目的:研究慢性胃炎辨属肝胃不和证患者运用疏肝调中汤加减的疗效.方法:采用前瞻性研究,选择2019年1月-2020年12月就诊的60例慢性胃炎且辨证属肝胃不和证的患者,采用随机数字表法,分为对照组和治疗组,每组30例.对照组予胃苏颗粒治疗,治疗组予疏肝调中汤治疗.对照组30例予胃苏颗粒治疗,治疗组30例予疏肝调中汤治疗.连续治疗1个月后进行指标评价.结果:治疗后,治疗组中医证候积分、胃功能三项(胃泌素-17、胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ)、血清炎症因子(表皮生长因子、白细胞介素-32、转化生长因子-β1)低于对照组(P<0.05),一氧化氮高于对照组,慢性胃炎患者报告结局指标量表之慢性胃炎模块(SSDPRO-CG)评分优于对照组(P<0.05),总有效率高于对照组(P<0.05).结论:疏肝调中汤加减治疗肝胃不和证慢性胃炎可有效调节患者的胃功能及炎症因子水平,显著提升疗效,使患者的生活质量获得较大改善.

胃癌前病变是一种常见的慢性消化系统疾病,同时也是正常胃黏膜转化为胃癌的关键阶段,及时的治疗和预防胃癌前病变,可有效降低胃癌的发生.胃癌前病变病因多样,病机复杂多变,具有难治性、缠绵性、复发性、易瘀、易滞、易积的特点,与"久病入络"理论相契合.其病在胃络,脾胃虚弱、瘀阻胃络、毒损胃络是胃癌前病变的主要发病机制.治疗上多以疏肝健脾和胃、化瘀活血通络为基本治则.

目的:探讨电针结合肌筋膜触发点穴位埋线治疗腰椎间盘突出症患者的临床效果.方法:试验组采用电针结合肌筋膜触发点穴位埋线方法进行治疗,对照组使用传统电针方法治疗,治疗周期为1个月.治疗前、每次治疗后及治疗完成后2个月使用日本骨科协会评分法(Japanese Orthopaedic Association Scores,JOA)评分和视觉模拟评分法(Visual Analogue Scale,VAS)评分进行评估.使用重复测量方差分析进行两组患者组内治疗前、第1、2、3、4次治疗及治疗后2个月的JOA评分和VAS评分比较,使用t检验进行两组患者组治疗前、第1、2、3、4次治疗及治疗后2个月的JOA评分和VAS评分比较.结果:两组术前JOA评分的差异无统计学意义,P=0.927;两组术前VAS评分的差异无统计学意义,P=0.283;组内比较显示:对照组术前和第1、2次治疗后JOA评分的差异无统计学意义,其余所有组内评分的差异均有统计学意义(P<0.05).VAS评分统计结果显示:对照组术前和第1次治疗后VAS评分的差异无统计学意义(P>0.05),其余所有组内评分的差异均有统计学意义(P<0.05).试验组总有效率优于对照组.结论:电针结合肌筋膜埋线法治疗腰椎间盘突出症效果较单用电针能更快减少患者的疼痛感和活动不适,疗效优于单独使用电针治疗,适合临床使用与推广.

目的:观察温通散熏洗辅治糖尿病合并周围神经病变的疗效.方法:96例随机分为治疗组和对照组各48例.两组均给予甲钴胺片,治疗组加用温通散熏洗.结果:两组治疗后空腹血糖、糖化血红蛋白均较治疗前降低(P＜0.05),但组间比较差异无统计学意义(P＞0.05).临床总有效率治疗组高于对照组(P＜0.05).治疗后两组Toronto评分均较治疗前降低(P＜0.05),治疗组低于对照组(P＜0.05);两组腓总神经和胫神经的SNCV、MNCV均加快(P＜0.05),且治疗组快于对照组(P＜0.05).两组胫前、胫后、足背动脉流速均加快(P＜0.05),且治疗组快于对照组(P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论:温通散熏洗辅治糖尿病合并周围神经病变可改善临床症状,提高治疗有效率,且不良反应小.

Objective To evaluate the efficacy of low resistance thought induction psychotherapy (TIP) technique combined with acupuncture and oral Chinese medicine in treating chronic insomnia elderly patients with syndrome of heart-kidney imbalance. Methods One hundred sixty-four chronic insomnia patients with syndrome of heart-kidney imbalance were randomly divided into four groups with 41 cases in each group. The control group was treated with family doctor contract, sleep health education and Tianwang-Buxin decoction as the basic treatment, the group A was treated with acupuncture and the basic treatment, the group B was treated with TIP technique and the basic treatment, the group C was treated with the combination of acupuncture and TIP on the basic treatment. After one month' treatment, scores of Pittsburgh sleep quality index (PSQI) were used to evaluate sleep quality, sleep efficiency, and the clinical efficacy. Results After treatment, scores of sleep time, sleep efficiency, sleep time, sleep disturbance, daytime function of the group A, B, and C were significantly lower than those in the control group (F value were 44.322, 92.808, 107.131, 79.467, 98.638 respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). Scores of upset, dizziness, tinnitus, hot flashes, and night sweats, hand foot and heart fever, forgetfulness, sores on the tongue and dry stool of the group A, B, and C were significantly lower than those of the control group (F value were 103.32, 135.91, 93.35, 77.61, 57.514, 92.283, 126.097, 53.217, respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). The total clinical efficacy of TCM syndrome and insomnia in group A,B and C was significantly higher than that in the control group (χ2=16.169, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.504, P<0.01). The total clinical efficacy of sleep efficiency in group A, B and C was significantly higher than that in the control group (χ2=14.078, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.856, P<0.01). Conclusions TIP technique combined with acupuncture and oral Chinese medicine can improve sleep quality of chronic insomnia elderly patients with syndrome of heart-kidney imbalance.

万全,字全仁,号密斋,湖北罗田县大河岸人,明代著名医学家.其三世家传幼科,早年习儒,兼功岐黄之术,幼年常代父出诊,渐有医名.随后整理家传儿科临证经验,先后著写《育婴家秘》、《幼科发挥》.后者是一部重要儿科名著,对于小儿咳嗽病的论治描述深刻,内含治法方药机圆法活、义理环周、暗合经旨.对于目前中医药治疗小儿咳喘病有着重要指导意义.

《临证医案指南》是清代著名医家叶天士临床经验的总结,是一部影响广泛的名医医案专著,全面展现了在各科杂病诊疗经验.本文从该书中总结叶天士的妇产科临床经验,运用于社区孕产妇预防健康管理工作,取得了较好的效果,该理论对孕产妇健康管理具有重要的指导意义.

目的:探讨益肾活血方煎服联合针刺治疗膝骨关节炎的疗效.方法:选取在本中心就诊的膝骨关节炎患者72例.根据数字表法随机将患者分为对照组和观察组,每组36例,对照组给予口服美洛昔康片治疗,观察组给予益肾活血方煎服联合针刺治疗,治疗2个月后,比较两组患者的总体疗效、膝关节功能评分、疼痛评分以及不良反应.结果:观察组患者的显效比例以及总有效率均显著高于对照组,且差异具有统计学意义;治疗前,两组患者的膝关节功能评分差异无统计学意义;治疗后,与治疗前相比两组膝关节功能评分均有显著提升,观察组显著高于对照组,且差异均具有统计学意义;治疗前,两组患者的疼痛评分差异无统计学意义;治疗后,与治疗前相比两组疼痛评分均有下降,观察组显著低于对照组,且差异均具有统计学意义;观察组患者治疗期间发生的不良反应显著低于对照组,差异具有统计学意义.结论:采用益肾活血方煎服联合针刺治疗膝骨关节炎可以有效提升总体疗效、提升膝关节功能,缓解疼痛,降低不良反应,值得临床推广.