Professor WANG Wanchun has accumulated rich experience in the treatment of male diseases for many years and put forward that male diseases were mainly caused by the spleen and kidney disorder. He proposes that "spleen deficiency is common among the youth while kidney deficiency is usually seen among the elderly", and "the spleen and kidney influence each other; kidney essence can be nourished by tonifying the spleen; the spleen qi is nourished by tonifying the kidney". Since the spleen is the foundation of acquired constitution while the kidney is the foundation of congenital constitution, male diseases are mostly caused by the insufficiency of the congenital constitution and acquired malnutrition. So, they are treated mainly by regulating the spleen and kidney, combined with soothing the liver and regulating qi. In the case of yang deficiency in the spleen and kidney, Tusizi（Semen Cuscutae）, Gouqizi（Fructus Lycii）, Shanzhuyu（Fructus Corni） etc. are used to warm and tonify the spleen and kidney and assist yang to dissipate qi. In the case of qi deficiency of spleen and kidney, Shanyao（Rhizoma Dioscoreae）,Renshen（Radix et Rhizoma Ginseng）, Yinyanghuo（Herba Epimedii） etc. are given to supplement the spleen and kidney as well as tonify qi and blood. When it is complicated with dampness, Fuling（Poria） and Baizhu（Rhizoma Atractylodis Macrocephalae） are administered to dry dampness and promote urination. When it is complicated with blood stasis, Mudanpi（Cortex Moutan） and Danggui（Radix Angelicae Sinensis） were given to circulate blood and dissolve stasis. The curative effect is remarkable. Thus, we share 4 medical records of treating male diseases from the perspective of spleen and kidney here.

Objective:To observe the effect of 717 Antidote Mixture on the levels of NO,MDA and SH in myocardium in rats bitten by Agkistrodon. Methods:A total of 50 8-week-old SPF SD rats,half male and half,were randomly divided into normal control group,model control group,717 Antidote Mixture low-dose group（0.6 mL/100 g）,717 Antidote Mixture medium-dose group（1.2 mL/100 g）,717 Antidote Mixture high-dose group（2.4 mL/100 g）. Except for the normal control group,the remaining rats were injected into the left hind limb with a dose of2.5 μg/g adder venene subcutaneously to establish the model. At 2 hours after successful model establishment,the administration was started and continued for 3 days. At 12 hours after the last administration,the rat heart was taken to prepare 10% myocardial tissue homogenate,the supernatant was extracted after centrifugation and the myocardial MDA level,myocardial TSH level,myocardial NPSH level,myocardial PSH level and myocardial NO level were measured. Results:Compared with the normal control group,the myocardial MDA level and NO level of the model control group showed a significantly increased state（P ＜ 0.05）,while the myocardial TSH,NPSH and PSH levels showed a decreased state（P ＜ 0.05）;the levels of myocardial MDA and NO of rats in the traditional Chinese medicine treatment group were significantly down-regulated（P ＜ 0.05）,and the levels of myocardial TSH and NPSH were also significantly up-regulated（P ＜ 0.05）and showed a dose-dependent trend. The higher the concentration of administration,the degree of improvement of myocardial injury was better. Conclusion:717 Antidote Mixture has a certain amelioration and protection effect on myocardial damage induced by Agkistrodon venom. It can improve the levels of myocardial MDA,NO,NPSH and TSH,which is worthy of further study.

目的 探讨中医正骨联合施罗斯体操治疗特发性脊柱侧弯的效果,为临床提供参考.方法 选取2020年12月至2023年1月江西中医药大学附属医院收治的60例青少年特发性脊柱侧弯患者为研究对象,按照随机数字表法分为观察组和对照组,各30例.观察组患者给予中医正骨(顶椎及远离中线部分椎体)矫正联合施罗斯体操治疗,对照组患者仅给予施罗斯体操治疗.比较两组患者治疗前后视觉模拟量表(VAS)疼痛评分、脊柱旋转角度(ATR)及头侧端椎上缘的垂线与尾侧端椎下缘垂线的交角(Cobb角).结果 治疗后,两组患者VAS疼痛评分较治疗前降低(P<0.05),但组间比较,差异无统计学意义(P>0.05).治疗后,两组患者ATR较治疗前减小,且观察组小于对照组(P<0.05).治疗后,两组患者Cobb角小于治疗前,且观察组小于对照组(P<0.05).结论 施罗斯体操治疗与中医正骨联合施罗斯体操治疗在脊柱侧弯腰背区疼痛中均有疗效,且中医正骨联合施罗斯体操治疗对于改善患者ATR和Cobb角的效果更好,建议临床对此类患者采用联合疗法治疗.

目的 研究解毒活血汤调节肠道菌群对慢性前列腺炎作用机制.方法 采用去势手术+雌激素皮下注射30天建立慢性前列腺炎大鼠模型.36只SPF级雄性SD大鼠随机分为空白组(生理盐水,2ml·kg-1)、模型组(生理盐水,2ml·kg-1)、前列康片组(2ml·kg-1)和解毒活血汤低(2ml·kg-1)、中(4ml·kg-1)、高剂量组(8ml·kg-1),每组6只,连续给药28天.造模及给药前后每组取3只大鼠新鲜粪便运用16SrRNA测序法检测大鼠肠道菌群丰度;苏木素-伊红染色观察各组大鼠前列腺组织病理炎症反应;RT-PCR方法检测大鼠前列腺组织中INF-γ、TNF-α、IL-1β、IL-2、IL-6表达情况.结果 病理结果显示模型组大鼠前列腺组织间质增生及炎性细胞浸润明显,而解毒活血汤组大鼠前列腺组织间质增生减轻、炎症细胞浸润减少.RT-PCR结果示前列康片与解毒活血汤能降低大鼠前列腺组织中INF-γ、TNF-α、IL-1β、IL-2、IL-6等细胞因子表达水平.16S rRNA结果显示,较模型组对比,解毒活血汤能上调菌群丰度,降低物种多样性,提高大鼠肠道拟杆菌门、纲以及普氏菌属的丰度,改善肠道菌群结构.结论 解毒活血汤能通过调控慢性前列腺炎模型大鼠肠道菌群P/B比例,调节肠道菌群组成,降低INF-γ、TNF-α、IL-1β、IL-6等细胞的表达,减轻大鼠前列腺组织炎症反应.

目的 探讨多学科综合教学法(MDT)联合案例教学法(CBL)在研究生规范化培训中医外科外治法教学中的应用效果.方法 随机把临床专硕型80名研究生分为观察组和对照组,每组40名,观察组采用MDT联合CBL教学,对照组采用传统教学法(LBL).规范化培训结束后,分别对2组进行临床技能考核和中医外科外治法考核,并让研究生填写调查问卷,最终以考核成绩和教学满意度作为评估教学效果的指标.结果 观察组基础理论知识、思维判断能力、实践操作、合作能力及知识面拓宽程度评分明显优于对照组(P<0.05);观察组四诊、体格检查、辅助检查、临床诊断、病例分析成绩明显优于对照组(P<0.05);观察组中医外科外治法考核成绩优于对照组(P<0.05).结论 与LBL相比,将MDT联合CBL的教学模式运用于中医外科外治法的教学中,能够加深规范化培训研究生对知识的理解,提升教学质量,提高研究生的综合素质,有利于培养团队协作精神.

Background: Chronic non-bacterial prostatitis (CNBP) accounts for more than 90 % of clinical prostatitis cases, and there is no specific and effective treatment for CNBP. The regulatory role of Jiedu Huoxue decoction (JDHXD)in CNBP remains unclear. We investigated if JDHXD could improve CNBP Methods: The animal model of CNBP was established by carrageenan injection with 1 % carrageenan (50 mu L). The prostate index, epithelial thickness, lumen area, and pain response time were investigated. The apoptosis levels were measured with TUNEL staining and flow cytometry, respectively. Inflammatory factors in the serum were measured with ELISA method. Results: Treatment with JDHXD significantly improve prostate tissues injury in CNBP rats. Some parameters, such as prostate index, and pain response time, reflecting the prostate function were improved by JDHXD. Inhibition of apoptosis, reactive oxygen species (ROS), and inflammatory response were achieved by JDHXD in vivo. JDHXD markedly suppressed the TGF-ss/SMAD signaling pathway, and activation of TGF-ss/SMAD signaling pathway could reverse the improvement of CNBP injury by JDHXD. The anti-inflammatory, anti-oxidative and anti-apoptotic effects of JDHXD were proved. Conclusion: JDHXD might improve CNBP injury through suppressing inflammation response, ROS, and apoptosis by targeting TGF-ss/SMAD signaling pathway. This research might provide a new thought for the prevention and treatment of CNBP through inhibiting TGF-ss/SMAD signaling pathway.

王万春教授根据多年临床经验发现,现代男科病不再以体虚为主,而多责之于湿、瘀病邪,故治疗上常从湿、瘀论治,并提出"男子多湿、瘀""湿瘀不分离,治瘀则湿自除,治湿则瘀易化".对于湿重而瘀轻者,药常用茯苓、泽泻、当归、丹参等渗湿活血;瘀重而湿轻者,药常用川芎、桃仁、粉萆薢、虎杖等活血利湿;而对于久病难愈,湿瘀并重者,药常用地龙、全蝎、黄柏、白术等燥湿逐瘀.同时配合补肾、健脾、疏肝等方法共同治疗,临床疗效显著.兹录其从湿、瘀论治男科病医案4则,以飨同道.

Abstract Background: Jiedu Huoxue decoction (JDHXD) can be effectively alleviated chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients’ pelvic pain, lower urinary tract symptoms, and other discomforts. But its mechanism of action involving multi-component, multi-target and multi-pathway is unclear. Objectives: Integrated strategy of network pharmacological prediction, molecular docking, and experimental validation elucidate potential mechanism of JDHXD in treating CP/CPPS.Study design and methods: Two traditional Chinese medicine systems pharmacology databases and three disease related databases were applied to identify the herbs active components and the putative targets of CP/CPPS. Using the Cytoscape to constructed and analysis the herbs-compounds-targets network. Subsequently, the protein-protein interaction (PPI) was investigated by STRING database. Using DAVID databases to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The binding of core active compounds with hub targets were assessed by molecular docking. Furthermore, in vivo efficacy of JDHXD was validated in CP/CPPS rat model. The key signal pathway of network pharmacological prediction would be validated by animal experiment.Result: In total, 149 active compounds of 10 Chinese herbals and 909 potential CP/CPPS-related targets were identified. Network pharmacology revealed 161 common targets between 136 potential active compounds and CP/CPPS. After topology analysis, 5 core active compounds and 18 hub targets have been screened. PPI analysis obtained 18 hub targets. Based on enrichment analysis of 161 targets, we obtained GO function 277 items and KEGG pathway 114 items. Molecular docking verification shown that the top 5 hub targets were well binding with 5 core active compounds. Animal experiment shown that JDHXD had protective effect on CP/CPPS. JDHXD can significantly down-regulated the key gene expression (JNK, ERK1/2 and P38) and inhibit phosphorylation of ERK1/2，JNK and P38 in the MAPK signaling pathway.Conclusions: This study demonstrated potential mechanism of JDHXD in treating CP/CPPS. Network pharmacological, molecular docking and experimental verification revealed its multi-component, multi-target and multi-pathway treatment characteristics. The reliability and effectiveness of those method are very helpful to explore the material basis and mechanism of traditional Chinese medicine.

Objectives. Psoriasis is a skin disease thought to be related to immune system dysfunction. Our study is aimed at analyzing the prevalence of psoriasis in China in multiple different categories and compared the prevalence at the global level, in order to bring insights to policymakers for treating this disease. Methods. We analyzed psoriasis trends from 1990 to 2019 in China as well as around the globe with data from the Global Burden of Disease 2019 study. Multiple metrics such as age-standardized prevalence rates, percent change in age-standardized prevalence rates, disability-adjusted life years (DALYs), and age and sex patterns were included. We also predicted the trends of psoriasis prevalence and DALYs in the following 30 years. Results. In China, the age-specific prevalence cases showed a right shift in 2019 compared to 1990 with a peak between the ages of 50 and 54 years and an obvious surpass in males between 40 and 69. Though China still had the largest number of psoriasis cases in 2019, the increase rate was below global level. A positive linear relationship between psoriasis prevalence and comorbidities was seen with rheumatoid arthritis, diabetes mellitus, multiple sclerosis, nonrheumatic valvular heart disease, cardiomyopathy and myocarditis, nonmelanoma skin cancer, non-Hodgkin lymphoma, and multiple myeloma in China within the male group in 2019. Discussion. The burden of psoriasis, as measured by the absolute number of DALYs, continues to increase around the world. The scarcity of modifiable risks for most psoriasis burdens suggests that new knowledge is needed to develop effective prevention and treatment strategies.

丹毒是一种累及真皮浅层淋巴管的感染性疾病,西医称之为急性淋巴管炎.此病通常是由β型溶血性链球菌感染所致,可引起局部皮肤红肿、疼痛、破溃,好发于颜面部及下肢.目前西医主要是采用青霉素等抗生素治疗下肢丹毒.中医针刺疗法治疗下肢丹毒具有操作简便、疗效确切、安全性高等优势.本文就针刺治疗下肢丹毒的研究进展进行总结,以期为临床上治疗本病提供参考依据.

目的:对复方卡力孜然酊联合NB-UVB治疗白癜风的疗效和安全性进行系统评价.方法:计算机检索中国知网、万方学术论文数据库、维普期刊文献数据库、中国生物医学文献数据、PubMed、EMBASE、Cochrane等关于复方卡力孜然酊联合NB-UVB治疗白癜风的临床随机对照试验.根据纳入排除标准选择文献,数据由两名研究者按Cochrane系统评价手册的要求单独提取,并交叉核对.采用RevMan 5.3软件对终纳入文献的有效率进行Meta分析.结果:最终纳入28个试验,共2569例患者.复方卡力孜然酊联合NB-UVB治疗白癜风的有效率与NB-UVB比较,RR=1.63,95％CI(1.50,1.77),与复方卡力孜然酊比较,RR=1.69,95％CI(1.49,1.91);不良反应发生率与NB-UVB比较,RR=1.42,95％CI(1.12,1.79),与复方卡力孜然酊比较,RR=1.88,95％CI(1.24,2.84).结论:复方卡力孜然酊和NB-UVB联合使用治疗白癜风疗效较单独使用更好,但同时其不良反应也相对增多.

negative pressure wound therapy (NPWT) for the treatment of local complications after snakebite.

目的 观察中药复方精油联合中药热奄包外用治疗带状疱疹后遗神经痛(PHN)气滞血瘀证的临床疗效及安全性.方法 将60例PHN气滞血瘀证患者随机分为对照组和治疗组各30例.治疗组予中药复方精油按摩局部疼痛部位联合中药热奄包外敷,每日1次;对照组予口服加巴喷丁胶囊,同时外涂复方利多卡因乳膏.两组患者均治疗28天.比较两组患者治疗前后疼痛视觉模拟(VAS)评分并判定临床疗效,比较两组总有效患者治疗前后生存质量(QOL)评分、疼痛消退时间,治疗前后及治疗过程中进行安全性观察.结果 治疗组临床疗效总有效率(93.33％,28例/30例)高于对照组(86.67％,26例/30例),两组比较差异具有统计学意义(P＜0.05).治疗后两组患者VAS评分均较本组治疗前下降,且治疗组较对照组下降程度更明显(P＜0.01).治疗后两组总有效患者QOL评分均较治疗前明显提高,且治疗组高于对照组(P＜0.01).治疗组总有效患者疼痛消退时间平均为(15.00±3.23)天,对照组为(21.80±4.39)天,两组疼痛消退时间比较差异有统计学意义(P＜0.01).两组患者均无明显不良反应.结论 中药复方精油联合中药热奄包外用治疗PHN气滞血瘀证安全有效,可明显缩短病程,缓解疼痛,提高患者生活质量.

Background: Chronic abacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) accounts for 90% of clinical prostatitis, and there is no specific and effective treatment for it. Jiedu Huoxue decoction (JDHXD) has been believed to be an effective agent for CP/CPPS, but the specific mechanism remains unclear. Methods: Carrageenan and LPS were used to established the animal and cell models of CP/CPPS, respectively. The prostate index, urine volume, lumen area, epithelial thickness, and pain response time were investigated. TUNEL staining and flow cytometry were applied to measure apoptosis levels in vivo and in vitro. Results: JDHXD improved CP/CPPS recovery in a dose-dependent manner. JDHXD restrained apoptosis and activated Wnt/GSK-3β/β-catenin signaling pathway in the CP/CPPS animal model. Inhibition of Wnt/GSK-3β/β-catenin signaling pathway remarkably aggravated apoptosis and suppressed the improvement of CP/CPPS by JDHXD. XAX939 markedly reversed the suppression of cell apoptosis and ROS level caused by JDHXD in vitro. Conclusion: Jiedu Huoxue decoction improved CP/CPPS through activating Wnt/GSKβ/β-catenin signaling pathway and inhibiting apoptosis. This study might provide a novel insight for the prevention and treatment of CP/CPPS through activating Wnt/GSK-3β/β-catenin signaling pathway.

目的:基于数据挖掘技术分析国家级名老中医刘巧教授治疗痤疮的诊治规律.方法:通过跟师学习,收集刘巧教授诊治痤疮的门诊病例,运用Microsoft Excel软件建立数据库,采用中医传承计算平台3.0深入挖掘刘巧教授治疗痤疮病例中的信息.结果:涉及100份病例中,女性患者占70％,男性患者占30％,证型以冲任不调(37例)、脾胃湿热(33例)、肺经风热(28例)为主,100个原始处方中得出核心药物59味,以清热类,归肺、脾、肾、肝经,寒性,苦、甘味药为主.结论:刘巧教授在多年诊疗痤疮的经验中提出"时空辨证观",认为临床上可根据痤疮患者发病年龄以及皮损部位临证用药.

目的 观察穴位贴敷联合中药灌肠治疗Ⅲ型前列腺炎的临床疗效.方法 选取2018年7月—2020年4月就诊于江西中医药大学附属医院男科门诊及住院部的96例Ⅲ型前列腺炎患者,随机分为观察组和对照组,各48例.对照组予以盐酸坦索罗率缓释胶囊联合琥珀酸索利那新片口服,观察组在对照组的基础上予穴位敷贴联合中药灌肠干预,观察8周.比较2组的临床治疗效果、美国国立卫生研究院慢性前列腺炎症状指数(National institutes of health chronic prostatitis symptom index,NIH-CPSI)积分、中医证候积分及前列腺按摩液镜检情况.结果 观察组的治疗总有效率为93.75％(45/48),高于对照组的79.17％(38/48),差异有统计学意义(P＜0.05);观察组治疗后的排尿情况、疼痛、生活质量评分及总评分低于对照组,差异有统计学意义(P＜0.05);观察组治疗后尿路症状、放射痛症状、性功能障碍、全身症状的中医证候积分及总分低于对照组,差异有统计学意义(P＜0.05);观察组治疗后的白细胞计数低于对照组,卵磷脂小体高于对照组,差异有统计学意义(P＜ 0.001).结论 穴位贴敷联合中药灌肠治疗Ⅲ型前列腺炎疗效佳,能缓解患者的症状,值得临床推广.

Background:Migraine is a clinically high incidence rate of neurovascular disease. It is a recurrent headache. It is characterized by nausea, vomiting, fear of voice, and photophobia. Nowadays, a large number of randomized controlled clinical studies have shown that Chinese patent medicine has the advantages of good curative effect and high safety in the treatment of migraine. However, due to the variety of proprietary Chinese medicines, their relative effectiveness and safety have not yet been verified. Therefore, this study will use the network meta-analysis method to verify the effectiveness and safety of different kinds of Chinese patent medicines in the treatment of migraine. Methods: All randomized controlled trials of Toutongning capsule, Yangxue Qingnao granule, naoxintong capsules, Tianmagouteng granules in the treatment of migraine were searched from PubMed, Cochrane Library, web of science, EMBASE, sinomed, CNKI, Wanfang database, VIP. The retrieval time is from the establishment of the database to November 18, 2020. In order to avoid omission, we will manually retrieve relevant references and conference papers. According to the inclusion and exclusion criteria, we evaluated the quality and risk of all the retrieved literatures. Methodological quality assessment and bias risk will be assessed using the Cochrane bias risk tool. Revman 5.3, WinBUGS 1.4.3, and stata14.2 software will be used for all data analysis. Results:This study will directly or indirectly compare the effectiveness of different interventions onmigraine outcome indicators, and rank the effectiveness. The main outcome measures included total effective rate (total effective rate= rocovery+obvious effective+ effective/total number of cases 100%), visual analogue scale (VAS) score, and secondary outcome indicators included analgesic effect evaluation index and quality of life scale. Conclusion: To provide evidence for evidence-based medicine and clinical researchers to choose more effective Chinese patent medicines to treat migraine. Abbreviations: RCTs = randomized controlled trials, TCM = traditional Chinese medicine, VAS = visual analogue scale.

雄激素源性脱发是临床上常见的慢性难治性疾病,近几年本病发病率呈上升趋势,且趋于年轻化,该病对美观的影响会造成一部分患者心理负担,甚至导致心理疾患.中医治疗本病历史悠久,其内、外治方法 具有浓厚的传统中医特色,并能取得良好的临床疗效,该文章总结近几年相关研究,分别从其病因病机和治疗等2个方面进行分析,认为中医治疗本病有明显疗效.

Background: Diabetic foot (DF) is one of the most common and serious chronic complications of diabetes. At present, there are many dressings used in the treatment of the diabetic foot. Among them, silver dressings are widely used, but the conclusion has not yet been formed. The purpose of this study is to search for relevant studies on the treatment of DF with silver dressings through evidence-based medicine methods and to draw conclusions with higher levels of evidence to provide a basis for the clinical treatment of DF. Methods: Computer search of databases such as CNKI, SinoMed, VIP, Wanfang, PubMed, Embase, and Cochrane Library. The search time is from the establishment of the database to January 23, 2021. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The meta-analysis will be completed by RevMan 5.3 software. Results: This systematic review will provide an assessment of the current state of DF, aiming to assess the efficacy of silver dressings for patients with DF. Conclusion: This systematic review will provide a credible evidence-based for the clinical treatment of DF with silver dressings.