案例式教学及PBL教学与传统教学相比较,均可以调动学生的积极性和主动性.临床专业的培养目标是要求学生有临床辨证施治的能力,创建基于PBL教学模式的方剂学案例库,可以引导学生自主学习,从而解决实际问题.通过分析方剂学案例库的现状,结合具体案例提出了基于PBL教学模式的方剂学案例库创建方法,为方剂学的教学改革提供参考.

Objective:To explore the research hotspot and development trend of Astragalus and its compound in the treat-ment of nephrotic syndrome.Methods:The Chinese literatures of Astragalus membranaceus and its compound treatment for nephrotic syndrome were retrieved from CNKI,Wanfang Data and VIP.The time range was from January 1,1990 to December 31,2021.The obtained literatures were checked by NoteExpress software and manually screened and excluded.CiteSpace6.1R2 software was used to map the authors and keywords of the literature,and the visualization analysis was carried out.Results:A total of 383 Chinese litera-tures were included,involving 560 relevant authors.The authors were mainly represented by Wang Haiyan,Ye Hong and Kang Guogui.In the keyword analysis,the high-frequency keywords included"primary nephrotic syndrome","Huangqi injection","Fangji Huangqi decoction","clinical observation",etc.Thirteen clusters were obtained in the keyword cluster analysis,and 20 e-mergent words were obtained in the keyword outburst analysis.Conclusion:The number of published papers is on the increase,but the cooperation among authors is scattered.The research hotspots mainly focus on the main types of treatment of nephrotic syndrome,compound therapy and mechanism of action.The future development trend is changing from clinical observation and clinical efficacy to the treatment of nephrotic syndrome based on network pharmacology,data mining and meta-analysis.

目的:观察升阳益胃汤对腹泻型肠易激综合征(IBS-D)大鼠结肠及下丘脑组织中5-羟色胺(5-HT)含量的影响,探讨其作用机制.方法:适应性喂养1周后,除空白组外,将其余50只雄性SPF级SD大鼠采用慢性束缚联合番泻叶灌胃、夹尾刺激构建IBS-D大鼠模型,造模成功后,将其随机分为升阳益胃汤高、中、低剂量组,模型组,阳性药对照组.给药组于造模2周后开始连续灌胃给药14 d,于第28天末次灌胃给药后进行大鼠体质量变化率测量、腹壁撤退反射评分(AWR);酶联免疫吸附法(ELISA)检测各组大鼠结肠、下丘脑组织中5-HT的含量;HE染色观察大鼠结肠组织黏膜病理变化.结果:与模型组比较,升阳益胃汤高、中、低剂量组大鼠体质量增长情况有所好转,AWR评分及结肠、下丘脑组织中5-HT含量显著改善(P<0.05).结论:升阳益胃汤各剂量组可有效改善IBS-D大鼠体质量变化率、AWR评分,降低结肠及下丘脑组织中5-HT的含量,效果呈剂量依赖性,升阳益胃汤治疗IBS-D有可能是通过降低结肠及下丘脑组织中5-HT的含量而实现.

在中医传统文化中深挖课程《方剂学》所蕴含的思政资源,构建教与学互动一体的思政教育实施方案,在课堂授课、学习讨论、课外作业、学习汇报等教学环节中融入渗透思政教育主题.融入课程思政的实验班,在提高学生的学习兴趣,培养学生文化自信,提升学生的职业认同感等方面优于传统对照班,认为中医药自信教育路径在于综合分析思政教育元素,构建教与学互动一体的实施方案,提升教师自身的政治素养与人文素养.

目的:本课题依据升降配伍理论,对升阳益胃汤进行拆方对比各给药组对疲劳模型大鼠功能和血CystatinC和血 β2-微球蛋白(β2-MG)影响,以期初步阐明升阳益胃汤对慢性应激状态下肾功能的调节机制,为临床应用提供科学依据.方法:方法:随机将实验动物为空白对照组,疲劳模型组,升阳益胃全方组(A给药组),升阳益胃去益气健脾组(B给药组),升阳益胃去升降相因组(C给药虚),每组10只,观察各组大鼠一般行为和体重变化,血清BUN和Cr含量、Cystatin C和血 β2-微球蛋白(β2-MG)变化以及肾脏指数和肾脏病理结构改变.结果:研究发现,疲劳模型组大鼠血清BUN含量增高,与空白组比较P<0.01.全方给药组可以降低模型大鼠血清BUN含量.各给药组均可提高模型大鼠血清Cr含量,各给药组均可以降低模型大鼠血Cystatin C和血 β2-微球蛋白(β2-MG)含量.病理学检查发现,模型组和C给药组(全方去升降相因组)肾脏组织有轻微水肿.结论:本研究显示升阳益胃汤对复合应激所致疲劳模型大鼠肾功能改善具有一定的作用,其具体机制有待于进一步研究.

Objective To study and evaluate the effect of student-centered seminar teaching model in the teaching of prescriptions of Chinese materia medica. Methods 99 students majoring in acupuncture and massage in Grade 2016 were divided into experimental group (49 students) and control group (50 students). Semnar teaching mode was used in experimental group and traditional teaching mode was used in control group. The final examination results, students' satisfaction and adjustment were expected. The questionnaire scores were compared and evaluated. Results The final grade of the experimental group was (76.97±16.18), and the passing rate was 100％, which was significantly higher than that of the control group (P ＜ 0.05). In the questionnaire, the satisfaction of the experimental group to teaching was 100％, of which 51.02％ was very satisfactory, and the satisfaction of the experimental group was higher than that of the control group. There were 5 scores in the questionnaire, which were significantly higher than those in the control group (P ＜0.01). Conclusion Semnar teaching mode can improve students' interest in learning and initiative in self-study. It is helpful to improve students' ability of induction and analysis of problems as well as their ability of thinking about clinical symptoms. It shows that seminar teaching mode combined with classical medical records has achieved good teaching effect in the teaching of prescriptions of Chinese materia medica.

ABSTRACT:From the perspective of enlarged health,medicine is not only a science of treating diseases,but also a sci-ence of health. The medical thought of"preventive treatment of disease"put forward by Traditional Chinese Medicine (TCM)2 500 years ago is very close to the concept of health medicine advocated by modern medicine. Based on the theory of"preventive treatment of diseases"of TCM,this paper conducts a metabonomics study on the spleen-deficiency type sub-health state,and puts forward a new idea of systematic and standardized research on the essence of TCM syndrome and the correlation of prescriptions and syndromes in sub-health state by using the metabolomics technology,an important compo-nent of modern frontier system biology.

中医将体质虚弱称体虚,把慢性疾病的虚弱称虚证,并将虚证分为气虚、血虚、阴虚、阳虚4种类型,不同的虚证有不同的食补方式,应对症进补. 气虚:黄芪山药 粥气虚患者多表现为全身乏力、面色苍白、头晕目眩、动则汗出.这种情况下可以来碗黄芪山药粥,取黄芪30克,山药60克,将山药研粉,黄芪水煎取汁300毫升,加入山药粉搅匀煮成粥.每日 1 ～2次服食,可以益气生津,健脾固肾.

Rheumatoid arthritis,one refractory case of autoimmune disease,has owned an extraordinary attention at home and abroad.To have a good understanding of the treatment status of rheumatoid arthritis with traditional Chinese medicine therapy,we reviewed the related studies in recent years and summed up advantages of traditional Chinese medicine therapy applied in rheumatoid arthritis from external treatment,internal treatment and the combined internal-external therapy of TCM so as to offer valuable references for clinical application.

目的 对重度失眠患者行酸枣仁汤加减治疗,观察临床治疗效果.方法 择取本院在2014年7月-2015年11月期间收治的重度失眠患者90例,按照随机抽签法,将患者分为实验组与参照组,每组各45例.对参照组患者行常规治疗,对实验组患者行常规治疗+酸枣仁汤加减治疗.对比两组患者的治疗效果.结果 实验组患者的总治疗有效率为95.56％,参照组患者的总治疗有效率为77.78％,组间比较差异显著,组间比较差异显著,即P＜0.05,本次实验存在统计学意义.结论 对重度失眠患者行酸枣仁汤加减治疗,可以有效改善患者的睡眠状态,强化临床治疗效果,提高患者的生活质量,应用价值显著,值得广泛应用及推广.

目的:在前期研究的基础上,选用附子的经典配伍药对(附子配伍干姜、附子配伍白芍)研究其对SD正常大鼠和阳虚模型大鼠心脏毒性作用的差异,以期为中医辨证毒理学假说提供一定的理论支持.方法:64只大鼠随机分为8组,空白对照组(A组),阳虚模型组(B组),附子给药组(C组),附子模型给药组(D组),附子芍药给药组(E组),附子芍药模型给药组(F组),附子干姜给药组(G组),附子干姜模型给药组(H组)每组8只,观察用药前后各组大鼠一般状态、体重、心脏系数及相关生化指标、病理学改变的影响,比较各组之间大鼠毒性反应的不同.结果:正常大鼠肌注醋酸泼尼松后均出现心脏毒性反应,造模成功.阳虚模型大鼠给药后附子给药组、附子干姜给药组毒性反应降低,且附子干姜配伍优于附子单独给药;附子白芍给药组LDH、CK含量仍高于空白对照组.结论:不同证候的动物模型附子的毒性反应存在差异,附子药物的毒性与证候以及配伍密切相关.

Objective:To investigate the change of cellular immune function of sub-health state rats with spleen qi deficien-cy. Methods:Rat models were prepared by the method of multi factors intervention(swimming in pool which water temper-ature was at room temperature combined dietary restriction and clampping tail). Rats were randomly divided into sub-health state 1、2、3 group which were respectively given multi factors intervention for 1、2、3 weeks ,then appearance char-acteristics of rats were observed,spleen index and thymus index were calculated,and expressions of T lymphocyte and its subsets were detected using immunofluorescence flow cytometry. Results:Compared with normal group,index of spleen and thymus of rats,expressions of CD+4、CD45RA+and CD45RA+/CD45RO+were decreased (P<0.05),expressions of CD+4CD45RO+、CD8+、CD8+CD45RO+、CD45RO+were increased(P<0.05) in sub-health state groups. Conclusion:The changes of number and ra-tio of T lymphocyte and its subsets could participate the process of physiological changes of sub-health state rats with spleen qi deficiency.

逍遥散始载于宋代《太平惠民和剂局方》,具有调和肝脾,疏肝解郁,养血健脾之功效,主要用于治疗肝郁脾虚证型的各类疾病.本文整理了部分贾跃进老中医对逍遥散的临床应用,包括:眩晕、郁证、心悸和失眠.贾跃进老中医通过对逍遥散的剂量改变和临床随症加减用药治疗各种内科疑难病症,凸显出从肝论治疾病的治学思想,取得了良好的治疗效果.

Objective:To find pathogenesis of chronic fatigue syndrome and provide effective treatment through construct-ing spleen-deficiency type sub-health state of chronic fatigue rat model. Methods:The rat model was constructed by eat-ing disorders,fatigue,mood disorders complex factors and evaluated through the general state,gastrointestinal function and immunological changes of the rats. Results:Performances of weight loss,decreased activity,eating less,irritable-emotion, loose stool,were in accordance with clinical manifestations of chronic fatigue syndrome. Compared with normal group,D-xylose excretory rate was decreased,the contents of MTL and VIP were first increased and then decreased,contents of DA and 5-HT were first decreased and then increased in model group. Conclusion:The performances of gastrointestinal dys-function of rat model accord with the clinical features of chronic fatigue,and nerves immunology change may be one of the mechanism of chronic fatigue.

目的:研究炮附子配伍芍药对阳虚模型大鼠血清LDH及CK作用的影响,旨在研究“相制相成”配伍药对——芍药对炮附子的减毒作用.方法:将实验大鼠分为4组,空白对照组(A组),阳虚模型组(B组),附子给药组(C组),附子芍药给药组(D组),每组10只.观察炮附子及芍药配伍后对阳虚模型大鼠体重、心脏指数、血清LDH及CK的影响.结果:附子对阳虚模型大鼠的心血管系统的毒性最小,芍药与附子配伍后对阳虚模型大鼠的减毒作用并不显著.结论:对附子芍药减毒配伍作用机理有待进一步研究.

姜坤教授认为对于围绝经期综合征的治疗要以调冲任为本，而调冲任又当调脏腑、和气血，其中尤须注重肝、脾、肾三脏。肝、脾、肾三脏功能调和，则气血自滋，冲任自调，诸病不起。姜教授以中医药为主，辅助心理疗法治疗围绝经期综合征，取得了确切的疗效。

从提高方剂学教学质量出发,阐发了方剂学教学中存在的问题,依据方药内涵及相关性、方剂的临床属性、中医教育的根本目标等,提出了方剂学回归临床的教学改革设想.

Objective: To clear the main diseases of Shengyang Yiwei decoction spectrum and clinical indications,will provide the basis for the next step of the animal experiment model,and provide the theoretical basis for guiding clinical.Method: Mining by using the method of documentary information,statistics and analysis the clinical literature and medical literature published from 2012 September to various domestic medicine periodicals.Result: The method of collection,screening and treatment are of Shengyang Yiwei decoction clinical literature of 96 references,including the number of cases in 909 cases,the types of diseases in digestive system disease,a total of 313 cases,accounting for 34.4%.The main clinical syndrome differentiation and indications for use of core indications: loose stool,eating less poor appetite,lassitude;the main indications: frequent urination,lusterless complexion,limb discomfort;the tongue: tongue pale moss white or fat have teeth marks;the pulse: pulse or ru.The use of modified drugs mainly compatibility,astringent,tonic,Qi dampness Xiaoshi drugs.

Objective: To investigate the clinical effect of Chaiqing Analgesics in treating hyperplastic disease of breast.Methods: 128 cases of hyperplastic disease of breast were randomly divided into treatment group of 66 patients and the control group of 62 patients.Results: after 3 courses of treatment,the efficacy was compared.The total efficacy is higher for treatment group than the control group(P0.01).After treatment,the serum PRL and E2 levels of two groups were shown different degrees of decline(P0.05),but PRL,E2 reduced more for treatment group than the control group(P0.01).Conclusion: Hyperplastic disease of breast treatment,starting from liver,promoting liver qi,and using analgesic method,is significantly effective.

目的:通过研究当归补血汤与大黄虫丸对D-半乳糖致衰小鼠血清SOD和MDA的影响,初步探讨其延缓衰老的作用,进一步探讨益气活血法在延缓衰老中的作用机理。方法:昆明种六月龄小鼠50只,随机分成模型组、正常组、VE胶丸组、当归补血汤及大黄虫丸组。以D-半乳糖致衰小鼠模型,检测各组小鼠血清超氧化物歧化酶（SOD）活性和丙二醛（MDA）含量。结果:与模型组比较,大黄虫丸组及当归补血汤组小鼠血清SOD含量显著升高（P＜0.05）,血清MDA含量显著降低（P＜0.05）。结论:大黄虫丸及当归补血汤可能通过清除衰老机体产生的过多自由基,提高抗脂质过氧化过程而达到延缓衰老的作用。