黄丽娟教授从事临床、教学、科研工作40余年,在心血管疾病方面效验显著,特别是对慢性心力衰竭有独到的诊疗思路.黄丽娟教授认为,慢性心力衰竭基本病机是以气虚、阴虚、阳虚为本,痰湿、瘀血、水饮为标,病性多属虚实夹杂,以益气温阳、活血利水为基本治疗原则.治疗上主张衷中参西分期论治,将其分为早、中、晚、终末期,早期多为气虚血瘀证,治疗以生脉散合血府逐瘀汤加减益气活血;中期多为气阴两虚、心血瘀阻证,治疗以自拟强心1号方加减益气养阴、活血化瘀;晚期多为心脾肾阳气俱虚、血瘀水饮内停证,治疗以自拟强心2号方加减温阳利水、活血通脉;终末期多为气机逆乱、阴阳离决证.治疗以独参汤、四逆散加减回阳救逆、敛阴固脱.

目的 探讨《中华医典》中古代医家治疗膝骨关节炎的遣方用药规律.方法 在《中华医典》中检索古代膝骨关节炎的内治方,采用中医传承辅助平台软件对方剂进行关联规则、复杂系统熵聚类等分析,挖掘药物使用规律.结果 共纳入197首方剂,包含236味中药,对其进行分析,发现这些中药性偏温平,味以辛、甘、苦为主,多归肝、脾、肾经.其中活血类药物占比最高,频数在前三位的是当归、牛膝和川芎,活血药多配伍祛风湿药、补益药、温里药使用;通过关联规则分析,挖掘出新处方9个.结论 《中华医典》中记载古代医家治疗膝骨关节炎最常使用的药物是当归、牛膝和川芎,最注重活血化瘀法,并配以祛风湿、补益、温里等治法.

冠心病是目前比较常见的疾病之一,具有较高的致死率,中医多认为其属于"心痛病".黄丽娟教授是国家级名老中医,根据患者不同时期病情虚实变化,治病求本,辨证施治.指出该病多为"本虚标实",急性发作时以邪实为主,"痰瘀互结",缓解期以正虚为主,且介入后再发心绞痛之本多为"阳虚阴凝",治疗时应"整体观念贯穿始终","调肝理脾与时俱进",坚持用"益气温阳""活血通脉""理气化痰"之法治之.

目的 基于中医传承辅助平台V2.5软件,探讨活血化瘀法治疗膝骨关节炎的组方用药规律.方法检索中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、维普数据库(VIP),收集活血化瘀法治疗膝骨关节炎的相关文献,录入中医传承辅助平台建立数据库,采用关联规则、复杂系统熵聚类等方法进行相关数据挖掘.结果共筛选出155个中药处方,涉及164味中药,对其进行分析,方剂中应用频次在前3位的活血药分别是牛膝、当归、鸡血藤,频次最高的药性为温,药味为甘,药物归经为肝.通过关联规则分析,挖掘出16个核心组合和8个新处方.结论活血化瘀法治疗膝骨关节炎,药物的配伍以牛膝为核心,和血药与活血药相须为用,最常配伍补益肝肾药,次为益气补血药.

黄丽娟教授认为桥本氏甲状腺炎发病阶段及临床表现不同,临床可分为甲亢期、亚临床甲减期、甲减期,可归为中医"瘿病""瘿瘤""惊悸""震颤""水肿"等范畴.基本病机为气滞、痰凝、血瘀、阴虚或者阳虚.治疗上不同证型采取不同的治疗原则.肝郁化火证治以清热泻火疏肝,消肿散结;阴虚火旺证治以滋阴清热宁心,散结消瘿;痰瘀互结证治以理气活血,化痰散结;阳虚痰凝证治以温肾健脾,软坚散结.

吕仁和教授在肾脏病的诊疗方面积累了丰富的经验,他认为该病的病机为本虚标实之证,常见证型为气血阴阳俱虚,浊毒内停;具体治疗应注重调整阴阳气血平衡,补虚与排浊兼顾,治疗手段可内外治结合.通过分析吕仁和教授治疗慢性肾功能衰竭的临证思路为临床治疗提供参考.

目的:观察鱼鳔对少弱精子小鼠精子质量的影响.方法:雄性SD小鼠48只随机分为正常组、模型组、鱼鳔低、中、高剂量组和阳性药组.正常组蒸馏水灌胃,其他各组均腹腔注射环磷酰胺60 mg/kg、持续5d制备少弱精子模型.第6天开始正常组与模型组给予蒸馏水,阳性药组给予五子衍宗丸,鱼鳔低、中、高剂量组以人体等效剂量5、10、20倍用量灌胃,连续灌胃2周后计算睾丸指数、附睾指数并检测精子质量.结果:与模型组比较,鱼鳔低、中、高剂量组小鼠精子浓度、精子活率、睾丸指数及附睾指数显著提高,鱼鳔高、中剂量组精子活力显著提升,精子畸形率降低.结论:鱼鳔能明显提高环磷酰胺所致小鼠少弱精子模型的睾丸指数、附睾指数及精子质量.

膝骨关节炎(knee osteoarthritis,KOA)是膝关节骨、软骨、滑膜的退化以及关节边缘和软骨下骨质增生为主要特征的关节疾病. 本病多发于中老年人,临床可表现为关节疼痛、肿胀、畸形,严重者可导致残疾[1]. KOA 的临床治疗较为棘手,西药治疗主要针对缓解疼痛,且疗效欠佳;手术治疗费用昂贵. 中医药治疗膝骨关节炎有多种方法,在 KOA 早期治疗有一定优势. 其中非药物疗法在临床较为常用,其经济安全,能有效改善关节活动度和功能,有效缓解疼痛. 现就中医非药物疗法治疗 KOA 的临床应用作一浅析,以飨同道.

目的:基于中医传承辅助平台分析黄丽娟教授治疗慢性心力衰竭用药规律.方法:采集黄丽娟教授治疗慢性心力衰竭的门诊医案,运用中医传承辅助平台建立医案数据库,基于该软件的集成规则分析 、改进互信息法 、复杂系统熵聚类分析等数据挖掘方法,对黄丽娟教授治疗慢性心力衰竭的用药规律进行总结.结果:整理出黄丽娟教授治疗慢性慢性心力衰竭的方剂共114首,共使用中药108味,其中使用频率以生黄芪 、丹参 、茯苓最多.药物四气以温性为主;药物五味中甘味最多;药物归经,以肝经 、心经频率最高.常用对药组合32组;常用角药组合48组,演化得到药物关联度网络展示图1幅,核心组合6组,新处3首.结论:黄丽娟教授治疗慢性心力衰竭以益气温阳 、活血利水为基本治法,兼以泻肺利水 、补益心阴.

OBJECTIVE:To investigate the effect of Bazi Granules on sperm quality in male rats with oligoasthenozoospermia (OAS) induced by multi-glycosides of tripterygium wilfordii (GTW).METHODS:Thirty-six SD male rats were randomly divided into six groups of equal number: normal control, OAS model control, Wuziyanzong Pills (WYP), and low-, medium- and high-dose Bazi. The OAS model was established in the rats except those of the normal control group by intragastrical delivery of GTW at 30 mg/kg/d for 40 days. From the 41st day, the animals of the normal and OAS model control groups were fed with distilled water, those of the WYP group treated by gavage with WYP at 1.02 g/kg/d, and those of the low-, medium- and high-dose Bazi groups intragastically given Bazi Granules 3 (5.27 g/kg), 6 (10.54 g/kg) and 12 (21.08 g/kg) times, respectively, that of the human-equivalent dose. Semen parameters and the contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in the testis tissue were determined after 28 days of treatment.RESULTS:After treatment, the rats of the of the high-, medium- and low-dose Bazi groups, compared with the OAS model controls, showed significant increases in sperm concentration (［1 050.71 ± 203.71］, ［1 370.06 ± 166.01］ and ［1 302.53 ± 476.51］ vs ［617.01 ± 237.08］ ×10⁶/ml, P < 0.05), sperm motility (［0.56 ± 0.24］%, ［0.73 ± 0.14］% and ［0.70 ± 0.23］% vs ［0.07 ± 0.05］%, P < 0.05), sperm average path velocity (［85.71 ± 30.35］, ［83.83 ± 10.31］ and ［75.06 ± 19.70］ vs ［43.45 ± 38.74］ μm/s, P < 0.05), sperm curvilinear velocity (［101.76 ± 23.28］, ［119.60 ± 21.22］ and ［102.11 ± 32.89］ vs ［53.63 ± 47.91］ μm/s, P < 0.05), sperm straight line velocity (［62.75 ± 7.63］, ［67.80 ± 5.05］ and ［64.11 ± 12.03］ vs ［40.18 ± 36.86］ μm/s, P < 0.05), and the SOD level (［380.23 ± 75.07］, ［349.53 ± 97.48］ and ［415.07 ± 72.01］ vs ［304.62 ± 27.17］ U/mg, P < 0.05), but a remarkable decrease in the MDA level (［0.33 ± 0.16］, ［0.22 ± 0.05］ and ［0.34 ± 0.22］ vs ［0.73 ± 0.20］ nmol/mg, P < 0.05).CONCLUSIONS:Bazi Granules can significantly improve the sperm quality of OAS rats, which may be related to its abilities of repairing oxidative stress injury and enhancing oxidation resistance.

膝骨关节炎是中老人常见的慢性膝关节退化性疾病,晚期关节可出现屈伸受限、蹲起困难,严重时不能行走.膝骨关节炎临床治疗中药物治疗占有重要的地位,但合理用药并没有受到重视.药物治疗包括口服药物和外用药物.大多数患者长期服用消炎止痛药物,并对其治疗的适应症及副作用认知不足;部分患者对外用药物的应用了解不够.本文主要对治疗膝骨关节炎的内服药物,如镇痛药、软骨保护药物;关节腔注射药物,如透明质酸、玻璃酸钠、医用几丁糖、激素类药物、自体富血小板血浆、臭氧等,以及外用药物进行归纳分析,以便更好的指导临床用药,提高膝骨关节炎的治疗效果.

膝骨关节炎是中老年人群常见的慢性疾病,关节疼痛和行动受限严重影响了患者的生活质量.目前临床治疗膝骨关节炎的主要目的在于缓解疼痛,延缓疾病的进展.非药物治疗如健康教育、功能锻炼、物理治疗等副作用及不良反应少,患者接受度高,治疗费用低,此类疗法主要适用于早期症状不明显的患者.本研究系统阐述了非药物疗法在防治膝骨关节炎中的应用,以期提高该病的临床治疗效果,改善患者生存质量.

膝骨关节炎(KOA)在老年人群中发病率较高,严重影响了老年人生活质量.现代医学认为科学的健康教育对预防的发生和进展有一定的作用.中医"治未病"思想也认为膝骨关节炎的治疗要"未病先防、已病防变".基于这种治疗观念下的饮食、运动健康教育可以有效防治膝骨关节炎,降低其发病率.如能对膝骨关节炎患者的饮食、运动开展中、西医健康教育,对于解除膝骨关节炎患者的疾苦,减轻社会与家庭负担具有重要意义.

目的 探讨糖尿病周围神经病变的中医证候分型规律.方法 采集糖尿病周围神经病变患者的临床病例(症状表现),建立糖尿病周围神经病变临床症状的数据库.最后采用聚类分析的统计方法,对糖尿病周围神经病变患者的中医证候分型规律进行统计分析.结果 糖尿病周围神经病变临床证候可分为毒瘀神络、气阴两虚,毒瘀神络、气阳两虚和毒瘀神络、阴阳两虚三类.结论 研究结果有一定的局限性,但在一定程度上可以反应目前临床糖尿病周围神经病变患者常出现的证型.

Ig A nephropathy is the most common primary glomerulonephritis. Currently,Western medicine research involves molecular,immunological mechanisms,genetic and expression and other factors,but the exact pathogenesis has not been elucidated. In recent years,there is great progress mainly in glycosylation lack,molecular gene,etc. Chinese medicine research has focused on syndrome differentiation,post-party experience and so on,which made some achievements in syndromes and renal microscopic pathology relations,but not yet fully unified.

Objective To discuss the method of caculating Traditional Chinese medicated serum dosage .Methods At pre-sent about experimental animals to fill the stomach to dose calculation method has a lot of kinds ,there is no unified stan-dard .In combination with related literature in recent years of the preparation of traditional Chinese medicine medicated serum in vitro experiments of animals to fill the stomach to dose the status quo ,such as weight ,according to adults ,according to fixed dose calculation method ,discusses relatively reasonable and effective calculation method .Results We designed one method of caculating dosage by referencing to age ,weight ,serum concentration .Conclusion The specific calculation formu-la should be selected according to the different research content .

血肌酐是临床评估肾功能的常用指标,然而临床上引起慢性肾功能不全血肌酐升高的原因有很多种,如饮食因素、劳倦房劳、六淫外感、药物因素等,在治疗血肌酐升高时应注意避免这些因素的存在.具体治疗上,中医认为血肌酐升高的基本病机为气血阴阳俱虚、浊毒内停、血脉不活,因此整个治疗过程应注重调补和降通络,同时根据影响血肌酐水平的其他因素给予患者生活指导,只有两者相结合,综合治疗才可获得良好效果.

This study was aimed to observe the effects on glucolipid metabolism of aqueous extract of traditional South African herb Sutherlandia. Intraperitoneal injection of streptozotocin (STZ) combined with high fat feed method was used in the establishment of type 2 diabetes rat model. Then, rats were randomly divided into the normal group, model group, pioglitazone group, and the Sutherlandia group. Observation was made on changes of body weight, oral glucose tolerance test (OGTT), blood triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). Western blot method was used to detect IRS-1 expression of skeletal muscle in rats of each group. The results showed that compared with the normal group, body weight in the model group was decreased, and indicators of OGTT, TG, TC, LDL-C were significantly increased (P< 0.05). Symptoms such as increased drink-ing, eating and urine were obvious; and the IRS-1 expression was obviously decreased (P< 0.05). After treatment, compared with the model group, there was no significant body weight increase in the Sutherlandia group or the pi-oglitazone group. Indicators of blood glucose, TG, TC in the Sutherlandia group and the pioglitazone group were ob-viously decreased with no statistical difference (P< 0.05 or P< 0.01). In the Sutherlandia group and the pioglitazone group, IRS-1 expression of skeletal muscle in rats was obviously increased with no statistical difference (P< 0.05). It was concluded that type 2 diabetes rats induced by intraperitoneal injection of STZ combined with high fat feed method can induce glucolipid metabolism disorders. Traditional South African herb Sutherlandia can obviously reduce the blood sugar level, improve blood lipid metabolism, and improve the level of insulin. Sutherlandia can improve the IRS-1 expression of skeletal muscle in rats, relief the insulin resistance, and lower blood sugar. However, the effect of its exact ways required further in-depth study.

目的：对公开发表的黄葵胶囊治疗DN的文献进行Meta分析，系统评价黄葵胶囊治疗DN的有效性及安全性。方法：计算机检索PubMed、Cochrane Library、CNKI 、VIP等中关于黄葵胶囊治疗DN的随机和半随机对照试验，并手工检索相关杂志，追溯相关研究及纳入文献的参考文献。由2位评价者独立筛选文献、提取资料和质量评价，然后采用RevMan 5．3．3软件进行Meta分析。结果：共纳入6个RCT。Meta分析显示，黄葵胶囊可减少DN患者的尿蛋白，改善肾功能，提高DN疗效，具有较好的安全性。但是受纳入研究的数量和质量所限。结论：上述结论尚需今后开展更多高质量的相关研究加以验证。

<正>近年来,维持性血液透析(HD)患者越来越多,很多学者从不同的角度分析了维持性血透患者的并发症及其死亡原因[1~3]。随着医疗水平的提高,血透患者的生存期也随之延长,已有研究成果表明,长期HD患者肿瘤发生率较高,其中以泌尿系肿瘤最为多见[4]。临床中其他系统的肿瘤也时有发生,我科在2011年3月~2013年1月维持性血液透析的120例患者中,发现3例垂体瘤患者,现报道如下。