慢性心力衰竭是多脏器受累性疾病.基于中医经络理论及运动康复方法提出的循经按摩方法,包含循任脉按摩、循手少阴心经-手太阳小肠经按摩、循足少阴肾经按摩等步骤.沿经络循行方向按摩过程中,患者身体、精神放松,自然深呼吸,用意念想象有气随着按摩而流动起来,达到精神内守、身心相合的状态.通过疏通经络,从整体上平衡阴阳、调畅气血、调和脏腑,提升人体的自愈力,达到促进慢性心力衰竭患者心脏康复的作用.另外,循经按摩操作中患者肢体相互配合运动,属于强度适宜的有氧运动,既锻炼肢体的协调性,也能达到西医运动康复的作用.因此,这套

Objective To observe the clinical effect of Liqi Huatan Huoxue Prescription in the treatment of acute exacerbation of chronic obstructive pulmonary disease（syndrome of phlegm and blood stasis obstructing lung）.Methods A total of 88 patients with chronic obstructive pulmonary disease admitted to our hospital were included in the study and divided into an observation group and a control group. The control group was given a conventional western medicine treatment, while the observation group was treated with Liqi Huatan Huoxue Prescription on the basis of that. Their course of treatment was both 4 weeks. The clinical efficacy of the two groups, the TCM symptom scores, the pulmonary function levels [forced expiratory volume in the first second（FEV 1 ）, percentage of FEV 1 in the predicted value（FEV 1 %pred）, ratio of FEV 1 to forced expiratory volume（FEV 1 /FVC%）], the levels of inflammatory factors [interleukin-6（IL-6）, white blood cell count（WBC）, C-reactive protein（CRP）], and the incidence of adverse reactions were observed and compared between the two groups. Results The total effective rate of the observation group（95.45%） was higher than that of the control group（81.82%）（P＜0.05）. After treatment, the symptom scores of the two groups were decreased compared with those before treatment（P＜0.05）, and the observation group was lower than the control group（P＜0.05）. After treatment, the levels of FEV 1 , FEV 1 % predicted value and FEV 1 /FVC%in both groups were significantly increased（P＜0.05）, and the observation group were significantly higher than the control group（P＜0.05）. After treatment, the levels of IL-6, WBC and CRP in the two groups were significantly decreased（P＜0.05）, and the observation group was lower than the control group（P＜0.05）. Conclusion Liqi Huatan Huoxue Prescription has a good effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease（syndrome of phlegm and blood stasis obstructing lung）, which can significantly relieve the clinical symptoms of patients, improve their lung function, and reduce inflammatory reactions, having a high safety and clinical application value.

Objective: To observe the clinical efficacy and safety of abdominal vibration therapy combined with mosapride citrate tablets in the treatment of Diabetic Gastroparesis. Methods: 80 patients with diabetic gastroparesis admitted to Fangshan Hospital of Beijing University of Traditional Chinese Medicine from April 2018 to September 2019 were selected as observation subjects and were divided into treatment group and control group using random number table, 40 cases in each group. The control group was given mosapride citrate tablets, and the treatment group was given vibrating abdominal therapy on the basis of the control group. The clinical efficacy, index score of the main symptoms of gastroparesis, Chinese medicine symptom score, and gastric emptying rate were observed in the two groups. Results: At the follow-up of 2 weeks and 4 weeks of treatment, the total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant (P＜0.05). The postprandial fullness/early satiety, nausea and vomiting, abdominal distension and total score were reduced in both groups, and the treatment group was lower than that of the control group, and the difference was statistically significant (P＜0.05). The TCM symptom scores were reduced in both groups, and the treatment group was lower than that of the control group, and the difference was statistically significant (P＜0.05). The gastric emptying rate increased in both groups, and was higher in the treatment group than in the control group, with a statistically significant difference (P＜0.05). Conclusion: Abdominal vibration therapy combined with mosapride citrate tablets is effective in treating diabetic gastroparesis, which can significantly improve the main symptoms of gastroparesis, improve postprandial abdominal distension and other TCM symptoms, and increase the gastric emptying rate.

This paper introduced the experience of the prestigious doctor in traditional Chinese medicine（TCM）, Wu Junyu, in the treatment of chronic cough. Professor Wu believes that the etiology and pathogenesis of chronic cough are attributed to the deficiency of qi, blood, yang, and yin in the human body combined with Zang-fu qi movement disorder. Professor Wu has proposed that healthy qi deficiency as the root combined with qi movement disorder is the basic pathogenesis of chronic cough, which leads to the failure of the lung in ventilation and purification and the upward reversal of lung qi, thereby triggering cough. Therefore, the key to the treatment of chronic cough is to restore the physiological functions of Zangfu organs on the basis of "reinforcing healthy qi and tonifying deficiency" as well as "flowing qi" to achieve a harmonious state and fundamentally cure chronic cough.

[目的]系统评价益气活血法治疗慢性阻塞性肺疾病急性加重期(AECOPD)的有效性及安全性.[方法]通过计算机检索中国知网、PubMed等7个中英文数据库,检索时限为建库—2019年7月,收集相关益气活血法治疗AE-COPD的临床随机对照试验(RCT).分别需要2位研究者,依据纳排标准独立筛查文献、提取相关数据等资料,然后用偏倚风险评价工具Cochrane对RCT文献质量进行评价,运用RevMan5.3软件行Meta分析,系统评价益气活血法治疗AECOPD的临床疗效、肺功能、血气改善情况.共纳入11篇RCT,包括818例患者.[结果]与对照组比较,益气活血组临床有效率更高[RR=1.20,95％CI(1.14,1.27),P<0.00001];肺功能改善明显,包括第1秒呼吸容积占用力肺活量百分比(FEV1/FVC)[MD=6.65,95％CI(3.97,9.33),P<0.00001]、第1秒呼气量(FEV1)[MD=0.40,95％CI(0.16,0.64),P<0.00001]、第1秒呼气量占预计值百分比(FEV1％pre)[MD=9.10,95％CI(3.70,14.49),P<0.00001]和用力肺活量(FVC)[MD=1.52,95％CI(-0.21,3.26),P<0.00001];同时能改善血气水平,包括降低动脉血二氧化碳分压(PaCO2)[MD=-8.14,95％CI(-13.25,-3.04),P<0.00001]、升高动脉血氧分压(PaO2)[MD=7.28,95％CI(3.38,11.18),P<0.00001]和调节动脉血酸碱度值(pH)[MD=0.06,95％CI(-0.02,0.13),P=0.001];同时统计临床资料中使用频次居前6位的中药,依次是丹参、黄芪、桔梗、党参、白术、甘草.目前证据表明临床治疗AECOPD时,应注重中医益气活血法的使用,同时重视丹参、黄芪、桔梗、党参等中药的灵活合理应用.并且益气活血组的不良反应发生率低.[结论]在常规西医基础治疗基础上加益气活血中药治疗AECOPD,可提高临床疗效,改善肺功能,调节血气指标,但因纳入研究数量及质量的限制,尚缺少高质量证据证实益气活血法的临床疗效,因此需更多设计严谨、大样本的多中心RCT加以验证.

目的 探讨传统门诊教学与病房案例教学结合的中医诊断学课间见习模式的效果.方法 将287名北京中医药大学课间见习学生按照专业、班级不同分为试验组和对照组,其中对照组145人,试验组142人,对照组采用传统门诊见习模式,试验组在门诊见习的基础上,结合病房案例式教学,在见习始、末学生通过问卷进行见习自我评价.结果 见习后学生自我评价项目"新知识、新事物与自身知识体系链接能力"、"运用四诊收集病人病情资料与要领掌握情况"、"对生命意义和人生价值,尊重生命、敬畏生命、关爱生命的理解"有明显差异,且具有统计学意义(P<0.05).结论 门诊与病房案例式教学结合的教学模式,能够使学生体会中医四诊的采集过程,初步建立临床思维,培养了医学生人文关怀精神,切实提高了医学人才培养质量.

目的 观察活血化瘀法联合阿托伐他汀对慢性阻塞性肺疾病缓解期合并肺动脉高压患者血管内皮功能及血液高凝状态的影响.方法 将2019年1月—2020年3月北京市房山区中医医院收治的80例慢性阻塞性肺疾病缓解期合并肺动脉高压患者随机分为2组,对照组40例给予西医常规治疗+阿托伐他汀口服治疗;观察组40例在对照组治疗基础上给予中医活血化瘀法口服治疗,连续治疗8周.对比2组治疗前后临床症状积分、肺动脉压力、运动耐量测定试验、血管内皮功能指标及血液流变学指标变化,比较2组不良反应发生情况.结果 2组治疗后喘促、乏力、自汗恶风、身体疼痛、发绀积分,肺动脉压力,血清内皮素-1(ET-1)水平,全血高切黏度、全血低切黏度、纤维蛋白原(FIB)水平均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组治疗后6 min步行距离、血清一氧化氮(NO)水平均明显升高(P均<0.05),且观察组明显高于对照组(P均<0.05);2组患者治疗期间均未出现严重药物相关不良反应.结论 活血化瘀法联合阿托伐他汀钙片能够降低慢性阻塞性肺疾病缓解期合并肺动脉高压患者血液高凝状态,调节血管内皮功能,有助于缓解临床症状,改善疾病的预后转归.

Objective To observe the traditional Chinese medicine (TCM) constitution and its distribu-tion in patients with chronic obstructive pulmonary disease(COPD),and to provide evidence for preven-tion and treatment of chronic obstructive pulmonary disease from the perspective of Chinese medicine. Methods A total of 416 patients with COPD were enrolled in this study. The physical characteristics and distribution of patients with COPD were investigated. Results In all cases,the proportion of qi-de-ficient constitution was the largest,accounting for 137 cases(32.9%),followed by yang-deficient consti-tution,59 cases,accounting for 14.2% of the total,phlegm-dampness constitution, blood-stasis consti-tution and yin-deficient constitution were 52 cases, 12.5% of the total, 29 cases of yin-yang harmony constitution,21 cases of allergic constitution, qi-stagnation constitution, damp-heat constitution were 7 cases. The distribution rule of constitution type varies according to different gender,age and BMI. Con-clusion Qi-deficient constitution and yang-deficient constitution are the common physical types of pa-tients with chronic obstructive pulmonary disease,and are affected by body mass index,gender and age.