Through the traditional clinical formula copying and case collection,it was to analyze the Chinese herbal data in the treatment of diabetes by Prof. Li Qiu - gui. The academic opinions on the treatment of diabetes with Chinese herbal decoction,the thinking of clinical practice and the characteristics and rule of herbal usage were explored. In clinical practice,Prof. Li prefers to the formula with fewer ingredients but pos-sessing the specific actions. Curcuma zedoary is used in the highest frequency. Of the first 25 herbs of the high using frequency,14 herbs had the definite action on reducing glucose level and 10 herbs had been recor-ded for the treatment of xiaoke in ancient literatures. Regarding"four properties",the herbs of cold property had been used in the highest frequency;regarding"five flavors",the herbs of bitter and sweet flavors had been used in the highest frequency;regarding"channel tropism",lung channel is the first one involved. Additional-ly,based on the clinical experiences for years,Prof. Li believed that pattern/ syndrome differentiation of diabe-tes should be emphasized,the action and pharmacology be combined. Prof. Li proposes the integration of Chi-nese medicine and western medicine and promotes its individual advantages to guide the clinical application of herbal medicines.

目的：探讨李文瑞教授应用中西医结合方法治疗糖尿病的临床思路。方法：对李文瑞教授行医期间的治疗思路作分类整理。结论：李老临证治疗糖尿病强调中西互参、取长补短，提倡中西结合、辨证为主、西为中用的临证理念，倡导辨证与辨病相结合、宏观与微观相结合的临证思路。并通过对大量糖尿病人的诊治及对《内经》、《伤寒杂病论》的研究，主张用阴阳、脏腑、气血辨证合参，临证将其大致分为气虚型、阴虚型、气阴两虚型，并认为湿热中阻、瘀血阻络是导致多种并发症的主要因素。

《伤寒论》作为一部旷世奇书,近两千年来,对它的研究从没有间断过,各家著述颇多,可以说创造了针对于一部书而著述的奇迹,前无古人,后无来者.目前在中医界流传的主要版本有宋本《伤寒论》《金匮玉函经》《注解伤寒论》《唐本伤寒论》《康平本伤寒论》《康治本伤寒论》及《桂林古本伤寒论》等,各本之间版本流传上有先后之别,内容上异同之处,给初学者或《伤寒论》研究者带来了很多的困惑.通过介绍常见《伤寒论》版本的简略,为喜爱和学习《伤寒论》的同志提供线索,选择适合于自己的《伤寒论》版本.

This paper introduces the clinical application of dachengqi decoction combined with tonic in the treatment of two cases of elderly constipation.As long as the individual treatment plans are formulated according to the state of illness , and the characteristics of very old people are considered , medication is proper and reasonable , the therapy can attack evil and nourishing body simultaneously , the therapy can attack evil without hurting healthy , and can nourish body without helping evil , thus signifi-cant effect can be achieved.

文章主要介绍李秋贵主任医师在临证方中常加入三棱、莪术,治疗男子不育症、阳痿、前列腺增生症、黄褐斑、闭经等病证的经验与体会.指出三棱、莪术虽药力较峻,但只要辨证准确,可广泛用于属瘀血性之不同的病证,据病者正邪之状,选择合适的剂量,大多可获满意疗效.然需注意,对脾胃虚弱者慎用或不用,血小板减少症、出血性或易出血性病证及孕妇等忌用.

介绍米逸颖治疗肿瘤经验:①谨守病机,审因论治,善用大方;②中西结合,减毒增效,善用古方,巧用对药;③重视固本,强调固本以补脾、肾二脏为主,补肝者兼以益肾,滋水以涵木;④辨证灵活,活用成方,小方合成大方。

Objective To explore the distribution rules and characteristics of TCM syndromes of retinopathy in the type 2 diabetes.Methods The clinical data of 256 patients of type 2 diabetes with retinopathy were collected.According to the syndrome differentiation of TCM,the patients were differentiated into four syndromes as deficiency of both qi and yin,yin deficiency of the liver and kidney,qi deficiency of the spleen,and blood stasis.The correlation of the syndromes with the course of disease and the laboratory indices(including blood glucose,blood pressure,blood fat,and body mass index,etc.) was studied.Results Of the 256 patients,there were 155 cases with the deficiency of both qi and yin,being 60.55%,significantly higher than the percentage of other syndromes(P0.05);the simple type of retinopathy was mainly the deficiency of both qi and yin,and proliferating type was mainly the blood stasis,compared with the other syndromes,the difference was statistically significant(P0.05);in those with course of disease shorter than 5 years,the deficiency of both qi and yin was the highest in percentage,in those with the course of disease 5 to 10 years,the blood stasis was the highest in percentage,while in those with the course of disease longer than 10 years,qi deficiency of the spleen was the highest in percentage. The fasting blood-glucose(FBG) and postprandial 2h blood glucose(P2hBG) of the patients with deficiency of both qi and yin were significantly lower than those of the patients with other syndromes(P0.01),the glycosylated hemoglobin(HbA1c) of the patients with blood stasis was significantly higher than that of the patients with other syndromes(P0.01),and the triglyceride(TG) of the patients with qi deficiency of the spleen was significantly higher than that of the patients with other syndromes(P0.01).Conclusion Deficiency of both qi and yin and blood stasis are the basic syndromes of retinopathy in the type 2 diabetes.TCM syndromes are correlated with the course of disease,stage of disease,and laboratory indices to a certain degree.

In this article,the professor LI respectively discuss the using of the ten merthods of tocolysis by eliminating disease in Synopsis of Golden Chamber from aspects of his own practical experience,On.ginal text and practical applications.The ten methods are:tonifying and harmonizing both yin and yang and keepping ying and weiqi in balance,eliminating blood stasis and dissolving abdominal mass and regulating qi and blood,warming yang and dispersing cold and warming uterus for tocolysis,moisturizing dryness by nourishing blood and clearing heat and relieving qi stagnation,inducing resuscitation and diuresis,excreting dampness and activating yang,tonifying blood and invigorating the spleen,clearing and dissipating dampness and heat invigorating the spleen for eliminating dampness,warmming the middle warmer for tocolysis.

Objective To observed the effect of Shendi Jiangtang Granule (Granule for reducing glucos), on insulin sensitivity in insulin resistance accompanied hypertension model rats and its mechanism. Methods Six-week-old male Sprague-Dawley rats were di-vided into blank group, model group and Chinese medicine group. The blank group were fed with normal rat chow, and the others were fed with fructose-rich chow (FFR). The Chinese medicine group was given Shendi Jiangtang Granule (3.24g/kg/day). Systolic blood pressure was measured weekly for 6 weeks. Then the euglycemie hyperinsulinemic glucose clamp technique was performed to esti-mate insulin sensitivity (M value). At the end of the glucose clamp, the soleus and extensor digitorum longus (EDL) muscles were dis-sected out for determination of the role of tumor necrosis factor-α(TNF-α) by an ELISA assay. Results Treatment with Shendi Jiangtang Granule significantly improved the M value in FFR rats (P<0.01);and siginificanty lowered TNF-α levels in the skeletal muscles(P<0.01). Conclusion Chinese medicine Shendi Jiangtang Granule may improve insulin resistance, the effect might be re-lated to reducing TNF-α in the skeletal muscles in hypertensive and insulin resistant fructose-fed rats.

Having worked in clinical field for decades of years,professor LI Wen-rui has obtained rich clinical experience in complex diseases,say,ankylosing spondylitis.Aware that the main pathogenesis of ankylosing spondylitis is the combination of deficiency、cold and stasis,he puts forward a rule of treating ankylosing spondylitis,which is invigorating the kidney,dissipating cold and removing stasis.The rule has achieved satisfactory curative effects in clinics and is an enlightenment to the treating method of ankylosing spondylitis.

<正> 研究者将2007年1月～6月66例符合糖尿病周围神经病变诊断标准的门诊患者分为治疗组和对照组(各33例),两组患者均进行严格的饮食控制,口服降糖药控制血糖;同时给予维生素B_1,每次10mg,每日3次口服;维生素B_(12),每次500μg,每日3次口服;弥可保每次500μg,每日3次口服。治疗组在此基础上加用中药脉血康胶囊(主要成分为水蛭)4粒,每日3次餐后口服。连续治疗8周后评定疗效。治疗后结果显示,治疗组总有效率显著高

心动过缓临床常继发于冠心病、窦性心动过缓、病态窦房结综合征(心率缓慢型)等疾病.卫生部北京医院李文瑞老师临证擅于应用麻黄附子细辛汤、四逆加人参汤治疗心动过缓,现举案例3则介绍如下.

李文瑞教授系全国首批老中医药专家学术经验继承工作指导老师,对<伤寒论>有较深入的研究.李师认为,少阴病热化证系热伤肾阴,热邪内郁,致手足两少阴俱受病之阴虚火旺证.症见心中烦、不得卧、口燥、咽痛、舌红、脉细数等.现结合病案将李师经验介绍于下.

李文瑞教授认为少阴病虽主证是寒证,然而在临床也有热证,且并不少见。这是因为少阴之本属阴而标属阳,故既有阴从阳化寒,又可有阳化热,所以少阴病有寒化、热化之别。少阴病热化证系热伤肾阴,热邪内郁,致手足两少阴俱受病之阴虚火旺证。症见心中烦,不得卧,口燥,咽痛,舌红,脉细数等,但临床证型各异。李文瑞教授根据《伤寒论》原文摘录内容,从病因病机、方解应用等方面对少阴病阴虚火旺心烦不得卧之黄连阿胶汤证、阴虚水热互结之猪苓汤证、阴虚热扰之猪肤汤证、少阴客热咽痛之甘草汤证及桔梗汤证、水亏火炎咽中生疮之苦酒汤证、少阴客寒阴盛阳郁咽痛之半夏散及汤证、阳邪郁遏之四逆散证等少阴病热化证进行论述,并附有治验案例。可能对临床在掌握经方的基础上,灵活应用经方有一定启示。

<正>糖尿病性周围神经病变是临床常见的糖尿病慢性并发症之一,由于其发病机制尚未完全阐明,目前仍无疗效确切的治疗药物。近年来,笔者在西医常规治疗的基础上,根据中医理论加用脉血康胶囊治疗本病,取得较好疗效,现总结如下。

李文瑞(1927～),男,黑龙江呼兰县人.卫生部北京医院主任医师、教授、硕士研究生导师.1950年8月毕业于中国医科大学医学系、1964年8月毕业于北京中医学院中医系.

Objective: To study the effects of Shendijiangtang Granula on insulin resistance (IR). Method: High fructoseand rats with hypertension and IR were used,and the mechanisms of plasma leptin was observed. Results: The content of leptin is higher than that of in control group; M value was also improved and it approached to the control. Conclusion: Shendijiangtang Granula has a good effect on IR.

前列腺增生症是老年男性的常见病、多发病,属中医"癃闭"范畴.中医认为,癃闭是由于肾和膀胱气化失司而导致尿量减少,排尿困难,甚则小便闭塞不通为主的病症.

Objective To observe the effects of Tangshenjiaonang (TSJN) on biochemistry, renal function and hemorheology of alloxan and achromycin induced diabetic nephropathy rats. Methods The diabetic nephropathy rats induced by alloxan and achromycin were divided into 5 experimental groups. compared with control group, to observe the changes of the indicators shown about. Results TSJN can significantly decrease the level of SCr, BUN, CCr, FIB, plasma viscosity and UAER (P 0.05 or P 0.01). Conclusion TSJN has significant preventive and therapeutic effects on diabetic nephropathy rats induced by alloxan and achromycin.

Objective To study the characteristics of TCM syndrome manifestations of metabolic syndrome on the base of type 2 diabetes mellitus.Method The retrospective materials of 254 hospitalized cases were chosen from the Department of Chinese Medicine,Beijing Hospital and the TCM syndrome characteristics of metabolic syndrome were discussed from the aspects of sex,age and disease course,taking the world definition of IDF's metabolic syndrome in 2005 as the standard.Result The(manifestations) of syndrome of both qi and yin deficiency and syndrome of blood stasis in meridians had a superiority in the number,but no statistic correlation with metabolic syndrome,while syndrome of dampnessretention due to spleen showed the statistic correlation in male,adult patients with metabolic syndrome in middle stage of disease course.Conclusion The syndrome of both qi and yin deficiency is main syndrome type of metabolic syndrome of type 2 diabetes mellitus.Some syndrome manifestations are related to age,sex and disease course,which indicates that dampness-retention due to spleen insufficiency is one of the main manifestations of metabolic syndrome of type 2 diabetes mellitus.