目的:探讨开窍醒神补虚通络针刺治疗对脑卒中后偏瘫患者血液流变学和Notch信号通路的影响.方法:选取东莞市中医院2020年12月至2022年7月期间收治的110例脑卒中后偏瘫患者,按照随机数字表法分为观察组(55例,脑卒中常规康复治疗结合开窍醒神补虚通络针刺治疗)和对照组(55例,脑卒中常规康复治疗).对比两组各项量表评分[日常生活能力量表(ADL)、美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer量表(FMA)]、平衡功能[前后倾斜角(F-BIA)、左右倾斜角(L-RIA)、Berg平衡量表(BBS)]、血液流变学和Notch信号通路相关指标.结果:与对照组相比,观察组干预4周后ADL、FMA评分更高,NIHSS评分更低(P＜0.05).与对照组相比,观察组干预4周后BBS、F-BIA、L-RIA更高(P＜0.05).与对照组相比,观察组干预4周后全血高切黏度、纤维蛋白原、血浆黏度、全血低切黏度更低(P＜0.05).与对照组相比,观察组干预4周后Notch 1信使核糖核酸(mRNA)、Notch2mRNA、Jagged1 mRNA、Jagged2 mRNA更低(P＜0.05).结论:开窍醒神补虚通络针刺治疗可有效改善脑卒中后偏瘫患者的日常活动能力、神经功能、运动功能和平衡功能,改善血液流变学和Notch信号通路.

[目的]观察祛疣方(主要由紫草、黄芩、马齿苋等组成)联合外用祛疣酊(主要由马齿苋、败酱草等组成)治疗扁平疣的临床疗效.[方法]将60例扁平疣患者随机分为治疗组和对照组,每组各30例.对照组给予0.025％维A酸乳膏外用治疗,治疗组给予口服祛疣方联合外用祛疣酊治疗,疗程为4周.观察2组患者治疗前后皮疹评分(包括皮疹数目、大小、颜色和自觉瘙痒程度评分)的变化情况,评价2组患者的临床疗效及安全性.[结果](1)治疗4周后,治疗组的总有效率为93.3％(28/30),对照组为83.3％(25/30);组间比较,治疗组的临床疗效明显优于对照组,差异有统计学意义(P<0.01).(2)治疗后,2组患者的皮疹数目、大小、颜色、瘙痒程度评分及其总积分均较治疗前明显下降(P<0.05),且治疗组的下降作用均明显优于对照组,差异均有统计学意义(P<0.05).(3)治疗过程中,2组患者均无明显不良反应情况发生,具有较高的安全性.[结论]祛疣方联合外用祛疣酊治疗扁平疣疗效确切,其疗效明显优于西药维A酸乳膏外用治疗.

目的 基于数据挖掘技术探讨针灸治疗慢性湿疹的选穴规律.方法 检索中国知网、万方数据知识服务平台、维普期刊全文数据库、中国生物医学文献数据库近10年收录的针灸治疗慢性湿疹的临床研究文献,建立慢性湿疹临床处方数据库,运用SPSS Statistics 24.0及SPSS modeler 14.1软件对数据进行描述性分析、关联规则分析与聚类分析.结果 共纳入98篇临床研究文献,收集穴位处方116条,涉及腧穴56个,频率最高的前5位腧穴为阿是穴、曲池、血海、足三里、三阴交,选取的经脉以足太阴脾经、手阳明大肠经、足太阳膀胱经、足阳明胃经为主,特定穴以合穴、交会穴、背俞穴最为常用,治疗方式以火针、穴位注射、毫针针刺应用最多.关联规则分析显示曲池-血海、曲池-血海-足三里为支持度最高的穴对和穴组.通过对使用频数≥5的腧穴进行聚类分析,可将腧穴分为3大类.结论 通过数据挖掘技术可发现针灸治疗慢性湿疹的选穴规律,为临床针灸治疗慢性湿疹选穴提供参考.

急性尿潴留属中医学"癃闭"范畴,癃闭的病因主要有外邪侵袭、饮食不节、情志内伤、瘀浊内停、体虚久病,基本病机是肾与膀胱气化功能失调.基于中医理论分析及西医神经解剖学支持,笔者采用双拇指推拿八髎穴治疗急性尿潴留2则,效果显著.

目的:基于数据挖掘探讨清代名医治疗便血的用药规律.方法:对《清代名医医案精华》所载医案进行收集、整理,采用Microsoft Office Excel 2007建立方药数据库,统计用药频数、药物分类及药物性味归经,运用IBM SPSS statistics 22.0软件对高频药物进行聚类分析,运用IBM SPSS Modeler 18.0 Apriori算法对高频药物进行关联规则分析.结果:共纳入叶天士、吴鞠通、王旭高、马培之、王九峰、张千里、巢崇山、尤在泾、曹柏仁、张聿青等10位名医治疗便血的医案39则,涉及方剂共39首,药物129种,总用药频数384,其中高频药物(出现频数≥4)37种,使用频数最多的是茯苓(15).129种药物按功效可分为17类,其中使用频数位于前4的药物分类分别为补虚药、清热药、利水渗湿药和止血药;药性以温性、寒性、平性为主;药味以甘味药、苦味药、辛味药为主;归经以肝、脾经为主;聚类分析得到有意义的药物聚类5组;关联规则分析得到7组二阶关联和10组三阶关联.结论:清代名医治疗便血注重"血病治气""见血不止血",临证多选补虚之品,以甘温健脾治血.

[目的]通过观察通元针法治疗脾虚痰湿型多囊卵巢综合征(PCOS)的临床疗效,以期为针灸治疗PCOS提供新方法,开拓新思路.[方法]将108例脾虚痰湿型PCOS患者随机分为对照组和治疗组,每组各54例.对照组给予常规西药治疗,治疗组在常规西药治疗基础上联合通元针法治疗,观察2组患者治疗前后高雄激素症状评分(痤疮皮损评分和多毛评分)、肥胖程度[腰臀比(WHR)和体质量指数(BMI)]、糖代谢[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能(HOMA-β)]、脂代谢[甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇(nHDL-C)升高率]、心理状态[焦虑自评量表(SAS)和抑郁自评量表(SDS)评分]的变化情况,比较2组患者的月经复常率及基础体温(BBT)双相率情况.[结果](1)治疗后,2组患者的痤疮皮损评分和多毛评分均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05).(2)治疗后,2组患者WHR、BMI、HOMA-IR均较治疗前下降,HOMA-β均较治疗前升高,差异均有统计学意义(P<0.05或P<0.01);组间比较,治疗组的WHR、BMI、HOMA-IR低于对照组,HOMA-β高于对照组,差异均有统计学意义(P<0.05或P<0.01).(3)治疗后,2组患者的LDL-C、TG、nHDL-C升高率均较治疗前明显降低(P<0.01),且治疗组的LDL-C、TG、nHDL-C升高率均明显低于对照组,差异均有统计学意义(P<0.05).(4)治疗后,2组患者的SAS、SDS评分均较治疗前明显降低(P<0.05),且治疗组的降低幅度均明显大于对照组,差异均有统计学意义(P<0.05).(5)治疗后,治疗组患者的月经复常率为88.89％(48/54),明显高于对照组的68.52％(37/54),差异有统计学意义(P<0.05);而2组患者的BBT双向率比较,差异无统计学意义(P>0.05).[结论]在常规西药治疗基础上联合通元针法治疗脾虚痰湿型PCOS患者疗效确切,其疗效优于单纯常规西药治疗.

目的 观察隔牵正散灸联合面部挂针治疗急性期周围性面瘫(风寒证)的临床疗效.方法 将60例患者随机分为对照组和观察组各30例.观察组应用隔牵正散灸联合面部挂针治疗,对照组采用常规针刺治疗.结果 治疗后,观察组的治愈率显著高于对照组(P＜0.05);两组面部残疾躯体功能指数(FDIP)积分均较治疗前升高,社会功能(FDIS)积分均较治疗前降低(P＜0.05),且治疗后观察组FDIP积分明显高于对照组,FDIS积分明显低于对照组(P＜0.05);治疗后两组中医证候疗效标准评分、面神经功能标准分级(H-B)分级分布均优于治疗前(P＜0.05),且观察组明显优于对照组(P＜0.05).结论 隔牵正散灸联合面部挂针治疗急性期周围性面瘫(风寒证)疗效确切,可改善患者面部残疾功能,促进神经功能恢复.

目的 观察温通针法治疗阳虚血瘀型稳定型心绞痛的临床疗效,以期为针灸治疗稳定性心绞痛提供新方法、开拓新思路.方法 收集116例阳虚体质的阳虚血瘀型稳定型心绞痛患者,采用随机数字表法分为对照组、治疗组,每组58例.对照组采用常规西药治疗,治疗组在常规西药治疗基础上采用温通针法,通过对比两组患者心绞痛的发作次数及持续时间,胸闷、胸痛、心悸、畏寒怕冷4个主要中医证候积分下降程度,疼痛视觉模拟量表(visual analogue scale,VAS)对治疗前后两组的临床疗效进行评价.结果 治疗组治疗后心绞痛的发作次数及持续时间较对照组显著降低(P<0.05);治疗组胸闷、胸痛、心悸、畏寒怕冷4个主要中医证候积分低于对照组(P<0.05);两组治疗后VAS评分低于治疗前(P<0.05),且治疗组低于对照组(P<0.05).治疗组总有效率(87.9％)高于对照组(70.7％)(P<0.05).结论 在常规西药治疗基础上采用温通针法可改善阳虚血瘀型稳定型心绞痛患者的临床症状及体征,有效预防急性冠脉事件的发生.可作为稳定型心绞痛治疗的辅助手段.

《灵柩·阴阳二十五人》是依据阴阳五行学说将人的形体分为五形并配合五色、五音归纳成二十五种禀赋不同的体质类型,依据传统中医的文化理论,根据每个人出生时的干支并与五运六气相结合确定针刺调治原则和方法.论述了出生年月日的干支代表的是人类个体的生命密码,具有相对的稳定性,可作为阴阳二十五形人分形标准,且有利于中医的科学化、有利于完善及辅助医者辨证论治的能力.阴阳二十五形人针刺调治原则为根据个体差异、外部环境、气血盛衰确定生命磁场主波动频率、确定调治的主要部位、确定调治的主要穴位,针对患者临床症状和疗效灵活调整治疗方案.

目的 探讨耳穴针刺联合压豆治疗痰湿质高血压的临床疗效,为耳针和耳穴压豆治疗高血压提供循证医学依据.方法 选取2015年6月-2016年6月于佛山市中医院就诊的中医体质辨证为痰湿质的原发性高血压病人80例,随机分为对照组和治疗组,各40例.对照组给予常规西医降压治疗,治疗组在对照组常规西医降压治疗基础上给予耳穴针刺联合压豆治疗.比较两组临床疗效,记录两组治疗前后血压、血脂、体重指数、痰湿质评分、健康状况调查简表(SF-36)评分.结果 治疗后,治疗组总有效率(85.0％)明显高于对照组(65.0％),差异有统计学意义(P＜0.05);治疗组收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、痰湿质评分、体重指数明显低于对照组,差异均有统计学意义(P ＜0.05或P＜0.01);高密度脂蛋白胆固醇和SF-36评分明显高于对照组,差异均有统计学意义(P＜0.01).结论 耳穴针刺联合穴位压豆治疗高血压,不仅可明显提高临床疗效,并且可平稳降压,降低血脂、体重、痰湿质评分和提高SF-36评分.

目的:观察浮针治疗急性椎间盘源性腰痛的临床疗效.方法:将90例急性椎间盘源性腰痛患者随机分为浮针组、毫针对照组和西药对照组,每组30例.浮针组使用浮针疗法,每次留针6～8h,1次/3d,治疗2次为1个疗程,共治疗2个疗程,疗程间休息1d.毫针对照组取肾俞、大肠俞、阿是穴、委中,并随证配穴,1次/d,治疗6次为1个疗程,疗程间休息1d.西药对照组予双氯芬酸钠肠溶片,50mg/次,3次/d,7d为1个疗程,共服用2个疗程.观察并比较3组患者治疗前、治疗1周、治疗2周的腰部疼痛评分、Oswestry功能障碍指数(ODI)以及血常规、C-反应蛋白、血沉情况,并比较3组患者治疗后总体疗效.结果:各组患者治疗后腰部疼痛评分、ODI指数以及C-反应蛋白、血沉情况均较治疗前明显改善(P<0.05),浮针组改善程度明显优于毫针和西药对照组(P<0.05),毫针对照组明显优于西药对照组(P<0.05).浮针组总体疗效明显优于毫针和西药对照组(P<0.05),毫针对照组疗效优于西药对照组(P<0.05).结论:浮针疗法可减轻急性椎间盘源性腰痛的疼痛程度和炎症反应,改善功能,疗效优于毫针治疗和西药治疗,安全简便,值得推广.

Objective:To explore the clinical significance of Sishen Needle in combined with auricular points sticking in the treatment of Brain Fag Syndrome (BFS),provide more favorable and simple methods for clinical treatment of rubella means.Methods:60 cases of patients were randomly divided into two groups,30 cases of patients with Sishen Needle in combined with auricular points sticking as the comprehensive group,30 cases of patients only received auricular points sticking group as the ear pressure group,one time of two day,5 times for a course of treatment,each two days est between treatments,for continuous 3 courses observing the fatigue degree of the two groups,evaluating therapeutic effect.Results:The fatigue degree was relieved in comprehensive group after treatment with significant difference (P ＜ 0.05);The relieving of the fatigue degree in comprehensive group was obviously higher than the ear pressure group (P ＜ 0.05).The recovery total effective rate of the comprehensive group was 96.7％,and the ear pressure group was 86.7％,The recovery rate and total effective rate in both group have statistical significance (P ＜ 0.05).Conclusion:Sishen Needle in combined with auricular points sticking have remarkable curative effect in treating Brain Fag Syndrome and worthy of clinical application and extension.

[Objective] To observe the effects of electroacupuncture combined with needle warming in the treatment of the patients with acute phase type wind chill peripheral facial paralysis,to provide the evidence for the treatment of the patients with acute phase type wind chill peripheral facial paralysis by electroacupuncture combined with needle warming. [Methods] 120 patients with acute phase type wind chill peripheral facial paralysis in Foshan Hospital of Traditional Chinese Medicine from September, 2015 to February, 2017 were randomly divided into the treatment group(n=60) and the control group(n=60).The patients of the treatment group were used electroacupuncture combined with needle warming,and those of the control group were treated with electroacupuncture.At the same time,all patients of the two groups were treated with the conventional western medicine.The clinical effects,the scores of House-Brackmann Facial Grading System scale,the scores of Facial Disability Index scale,the scores of Portmann's Simple Scale were compared between the two groups. [Results] The rate of effectivity of the treatment group was significantly higher than the control group( P<0.05).The scores of FDI somatic function, Portmann scale was significantly higher than those of the control group,but the scores of FDI social function, H-B scale lower( P<0.05). [Conclusions] The electroacupuncture combined with needle warming in treatment of the acute phase type wind chill peripheral facial paralysis,could improve the clinical effect,improve symptoms,promote nerve function recovery.

Objective:To observe the clinical curative effect of plum acupuncture combined with Chinese herbal medicine in the treatment of diabetic peripheral neuropathy.Methods:Selected 66 cases of patients with diabetic peripheral neuropathy from November 2014 to March 2015 in our hospital,used the digital meter were randomly divided into two groups with thirty-three cases in each group based on routine treatment fordiabetes,the treatment group was given plum acupuncture combined with traditional Chinese medicine,plum acupuncture was once two days,traditional Chinese medicine was twice a day,the controlled group were observed before and after treatment with intramuscular injection of mecobalamin,once a day,after 4 weeks,sign and the nerve conduction velocity of two groups of patients' symptoms and changes.Results:The clinical efficacy of the two groups patients after 4 weeks treatment,according to the comparison of the clinical curative effect of the two groups of patients were improved.Shallow feeling and tendon reflex were improved.Treatment was obviously improved,two groups of patients improved the nerve conduction velocity than that before treatment,after treatment the MCV and SCV was obviously improved (P ＜ 0.05).Conclusion:Plum acupuncture combined with activating blood circulation and removing blood stasis method can obviously dredge the meridians,improve blood circulation,improve neurological function,reduce clinical symptoms,the clinical guiding significance,is worthy of clinical promotion.

探讨蜂针导致硬结的原因,介绍阿瑟氏反应系免疫复合物所致局部血管炎,属于Ⅲ型超敏反应,即有局部充血水肿、组织坏死、硬结现象.探讨蜂针引起阿瑟氏反应的发生机制,主要是因为蜂针中的蜂毒抗原与体内相应的抗体反应,形成中等大小的可溶性免疫复合物,沉积于注射部位的血管壁基底膜上,导致坏死性血管炎,出现局部皮肤或皮下组织的红肿、瘀紫、硬结等症状.

中医学专业认证和本科教学工作水平评估均是高等教育外部质量保障措施,两者各有侧重,通过辨明两者之间的异同,对开展专业认证工作的思路进行了初步研究,探讨以专业认证为契机,深化教学改革,强化教学管理,提高人才培养质量,进而提高中医学专业在社会上的影响力。

In the current trend of enrollment expansion of undergraduate schools,student-teacher ratio is increasingly rising and teachers are under unprecedented pressure.Moreover,students cannot receive timely,effectively,and per sonalized guidance.Traditional and single practice teaching mode is difficult to adapt to the changing demands of the new situation.Therefore,practice teaching in colleges and universities of Chinese medicine requires a multistakeholder,flexible,and multidimensional mechanism for guidance and support.In this way,undergraduates' innovative ability can be improved,and requirements for professionals of Higher Institutions of Chinese medicine can be met in the so cial development.On the basis of both domestic and foreign advanced experience,this paper puts forward a new idea of constructing multidimensional practice teaching guidance system in colleges and universities of Chinese medicine.The guidance system,which consists of eight patterns,can improve and perfect the existing practice teaching guidance system by combining and integrating various teaching resources.

As an application-oriented science with high practicality,Chinese medicine has its unique theoretical system.With the continuous advancement of the society and the rapid development of science and technology,the traditional mode of Chinese medicine education cannot meet the modern society's demands on the training of innovative and pragmatic students in the field of Chinese medicine.Thus,it is necessary to adopt Cooperative Education with enterprises,schools and research institutes,which is an effective way for schools to train high-quality students who are pragmatic and innovative.colleges and universities of Chinese medicine should make full use of the advantages of Cooperative Education,reforming the traditional education mode,and to build a more scientifically sound Chinese medicine training mode for cultivating innovative and pragmatic professionals,which can adapt to the development of the times.

到课率低是成人教育影响教学质量的重要因素,本文通过对到课率影响因素进行问卷调查,对结果进行分析,并提出建议和措施。