OBJECTIVE:To compare the analgesic effect of bloodletting acupuncture at jing-well points along three-yang meridians of foot combined with routine acupuncture and simple routine acupuncture on migraine. METHODS:A total of 60 patients with migraine were randomized into an observation group and a control group, 30 cases in each one, of which, 4 cases were dropped out in the observation group, 1 case was dropped out in the control group. In the observation group, bloodletting acupuncture at jing-well points combined with routine acupuncture were applied. The bloodletting acupuncture was applied at corresponding jing-well points of three-yang meridians of foot [Lidui (ST 45), Zhiyin (BL 67), Zuqiaoyin (GB 44)] according to pain location. And routine acupuncture was adopted at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20), Hegu (LI 4), Taichong (LR 3), Zulinqi (GB 41), Yanglingquan (GB 34) and Waiguan (TE 5). In the control group, routine acupuncture was applied, acupoint selection and operation were the same as the observation group. The treatment was given once a day, 30 min a time, 5 days as one course with 2 days interval, and 2 courses were required. Before treatment, immediately after needle withdrawal, 4 h after needle withdrawal and after 2 courses of treatment, the visual analogue scale (VAS) score was compared in the two groups. Before and after treatment, the migraine comprehensive score was observed in the two groups, and the therapeutic effect was evaluated. RESULTS:Immediately after needle withdrawal, 4 h after needle withdrawal and after 2 courses of treatment, the VAS scores in the two groups were decreased (P<0.05), the VAS scores immediately after needle withdrawal, 4 h after needle withdrawal and after 2 courses of treatment in the observation group were lower than those in the same time of the control group (P<0.05). After treatment, the migraine comprehensive scores in the two groups were decreased (P<0.05), the reducing degree in the observation group was greater than the control group (P<0.05). The total effective rate in the observation group was 92.3% (24/26), which was higher than 89.7% (26/29) in the control group, there was no significant difference (P>0.05). CONCLUSION:Bloodletting acupuncture at jing-well points along three-yang meridians of foot combined with routine acupuncture and simple routine acupuncture have analgesic effect, and the combined therapy is superior to simple routine acupuncture.

目的:通过CT观察双侧上颌窦影像特征与二十四节气变化的关系,初步探讨天人相应的中医整体观.方法:收集2015年立冬至2016年立冬之间的所有因鼻科症状来我院进行鼻窦CT检查患者的病例资料共计826例,分析不同节气太阳赤纬角、双侧上颌窦口完全闭塞患者比例对应特点.结果:826例患者中,双侧上颌窦口完全闭塞患者比例在小寒节气最高,在小署节气最低.结论:二十四节气太阳射到地面上的热产生气的升降阴阳变化,地表气温的极点变化相对具有一定滞后性,患者群中鼻部上颌窦口完全闭塞比例与之相适应,体现了天人相应.

目的:探讨反流性食管炎患者四诊信息的因子分析和复杂网络技术分布模式,为该病的中医证候研究提供新的思路和方法.方法:对200例反流性食管炎患者的临床资料进行调查,运用因子分析、复杂网络技术对其中医证候、证素分布特点进行探索性分析,总结分布特点.结果:经因子分析、复杂网络技术共同提取出证素8个,病位证素:胃、肝、脾,病性证素:气滞、热、痰湿、气虚、阳虚.结论:综合多种数理统计方法,更有利于阐释反流性食管炎的证候证素分布特点,复杂网络技术较因子分析更能直观阐释中医证候分布特点.

Objective To explore the evolvement rule of TCM syndrome types of the transformation of chronic gastritis (CG):from chronic non-atrophic gastritis (CNAG),chronic atrophic gastritis (CAG) to precancerous lesions of gastric carcinoma (PLGC).Methods Based on gastroscopy and gastrobiop-sy,altogether 592 patients included from three hospitals affiliated to Beijing University of Chinese Medi-cine Dongzhimen Hospital,(Dongfang Hospital and Third affiliated Hospital)and Wangjing hospital of China Academy of Chinese Medical Sciences from September 2013 to February 2014,were diagnosed with CNAG (338 cases),CAG (134 cases)and PLGC (120 cases).By using Epidata 3.1 the database was established,then principal component analysis,factor analysis and Chi-square test were conducted by using software SPSS 17.0.Results There were nine common syndrome types in CNAG,and the&nbsp;three leading ones were syndrome of incoordination between spleen and stomach,syndrome of heat-stag-nation in liver and stomach,syndrome of incoordination between liver and stomach.There were ten syn-drome types in CAG,and the highest frequency was syndrome of incoordination between liver and stom-ach,then syndrome of static blood in stomach collaterals and syndrome of deficient cold of spleen and stomach.The highest frequency of three syndrome of ten in PLGC were syndrome of yin deficiency in stomach,syndrome of yang deficiency in stomach and syndrome of static blood in stomach collaterals. The frequencies of location factors of CNAG from high to low were stomach,liver and spleen,the same as those of CAG;the frequencies of nature factors from high to low were qi stagnation,heat,qi deficiency, dampness and yang deficiency,which were some different from those of CAG being qi stagnation,heat, yang deficiency,dampness,blood stasis,yin deficiency and qi deficiency.With the disease progression, the frequencies of location factors of PLGC from high to low were stomach,spleen and liver,while those of nature factors were heat,yang deficiency,yin deficiency,qi stagnation,blood stasis,dampness,and qi deficiency.The distributions of location factors as well as nature factors were significantly different dur-ing the whole procedure of CG progression,CNAG,CAG and finally PLGC.Conclusion During the procedure of:CNAG turned into CAG and into PLGC in the end,the evolvement characteristic of “sthe-nia transforming into asthenia and appearing yin deficiency and blood stasis gradually”was found.

Objective To explore the correlation of chronic atrophic gastritis( CAG) with Hp infection of spleen and stomach damp heat pattern /syndrome with cytotoxin- associated gene- a( Cag A),cyclooxygenase 2( Cox- 2) and gastric mucosa disorder. Methods Seventy cases of CAG,diagnosed via Hp determination,gastroscope and pathological examination were included. There were 30 cases for each of Hp positive and spleen and stomach damp heat pattern /syndrome and of Hp positive and spleen and stomach deficiency cold pattern /syndrome. Ten cases of Hp negative were included in the negative control group. ELISA was adopted to determine serum Cag A and Cox- 2 expressions. In association with pathological results,Cag A positive rate,Cox- 2 expression level and gastric mucosa disorder were compared and analyzed among groups. Results In CAG plus Hp infection spleen and stomach damp heat group,Cag A positive rate and serum Cox- 2 expression were higher than those in spleen and stomach deficiency cold group,and the results in the two groups were all higher than those in Hp negative group,indicating the significant difference( P 0. 05). The difference in gastric mucosa disorder severity was not significant between spleen and stomach damp heat group and the spleen and stomach deficiency cold group( P 0. 05),but the condition was mild in tendency in the spleen and stomach damp heat group. Conclusion Cag A and Cox- 2 are possibly involved in the formation of spleen and stomach damp heat pattern /syndrome in the patients of CAG and Hp infection.The spleen and stomach damp heat pattern /syndrome plays the important role in the early progression of CAG with Hp infection,which provides a certain evidence on the exploration of the effect mechanism of spleen and stomach damp heat pattern /syndrome in the progression of CAG.

目的:系统评价中医理气和胃法治疗慢性胃炎的临床疗效.方法:检索PubMed、OVID数据库和中国知网与维普中文科技期刊全文数据库的英文和中文随机对照试验(RCT)文献,将Jadad积分≥1分的以慢性胃炎患者为研究对象的临床随机对照试验文章纳入研究,并提取纳入研究的特征信息.采用Revman 5.2软件进行Meta分析,检验异质性,并根据异质性结果选择相应的效应模型,最后绘制漏斗图及Egger回归方程评定有无发表偏倚.结果:最终有9项RCT,共1076例患者入选,文献质量普遍较低.理气和胃法治疗慢性胃炎的总体疗效优于单纯的西医治疗,其汇总OR=6.77,95％CI(4.39,10.43),差异均具有统计学意义(P＜0.0001).漏斗图显示左右两侧的点估计值分布不对称,说明发表偏倚可能性大,有2篇文章处于漏斗的底部,说明其样本量偏小.线性回归常数项检验统计量表明存在发表偏倚.结论:理气和胃法治疗慢性胃炎,在总有效率方面可能优于单纯西医治疗组,但尚需更多高质量研究以增加证据的强度.

目的:明确丁霞教授治疗胃脘痛的用药规律,阐发丁霞教授治疗胃脘痛的学术思想与临床用药经验.方法:选取丁霞教授临床治疗胃脘痛自诊处方360首,详细记录首诊用药情况,确定首诊处方各药物的使用频次.采用关联规则Apriori算法,进行基于改进的互信息法的药物间关联度分析;以药物间关联度分析结果为基础,依据相关度与惩罚度约束,进行基于复杂系统熵聚类的药物核心组合分析;在此基础上运用无监督熵层次聚类算法,获得治疗胃脘痛新处方;根据结果绘制出用药关联规则网络图、新方的核心组合药物网络图及新方的药物网络图.上述操作基于中医传承辅助平台V1.1 (TCMISS)完成.结果:通过分析360首胃脘痛医案处方,提取用药核心组合46组,挖掘治疗胃脘痛新方23个,明确了丁霞教授治疗胃脘痛的处方药物的使用频次规律及药物间的关联规则.结论:丁霞教授治疗胃脘痛临证重视调胃、调肝、调脾三端,用药具有通降与清降并举、健脾与助脾并重、寓柔肝于疏肝的特点.

目的:运用因子分析并结合数据挖掘的方法总结和分析丁霞教授临床治疗慢性胃炎的用药规律.方法:收集自2013年1月至2013年3月间在丁霞教授门诊就诊且有明确疗效的98例慢性胃炎患者的病历资料及首次用药处方,录入Microsoft Excel数据库,使用PASW Statistics 18统计软件包进行因子分析及数据挖掘.结果:共提取药物组合公因子9个,能够涵盖全部变量信息的74.9％;通过数据挖掘发现在丁霞教授临床诊疗过程中部分公因子药物的使用与患者的临床表现有明显的相关性.结论:丁霞教授在临床治疗本病时注重脏腑关系,遵循从肝论治、调畅脾胃气机等原则和方法在临床上取得了良好的疗效.这种用药思路值得进一步研究和推广.

Objective: To investigate the objectivity of syndrome classification of Alcoholic Liver Fibrosis( ALF).Methods: The relationship between syndrome patterns of 326 confirmed ALF patients and four indicators of hepatic fibrosis,radiology( hepatomegaly,splenomegaly,portal vein enlargement) and pathological stage was analyzed. Results: The physical and chemical indexes were all correlated with syndrome patterns( P < 0. 05),radiology was more closely with Qi stagnation and blood stasis. Accumulation of dampness and heat,Qi stagnation and blood stasis lasted the whole process of pathological changes. Each of Four indicators of hepatic fibrosis was closely related with syndrome patterns. Conclusion:There was a clear correlation between syndrome patterns and four indicators of hepatic fibrosis,radiology and pathological stage.

Objective: To extract syndrome elements and investigate distribution characteristics of TCM syndrome of Hp related chronic gastritis through literature study.Methods: An extensive search including CBM,CNKI,Wanfang and VIP was performed up to September 2011 for literatures about Hp related chronic gastritis of TCM,to summarize syndrome types,then to extract syndrome elements of it.Results: 36 documents were included in this review,7 331 cases were reported and 19 syndrome types were related to Hp related chronic gastritis,most common syndrome types were incoordination between liver and stomach and damp-heat of spleen and stomach;14 syndrome elements were extracted,the main location elements were stomach,liver and spleen;heat and dampness were the main excess elements;for deficiency elements,the frequency of qi and yin deficiency was higher.Results: The main syndrome types of Hp related chronic gastritis are incoordination between liver and stomach and dampheat of spleen and stomach.Stomach,liver and spleen are the main locations of the diseases,excess syndromes are the most common.

目的:通过了解青海大通地区中医药应用情况,进而掌握该地区的中医药应用情况,加以分析后,以期对西部高原多民族聚集地区的中医药应用及发展有一定的指导作用。方法:根据现有文献资料,结合当地实际情况设计调查问卷,对青海大通地区居民进行问卷调查,并对收集来的问卷进行统计,参考相关文献进行分析。结果:目标人群中医药服务需要迫切,但需求未得到充分满足。结论:针对以青海大通县为代表的西部高原多民族聚集地区居民中医药服务需要旺盛的情况,可以考虑加强对当地居民中医药知识的科普宣传及教育,积极提升卫生诊疗水平,推广中西医结合卫生服务等,以满足基层群众日益旺盛的高质量的医疗服务的迫切需求。

Objective: To study the classification of Chinese clinical syndrome differentiation of alcoholic liver fibrosis to establish foundation for the standardization of clinical syndrome research.Methods: 326 patients with alcoholic liver fibrosis were investigated.And factor analysis and entropy-reactor analysis of complex system were used to study the distribution of Chinese syndromes.Results: There were 6 basic syndromes including liver depression and spleen deficiency,accumulation of dampness and heat,Qi stagnation and blood stasis,deficiency of both Qi and yin,yin eficiency of liver and kidney,and spleen Yang deficiency,which covered more than 90% of the clinical cases.Conclusion: The factor analytical model and entropy-reactor analytical model of syndrome distribution unveiled the Chinese syndrome characteristics of the disease,enriched methods of syndrome classification.It would promote syndrome classification towards the objective process of the disease.

回顾研究发现,既往研究存在一些问题,如纳入及排除标准不严格,难以保证西医“病”与中医“证”之间关系的对应性；基于部分学者经验的病例观察表(CRF)难以获取Hp相关性慢性胃炎在自然状态下的四诊信息；对环境、发病季节、气候等有可能影响中医证候的因素考虑不足,也在一定程度上影响了研究结果；对以单一证型进行统计分析,忽略了复合证型的存在,致使研究结果过于片面.

Objective: To probe into distribution characteristics of TCM syndromes and syndrome essential factors of reflux esophagitis through literature study.Methods: An extensive search including CBM,CNKI,Wanfang and VIP databases was performed up to September 2011 for literatures about reflux esophagitis of TCM,to summarize syndrome types,then to extract syndrome essential factors of it.Results: 37 documents were included in this review,3 078 cases were reported and 26 syndrome types were related to reflux esophagitis,most common syndrome types were stagnated heat of liver and stomach and incoordination between liver and stomach;16 syndrome essential factors were extracted,the main location factors were stomach,liver and spleen;heat,qi stagnation,phlegm and dampness were the main excess factors;the frequency of yang deficiency and yin deficiency was higher in deficiency factors.Conclusions: The main syndrome types of reflux esophagitis are stagnated heat of liver and stomach and incoordination between liver and stomach.Stomach,liver and spleen are the main locations of the disease,and excess syndromes are the most common.

Objective:To investigate the distribution characteristic of common TCM syndrome and syndrome factors of peptic ulcer.Methods: We retrieved literatures about peptic ulcer from CNKI and VIP bibliographic databases,then built a database.Finally,we made use of SPSS17.0 to analyze the frequency of TCM syndrome types and syndrome factors.Results:The common syndrome types were incoordination between the liver and stomach,deficient cold of spleen and stomach、stomach yin deficiency、static blood in stomach collaterals、stagnated heat of liver and stomach etc.The common syndrome elements of disease location were stomach、spleen、liver and stomach collateral,and the common syndrome elements of disease character were qi stagnation、heat、yang deficiency、blood static、qi deficiency、yin deficiency、qi depression、dampness.Conclusions:The distribution of TCM syndrome types of peptic ulcer was scattered,and differentiation of syndrome elements could cover the most of clinical syndromes to standardize clinical identification better.

1 证素概念的产生与意义 辨证论治是中医临床医学的精髓,然而证候分类、证型命名不统一,往往古今诸法混用,概念欠确切,内容不完整,甚至相互矛盾、错杂.王永炎指出,证候相关名称与分类亟待规范,需要降维升阶以寻求简约清晰的表达,以象为素,以素为候,以候为证,病证结合,方证结合是辨证方法体系的理论依据.