现代医学对复发性口腔溃疡病因及发病机制尚不明确,亦无特效药治疗.李俊教授认为复发性口腔溃疡经久不愈,红肿不显,多伴少气、纳差、便溏、脉虚等症,多属"脾虚证",故在治疗上以培护中土为本,结合疡科"托""补"及外治之法,内外合用,可有力促进口疮愈合,收效良好.附验案1则以佐证.

《神农本草经》作为中医学奠基著作,一直是历代医家必读本草,且后世学者对其主治疾病多有发掘.然而,时至今日,书中所载许多药物的重要功效却被忽视,鲜有使用.笔者结合古方叙述、名家医论、现代研究等资料,仅对《神农本草经》中干地黄、桑叶、当归的有关重大功效记载进行阐述.

2018月11月5日,美国心脏协会(AHA)发布了"国际心肺复苏(CPR)指南的更新版".指南更新版中并未对复苏后的治疗方案,尤其是诱导亚低温方面进行重大调整.本文结合国内外新的基础研究和临床研究资料以及国内CPR现状,评价复苏后治疗方案,尤其是亚低温治疗的进展,建议开通心搏骤停的院前与院内绿色通道,尽早开展以物理降温为主、血液降温为辅的体温目标管理,同时应该结合我国国情,开展更多包括中医药在内的复苏后综合抢救的临床研究.

目的 观察益气泻浊活血法对急性肺损伤(ALI)高危患者的有效性及安全性并探讨其作用机制.方法 59例患者随机分为观察组29例与对照组30例.对照组予西医常规治疗,观察组在西医治疗基础上联合益气泻浊活血法中药汤剂.比较两组治疗前后呼吸、血氧分压、动脉血氧饱和度、氧合指数及炎症、免疫等指标变化情况.结果 观察组治疗后呼吸、血氧分压、血氧饱和度(SaO2)、氧合指数均较治疗前改善(均P＜0.05或P＜0.01),对照组治疗前后呼吸、血氧分压、SaO2、氧合指数比较,差别均不大(均P＞0.05).两组治疗后呼吸、血氧分压、SaO2、氧合指数指标比较,差别均不大(均P＞0.05).两组治疗后白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)均较治疗前改善善(均P＜0.01),但两组治疗后上述指标比较,差别均不大(均P＞0.05).两组治疗后血IgA、血C3、CH50均较治疗前改善(均P＜0.05或P＜0.01),且观察组治疗后血C3、CH50高于对照组(均P＜0.05).两组治疗后ALI发生率、28 d生存率、住院总天数及住院总治疗费用比较,均差别不大(均P＞0.05).结论 益气泻浊活血法虽未改善ALI高危患者的住院7 d ALI发病率与28 d生存率,但无负性影响;益气泻浊活血法对ALI高危患者免疫功能具有一定改善作用,可改善患者呼吸、氧合情况,从而改善短期内病情,可能是ALI高危患者一个潜在有效的中医切入方案.

Background. Sepsis is a global major health problem with high mortality rates. More effective therapy is needed for treating sepsis. Acupuncture has been used for various diseases, including severe infection, in China for more than 2,000 years. Previous studies reported that acupuncture at Zusanli (ST36) might be effective in treating sepsis, but the efficacy and the quality of evidence remain unclear since there is no systematic review on acupuncture at ST36 for sepsis. Methods. Seven databases were searched from the inception of each database up to May 2019. Ultimately, 54 studies using acupuncture at ST36 for the treatment of experimental sepsis were identified in both English and Chinese literature with systematic review procedures. Results. Acupuncture might be useful in reducing injuries induced by sepsis in cardiac, lung, kidney, liver, gastrointestinal tract, and immune system. Its potential mechanisms for antisepsis might include reducing oxidative stress and inflammation, improving microcirculatory disturbance, and maintaining the immune balance mediated by dopamine. However, the positive findings should be interpreted with caution due to poor methodological quality and publication bias. Conclusion. Acupuncture at ST36 might be a promising complementary strategy for controlling sepsis inflammation, yet further studies are needed.

Objectives. Acupuncture has increasingly been used for insomnia relief after stroke. We aimed to evaluate the methodological quality and summarize the evidence regarding the effectiveness of acupuncture for poststroke insomnia (PSI) from systematic reviews/meta-analyses (SRs/MAs). Methods. Eight databases were searched from inception through August 23, 2020. SRs/MAs on acupuncture treatment for PSI were included. Methodological quality assessment was performed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and evidence quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results. Six SRs/MAs on acupuncture treatment for PSI were included. The AMSTAR-2 showed that the methodological quality of all included SRs/MAs was rated as critically low. According to the evaluation results of GRADE, 38.9% (7/18) of outcomes were rated as very low-quality evidence, 22.2% (4/18) were low-quality evidence, and 8.9% (7/18) were moderate-quality evidence. Descriptive analysis results showed that acupuncture was an effective treatment modality for PSI. Conclusions. All included reviews indicated that acupuncture was more effective than the control group for the treatment of PSI, but the credibility of the results is limited owing to the generally low methodological and evidence quality of the included SRs/MAs. More high-quality evidence is needed to determine whether acupuncture is more effective than other treatments.

目的 了解中医院住院医师规范化培训医生(规培生)在急诊科轮科的疲劳情况.方法 调查2017年3月至9月期间,广东省中医院规培生在急诊科轮科前后的疲劳评定量表14评分(FS-14),进行自身前后对照.结果 研究共纳入111名受访者,轮科前后的FS-14配对样本t检验有统计学差异(P＜0.05);女性受访者以及普通规培轮科前后的FS-14存在统计学差异(P＜0.05).专硕规培、普通规培之间的轮科前后FS-14比较无明显差异(P＜0.05).结论 急诊科轮科导致的规培生轮科的疲劳度增加无法避免,需要我们予以重视.资源的优化、合适的培养模式可能是减低规培生疲劳度的有效策略.