目的:观察中药香囊对新型冠状病毒高危人群的临床预防效果.方法:选择自愿参加的医院在职医务人员或疑似/确诊新冠感染病例的社区人员佩戴辟瘟香囊3周,并配合填写调查问卷,观察受试者感染新型冠状病毒的情况.结果:完成本项目的1220例受试者中,佩戴香囊前(第0周)有不适症状者共244例.针对244名受试者建立有效数据集,佩戴香囊前后症状计分比较采用重复测量方差分析,校正后(P =0.000＜0.05),提示佩戴香囊前后受试者不适症状改善情况有显著意义,且受试者佩戴香囊后第1周及第2周症状改善更为显著,提示症状改善情况可能并不与佩戴时间的明显延长成正相关.截止2020年11月初,参与完成本项目的1220名受试者均未发生新冠病毒感染.结论:佩戴中药香囊可能对新冠病毒的感染起到一定的预防作用.

黄连阿胶汤首见于《伤寒论》,是仲景经典方中的代表方剂,诚如:"少阴病,得之二三日以上,心中烦,不得卧,黄连阿胶汤主之".而心肾二者又属于少阴经,故黄连阿胶汤对于调整少阴之病具有很好的疗效.心火亢盛或肾阴不足,水火共济失调,心肾不交,使得心火无法温肾,而肾阴不能濡心,阴阳失调则发为不寐;肾阴不足,无以上行而制约心火,心肾不交,心之阳气过盛而阴气不足,心神失养入里无门,发为焦虑,且心火过旺更加耗伤肾阴伤津,恶性循环,焦虑更重;"命门火衰"则不能腐熟水谷,水谷精气无法上濡于肺胃等脏,发为消渴.诸病发病均为心肾不交所致,皆可应用黄连阿胶汤治疗,概述黄连阿胶汤治疗少阴病之失眠、焦虑症、糖尿病的思路.

"乌梅丸"出自汉代张仲景《伤寒论》,是抑木扶土之经方之一,乌梅丸多用于"久利",历代医家在谨守原方配伍和功用特点的基础上,对本方进行了深入研究,辨证施治,随证化裁,并将其广泛应用于内、妇、儿科等多种疾病,现对乌梅丸基于抑木扶土之辨治诸病思路进行总结,为抑木扶土角度论乌梅丸辨治厥阴病提供思路.

近年来高血压疾病的发生多从阴虚阳亢立论,然而笔者发现结合高血压患者的临床表现及辨证施治,认为高血压疾病从气虚论治仍不容忽视,传统观念上都认为高血压患者多是阴虚阳亢或肝阳上亢之体,然而不少患者都是气虚之体,笔者经过搜集整理相关文献及临床实践,由气虚而论治高血压患者,可以从补脾益气、补肾益气两方面治疗.

目的:探讨天麻钩藤饮联合穴位贴敷治疗1级高血压及其对生活质量的影响.方法:选取2016年11月-2018年4月我院收治的1级高血压患者240例,采用随机数字表法分为对照组和治疗组,各120例.其中对照组予以宣传教育、限盐饮食及运动处方进行治疗;治疗组在对照组的基础上予以天麻钩藤饮联合穴位贴敷的治疗方案,两组患者均治疗2周.比较两组患者临床疗效、治疗前后不同时段血压改善情况、中医证候积分及生活质量.结果:治疗组患者临床总有效率为96.67％,对照组患者临床总有效率为68.33％,差异具有统计学意义(P＜0.05);与对照组相比,治疗组患者治疗后1周、2周的收缩压及舒张压改善更显著(P＜0.05);经治疗,与对照组相比,治疗组患者中医证候积分改善更显著(P＜0.05);治疗后,治疗组患者生活质量较对照组患者改善明显,差异具有统计学意义(P＜0.05).结论:天麻钩藤饮联合穴位贴敷治疗1级高血压取得较好的临床疗效,起到平肝熄风、清热活血、补益肝肾之功效,同时还可提高患者生活质量,促进恢复速度,值得临床推广应用.

Objective:The objective of this review is to inquire the efficiency of the treatment to hypertension by herbs sticking on Yongquan point combined with hypotesor.Methods:According to the strict inclusion and exclusion criteria,we searched the China knowledge network,WanFang database and Weipu database in subject heading by using the search terms of Yongquan,sticking,hypertension.We selected all the randomized controlled trails.Collected all the information of the selected studies on the methodology and used the information to synthesis and analysis and finally to evaluate the efficiency of the treatment to hypertension by herbs sticking on Yongquan point.Results:We identified 10 reports meeting the inclusion criteria for our review.In those studies,experimental group contains 432 patients and control group contains 367 patients.All those studies using the treatment of herbs sticking on Yongquan point and hypotensor compared with hypotensor only.Meta analysis showed that ORccombination=3.24,95％CI=2.06-5.08,P＜O.00001,means that the combination treatment of herbs sticking on Yongquan point and hypotensor is more effective than only using hypotensor only.Conclusion:Herbs sticking on Yongquan point and hypotensor is more effective than only using hypotensor only.But because of small size of the sample,low quality of the included studies and publication bias.Those may influence the argumentation intensity of this meta analysis.

目的:探讨高血压前期体质类型及与心血管危险因素的相关性,为高血压前期及高血压的防治提供科学依据.方法:选取200例高血压前期人群,90例高血压人群,100例正常血压人群为研究对象;通过问卷调查的形式收集入选对象的基本信息、体质类型、心血管危险因素,对数据进行统计与分析.结果:高血压前期组与正常血压组相比,阴虚质、阳虚质、痰湿质是高血压前期的主要危险因素(OR值均＞1);高血压前期组阴虚质、阳虚质、痰湿质体质类型与心血管危险因素有一定的相关性.3组体质人群在性别、有无吸烟史、有无饮酒史、年龄、BMI、血尿酸水平上有显著差异,在高血压家族史、空腹血糖、总胆固醇、甘油三酯、低密度胆固醇、高密度胆固醇水平上,差异均无统计学意义(P＞0.05).其中阴虚质年龄显著小于阳虚质(P=0.007＜0.05);痰湿质男性发生率显著高于阴虚质、阳虚质(P＜0.05);痰湿质吸烟人群显著高于阴虚质、阳虚质(P＜0.05、P＜0.05);阳虚质饮酒人群显著少于痰湿质、阴虚质(P＜0.05、P＜0.05);痰湿质、阴虚质的体重指数显著高于阳虚质(P＜0.05、P＜0.05);痰湿质血尿酸水平显著高于阴虚质、阳虚质(P＜0.05、P＜0.05).结论:高血压前期组与正常血压组相比,痰湿质、阴虚质、阳虚质是高血压前期发生的主要危险因素;高血压前期组痰湿质、阴虚质、阳虚质体质类型与性别、有无吸烟史、有无饮酒史、年龄、BMI、血尿酸心血管危险因素存在一定的相关性.

目的:采用天麻钧藤饮联合盐酸贝那普利(洛丁新)治疗肝阳偏亢型高血压,观察分析两者结合治疗的临床有效性和安全性.方法:收集2014年1月-2014年12月来我院门诊就诊的原发性高血压(肝阳偏亢型)患者181例.采用随机数字袁法,将全部病例随机分成治疗组(n=90例)和对照组(n=91例).对照组均给予盐酸贝那普利(洛丁新)10 mg口服1次/d;治疗组在对照组基础上给予天麻钩藤饮水煎剂,1剂/d,分早晚服用.4周为1个疗程.治疗1个疗程后比较两组治疗后血压、血脂水平变化和不良反应情况.结果:治疗1个疗程后比较结果发现,治疗组总有效率为84.44％,对照组为71.43％,两组总有效率比较差异有统计学意义(P＜0.05);用药后两组血压均明显下降(P＜0.05),治疗组血压降低程度明显高于对照组(P＜0.05);治疗组24 h平均收缩压明显降低,血压晨峰现象明显好转,与对照组比较差异有统计学意义(P＜0.05);治疗组治疗后TC、TG、HDLC、LDLC均优于对照纽,以上差异具有统计学意义(P＜0.05),治疗组不良反应和对照组发生人数基本持平,无统计学意义(P＞0.05).结论:天麻钩藤饮联合盐酸贝那普利(洛丁新)治疗肝阳偏亢型高血压降压临床效果满意,血压、血脂明显改善,对肾功能有一定的保护作用,临床安全性好,适合临床广泛应用.

Objective To explore the clinical efficacies of Naoxinqing Tablets combined with cinepazide maleate and tanshinone ⅡA sodium sulfonate in treatment of coronary heart disease with angina pectoris. Methods Patients (96 cases) with coronary heart disease with angina pectoris from January 2015 to January 2016 in Affiliated Hospital of Liaoning University of TCM were randomly divided into control (48 cases) and treatment (48 cases) groups. All patients were given basic treatment with low salt and low fat diet, anticoagulation, lipid lowering, etc. Patients in the control group were iv administered with Cinepazide Maleate Injection, 320 mg added into normal saline 500 mL, once daily. At the same time, they were iv administered with Tanshinone ⅡA Sodium Sulfonate Injection, 60 mg added into normal saline 250 mL, once daily. The patients in the treatment group were po administered with Naoxinqing Tablets on the basis of control group, 2 tablets/time, three times daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the improvement of serum indexes, symptoms and hemorheology indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment group were 79.17%and 93.75%, respectively, and there were differences between two groups (P<0.05). After treatment, serum adiponectin (APN) and nitric oxide (NO) in two groups were significantly increased (P<0.05), and tumor necrosis factor-α(TNF-α), hypersensitive C-reactive protein (hs-CRP), endothelin (ET) and thromboxane B2 (TXB2) were significantly decreased (P < 0.05). For serum indexes, the treatment group improved more significantly than the control group (P < 0.05). After treatment, frequency and duration of angina pectoris, and also nitroglycerin dosage of two groups were significantly decreased (P<0.05);Compared with the control group, the serum indexes in the treatment group decreased more obviously (P < 0.05). After treatment, hematocrit, fibrinogen, whole blood viscosity and plasma viscosity of two groups were decreased more than those before treatment with significant difference (P<0.05). And these hemorheology indexes in treatment group were decreased more than those in the control group, and the difference was significant (P < 0.05). Conclusion Naoxinqing Tablets combined with Cinepazide Maleate Injection and Tanshinone ⅡA Sodium Sulfonate Injection has clinical curative effect in the treatment of coronary heart disease with angina pectoris, can significantly improve the serum indexes, clinical symptoms, and reduce hemorheology indexes.

目的：探讨胆囊息肉中医证型分布规律及其与B超征象间的关系。方法：对2012年B超检出的72例胆囊息肉患者进行中医辨证分型，并结合超声检查的肝胆图像资料进行统计和分析。结果：72例胆囊息肉患者中，痰湿内蕴证和肝胆湿热证男性多于女性，肝气郁结证和肝郁脾虚证则女性稍高于男性，四个证型男女间均存在统计学差异（P＜0.05）；胆囊息肉发病率随着年龄增长而上升（P＜0.05）；胆囊息肉发病率在脂肪肝患者中高于正常人群，痰湿内蕴证胆囊息肉与脂肪肝具有相关性（r＝0.715， P＜0.05），肝胆湿热与胆壁增厚具有相关性（r＝-0.354，P＜0.05）。结论：胆囊息肉发生率随年龄增长而升高，胆囊息肉中医证型与性别、脂肪肝、胆囊壁毛糙具有相关性。

This study aimed to explore the rationality of herbaceous compatibility of peony liquorice decoction by analyzing the pharmacokinetic parameters of peoniflorin and glycyrrhetinic acid in SD rats' plasma. A HPLC/MS/MS method was used to detect the concentrations of peoniflorin and glycyrrhetinic acid in plasma of SD rats which were administrated with peony, liquorice and peony liquorice decoction, respecttively. Compared with the rats having single administration of either peony or liquorice, it took less time for the glycyrrhetinic acid in the plasma of rats administered with peony liquorice decoction to reach the peak concentration and its maximum concentration level was also increased. Moreover, the peoniflorin's peak concentration was increased, and the relative bioavailability was also enhanced. The half-life reduction happened to both peoniflorin and glycyrrhetinic acid. The liquorice promoted the absorption of peoniflorin in peony and enhanced its in vitro concentration, which in turn induced stronger and more powerful functions from the peoniflorin, such as spasmolysis, pain relief and calmness. The peony had shortened the time for glycyrrhetinic acid in liquorice to appear in intracorporal and had increased the quantity of glycyrrhetinic acid in intracorporal, bringing out the effects of anti-ulcer, spasmolysis, and anti-inflammation. This experiment had proven the rationality of the peony liquorice decoction compatibility in terms of pharmacokinetics.

医圣张仲景融理、法、方、药于一体而写成《伤寒论》,他之所以能写出这部医学巨著,与当时的气候变化有着很大的关系。东汉末年,天之寒气太过,自然之气阳气不足,造成人们阳气相对不足,阳气不及,则触冒寒邪发为伤寒疾病。仲景精于思考独创扶阳抑阴大法而驱邪外出或防治伤寒疾病。

The study is designed to understand the rationality of herbaceous compatibility of a peony liquorice decoction through analyzing the pharmacokinetic parameters of peoniflorin and glycyrrhetinic acid in SD rats plasma. A HPLC/ MS/MS method was used to detect the concentration of peoniflorin and glycyrrhetinic acid in SD rats administrated with peony, liquorice or peony liquorice decoction. Results show that peoniflorin and glycyrrhetinic acid in peony liquorice decoction have a short Tpeak, a high Cmax, and a short T1/2. Comparing with the sole administration of peony or liquorice, the peony liquorice decoction was able to make glycyrrhetinic acid in rat plasma reach the peak concen-tration in a faster manner, with an increased Cmax. Peoniflorin’s peak concentration got enhanced, and so did the relative bioavailability. Both the ingredients have showed a reduced half-life. It is believed that liquorice facilitates the absorption of peoniflorin in peony, and enhances in vivo concentration, which is possibly associated with the pharma-cokinetic effects of peoniflorin, including spasmolysis, analgesia, and tranquilization. Peony promotes the releases of glycyrrhetinic acid in liquorice, in terms of both time and quantity, allowing an enhanced anti-ulcer, spasmolysis, and anti-inflammatory effect. The experiment has proved the rationality of peony liquorice decoction compatibilities in the context of pharmacokinetics.

目的采用颈动脉粥样硬化的彩色多普勒超声检查,探讨颈部动脉粥样硬化与脑梗死形成的关系。方法采用高频探头检测38例脑梗死病人及42例普通就诊病人的颈动脉粥样硬化及斑块形成的情况并作对比。结果脑梗死病人的颈动脉斑块形成数量及程度显著高于非脑梗死病人的斑块形成数量及程度。有颈动脉粥样硬化及斑块形成的病人其脑梗死的发病几率显著高于普通人群,因而应提前预防及治疗。结论颈动脉粥样硬化是引起脑梗死的重要原因。