The total effective rate was 36. 67% in control group and 96. 67% in treatment group. FBG,PBG,HBA1C,GA and HOMA - IR dropped in treatment group(P ﹤ 0. 05),and FBG,HBA1C,GA dropped significantly greater than the control group(P﹤ 0. 05). Levels of FINS,Fasting C - peptide,Postprandial C - peptide and HOMA - B raised in treatment group(P ﹤ 0. 05),and HOMA - B raised significantly greater than the control group(P ﹤ 0. 05). Conclusion Modified Huangqizhuye decoction can effectively improve symptoms of Qi and Yin deficiency in Type 2 Dia-betes,lower blood glucose,improve islet β - cell function and relieve insulin resistance.

目的:观察桃蛭通络方治疗糖尿病周围神经病变(DPN)的临床疗效.方法:采用随机、平行、对照研究的方法,将60例患者随机分为两组,治疗组给予桃蛭通络方,对照组给予甲钴胺,疗程共8周.观察比较疗效性指标(中医证候评分、神经传导速度)和安全性指标(肝肾功能、血常规、尿常规、心电图).结果:治疗组的中医证候评分下降幅度明显大于对照组(P=0.029),中医证候临床疗效治疗组总有效率93.33％,对照组70.00％,治疗组疗效优于对照组(P=0.01);两组腓总神经运动传导速度、腓肠神经感觉传导速度均有所提高(均P＜0.05),提高幅度方面两组之间无显著性差异(P＞0.05).结论:桃蛭通络方能有效改善DPN患者的症状、体征,提高神经传导速度,在改善症状、体征方面疗效优于甲钴胺.

2012年9月，95岁的国学大师南怀瑾因为感冒引发肺炎不幸逝世。这位心态超然，兼及拳术、剑道等各种功夫于一身的大师，却因小小的感冒失去了生命……<br>　　据报道，老人肺部感染的死亡率为36%；也有调查显示，65岁以上老人肺死亡率高达30%～61%，是65岁以上老人的第四位致死病因，是80岁以上高龄老人的首位死因，而90岁以上老人有半数以上死于肺炎或肺部感染。

川芎是治疗头痛的常用药物，临床上配伍得当，用量合适，可用于多种头痛的治疗，故有“头痛不离川芎之说”，如《神农本草经》谓川芎“主中风入脑头痛”，《本草衍义》言：“头面风不可阙也”；《本草纲目》云：“人头穹窿穷高，天之象也。此药上行，专治头脑诸疾”。然而对川芎用量、用法、适应症、禁忌症、药对配伍等方面各医家有多种见解，对于这些经验或观点应如何理解，让我们在临床应用川芎治疗头痛时达到心中有数。

《内经》中有关头痛的论述颇为丰富,提出了六经病变所致头痛及其伴随症状、针灸治疗方法,并根据头痛伴随的症状、症状所在的经络脏腑,而调其有关脏腑经络所归宿的腧穴.头痛外感病因:风、寒、湿、寒湿、热,内伤病因:脏腑气血功能紊乱,寸口脉短弱而出现头痛的脉诊诊断,提出治疗头痛的原则:调阴阳,补不足,泻有余;详细记述了厥头痛、头项部疼痛的治疗方法,同时还提出头痛治疗的宜忌及头痛的预后.为后世关于头痛病因、病机、辨证论治、治疗方法、针灸理论奠定了理论基础.

高糖高胰岛素、游离脂肪酸、炎症因子、地塞米松、金属铬、雌激素、葡糖胺等均可诱导3T3-L1脂肪细胞建立胰岛素抵抗模型,且具有稳定、可靠、易于重复等优点.目前已证实小檗碱+梓醇、小檗碱、熊果酸、西洋参茎叶总皂苷及其他活性成分、蒲黄总黄酮、灵芝多糖、附子多糖、地黄寡糖、积雪草酸、白藜芦醇、葛根素等中药有效成分具有改善胰岛素抵抗及调节糖代谢作用.

中医将具有善行多变,动摇不定等特性的致病邪气,取类比象命名叫“风邪”,风的产生中医学分“外风”和“内风”两类.由于风为阳邪,其性轻扬,易袭阳位,而头为诸阳之会,位居高巅,因此易致风邪侵袭而引发头痛.肝为风木之脏,当情志刺激引起肝木失和,肝阳升而无制,肝阳化风,风阳上扰则可致偏头痛.风与头风(偏头痛)有密切的关系,对于头风(偏头痛)的治疗必用“风药”.“风药”具有以下功用:①祛风；②升阳(升发脾阳、升发肝胆、固肾助气化)；③升清(升发清气、升精至脑)；④疏肝解郁；⑤助行气血；⑥发散郁火；⑦除湿；⑧引经；⑨开通玄府；⑩熄风.风药与其他药物合理配伍可产生明显的增效作用.

Objective To observe the therapeutic effect of Fuzheng Jiedu Huayu Granules(Granule for reinforcing the healthy qi,detoxify and resolving stasis)for elderly patients with community acquired pneumonia(CAP).Methods Seventysix elderly patients with CAP were randomized into treatment group and control group,with 38in each.The standard anti-infective therapy was used in both groups.Fuzheng Jiedu Huayu Granule and placebo were added to the treatment group and control group 2packs once,3times a day respectively.The treatment lasted for 7days.Chinese medical symptom scores,clinical effect and safety were observed before and after the treatment.Results The total effective rate of the treatment group and the control group was 71.1%and 47.4%respectively,the difference between was statistically significant(P<0.05).After the treatment,the symptom scores were all significantly decreased in the treatment group(P<0.05),while the scores of cough, expectoration,fever,chest distress,chest pain and wheeze were significantly decreased in the control group(P<0.05).The scores of expectoration and dry mouth were significantly different between groups after the treatment(P<0.05).There was no obvious laboratory abnormality or adverse reaction in both groups.Conclusion Fuzheng Jiedu Huayu Granule has better therapeutic effect for the elderly patients with CAP.

Objective To observe the therapeutic effect of Qiyin Sanliangsan Formula [formula of huangqi (Radix Astragali) and Jinyinhua (Flos Lonicerae Japonicae)] on elderly community acquired pneumonia (CAP). Methods Seventy one patients were randomized into treatment group of 36 cases and control group of 35 cases. Both groups were given symptomatic treatment and antibiotics and the treatment group was combined with Qiyin Sanliangsan Formula. The treatment course lasted for 14 days. The therapeutic effect, symptom integral and the relief rate of lung inflammation were observed and compared before and after the treatment in both groups. Results The total effective rate of the treatment group and the control group was 91.7% and 71.4% respectively, with significant difference (P0.05). After the treatment, there were significant differences between groups in the integrals of fever, cough and expectoration (P0.05). The relief rate of lung inflammation of the treatment group and the control group was 88.9% and 77.1% respectively, with significant difference (P0.05). Conclusion Qiyin Sanliangsan Formula is effective for the elderly CAP, especially in reliving the main symptoms and promoting inflammation absorption.