目的:探讨黄连温胆汤加减治疗心悸(室性早搏)痰火扰心证的中医证候改善及预后情况,为临床治疗提供依据.方法:选取我院2018年1月～2020年1月收治的心悸(室性早搏)痰火扰心证患者90例进行研究.按照随机数表法将患者分为两组各45例.对照组给予常规药物治疗,观察组给予黄连温胆汤加减治疗.于治疗一个月后观察比较两组患者的临床疗效,不良反应发生率,并比较治疗前后两组患者中医证候评分及室性早搏次数.结果:观察组总有效率明显高于对照组(86.67％ vs 68.89％),差异有统计学意义(P＜0.05);治疗后,观察组患者中医证候单项评分中,心悸[(1.91±0.32)分]、胸闷[(1.47±0.26)分]、气短[(0.87±0.15)分]、乏力[(0.74±0.17)分]、心烦[(0.33±0.07)分]、口干[(0.62±0.19)分]、失眠[(0.21±0.04)分]、脉象[(0.73±0.17)分]、舌象[(1.07±0.15)分]、纳差[(0.19±0.03)分]均明显低于对照组[(2.76±0.56)分、(2.26±0.51)分、(1.67±0.33)分、(1.68±0.26)分、(0.89±0.23)分、(0.96±0.31)分、(0.38±0.09)分、(1.04±0.29)分、(1.26±0.26)分、(0.33±0.06)分],差异有统计学意义(P＜0.05);观察组患者治疗后室性早搏次数[(1290.00±210.10)次]明显少于对照组[(3112.80±280.20)次],差异有统计学意义(P＜0.05).结论:黄连温胆汤加减治疗心悸(室性早搏)痰火扰心证临床疗效显著,可促进患者中医证候的改善,减少室性早搏次数,安全性高,值得临床推广应用.

高血压(HT)是以体循环动脉压升高为临床表现的独立性疾病,且病因仍未明确.HT的治疗方式主要包括药物疗法和非药物疗法,其中药物疗法有一定经济支出,部分药物有可能对肝肾功能、电解质有某些影响,而非药物疗法(中医五行音乐疗法)可避免机体对药物依赖性,减少用药支出,易于被患者接受.中医五行音乐疗法以五脏相音为理论基础,同时根据辨证结果针对性选曲治疗,将预防和治疗高血压提高到新的高度.本文主要对中医五行音乐疗法在HT患者中的应用价值进行综述,旨在为治疗HT提供新思路、新方法和临床依据.

OBJECTIVE To observe the curative effect of joint administration of acupuncture, western and herbal medicines and bamboo-jar-cupping in the treatment of locomotor dysfunction in patients with apoplexy (acute phase) of wind-phlegm blocking meridian-collateral type in acute stroke patients, and its influence on some relevant laboratory indexes. METHODS A total of 100 cases of acute stroke patients of wind-phlegm blocking meridian-collateral type were recruited, and equally and randomly divided into control group and treatment group according to the random number table. The patients of both groups received treatment of conventional western medicines (for anti-platelet aggregation, blood-lipid regulation, arterial plaque-stabilization, cerebral cell protection and blood pressure-lowering), Chinese herbal medicines (for promoting blood circulation to dredge the meridian-collaterals), and acupuncture of Neiguan (PC6), Chize (LU5), Zusanli (ST36), Binao (LI14) and Sanyinjiao (SP6); and in addition, the patients of the treatment group also treated by cupping with bamboo-jar (kept for 10 min). The treatment was conducted once a day for 2 weeks. After the treatment, the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA), Barthel Index (BI), and traditional Chinese medicine (TCM) syndrome score were used to assess the state of neurofunction, locomotor function, daily living ability, and TCM symptoms. The contents of serum C-reactive protein, D-dimer and blood homocysteine were detected using radical immunodiffusion, immunoturbidimetry, and enzymic methods, respectively. RESULTS After the treatment, of the 50 and 50 cases in the control and treatment groups, 5 and 6 were cured, 7 and 18 experienced marked improvement, 23 and 20 were effective, and 15 and 6 ineffective, with the effective rate being significantly higher in the treatment group (88.0%) than in the control group (70.0%, P<0.05). Self-comparison showed that the FMA and BI scores were significantly increased (P<0.01), and the NIHSS score and TCM syndrome score notably decreased in both groups ( P<0.01) in comparison with their own pre-treatment. Comparison between the two groups showed that the FMA and BI scores were obviously higher in the treatment group than in the control group (P<0.05), whereas the NIHSS score and TCM syndrome score as well as the C-reaction protein content evidently lower in the treatment group than in the control group (P<0.05, P<0.01). CONCLUSION Joint administration of acupuncture, western and Chinese herbal medicines and cupping can promote the recovery of nerve function, improve locomotor function, activities of daily living and quality of life, and reduce inflammatory state in acute stroke patients with wind-phlegm blocking collaterals.

Objective: To explore the clinical effect of traditional Chinese medicine Tone- Breathing Exercise therapy combined with conventional western medicine on hyperactivity of liver-yang in hypertension. Methods: 60 patients diagnosed with hypertension (hyperactivity of liver-yang syndrome) from theFirst people's hospital of Dongcheng District were randomly divided into control group and intervention group. The control group (n=30) received conventional treatment, including essential drug therapy and lifestyle education. The intervention group(n=30) was treated with TCM tone-breathing exercise therapy and conventional treatment. The course of treatment was 4 weeks. Results: (1) Intervention group was better than the control group in the TCM syndrome score, the scores of anxiety scale, and the reduction of 24h systolic blood pressure, 24h diastolic blood pressure and 24h standard deviation of systolic blood pressure. Conclusion: On the basis of conventional treatment, TCM tone-breathing exercise therapy can improve clinical efficacy and play an important role in reducing blood pressure, alleviating symptoms and improving anxiety for hyperactive liver-yang type hypertension.

目的 观察清肝安神汤治疗肝火亢盛型失眠的有效性和安全性.方法 将124例肝火亢盛型失眠患者随机分为治疗组和对照组各62例,其中治疗组给予清肝安神汤治疗,对照组给予艾司唑仑片治疗,疗程均为4周.对比治疗结束后2组患者总有效率、匹兹堡睡眠质量指数(PSQI)及中医证候积分的改善情况,观察并记录不良反应.结果 治疗组总有效率为85.48％,显著优于对照组的56.45％ (P＜0.01);治疗组PSQI四个因子(睡眠质量、入睡时间、催眠药物和日间功能障碍)改善情况均优于对照组(P＜0.01,P＜0.05);治疗组中医证候总有效率显著优于对照组(P＜0.01),不寐多梦、急躁易怒、头晕头胀等症状显著改善.结论 清肝安神汤能提高肝火亢盛型失眠患者的整体睡眠质量,且能改善不寐多梦、急躁易怒、头晕头胀等临床症状,安全性好.