刘爱民教授是河南省名中医,师从中医名家傅贞亮教授和国医大师禤国维教授,从事中医药防治皮肤疾病的临床及科研工作三十余年,对中医药防治慢性皮肤病有较为深入的研究.围绕刘爱民教授辨论湿疹的临证经验,形成"理-法-方-药"完整的刘爱民湿疹辨证论治体系,基于学术交流和经验传承这一目的,通过文献的学习及对刘爱民教授有关湿疹的医案、课件、著作、论文等资料的整理挖掘,运用领悟式分析法,对刘爱民教授辨治湿疹的学术经验进行总结.刘爱民教授认为,湿疹的核心病机为湿热蕴肤,湿热的来源途径主要有外湿、内湿、不内外湿和内外合邪4个方面,以季节、脏腑、经络、部位"四位一体"的辨证模式探究病机来源.刘爱民教授基于审湿求机的辨证论治体系,提出湿疹的治疗方案:病因病机属风寒束表、湿热蕴肤者,治宜宣肺散寒、除湿清热,方药用麻黄连翘赤小豆汤加减;病因病机属阳虚外寒者,治宜温阳宣肺化湿,方药用麻黄附子细辛汤加减;病因病机属湿热蕴肤者,治宜除湿清热,方药用龙胆泻肝汤或萆薢渗湿汤加减;病因病机属脾虚湿蕴者,治宜健脾除湿或除湿健脾,方药用参苓白术散加减或除湿胃苓汤加减;病因病机属风热夹湿、侵犯肌肤者,治宜祛风清热、凉血除湿,方药用消风散加减;病因病机属湿瘀阻滞、肌肤失养者,治宜益气通阳、除湿活血,方药用黄芪桂枝五物汤加减.

目的:基于数据挖掘技术研究刘爱民教授治疗湿疹的用药规律.方法:运用中医传承辅助系统V2.5对刘爱民教授门诊治愈的130个湿疹医案(包含方剂298首)进行数据挖掘,得出药物频数及药物组合、药物性味归经、药物的关联度等用药规律.结果:数据挖掘结果显示,刘爱民治疗湿疹的用药规律:①药物以温性和寒性为主,二者频数比为1.28:1;②药物以苦、辛、甘味药为主,占比达98.6％,且三种药味之比接近1 ∶ 1 ∶ 1;③药物归经以肺、脾、胃和膀胱经为主;④处方药味数多为12味左右,药方精炼.使用频数为90以上的药物有:黄柏、白鲜皮、防风、苍术、薏苡仁、陈皮、柴胡、甘草、麻黄、黄芪、茯苓、赤小豆、桂枝等.常用药物组合:①黄柏、白鲜皮;②黄柏、薏苡仁;③黄柏、苍术;④白鲜皮、苍术;⑤黄柏、防风等.常用药对:茯苓-当归,厚朴-干姜,茯苓-白扁豆,炒白术-麻黄,苍术-甘草等.核心药物组合有:牡蛎-柴胡-黄芪,黄芩-川牛膝-蜈蚣,炙甘草-甘草-薏苡仁,荆芥-茯苓-防风,白芍-黄柏-生姜等.新处方有:①牡蛎,柴胡,黄芪,砂仁,白扁豆;②黄芩,川牛膝,蜈蚣,山药,鸡内金;③炙甘草,薏苡仁,黄柏,大枣;④荆芥,茯苓,防风,制附子,麻黄;⑤白芍,黄柏,生姜,炙甘草,大枣等.结论:刘爱民教授治疗湿疹的用药规律体现其审湿求机、重视天人合一和脏腑辨证的学术思想.

Objective To investigate the curative effect of Ningweixiaoyu decoction combined with the gastrointestinal prokinetic, acid inhibitory and anti-somatization therapy on patients with functional dyspepsia (FD). Methods 116 patients with both FD and somatization symptoms treated in Jiyuan Hospital of Traditional Chinese Medicine from February of 2015 to November of 2016 were enrolled in the study and randomly divided into the observation group (n=58) and the control group (n=58). The patients in the control group were given the conventional drug treatment with the gastrointestinal prokinetic agent Mosapride Citrate, the acid inhibitory drug Lansoprazole and the anti-somatization drug Flupentixol Melitracen, while those in the observation group were treated with more Ningweixiaoyu decoction on the basis of the conventional drug treatment. The scores of symptoms, the total scores of Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI), and the clinical efficacy were compared between the two groups before and after treatment. The recurrence rates were also compared between the two groups after 3 and 6 month of treatment respectively. Results The scores of all symptoms in the observation group were significantly lower than those in the control group (P<0.05) after treatment. The total scores of PHQ-15 and NDI in the observation group were significantly lower than those in the control group (P<0.05), and the clinical efficacy in the observation group was significantly better than that in the control group (P<0.05). The recurrence rates after 3 and 6 months of treatment in the observation group were 8.6% and 12.1% respectively and significantly lower than those in the control group which were 22.4% and 27.6% respectively (P<0.05). Conclusion The curative effect of Ningweixiaoyu decoction combined with the gastrointestinal prokinetic, acid inhibitory and anti-somatization therapy in the treatment of FD is satisfactory, and it can significantly relieve patients′ clinical discomfort, improve their quality of life and lower the recurrence rate, so it is worthy of clinical application.

目的 探讨经导管肝动脉化疗栓塞术治疗中晚期原发性肝癌患者的疗效以及安全性.方法 2015年7月~2016年8月在我院接受治疗的原发性肝癌患者45例,采用经导管肝动脉化疗栓塞术治疗.结果 在治疗后3 m行腹部CT检查,在45例PLC患者中,获得完全缓解15例(33.3%),部分缓解16例(35.6%),病情稳定6例(13.3%),病情进展8例(17.8%);随访3年,生存患者7例(15.6%);术后不良反应可控,未影响治疗的进行.结论 采用经导管肝动脉化疗栓塞术治疗原发性肝癌患者,毒副反应发生率低,效果显著.

目的 观察将雷贝拉唑联合左氧氟沙星及呋喃唑酮治疗慢性萎缩性胃炎患者的效果.方法 抽取我院于2016年2月~2017年1月诊断为慢性萎缩性胃炎的58例患者作为实验对象.分为试验组以及对照组.试验组治疗时给予雷贝拉唑联合左氧氟沙星及呋喃唑酮,对照组给予雷尼替丁联合左氧氟沙星及呋喃唑酮.比较两组的治疗结果.结果 试验组的总有效率与对照组相比更占优势,P<0.05;试验组的不良反应率较对照组显著降低,P<0.05,差异有统计学意义.结论 与常规的治疗方法相比,对慢性萎缩性胃炎患者实施雷贝拉唑联合左氧氟沙星及呋喃唑酮的治疗方法,其临床效果很好,可在临床上推广.

Objective To compare the efficacy and safety of bicyclol combined with adefovir dipivoxil in the treat-ment of HBeAg positive chronic hepatitis B. Methods The 118 patients with HBeAg positive chronic hepatitis B were ran-domly divided into treatment group(60 cases)and control group(58 cases). For the control group,each patient was given adefovir dipivoxil 10 mg,1 time/ d,take orally. For the treatment group,on the basis of control group,each patient was given bicyclol tablets 25 mg,3 times/ d,take orally. No other drugs of anti-virus,immunity adjusting and anti-hepatic fi-brosis were used in both groups,the treatment lasted for 48 weeks. The assessments of hepatitis B virus index(HBV DNA, HBeAg-negativity,HBeAg seroconversion),liver function and liver fibrosis index were performed. Results At the end of the treatment,the rates of HBV DNA below detection limit,HBeAg-negativity and HBeAg seroconversion of the two groups were similar,there was no significant difference(P ﹥ 0. 05);but there were significant differences in liver function and re-duction of liver fibrosis index between the treatment group and control group(P ﹤ 0. 01,P ﹤ 0. 05). There were no adverse drug reactions. Conclusions Bicyclol combined with adefovir dipivoxil in the treatment of HBeAg positive chronic hepati-tis B is safe and effective. The efficacy is striking better than that of only use of adefovix dipivoxil.