Objective:To revaluate the systematic reviews/meta-analysis of the literature on acupuncture in the treatment of stroke spastic hemiplegia.Methods:CNKI, Wangfang, VIP, CBM, Cochrane Library, PubMed and Embase were searched for systematic reviews/meta-analyses of acupuncture in the treatment of stroke spastic hemiplegia from the establishment of the databases to July 27, 2022. AMSTAR 2 Scale, Prisma statement (2020) and GRADE system were used to evaluate the quality of the collected literature.Results:A total of 5 systematic reviews/meta-analyses were included, all of which were rated as very low by AMSTAR 2. The 5 studies involved a total of 22 outcome measures, and the GRADE rating results were intermediate evidence in 5, low evidence in 8, and very low evidence in 9.Conclusions:Acupuncture therapy has certain therapeutic effects on reducing the degree of limb spasms and improving limb motor function in patients. However, the methodological quality of the included literature is poor, and there is limited high-level evidence to support conclusions. More high-quality experimental research is still needed to provide strong evidence-based medicine evidence.

本文通过对比叶天士与唐容川论治吐血的经验以探析其异同点.叶天士与唐容川皆认为火热邪气为致病的首要因素,治疗上都以中焦脾胃为论治重点,且两人都继承了缪希雍降气止血的思想.叶天士注重季节对发病的影响,认为春夏阳气升动太过与秋冬阳气闭藏不及皆会导致吐血发病,并在治疗上引入络病理论,分别运用辛润通络法、降气通络法、化瘀通络法使络脉通畅,达到不止血而血止的目的.且叶天士好用经方,化桂枝汤为止血良剂,师古而不泥古.唐容川则注重消瘀,认为瘀血与新血相互影响,提出祛瘀的同时要补充新血,且从三焦分治瘀血,并在消瘀法、止血法中分别论述了胃、脾、肾冲气上逆的调治方法.通过探析二者治疗吐血的异同点,以期对血证学说理解更加透彻,从而对临床上治疗吐血有所启发.

目的:通过搜集医案,分析清代医家治疗不寐的用药规律.方法:将《中华医典》收集的医案方剂导入古今医案云平台(V2.3.5),借助其数据挖掘功能分析药物使用频次,四气五味、功效归经分布,药物的关联及聚类规则.结果:共收集到符合条件的处方316个,共计363个药物,使用频次3 303次,药物频次≥30次的药味有27个,排名前5位的高频药物依次为酸枣仁、茯神、半夏、茯苓、首乌藤.四气分布以平为主,五味以甘、苦、辛为主.药物功效主要集中于宁心,其次为养血安神、清热凉血.归经以肺、心、脾经为主.排名前3位关联药物组合位"首乌藤,茯神"、"茯神,酸枣仁"、"酸枣仁、龙眼肉".对频次前20位的药味进行聚类分析,得到5个核心药物组合.结论:清代医家治疗不寐以滋阴宁心安神为本,兼顾清热、化痰、理气,标本同治.

缺血性脑卒中,俗称脑梗死,是血管闭塞导致机体局部缺血引起的病变.约20％～30％的脑梗死患者合并认知功能障碍,脑梗死后认知功能障碍(PSCI)患者的生活质量及生存时间受到严重影响,需及时治疗.目前,PSCI的发病机制尚未完全明确,其与大脑认知功能神经环路、神经递质分泌紊乱、炎症因子与氧自由基受损等相关.PSCI危险因素有高血压、高血脂、高血糖、心房颤动、吸烟等.中医治疗PSCI有独特优势,包括中药汤剂、综合康复治疗、针灸等治疗方法,可提高治疗总有效率,缩短患者的住院时间,修复认知功能,提升患者满意度和生活质量,对PSCI患者的康复具有重要意义.

目的 通过描述性统计分析、关联规则算法和聚类分析等方法挖掘叶天士治疗痰饮病的临证用药规律,为临床辨证论治提供新思路.方法 搜集整理叶天士所著《临证指南医案》中治疗痰饮病全部医案,采用IBM SPSS 23.0软件对其处方用药进行描述性统计分析,并对高频药物进行关联规则算法和聚类分析.结果 纳入69个医案,涉及75味药物(剔除炒川椒、鱼胶、青盐),共用药566频次.高频药物有茯苓、桂枝、半夏、生姜、大枣,用药重在燥湿健脾、益气化痰、利水渗湿.挖掘得到关联规则药物组合18组.聚类药物组合6组.结论 叶氏临证辨治痰饮病尤重肺、脾、心、肾,多以温药平补脏腑之阳气以消痰化饮,利水渗湿药以祛痰消饮,急则治标,祛壅滞之痰饮,缓则治本,温补脾肾之阳气,标本兼施,则痰饮自愈.

现代青春期女性多因生活失调、饮食不节,工作压力增大等原因,月经失调的发病率越来越高,主要表现为月经周期和月经量的异常,笔者的研究生导师方铁根教授在临床上治疗青春期女性月经不调之证,多从调理三焦气化功能入手,内外合治,针药并用,收效甚好,笔者将就导师在这方面的临床经验进行一定的总结,并结合前期在理论方面的探讨和实际案例,进一步分析和探讨.

为了贯彻中共中央、国务院“关于卫生服务体系,使社区居民都能够拥有自己的全科医师,教育行政部门要支持和指导卫生行政部门建立以毕业后医学教育为核心的全科医学教育体系”的精神,本课题在前期调研的基础上,围绕如何在高等中医药院校进一步深化医学教学改革,强化在校临床医学专业本科生社区卫生服务意识教育的同时,如何从中医全科人才的培养模式上寻求突破,为社区卫生服务机构培养实用型社区基层医疗人才进行了相关探索.

目的:从社区医院运动功能失常患者及康复科工作人员两个方面对运动功能失常患者的现状进行调查,了解目前武汉社区医院康复医疗管理措施的现状,也是运动功能障碍患者目前康复治疗干预的现状,并通过此研究能够为社区康复医师今后的发展和规范化建设提供科学的数据.方法:把武昌区、汉口区2个区作为研究地点,选取了其中的5个社区,进行问卷调查并对问卷调查统计分析.结果:社区医院运动功能失常患者多以老年人为主,对社区医院满意程度高.社区医院康复机构有较全面的康复医疗体系,以中医康复为主,康复工作人员认为社区医院人力、技术、财政、管理都需要改善,社区医院为理想康复模式.结论:社区医院仍有许多方面需要加强,本资料将为运动功能失常患者在社区的康复治疗现状提供依据,从而建立健全医疗服务体系.

Objective:To investigate the method and mechanism of "Sanjiao acupuncture method" combined with Shugan Bushen Method for the treatment of adolescent polycystic ovary syndrome.Methods:The implementation method of "Sanjiao acupuncture method" combined with Chinese medicine therapy for patients with liver Qi and kidney,through.the observation of basal body temperature,menstrual status indicators such as clinical evaluation.Conclusion:The symptoms of adolescent polycystic ovary syndrome alleviated or disappeared before treatment.Using "Sanjiao acupuncture method" combined with Chinese medicine Shugan Bushen Method has significant effect in the treatment of adolescent polycystic ovary syndrome.

目的 观察天麻葛根定眩汤治疗眩晕的的疗效.方法 通过对眩晕病因病机的探讨,明确其致病的原因,结合魏发善教授的临床治疗验案,将用天麻葛根定眩汤治疗的病例加以收集、总结,观察其治疗效果.结果 运用天麻葛根定眩汤加减治疗眩晕病例中,疗效明显,眩晕的症状明显缓解.结论 天麻葛根定眩汤作为基本方对于治疗各种类型眩晕的病证具有良好的效果,可供临床医学者加减运用.

颈椎病是由于各种原因引起的颈椎椎体、椎间盘变性或周围软组织的退行性改变，导致脊柱内、外平衡失调，压迫和刺激周围的神经、血管、脊髓，产生一系列临床表现的症候群。该病多发于中老年人，但近年来随着工作、学习压力的增大，以及生活习惯的改变，颈椎病的发病率逐渐趋向年轻化。颈椎病临床分为颈型颈椎病、神经根型颈椎病、椎动脉型颈椎病、交感型颈椎病、脊髓型颈椎病以及混合型颈椎病等，主要表现为项背痛、肢体麻木、头晕、恶心，甚者可致瘫痪。多将其归属中医学“项痹病”、“眩晕”、“痹症”等范畴。颈椎病的治疗除了传统的内服中药外，外治法为其主要治疗方法之一，且有立竿见影之效。包括针灸、推拿、牵引、膏药外敷等传统手段，近年兴起的离子导入、超声导入、红外线热疗、磁疗等新方法的介入极大丰富了中医外治法的范畴。

目的 颈椎病已成为临床上的高发病,并有呈低龄化的趋势,故加强对颈椎病的防治显得尤为重要.本团对尝试设计一种具有防治两用的颈椎病治疗仪.方法 将中医经络推拿理论与现代颈椎生物力学理论相融合,发挥现在颈椎治疗仪的优势,弥补其不足之处.一方面采用间歇进行式类推拿手法,即通过设定程序控制模拟人手推拿的治疗方式,这也是本作品的创新之处.另一方面结合中药疗法、热疗、穴位疗法于一体,对颈椎不适的部位进行持久、稳定的刺激,从而起到安全、有效的防治作用.结果 本作品在设计上对于颈椎病症状较轻的患者能起到预防及防止症状进一步加重的作用,同时对于症状明显的患者有很好的治疗作用,以延缓病情的发展.结论 这种将中医传统治疗方法与西医现代技术相结合的颈椎中医防治仪很好地满足了社会需求,值得发展与推广.

It is with build-in traditional cultural characteristic of science of health maintenance of traditional Chinese medicine,which comes from the integration of life science and humanistic and social science. The combination of the attribute of science of health maintenance of traditional Chinese medicine and the concept of general education make it very suitable for being an elective course. The author clarified the necessity of launching the general education for the science of health maintenance of traditional Chinese medicine and made some useful exploration in accordance with the intrinsic requirement of the general education. Valuable advice on preparation of teaching material and methodology improvement for teaching was given by the author.

医学模式是指一定时期内人们对疾病和健康总的认识,并成为当时医学发展的指导思想.它的发展受到许多因素的影响,尤其是受到社会经济、科学、文化的影响,是社会进步和发展的结晶.生物-心理-社会医学模式就是目前医学发展的必然[1].随着人们生活水平地不断提高,生活方式的不断变化,糖尿病、高血压、心脑血管等慢性疾病和交通、工业意外带来的身体和精神伤害伤残患者也日益增多,随之产生大量的功能障碍患者,对康复医疗的要求已经到了一个刻不容缓的地步.

本文通过教学方法和方式的改进与运用,旨在探讨和研究中医康复专业人才培养的新途径和新方法,特别是对于多媒体技术以及实践教学的结合在中医临床康复专业临床课程的教学中的效果进行了摸索和尝试,该方式使课堂效果生动,能增加学生趣味性和兴奋性,达到了一定的效果,有待进一步研究和探索.

在医学构成体系之中,康复医学是一门理论与实践性都很强的学科,尤其在实践技能的培养上,对于医学生的实际操作能力的养成和提高,有举足轻重的地位.而在实际的教学过程之中,由于一些主观或者客观因素的影响,仍然存在传统教学模式中过于理论知识的灌输和传授、而疏于学生动手能力和运用知识解决实际问题能力的培养,以及如何提高学生的学习兴趣和积极性上,还亟待改进和提高.就如何改革中医药院校医学生康复医学教学培养模式,如何让学生的培养目标适应医学的发展要求,如何利用现有的教学资源和条件来改进和完善教学方式方法,提高教学效果等问题,笔者在该校中医专业医学本科生中就康复医学教学改革与实践进行了一定的尝试和探索.

the continuous development of China's higher education system, institutions of higher learning in medicine from a single comprehensive university academic institutions to move, how to fully develop the Chinese medicine is a discipline issue worth exploring, clinical workers and the general lack of awareness of the concept of rehabilitation, The lack of medical condition, unable to adapt and meet the needs of modern people's health, rehabilitation of medical students how to develop the concept and awareness, how to make full use of Chinese medicine colleges and universities own resources, give full play to the characteristics of rehabilitation medicine is also worth considering, This article published this little humble opinion, learning from them.

Objective To observe the clinical use of traditional massage combined with mud volcano,interference wave hot compress physiotherapeutic methods in the treatment of lumbar muscle strain.Method Using a direct observation method,random observation of 62 cases of patients with lumbar muscle strain,using the traditional massage,cupping combined with mud volcano hot compress,interference wave physiotherapy treatment,were once a day,5 times as a course of treatment,continuous observation of treatment two.Results After treatment,42 cases were cured,accounting for 67.7%,17 cases markedly effective,accounting for 27.4%,3 cases effective,accounting for 4.9%,and 0 cases ineffective.Among the 1 courses of treatment to be cured effectively or improved in 54,accounted for 87.1%.Conclusion The method of exact curative effect in the treatment of lumbar muscle strain,is worth the clinical promoted application,but also can make the further study on the therapy.

目的:观察丹参注射液和川芎嗪注射液辨证治疗偏头痛的临床疗效。方法:60例患者随机分为对照组和治疗组各30例,治疗组在一般治疗的基础上辨证施治,血瘀为主者予丹参注射液30 mL静滴,气滞为主者予川芎嗪注射液30 mL静滴,对照组随机选用上述两种注射液。结果:中医证候疗效和偏头痛疗效比较,治疗组优于对照组(P<0.01)。结论:中成药注射液辨证论治气滞型和血瘀型偏头痛疗效显著。

Objective To observe the effect of physiotherapies like traditional massage manipulation combined with volcanic mud hot compress and interference wave.Methods 84 patients with cervical spondylopathy of radicular type and vertebral artery type were treated with physiotherapies like traditional massage manipulation combined with volcanic mud hot compress and interference wave,1 time a day,5 times as a treatment course.They were treated and observed for two continuous courses. Results After systematic treatment,63 cases were obviously effective.And the obvious effective rate was 75.00%.And 43 cases had obvious effective after one course.19 cases were effective,accounted for 22.62%.The total effective rate was 97.62%.2 cases were ineffective,accounted fro 2.38%.Conclusion The method has exact effect for the treatment of cervical spondylopathy,and is worthy of wider application and further research.