特发性肉芽肿乳腺炎(idiopathic granulomatous mastitis,IGM),又称肉芽肿性小叶性乳腺炎、肉芽肿性乳腺炎,是一种局限于乳腺小叶、以非干酪样坏死性肉芽肿为主要病理特征的慢性炎症性疾病,近年来在全世界范围内呈爆发性增长,尤其是年轻女性,大多数患者来自地中海地区(如土耳其、约旦)和亚洲(如中国、马来西亚)[1].

目的:肿瘤相关抑郁发病率高、危害性大,中医治疗具有一定优势,本研究观察评价养心疏肝方防治靶向期HER-2阳性乳腺癌相关抑郁状态、缓解赫赛汀心脏毒性的临床优势.方法:采用前瞻性研究方法,选取山东中医药大学附属医院收治的HER-2阳性乳腺癌靶向治疗期的患者110例,随机分为对照组(赫赛汀组)55例和试验组(赫赛汀+养心疏肝方组)55例,观察周期为63日,以每个靶向治疗周期(21日)作为1个疗程,在第1、2两个疗程连续服用中药,第2疗程结束21日后进行随访,两组均在治疗前后进行中西医抑郁状态相关症状评分,并记录射血分数及安全性指标,采用重复测量资料分析统计学方法评估两组治疗抑郁相关状态的临床疗效.结果:与治疗前相比,治疗后中医症状总评分及各症状评分对照组呈升高趋势,试验组呈降低趋势,2组间差异具有统计学意义(P<0.05),HRSD24总积分及各症状积分组间比较均有统计学差异(P<0.05),HRSD24总积分组内对比,对照组第1疗程评分与治疗前相比无统计学差异(P>0.05),第2疗程及随访评分低于前1疗程,试验组治疗后评分均明显低于前1疗程,且试验组HRSD24总积分明显低于同期对照组,差异具有统计学意义(P<0.05).治疗前后比较,对照组射血分数有所减低,试验组射血分数均明显高于同期对照组.结论:养心疏肝方可明显减轻患者情绪抑郁、精神与躯体焦虑等相关症状,对Her-2阳性乳腺癌患者靶向治疗期相关抑郁状态具有防治效果,且远期效果显著.

目的:通过对初期特发性肉芽肿乳腺炎病例的观察,探讨益气和营方联合激素治疗的疗效和优势,同时初步验证外周血及病变组织中C3、C4免疫紊乱机制.方法:选取80例初期肉芽肿性乳腺炎患者,随机分为激素组、中药+激素组,每组40例.治疗期间定期观察乳房肿块大小、肿块疼痛评分,治疗后计算临床总有效率,治疗前后检测血清C3、C4水平,免疫组化法检测病变组织C3、C4阳性表达水平.结果:中药+激素组较激素组更有效缩小肿块、缓解疼痛(P<0.01),中药+激素组临床总有效率明显高于激素组(P<0.01),中药+激素组较激素组更能降低外周血C3、C4水平,更能降低病变组织内C3、C4的阳性表达水平(P<0.05).结论:中西医结合治疗特发性肉芽肿乳腺炎临床疗效显著,特发性肉芽肿乳腺炎外周血和局部病变组织内均存在C3、C4免疫紊乱,益气和营中药联合激素治疗可以更好地改善C3、C4免疫紊乱状态.

Objective:To explore the general compatibility rule of Zhigancao (Glycyrrhizae radix et rhizoma praeparata cum melle) based on the four properties and five tastes. Methods:According to the rules of the selection,formulas in the Treatise on Febrile and Miscellaneous Diseases were selected to build a database, and the related information was input into the database. Then the frequency analysis and association were conducted for data excavation. Results:There were 224 formula included,which were divided into 15 cate-gories according to their efficacy. The correlation analysis on the number of the herbs and Zhigancao indi-cated that the confidence was positively correlated with the number of herbs in the antecedent. The effective rule in the four properties compatibility is {cold and hot in combination}→{Zhigancao},with the support of 56.70％ and confidence of 51.18％. The correlation analysis on the compatibility of five tastes and zhi gao cao indicated that confidence was positively correlated with five tastes compatibility in the antecedent. The effective correlation rules pertain to releasing the exterior,harmonizing,regulating blood,regulating qi,warming interior and removing dampness,totally six categories. Conclusion:It is concluded that there are 4 compati-bility rules of Zhigancao correlating with the four properties and five tastes,that is,the more complex of the four properties and the five tastes,the more likely Zhigancao is to be used. Pungency and sweetness trans-forming into yang and sourness and sweetness transforming into yin is an important compatibility principle. Zhigancao entering the middle to harmonize qi movement also is an important compatibility rule. Without the influence of other herbs,Zhigancao can be used to protect the stomach and harmonize the middle.

目的:通过针刺治愈色盲近60年病例来探讨临床疗效好的穴位,总结出色盲取穴归律.方法:统计1959年-2017年文献,检索维普、万方、CNKI、PUBMED数据库,选取整理色盲临床应用的常用穴及使用频次,统计归经、所属部位.对符合要求的28篇文献,48个穴位进行归类分析.结果:临床常用穴为合谷、风池、局部穴及足三里、臂臑,常用经脉依次为足少阳胆经、足太阳膀胱经、手阳明大肠经、经外奇穴、手少阳三焦经,分部取穴以眼、眉、上肢、颈项为主.结论:针刺治疗色盲在取穴、选经及穴位所在部位方面有一定的规律,掌握规律对临床施治具有指导意义.

目的 探讨补火生土法理论的发展与应用使其更好的指导临床.方法 采用手工检索历代医书,计算机检索相关文献.结果 归纳了补火生土的四种观点以及每种看法的依据及应用于临床疾病的例子.结论 补火生土有补心火滋脾土、补命门之火滋脾土、补心火滋胃土、补命门之火滋胃土四种理论.