Thyroid associated ophthalmopathy（TAO） is a common blinding adult orbital disease, which can significantly change the appearance of patients, and even cause serious consequences such as exposure corneal ulcers, secondary glaucoma, and optic nerve damage. At present, modern medicine treatment is mainly based on hormones, immunosuppressants, radiation and surgery, with poor efficacy and many adverse reactions. Traditional Chinese Medicine（TCM）has unique advantages and remarkable curative effect. GAO Jiansheng sums up many years of clinical experience and believes that emotional factors are the primary cause of this disease. The diseased viscera is closely related to the liver, spleen and kidney. This disease is divided into liver stagnation and spleen deficiency, phlegm and blood stasis syndrome and spleen-kidney Yang deficiency, phlegm stasis toxin syndrome. In the treatment, it is advocated to treat both the tip and the root, use combined therapy of cold and hot, and pay attention to "warming Yang and dredging collaterals". Commonly, medicinal with effects as warming Yang, dredging collaterals, clearing heat, ascending-ushering, as well as promoting blood circulation and removing blood stasis paired medicinal are used to treat this disease.

目的 评价温肾逍遥汤对围绝经期干眼患者泪液分泌功能及性激素水平的影响.方法 采用随机双盲双模拟的前瞻性研究,纳入2013年3月—2016年6月门诊围绝经期干眼患者60例(120只眼),随机分为治疗组及对照组,每组30例(60只眼).治疗组口服温肾逍遥汤颗粒,灭菌用水点眼,对照组口服安慰剂颗粒,聚乙二醇滴眼液点眼.28 d为1个疗程,治疗1个疗程.治疗前后分别进行角膜荧光素钠染色(FL)评分、泪液分泌试验(SIT)、泪膜破裂时间(BUT)、性激素水平、眼部症状及全身症状(KI评分)检查.结果(1)总有效率:治疗组为86.67％,对照组为60.00％,2组比较差异有统计学意义(x2=5.963,P=0.030).(2)症状积分:治疗后组间比较,t=2.286,P=0.026,差异有统计学意义;治疗前后比较,差异均有统计学意义(t治疗组=5.475,t对照组=7.906,均P=0.000).(3)全身症状指标:治疗后组间KI改善值比较,t=2.129,P=0.038,差异有统计学意义.(4)干眼指标:治疗后组间比较,治疗组优于对照组,差异均有统计学意义(tBUT=-3.017,P=0.003;t SIT=-2.680,P=0.008;t FL=4.933,P=0.000).治疗前后组内比较,治疗组(tBUT=-9.323,tSIT=-10.554,tFL=18.416,均P=0.000),对照组(tBUT=-4.752,tSIT=-5.185,tFL=13.218,均P=0.000),差异均有统计学意义.(5)性激素水平:治疗后组间比较,治疗组E2升高水平高于对照组(t=2.298,P=0.044),治疗前后组内比较,治疗组E2(t=2.577,P=0.028),差异有统计学意义,而其他指标及对照组E2均无统计学意义(P>0.05).结论 温肾逍遥汤能够明显改善围绝经期女性的泪液分泌功能及性激素水平,其治疗围绝经期干眼的疗效优于人工泪液.

目的:观察川椒方含药血清对过敏性结膜炎(AC)组胺及炎症因子白细胞介素-6(IL-6)释放水平的影响.方法:体外培养RBL-2H3细胞,加入抗体DNP-IgE、抗原DNP-BSA建立RBL-2H3细胞脱颗粒模型;甲苯胺蓝染色法观察细胞形态;采用川椒方含药血清干预,酶联免疫吸附试验(ELISA)法检测川椒方对RBL-2H3细胞脱颗粒中组胺及IL-6的释放水平.结果:与模型组比较,川椒方含药血清各剂量组和阳性药对照组均可抑制RBL-2H3细胞脱颗粒中组胺及IL-6的释放(P＜0.01,P＜0.05);含药血清各组间比较,组胺及IL-6分泌量差异无统计学意义.结论:川椒方对肥大细胞脱颗粒过程中组胺及IL-6的释放有抑制作用.

糖尿病黄斑水肿(DME)是糖尿病患者视力丧失的主要原因,早期有效治疗DME对患者视力愈后至关重要.目前抗血管内皮生长因子(VEGF)药物是治疗首选,但需多次注射,造成沉重的社会经济负担.糖尿病视网膜病变临床研究网提出了亚临床DME的概念,发现其进展为临床有意义黄斑水肿的风险显著增加.但西医缺乏有效的干预手段,为此团队率先将亚临床DME的概念引入国内,分析亚临床DME的病因病机,以中医治未病思想为指导,探讨亚临床DME的中医药干预策略,以期引起国内学者的重视,将DME的防治工作前移.

通过分析临床1例眼缺血综合征的治疗过程,探讨联合疗法治疗眼缺血综合征的临床意义.

新型冠状病毒肺炎(COVID-19)流行病学特征分析显示,COVID-19合并糖尿病的病死率仅次于合并心血管疾病患者,居第二位.糖尿病患者可能更容易感染新型冠状病毒,且重症率和病死率更高.糖尿病眼病患者自身基础疾病多,病情复杂,部分疾病不及时治疗可严重损害患者的视觉健康.在疫情期间为避免潜在的感染风险,除急危重症紧急手术外,对可能造成视力损害的其他疾病,应充分发挥中医药特色优势,保护提高患者视功能.本文就COVID-19合并糖尿病的临床概况、新型冠状病毒对糖尿病的影响及在新型冠状病毒肺炎疫情下,糖尿病眼病患者的中医药防治与管理进行探讨.

杨则民先生为我国近代著名中医理论家,在其著作“内经之哲学的检讨”中首次将唯物辩证法与《黄帝内经》(以下简称《内经》)相结合,从哲学高度阐述传统中医的理论内涵,其思想在当时的中医界独树一帜并影响至今.本文主要通过对其生平介绍,如何运用辩证法思想统筹《内经》研究,《内经》中主要的阴阳五行、生长化收藏理论与唯物辩证法的关系,以及《内经》治疗学中所蕴含的辩证法思想等方面来阐述其《内经》研究的主要学术思想,从而缅怀这位为近代中医哲学研究做出突出贡献的理论家.

BACKGROUND:Bruceine D (BD) is a major bioactive component isolated from the traditional Chinese medicinal plant Brucea javanica which has been widely utilized to treat dysentery (also known as ulcerative colitis [UC]).METHODS:To improve the water solubility and absolute bioavailability of BD, we developed a self-nanoemulsifying drug delivery system (SNEDDS) composing of MCT (oil), Solutol HS-15 (surfactant), propylene glycol (co-surfactant) and BD. The physicochemical properties and pharmacokinetics of BD-SNEDDS were characterized, and its anti-UC activity and potential mechanism were evaluated in TNBS-induced UC rat model.RESULTS:The prepared nanoemulsion has multiple beneficial aspects including small mean droplet size, low polydispersity index (PDI), high zeta potential (ZP) and excellent stability. Transmission electron microscopy showed that nanoemulsion droplets contained uniform shape and size of globules. Pharmacokinetic studies demonstrated that BD-SNEDDS exhibited enhanced pharmacokinetic parameters as compared with BD-suspension. Moreover, BD-SNEDDS significantly restored the colon length and body weight, reduced disease activity index (DAI) and colon pathology, decreased histological scores, diminished oxidative stress, and suppressed TLR4, MyD88, TRAF6, NF-κB p65 protein expressions in TNBS-induced UC rat model.CONCLUSION:These results demonstrated that BD-SNEDDS exhibited highly improved oral bioavailability and advanced anti-UC efficacy. In conclusion, our current results provided a foundation for further research of BD-SNEDDS as a potential complementary therapeutic agent for UC treatment.

围绝经期干眼的发病率逐年上升,患者具有眼部干涩、异物感等不适的局部症状,还常伴有烘热汗出、烦躁易怒、心悸失眠或忧郁健忘等全身症状,这严重影响了患者的生活质量.本文就围绝经期干眼的发病机制及中医、西医治疗方面的研究进展进行综述.

高健生认为Meige综合征属于本虚标实证,其病机为脾气亏虚,运化失常,气血化生不足,目窍经络失养为本;血虚化生内风,复感外来风邪,扰动经络则胞轮振跳为标.治疗上当审病求因、标本同治,方选玉屏风散加减,常加入茯苓以助黄芪、白术健脾益气、扶正固本之功.血虚化生内风,复感外来风邪是标,治疗时注意祛风解痉,此乃治其标,多选蜈蚣、蛇蜕、重楼等药物.高健生常在本方中加入交泰丸,既可安神定志以助患者之睡眠,又可镇静以增强全方祛风解痉之力.

Aiming at allergic conjunctivitis with the main clinical manifestations of eye itching and recurrence, the authors discussed the effect of the lung on allergic conjunctivitis and the function and significance of the lung in the clinical treatment of allergic conjunctivitis by collecting and arranging literature, which provides the theoretical basis for the method of lung-ventilation and wind-expelling treating allergic conjunctivitis.

目的:总结名中医高健生研究员治疗缺血性视神经病变的临床经验.方法:缺血性视神经病变是营养视神经的血管发生循环障碍而出现的一种营养不良性疾病,视功能损伤较大,对于本病尚无确切有效的治疗方案.本文阐述名中医高健生对缺血性视神经病变的病因病机认识 、辨证思路 、临证用药,并列举临床典型医案.结果:高健生研究员在长期的临床基础上总结出"高健生益气温阳通络法",自拟益气通脉方,联合大剂量葛根素注射液静脉点滴,用以治疗缺血性视神经病变,能够有效改善视野,提高视力,临床疗效较好.

目的:观察三伏天穴位贴敷配合川椒方治疗过敏性鼻炎的临床疗效.方法:将165例过敏性鼻炎患者按随机数字表法分为治疗组、敷贴组、中药组.治疗组65例,在初伏、中伏和末伏分别取不同穴位药膏敷贴,敷贴期间同时口服川椒方,连服30 d为1个疗程;敷贴组与中药组50例分别仅用药膏敷贴穴位或仅服用中药川椒方治疗,各组均治疗1～3个疗程并观察临床疗效.结果:治疗组疗效明显优于敷贴组与中药组,差异有统计学意义,且治疗组随着疗程的增加,疗效逐渐提升.结论:三伏天穴位敷贴配合川椒方综合治疗过敏性鼻炎疗效较好,值得临床推广使用.

济生肾气丸为补益肝肾类方剂,具有补肾填精、温肾化气、利水消肿的功效,临床应用较为广泛,可用于临床各科疾病的治疗中.文献中用于治疗眼科疾病较为少见.眼科名中医高健生研究员在临床实践中发现,济生肾气丸辨证治疗黄斑水肿之肾阳亏虚证取得较好临床疗效,可以提高患者视力,同时也能够改善患者全身不适症状.

OBJECTIVE To observe the effects of Chuanjiao decoction (CJD) on basophilic leukemia (RBL-2H3) rat with allergic conjunctivitis (AC),and to clarify its mechanism.METHODS For this experiment,RBL-2H3 cells were divided into the normal group,the model group,the blank serum group,and the low,medium,and high dose CJD groups,to study the impact of drug-containing serum of CJD on IL-4,TNF-α of RBL-2H3 cells.We chose the 10％ concentration of serum and incubation with cell 120 min,before adding antigen for experiment.After induced RBL-2H3 cells degranulation by antigen,the number and the ratio of degranulated RBL-2H3 were determinated using toluidine blue staining method;The levels of tumor necrosis factor-alpha (TNF-α) and interleukin 4 (IL-4) in the culture media were determined using commercial ELISA kits.The levels of TNF-α and IL-4 mRNA were determined using commercial real time PCR.RESULTS Compared with the normal group,the ratio of degranulated RBL-2H3 was increased in the model and blank serum group (P＜0.01);the expression of IL-4 and TNF-o in media was significantly increased in the model and blank serum group (P＜0.01);the mRNA levels for IL-4 and TNF-α were significantly increased in the model and blank serum group (P＜0.01);Compared with the model and blank serum group,the ratio of degranulated RBL-2H3 was decreased in the CJD groups and the PP2 group (P＜0.01);the expression of IL-4 and TNF-α in media significantly decreased in the CJD groups and the PP2 group (P＜0.01);and the CJD groups and the PP2 group significantly decreased IL-4 and TNF-α mRNA levels in Ag-stimulated RBL-2H3 cells.The inhibitory effect of CJD on mast cell degranulation was in a concentration dependent manner.CONCLUSIONS The mechanism of CJD in treating allergic conjunctivitis nay be related to the inhibition of degranulation in mast cells.

目的 评价“川椒方”治疗过敏性结膜炎的有效性.方法 采用双盲、双模拟、阳性药西替利嗪对照,将符合纳入标准的122例过敏性结膜炎患者随机分为治疗组和对照组.其中治疗组口服川椒方颗粒剂及西替利嗪安慰剂,对照组口服西替利嗪胶囊及川椒方颗粒剂安慰剂.分别于治疗前、治疗1周后、治疗2周后,评价两组患者的眼部症状、体征.结果 两组治疗后与治疗前症状体征积分比较:治疗2周后＜治疗1周后＜治疗前,经分析,差异具有统计学意义(P＜0.05).两组间眼部症状、体征积分比较:治疗1周后,治疗组＜对照组,差异无统计学意义(P＞0.05);治疗2周后,治疗组＜对照组,差异具有统计学意义(P＜0.05).结论 川椒方治疗过敏性结膜炎有效,且优于西替利嗪.

目的 评价健康气功八段锦对眼压控制的原发性青光眼患者的心理状态及生存质量的影响.方法 收集在我院门诊就诊的眼压已控制稳定的原发性青光眼患者60例,包括原发性开角型青光眼和原发性闭角型青光眼,随机分为干预组和对照组,每组30例.对照组予青光眼基础治疗,干预组在基础治疗的基础上每天练习八段锦30 min.两组均观察3个月,干预前后进行视力、眼压检查,以及A型行为量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)、症状自评量表(SCL-90)、生存质量(QOL)量表评定,比较组内及组间差异.结果 60例原发性青光眼患者中A型性格占61.7％,有抑郁倾向者占75％,有焦虑倾向者占76.7％,两组各项比例数值与总体比例接近.干预3个月后,两组视力均未见明显变化(P＞0.05),干预组眼压较干预前降低(P＜0.05),并低于对照组(P＜0.05),对照组眼压未见明显变化(P＞0.05).干预组A型行为量表、SDS、SAS、QOL量表评分较前改善(P＜0.05),并好于对照组(P＜0.05).在SCL-90评定中,干预组除强迫因子外,其余均较治疗前改善(P＜0.05),其中躯体化症状、人际关系、抑郁、焦虑、偏执、精神病性因子评分明显低于对照组(P＜0.05);对照组仅精神病性、敌对、偏执因子评分较前有统计学意义的降低(P＜0.05).结论 青光眼患者与A型性格相关,存在焦虑、抑郁等情绪变化;健康气功八段锦可降低眼压,有效改善患者的情绪变化与心理状态,提高患者生存质量.

目的 观察川椒方治疗过敏性鼻炎的临床疗效.方法 本研究采用随机、阳性药对照,双盲双模拟方法评价川椒方治疗过敏性鼻炎临床疗效.将符合诊断标准的过敏性鼻炎患者122例根据随机数字表序号分为治疗组与对照组,治疗组服用川椒方颗粒剂和西替利嗪安慰剂,对照组服用西替利嗪胶囊和川椒方安慰剂,连续服用2周,分别于服药1、2周后复诊,观察疗效.结果 2组治疗后鼻部鼻瘁、喷嚏、流涕症状均较治疗前明显好转(P＜0.05).结论 川椒方防治过敏性鼻炎疗效显著.

Objective To explore the protective effect of Radix Astragali (Milkvetch Root,Huangqi)on the retinal ganglion cells (RGC)of high intraocular pressure(HIP)rats,and the influence of HIP on the protective effect.Methods All rats were randomly divided into sham operation group,model group, Huangqi group,eye drops group,and Huangqi + eye drops group.HIP rat model was induced by cauterization of episcleral veins of both eyes.Four weeks after modeling,rats of sham operation group and model group were administered i.g.normal saline,those of Huangqi group were i.g.Huangqi water decoction(20 g/kg),rats of eye drops group took eye drops of Bimatoprost,and Huangqi +eye drops group took i.g.Huangqi water decoction combined with Bimatoprost.After four weeks’intervention,the RGC number and RGC apoptosis rate were analyzed quantitatively using laser confocal microscope. Results The number of RGC in sham operation group was significantly higher than that of other groups (P <0.01),and RGC apoptosis rate was significantly lower (P <0.01 ).While the results of model group was opposite.Although RGC of eye drops group were more than those of Huangqi group,and apop-tosis rate was lower,there were not significant difference(P >0.05).The number of RGC of Huangqi +eye drops group was significantly higher than that of Huangqi group and eye drops group,and the apopto-sis rate was significantly lower than that of the two groups (P <0.05).Conclusion Huangqi water de-coction can protect visual nerves of HIP rats by inhibiting RGC apoptosis,and the protective effects can improve by combination with intraocular pressure lowering medication.

目的：评价高健生补肾托毒方防止和减少单纯疱疹病毒性角膜炎复发的作用。方法：将单纯疱疹病毒性角膜炎患者18例予局部抗病毒（或联合激素抗炎、散瞳、降眼压）联合口服高健生补肾托毒方治疗，观察1年内复发次数、单次治疗天数和计算平均治疗天数，并与患者上一年进行自身对照。结果：1年内复发次数为（1.44±1.10）次，较上一年（2.72±1.18）次明显减少，有显著性差异，平均单次治疗天数为（17.38±10.00）天，比上一年（20.67±4.27）天缩短，但差异不明显。结论：高健生补肾托毒方具有减少和防止单纯疱疹病毒性角膜炎复发的作用。