目的:观察补肾活血方联合常规西药治疗卵巢储备功能低下所致不孕症的临床疗效.方法:将86 例卵巢储备功能低下所致不孕症患者按照随机数字表法分为对照组和观察组,每组各43 例.对照组给予雌二醇/雌二醇地屈孕酮治疗2个月经周期后,给予常规促排卵方案,观察组在对照组治疗的基础上联合补肾活血方.比较两组患者的临床疗效、排卵日子宫内膜厚度、妊娠率及治疗前后中医证候积分、窦卵泡计数(antral follicle counting,AFC)、激素水平[卵泡刺激素(fol-licle stimulating hormone,FSH)及抗苗勒管激素(anti mullerian hormone,AMH)].结果:两组患者治疗后中医证候积分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P＜0.05).观察组有效率高于对照组,差异具有统计学意义(P＜0.05).两组患者治疗后FSH 低于本组治疗前,且治疗后观察组低于对照组(P＜0.05);观察组AMH 高于本组治疗前及对照组治疗后(P＜0.05).观察组治疗后AFC 高于本组治疗前及对照组治疗后,差异具有统计学意义(P＜0.05).观察组排卵日子宫内膜厚度、妊娠率高于对照组,差异具有统计学意义(P＜0.05).结论:补肾活血方联合常规西药治疗卵巢储备功能低下所致不孕症,可改善患者的临床症状及激素水平,增加基础AFC,促进子宫内膜生长,从而提高妊娠率.

庞玉琴教授认为,气血失调、脏腑失和为产后抑郁主要病机,主要涉病脏腑为心、肝、脾,在治疗产后抑郁时,以移情易性,畅气通滞,养血安神为治疗总则.庞教授治疗产后抑郁,调气血与和脏腑并举,移情志与安神魂并重,不忘多虚多瘀之机,辨证分型且分段论治,以气血为路,脏腑为靶,畅气养血,调志安神.肝气郁结者,方用自拟疏郁清明汤;心脾两虚者,方用自拟补益定神汤.庞教授治疗产后抑郁强调当分阶段施治:若妇女新产阶段发生产后抑郁,以活血祛瘀为主,加川芎、桃仁、炮姜之品;若妇女产后子宫已恢复,以补益气血为要,加当归、丹参、黄芪之品.另外,产后用药需要注意:产后不宜单用过用补益之品;产后不宜单用破血之品;产后不能过用寒凉;产后不能过用辛散之品.

目的:观察庞氏安胎止血汤治疗先兆流产血热证的临床疗效.方法:收集河南中医药大学第三附属医院先兆流产血热证患者130例,随机分为对照组与治疗组,每组65例.治疗组给予庞氏安胎止血汤口服,每日1剂,分2次口服;对照组给予口服地屈孕酮片,首次剂量为40mg,维持剂量每天2次,每次10mg;疗程均为10d.检测两组治疗前后中医证候积分,血清中人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E2)以及白细胞介素-10(IL-10)、γ干扰素(IFN-γ)的表达情况.结果:与对照组比较,治疗后治疗组中医证候积分显著降低(P＜0.05),血清中β-HCG、P、E2、IL-10水平显著升高(P＜0.05),IFN-γ水平显著降低(P＜0.05).结论:庞氏安胎止血汤可降低先兆流产血热证患者的中医证候积分,减轻患者临床症状,显著升高血清β-HCG、P、E2水平,同时能提高血清IL-10水平、降低IFN-γ水平,从而达到保胎效果.

目的:观察清热祛湿化瘀周期疗法治疗抗精子抗体(anti-sperm antibody,AsAb)阳性免疫性不孕症的临床疗效.方法:将82例AsAb阳性免疫性不孕症患者随机分为治疗组和对照组各41例.治疗组采用清热祛湿化瘀周期疗法治疗,对照组采用醋酸泼尼松片治疗,两组均以治疗1个月为1个疗程,共治疗3个疗程.观察两组患者AsAb转阴时间、转阴率及转阴后6个月内的妊娠情况.结果:治疗组转阴率为74.36％,对照组为61.11％,两组比较,差异无统计学意义(P＞0.05).治疗组的妊娠率为46.15％,对照组为22.22％,治疗组妊娠率显著高于对照组,两组比较,差异有统计学意义(P＜0.05).结论:清热祛湿化瘀周期疗法治疗AsAb阳性免疫性不孕症患者疗效显著.

目的 探讨庞氏安胎汤治疗先兆流产的可能作用机制.方法 60只孕1天大鼠随机分为正常组、模型组、地屈孕酮组和庞氏安胎汤(简称安胎汤)高、中、低剂量组,每组10只.安胎汤高、中、低剂量组在孕1 ～12天分别灌胃安胎汤89.6、44.8、22.4g/(kg·d),地屈孕酮组给予地屈孕酮片溶液3.02 mg/(kg·d),每日1次.孕12天,除正常组外其余各组一次性灌胃米非司酮片溶液3.75 mg/kg建立先兆流产大鼠模型.各组大鼠孕13天检测血清中γ干扰素(IFN-y)、肿瘤坏死因子α(TNF-α)、白细胞介素2(IL-2)、白细胞介素4 (IL-4)、白细胞介素6(IL-6)、白细胞介素10(IL-10)以及血清雌二醇、孕激素、β人绒毛膜促性腺激素(β-HCG)水平.结果 与正常组比较,模型组大鼠血清IFN-γ、TNF-α、IL-2水平升高,IL-4、IL-6、IL-I0水平降低,血清雌二醇、孕激素、β-HCG水平亦降低(P＜0.05).与模型组比较,安胎汤中、高剂量组IFN-γ、IL-2水平降低,IL-4水平升高(P＜0.05);安胎汤中、低剂量组TNF-α水平降低,IL-6、IL-10水平升高(P＜0.05);各给药组大鼠血清雌二醇、β-HCG和孕激素水平均升高(P＜0.05).安胎汤申剂量组血清中雌二醇、β-HCG和孕激素水平高于安胎汤低剂量组、地屈孕酮组(P＜0.05).结论 安胎汤可调节先兆流产大鼠免疫因子,使Th1/Th2值向Th2偏移,提高激素水平,从而达到保胎的目的.

目的 初步探讨庞氏安胎止血汤对热证自然流产模型大鼠血清CD4+、CD8+的表达干预及庞氏安胎止血汤的安胎机制.方法 将妊娠SD大鼠随机分为模型组、西药组(地屈孕酮组)、庞氏安胎止血汤高剂量组、庞氏安胎止血汤中剂量组、庞氏安胎汤止血低剂量组和正常组,用附子、干姜、肉桂和米非司酮建立热证自然流产动物模型,末次给药24h后,腹主动脉取血并分离血清;剖视子宫观察着床数和流产率;酶联免疫法检测大鼠血清CD4+、CD8+表达.结果 模型组大鼠流产率、血清CD4+明显升高、CD8+水平显著降低;经治疗后,中药低剂量组、中药中剂量组和西药组大鼠流产率显著降低(P＜0.01),中药低剂量组、中药中剂量组、中药高剂量和西药组血清CD4+明显降低,CD8+水平显著升高.结论 庞氏安胎止血汤可能通过降低热证自然流产大鼠血清中T淋巴细胞亚群CD4+,升高CD8+,使CD4*/CD8*的平衡向CD8+方向转移,发挥安胎作用.

Objective:Analysis of Yangyin Qingre decoction and Baofukang suppository for cervical erosion of serum interleukin-6(IL-6),interleukin-8(IL-8)content changes and clinical efficacy.Methods:Review cases of cervical erosion patients,according to the different treatment methods were divided into control group and observa-tion group.The control group was treated with Baofukang suppository treatment,observation group were treated with Baofukang suppository combined with Yangyin Qingre decoction.Observe the main symptoms of the two groups of patients after treatment points,cure time,row liquid time,cervical tissue interleukin-1 beta(IL-1 β)pos-itive cells and the expression of cytokines.Results:Two groups of patients after treatment of erosion area,the de-gree of erosion,leucorrhea and abdominal pain score were improved compared with before treatment,TNF-α,IL-6, IL-8,SOD,IL-1 β,the average gray value and the value of optical density levels were lower than that before treat-ment,the observation group patients after the main symptoms integral,TNF-α,IL-6,IL-8 SOD,IL-1β,the aver-age gray value of beta and optical density values were better than those of control group(P<0.05).The healing time of patients in the observation group after treatment and discharge time was shorter than the control group(P<0.05).Conclusion:Yangyin Qingre decoction combined with Baofukang suppository in the treatment of cervical ero-sion can effectively improve the symptoms,shorten healing and discharge time,reduce the positive cells of IL-1 β cervical tissue of patients with IL-6,the level of IL-8.

妇女妊娠期阴血下注胞胎妊养胎儿,可导致体内气血阴阳失衡,脏腑亏损,冲任失和,波及胞胎:一者,阴血偏虚,气血虚弱,则有气虚、血虚、气血俱虚,或气血运行无力,因虚致郁,即见气郁;二者,阴血偏虚,阳气偏亢,则易热伏冲任,灼热胞宫;三者,妊娠期间,情志失和或跌仆劳累,易影响气血运行,冲任调畅.庞玉琴教授临床治疗以“治病与安胎并举,脏腑经络气血同治”为总则,重视肝脾肾及冲任,以通调气血为通路,调理脏腑为靶向,使得冲任调和,胞宫自安,胎儿可正常生长发育.妊娠腹痛、胎漏和胎动不安,证型较多,在临床上需要准确辨证,处方用药灵活应对,不可百证一方.

Professor Pang Yuqin classifies dysmenorrhea into syndrome of qi stagnation and blood stasis,syndrome of cold coagulation and blood stasis,syndrome of damp heat and stagnation,sydnrome of qi and blood deficiency and syndrome of liver and kidney deficiency.Professor Pang values the treatment of the thoroughfare vessel,conception vessel,governor vessel and belt vessel,regulation of the spleen and stomach and reglation of qi and activation of blood flow and she is good at clearing heat and removing dampness.For dysmenorrhea with different sydnrome,causes and pathogenesis,She adopts different therapeutic methods and uses drug accurately and flexible.Besides,mental counseling should also valued during the treatment with drugs since most patients are accompanied with sorrow,fear,irritability and anxiety.In daily life,it is advisable for the patients to do regular exercises and keep good mood and healthy diet in order to cure dysmenorrhea by improving their health state by themselves.

目的:观察疏肝理气,活血调经类中药配伍治疗不孕症的疗效.方法:采用四逆散加味(柴胡、枳实、白芍、甘草、当归、丹皮)治疗本症60例.结果:怀孕率51.7%.提示疏肝理气,活血调经,调整脏腑与冲任有助于受孕.

"止血三法"是指治疗崩漏下血常用的"塞流"、"澄源"、"复旧"3种治疗方法.它首见于明*方约之所著<丹溪心法*附余>,方氏主张治崩"初用止血以塞其流,中用清热凉血以澄其源,末用补血以还其旧".庞清治老师曾任河南中医学院妇科教研室主任,从事中医妇科教学及临床50余载,擅治妇科病,尤其在崩漏的辨治方面别有体会,临证运用"止血三法",常本着急则治其标,缓则治其本的原则,谨守病机,结合临床具体见症,灵活变通,对"止血三法"进行了充实和完善.现将其运用"止血三法"的经验介绍如下.

汗法,是通过发汗而驱除病邪的一种治疗方法.发汗方药其性无论是寒,还是温,但其味辛则是共有之处,因其味辛而决定主治病证有其一般性与特殊性.其一般性是针对表证而设,是其主治的基本点;其特殊性是针对非表证而设,是其主治的扩大范围.<经方药物药理临证指南>说:"辛:主行,主散,主治病证与卫、营、气、血、津、液、郁、瘀的病理变化有关."在临床中若能以法用汗法治疗非表证,则可明显提高治疗效果,于此试将拙识略述于次,以飨同道.

支气管炎是临床易辨难治性病证之一，其病证或因寒或因热极易复发，治疗控制症状较易，但欲收到远期治疗效果，则非易事。对此若能审证求因依法用经方治疗支气管炎，则可收到远期治疗效果，于此试……

An observation was made on the effect of pelle Rhubarb and Zhechong on the collagen of liver and mucoprotein of blood serum in the rats with CCl_4 hepatic fibrosis model in different stages.The results did not show the effects of pelle Rhubarb and Zhechong in the prevention of hepatic fibrosis,but it showed an effect in treatment of hepatic fibrosis,it could decrease the levels of serum HA,LN and desposit of ECM,meanwhile can increase degradation of collagen,but it can not sever the hepatic fibrosis.

An observation was made on the effects of Xiaochaihu Decoction, Dahuangzhechong Pills and Biejiajian Pills on serum procollagen Ⅲ (Pc Ⅲ), Hyaluronic Acid (HA) and laminin (LN) in different stages of rat hepatic fibrosis. The levels of Pc Ⅲ, HA and LN were determined in rat CCl4 hepatic fibrosis model by radioimmunoassay. The results showed that Xiaochaihu Decoction could obviously decrease the levels of serum LN and HA in the prevention of hepatic fibrosis, and could lower the level of HA in the treatment of minor hepatic fibrosis, which suggested that in the treatment of hepatic fibrosis, Xiaochaihu Decoction should be given in an early stage; Dahuangzhechong Pills could decrease the levels of serum HA, LN and Pc Ⅲ in the rats with hepatic fibrosis in every stages, which suggested that Dahuangzhechong Pills had therapeutic effects on hepatic fibrosis; although both preventive dose and therapeutic dose of Biejiajian Pills could decrease the level of serum HA, only the therapeutic dose could decrease the levels of serum LN and Pc Ⅲ, but at the same time it brought unfavorable effects on the rats, which suggested that Biejiajian Pills had no good preventive effects on hepatic fibrosis, and the measures for keeping and maintaining the vitality of the body should be adopted when to use Biejiajian Pills clinically, because they could damage the vitality of the body despite their therapeutic effects.

感冒是一种常见的外感疾患,一年四季均可发病.而体虚感冒是指年老人或素体虚弱而常常感冒,体温往往不高,或感冒反复发作,经久不愈者.赵清理教授在近60年的临床实践中,对本病的治疗积累了丰富的经验.

吾师庞清治,出身中医妇科世家,为第二批全国老中医药专家学术经验继承指导老师.庞师从事中医妇科临床及教学五十余载,学验俱丰,尤在热证崩漏的辨治方面别有会心 ,临床每获良效.现介绍如下.