代谢相关脂肪性肝病(MAFLD)是全身代谢综合征在肝脏的表现,其流行率与肥胖、糖尿病等糖脂代谢疾病紧密相关[1].当前,该病已跃居我国肝脏疾病之首,并且是隐源性肝硬化及部分肝癌的重要病因.然而,快速增长的MAFLD至今仍缺乏理想的治疗策略及有效药物[2].本团队结合中国传统医学服药辟谷及消渴病中消的治疗实践经验,围绕MAFLD的深层发病机制,提出了脂肪肝"从脑论治"学说并初步构建了临床治疗方法,取得了较为理想的临床效果.现将其理论基础及相关实践经验介绍如下.

便秘是当今社会人群普遍存在的问题之一,其中最常见的为慢传输型便秘,以肠道运输能力降低为特点的顽固性便秘.目前,临床中没有治疗便秘的特效药,针对便秘的常规疗法通常为泻药、促分泌剂、促动力药及灌肠剂等,此类药物治疗会对人体产生危害.本文通过对于超声药物导入治疗效果观察研究,为临床护理治疗提供无创、简便的参考依据.

目的 分析脏腑经络辨证针灸干预对中风偏瘫后肩痛患者康复水平的影响.方法 选取2021年1月—2021年12月期间北京中医药大学附属护国寺中医医院收治的60例中风偏瘫后肩痛患者,按随机数字表法分为对照组(30例)和观察组(30例).对照组采用常规康复训练,观察组在对照组康复训练的基础上采用脏腑经络辨证针灸干预,比较两组康复效果、生活质量.结果 干预后,两组患者肩关节屈曲、外展、外旋活动范围均优于干预前(P＜0.05),且观察组均优于对照组(P＜0.05);观察组临床总有效率(96.67％)高于对照组(73.33％,P＜0.05);两组患者脑卒中专用生活质量量表(SS-QOL)评分均较干预前提高(P＜0.05),且观察组高于对照组(P＜0.05).结论 脏腑经络辨证针灸干预可明显提高中风偏瘫后肩痛患者肩部功能,改善患者生活质量.

肝纤维化是各种慢性肝病向肝硬化发展过程中的关键步骤和影响肝病预后的重要环节.叶永安教授在肝纤维化治疗实践中形成了具有一定个人特色的诊疗思路.肝纤维化治疗首重病因,以毒立论;次重病机,强调守方;善调气血,由重向轻;兼调他脏,注重脾肾等观点,构成了其肝纤维化诊疗的主要思路.

目的 观察针灸联合小建中汤治疗脾胃虚寒型消化性溃疡的临床效果.方法 选择2018年3月-2019年2月石景山区中医医院收治的脾胃虚寒型消化性溃疡患者98例,采取随机数字表法分为观察组和对照组,每组49例.对照组给予小建中汤治疗,观察组在对照组基础上联合针灸治疗.比较2组治疗前后胃功能指标[血清表皮生长因子(EGF)、胃液EGF、胃黏膜表皮生长受体(EGFR)水平]、治疗效果、溃疡复发率及Hp清除率.结果 治疗后,观察组血清EGF、胃液EGF、胃黏膜EGFR积分光密度及面积百分比均高于对照组(P<0.01);观察组总有效率为97.96％,高于对照组的85.71％(χ2=10.105,P<0.01);观察组溃疡复发率为4.08％,低于对照组的20.41％(χ2=6.078,P<0.05);观察组Hp清除率为79.59％,高于对照组的55.10％(χ2=6.681,P<0.01).结论 针灸联合小建中汤治疗脾胃虚寒型消化性溃疡的效果较好,可显著提升患者血清及胃液EGF水平,改善患者胃黏膜状态,且近期与远期疗效均较显著,值得临床推广应用.

Objective To compare the efficacy of Wang Juyi meridian regulating method for determining abnormal meridians versus syndrome differentiation-based acupoint selection in the textbook in treating stroke patients and analyze whether this method has an advantage in discriminating and treating stroke disorders. Method One hundred and thirty-eight stroke patients were allocated, in order of visits, to treatment and control groups. The therapeutic effects were evaluated after 20 treatments and compared at three months after treatment. The Stroke Specific Quality of Life (SS-QOL) scale score, meridian distribution state and correlation between syndrome type and meridian distribution were used as indicators. Result In the treatment group, the SS-QOL score had a statistically significant difference after treatment and at three months after that compared with before (both P<0.05), indicating that the quality of life improved in the treatment group of stroke patients. There was no statistically significant difference in the SS-QOL score after treatment (P>0.05) but there was at three months after treatment (P<0.05) between the two groups, indicating that after stroke the quality of life improved more in the treatment group than in the control group. In the stroke patients,meridian abnormality mainly occurred in hand and foot Taiyin, hand and foot Yangming, foot Jueyin and hand and foot Shaoyang meridians and seldom in hand and foot Taiyang, foot Shaoyin, Ren and Du meridians. There was a correlation between every syndrome type and a certain meridian. Conclusion Meridians have a specific distribution in stroke patients. There is a correlation between different syndrome type and the corresponding meridian. In stroke patients, Wang Juyi meridian regulating method can improve the quality of life in discriminating and treating stroke disorders.

消化系统恶性肿瘤术后胃肠道功能紊乱（PGID）是肿瘤最常见的术后并发症之一。根据临床症状，PGID 可分为术后胃瘫、术后恶心呕吐、术后呃逆、术后粘连性肠梗阻、术后便秘和术后腹泻6类。据报道，我国 PGID 的发生率为9％～20％［1－4］。由于本病的病程长，且易反复发作，因此常延误肿瘤后续治疗。中医治疗 PGID 具有疗效显著、操作简便、副作用小等优势。纵观中医文献可知，历代医家对本病的认识不一，治疗方法多样。本文章对既往文献中的辨证方法及用药特点进行统计分析，期望总结出可行、适宜推广的治疗方案，提高本病的治疗有效率。

Objective To study the effect of cinobufacini (CINO) on proliferation of human colon cancer SW480 cells and its mechanism.Methods The SW480 cells were cultured generally,the cells at logarithmic phase were inoculated into 96-well plates by 4×103/hole,the nutrient solution was used to filled to total volume 200 μL,and they were ran domly divided into four groups:blank control group (control group,200 μL complete medium),CINO 1 mg/mL group (CINO was diluted to 500 times using complete medium and take 200 μL),CINO 10 mg/mL group (CINO was diluted to 50 times using complete medium and take 200 μL),CINO 100 mg/mL group (CINO was diluted to 5 times using complete medium and take 200 μL).The anti-proliferative effect of CINO for SW480 cells was measured by MTT assay.The apoptotic morphology of SW480 cells were observed with inverted real-time fluorescence microscopy imaging.Enzyme linked immunosorbent assay (ELISA) method was used to detect the effects of SW480 cells for the expression of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGF-R2).Results After 24,48,72 h,the MTT test showed that compared with the control group,the A540 of CINO 1,10,100 mg/mL groups was dropped significantly,the difference was statistically significant (P ＜ 0.05).After 0,24,48 h,the inverted realtime fluorescence microscopy imaging showed that the number of apoptotic cells in CINO group (1,10,100 mg/mL) were significantly higher than those of control group.Compared with the control group,ELISA results showed that CINO group could reduce the protein expression of VEGF and VEGF-R2,the difference was statistically significant (P ＜ 0.05).Conclusion CINO can inhibit the proliferation of colonic cancer cells,and induces apoptosis,and its mechanism may be related to inhibiting the autocrine of VEGF and VEGF-R2 in cancer cells.

<正>刘世平主任医师师从全国著名中医专家吴效仁,其临床辨证施治针法精深,每取佳效,擅长治疗脑血管病、面瘫、痹证、坐骨神经痛、内分泌失调、痛证等。刘世平主任医师的镇静调气针刺手法是经过不懈的练习而得来的,能达到200次/min以上均匀稳定的捻针速度。笔者有幸跟随刘世平主任医师进行针灸学习,体会到其针灸经验丰富,在明确辨证后,根据不同的病证,按照"君臣佐使"的穴位组合,应用不同的针刺手法进行治疗,效果甚佳,举一医案予以详细说明。

<正>腹腔镜阑尾切除术以其创伤小、出血少、痛苦轻、恢复快等优点被广大患者所接受。现将我科腹腔镜阑尾切除术围手护理体会总结如下。1相关知识资料1.1定义及临床表现阑尾炎是腹部外科常见疾病,是最常见的急腹症。主要临床表现:①转移性右下腹痛;②恶心、呕吐;③发热;④肠麻痹表现。1.2腹腔镜阑尾切除术方法

To summary the peculiar experience of Chief LIU Shiping on treating vertigo by acupuncture.Chief Liu discriminated vertigo by excess and deficiency.He believed that most deficiency because of kidney deficiency,while excess resulted in excessive rising of liver-Yang,stagnation of Qi due to depression of the liver and phlegmatic hygrosis.Treating vertigo mainly based on differentiation of symptoms and signs,so that to choose points.Yin conceals Yang,Yang conceals Yin.Needling a point by three methods at the same time.There were both importance on needling method and choose points.Then an excellent could be obtained.

刘世平老师师承名老中医吴效仁先生,临床辨证施治,针法精深,临床每取佳效,现于北京中医药大学附属护国寺中医药针灸科出诊.自跟随刘世平老师出诊以来,眩晕一症多见,刘师仅以寥寥数针,解患者疼痛,尤其对于肝郁气滞,郁热上扰者,临床经验颇丰,现取其病案一例,与诸同仁分享刘师针灸治疗该证之经验.

目的探讨中药灌肠治疗肠梗阻的护理方法并对其效果进行评价。方法结合理论知识及临床经验,使用一次性灌肠器对肠梗阻患者进行中药灌肠,观察治疗效果,总结控制条件及方法。结果运用有效的护理方法对肠梗阻患者进行中药灌肠,临床效果满意。讨论中药灌肠对肠梗阻患者具有较好的疗效,护理人员在操作过程中应尽量充分发挥其药效,促进患者的康复。

Medicinal prescription is one of the important criteria for the compatibility of Chinese medicine. This article analyzes the herbal medicine combination prescribed by Prof. Yan Zhenghua, a national Chinese medicine expert, for the treatment of stomach pain. Prof. Yan has explored research methods for the compatibility of Chinese medicine based on the natural medicine combination modes. The corresponding prescription database of existing prescriptions has been established. Algorithms for association rules were used in the analysis of combination modes of Yan Zhenghua's prescription for the treatment of stomach pain. The results revealed the prescription characteristics of Yan Zhenghua's treatment of stomach pain. This study puts forward new ideas based on the prominent doctor's academic views.

<正>药对是中药方剂的基本功能单位,研究药对的组成规律,对于方剂配伍规律的研究具有重要借鉴意义[1]。因此,近年来药对配伍规律研究引起了广泛关注,在理论、实验、临床应用方面积累了大量研究成果。而以此为基础的数据挖掘,以其在

Objective:To analyze the experience of XU Peng-lin in using medicine in treating chronic gastritis,exploring the method for summarizing the experience of famous TCM practitioner.Methods:Professor Xu's 212 typical cases of chronic gastritis were collected,using related rules and point mutual information to analyze the prescription compatibility for the chronic gastritis.Results:Utilization of 12 kinds of drugs were over 30 percents,includinging Pinellia,dried ginger,mongolian milkvetch root,Medicinal Evodia Immature Fruit,and liquorice root,etc..The common compatibility rules were warming spleen-stomach to eliminat dampness,acridness and sweetness activating yang,sour-sweet herbs nourishing yin,pungency disperses while bitterness descends,application of both cold and heat,and combination of reinforcing and reducing.The basic prescriptions for chronic gastritis used by professor XU were Pinelliae Decoction for Purging Stomach-Fire,Zuojin Pill,Huangqi Jianzhong Decoction.Conclusion:Harmonizing yin and yang,reinforcing deficiency and reducing the excess,regulating the activities of qi,harmonizing zang and fu organs were the treatment for chronic gastritis by professor XU,which provided the methodological reference toTCM in treating the chronic gastritis.

许彭龄教授为第三、四批全国老中医药专家学术经验继承工作指导老师,北京中医药大学研究生导师,主任医师.临床辨证精确,善组方配伍,法于古而不泥于古,治疗慢性胃炎从理论到临床形成了一套独特的辨证思维方法和完整的治疗体系.许彭龄教授临证应用和化法治疗慢性胃炎120例,结果如下.