BackgroundIntracerebral haemorrhage (ICH) is the deadliest subtype of stroke. Surgery remains a vital measure for life-saving in emergency situations, however, the recovery of post-operative patients is not optimistic. This study aimed to evaluate the evidence of the efficacy and safety of Xingnaojing injection (XNJ) for post-operative patients of ICH.MethodsFrom inception to 31 January 2024, we searched eight representative databases for randomized controlled trials on post-operative patients of ICH treated with XNJ. A meta-analysis was conducted using R4.2.2, and the quality of the evidence was evaluated by GRADE criteria.ResultsThe results indicated that the combination of XNJ with conventional western medicine therapy improved the total efficiency rate (RR = 1.26; 95% CI [1.21 to 1.32]; p < 0.0001), reduced the all-cause mortality within 15 days (RR = 0.45; 95% CI [0.30 to 0.67]; p < 0.0001), decreased the volume of hematoma (MD = −4.72; 95% CI [-7.43 to −2.01]; p = 0.0006) and perihematomal edema (MD = −4.11; 95% CI [-8.11 to −0.11]; p = 0.0441), reduced the TNF-α levels (SMD = −1.61, 95% CI [−2.23 to −0.99], p < 0.0001), decreased neurological impairment (SMD = −1.44; 95% CI [-1.78 to −1.11]; p < 0.0001), improved the activities of daily living (SMD = 1.22; 95% CI [0.78 to 1.66]; p < 0.0001), and enhanced the consciousness level (MD = 2.08, 95% CI [1.22 to 2.93], p < 0.0001). In addition, the complications of the combination therapy group were lower (RR = 0.43; 95% CI [0.35 to 0.54]; p < 0.0001) and the adverse drug reactions were comparable to the control group (RR = 0.89; 95% CI [0.55 to 1.45]; p = 0.6521). The trial sequential analysis results showed that the sample size is sufficient.ConclusionCurrent evidence indicates that XNJ can enhance the efficiency, reduce mortality, and lower the incidence of complications, while demonstrating good tolerability of post-operative patients of ICH. However, the level of evidence from existing studies is relatively weak, and only prove short-term effects, and high-quality RCTs are needed to further verify the accuracy of these conclusions.Systematic Review Registration: identifier (PROSPERO 2024 CRD42024503006). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024503006, Identifier CRD42024503006.

餐后低血压临床上老年人为高发群体,常发生于早餐后,伴血压控制不良,诊治率低.王新志从脾肾相关理论出发,认为老年餐后低血压发生的主要病机在于脾肾亏虚,发病的关键诱发因素为气机升降失常,主要病理实邪为痰凝血瘀,治疗上结合老人脏腑生理病理特点,兼顾病后多思虑的心理变化,提出健脾益肾、畅达气机、久病治瘀等法则,实中焦、固肾本、调脏腑、理气血,取得了良好的诊疗效果.

认为阴虚是多系统萎缩的关键病机,病变脏腑涉及肝、肾、心、脾,久积痰瘀是其病情进展的重要因素.提出以育阴法为基本治则进行辨证论治,髓海亏虚证,治以补肾益精、养阴封髓,自拟封髓丹加味;阴血不足证,治以养血充脉、滋阴舒筋,自拟养血舒筋汤;心肾阴虚证,治以滋肾潜阳、育阴降火,常用引火汤加减;阴虚风动证,治以敛肝滋肾、滋阴熄风,常用三才封髓丹加减;阴阳俱虚证,治以阴阳双补、化痰逐瘀,常用地黄饮子加减.

肝阳上亢证是临床常见证候,在多种疾病中扮演着重要的角色.构建动物模型是研究肝阳上亢证的重要手段,现代生物学研究有助于认识该证的物质基础、效应机制以及其在疾病中发挥的作用.本文检索了肝阳上亢证相关文献,发现该证模型制备方法包含药物注射、中药灌胃等,中药灌胃法运用最为广泛,附子汤是运用最多的中药.整理该证生化指标、影像学、蛋白质组学、代谢组学等相关文献,发现近期以病证结合研究为主,单纯对证候的研究有待于进一步开展.本研究为肝阳上亢证的研究方向提供了参考.

中焦膜系属于三焦膜系的重要组成部分,处于中间位置,起着宣上导下、维持平衡的枢纽作用.脾胃疾病的发生与中焦膜系的状态密切相关,当邪气怫郁、内外因叠加,会导致膜系功能紊乱,出现中焦膜系的拘挛、纵缓、破损、瘀阻、津气不利,进而导致中焦脾胃通降失常、润燥纳运失司等病理状态.因此,对中焦膜系的疏通、补养、固护,能纠正膜系状态,使中焦脾胃健运.

《黄帝内经》载有"心在志为喜","喜"属火而归于心,适度喜乐可助心行血以养神,并可改善由心气虚所致的悲忧状态.现代医学习惯性地将"喜"视为一种良性情绪表现.然而"过喜伤心"易导致喜证的产生,其病机主要与心火旺盛有关,病性多为实或本虚标实."喜伤心"相关理论对癫狂、胸痹、心 悸、不寐、郁证等心系病、神志病的临床治疗具有重要指导意义.

恐惧是情志病常见症状之一,胆与恐的中医生理病理关系十分密切,然而中医临床辨治恐证常易忽略其与胆的密切关系.本文从胆与恐的中医理论研究、现代实验研究和"胆虚善恐"相关病证方面,对"胆虚善恐"进行述评,发现生理的胆与勇怯关系密切,病理的胆与恐惧关系密切;"胆虚善恐"的中医发病机制十分明确,但缺乏系统的文献研究和现代科学研究;从胆论治恐证疗效显著,但仍有部分恐证缺乏从胆论治的经验报道.认为今后应完善"胆虚善恐"的专题研究、临床应用和胆腑理论的教材内容,明确胆虚证的辨证分型,探讨恐与胆的现代科学意义,进一步研究"胆虚善恐"的体质意义,以指导惊恐相关病证的中医教学与临床.

张仲景为"医方之祖",他辨证准确,用药精准,使用的每一味药皆独具匠心,地黄为张仲景最善用的中药之一.本文通过对张仲景地黄的炮制、剂量、功效、应用、配伍及存疑的地方进行整理探究,发现仲景治疗神志病时多用鲜地黄,治疗血证时多用干地黄,鲜地黄用量日用量大概250～500 g,地黄日服量范围为46.8～62.4 g,仲景用地黄多与酒、桂枝、阿胶同用,以取其不同的治疗作用,并对百合地黄汤"中病勿更服"和防己地黄汤"以铜器盛其汁"这2个前年的争议疑点给出解释.

郁证患者逐年增加,且与不寐、心悸、怔忡等诸多身心疾病交织错杂,诊断率低,治疗率差.王新志教授十分重视郁证的临床识别和诊治,注重郁证与气血的关系,提倡从气血辨治郁证,指出"久郁要勿忘逐瘀、敢于逐瘀",创新性提出运用经方、气血辨证和脏腑辨证相结合综合论治郁证的思想.在郁证的识别诊断、辨证论治方面积累了大量经验,取得了良好的临床疗效,形成了诸多值得借鉴的学术思想.