目的 探讨滋肾调脾敛汗方治疗阴虚火旺型围绝经期汗症的效果及对患者神经内分泌系统的影响.方法 选取2017年6月至2019年10月中国中医科学院广安门医院收治的阴虚火旺型围绝经期汗症患者82例,采用随机数字表法分为观察组和对照组,各41例.对照组采用玉屏风颗粒治疗,观察组在对照组基础上加用滋肾调脾敛汗方治疗.比较2组治疗前后主症评分、次症评分及总评分,临床疗效,治疗前后神经内分泌系统指标,并比较2组治疗期间不良反应发生情况.结果 治疗后,2组患者主症评分、次症评分、总评分均低于治疗前,且观察组均低于对照组[(2.2±0.4)分比(4.4±0.7)分、(1.7±0.5)分比(3.1±0.7)分、(3.8±0.7)分比(7.5±1.5)分],差异均有统计学意义(均P＜0.05).观察组总有效率高于对照组[97.6％(40/41)比82.9％(34/41)],差异有统计学意义(P＜0.05).治疗后2组血清5-羟色胺、雌二醇、孕酮水平均明显高于治疗前,且观察组高于对照组[(183±29)μg/L比(169±28)μg/L、(97±10)pmol/L 比(92±9)pmol/L、(2.2±0.4)μg/L比(1.9±0.4)μg/L](均P＜0.05),2组血清促卵泡生成素、促黄体生成素水平均明显低于治疗前,且观察组均低于对照组[(26±4)IU/L比(39±5)IU/L、(17±4)IU/L比(21±4)IU/L](均P＜0.05).2组治疗期间不良反应发生率比较差异无统计学意义(P=0.644).结论 滋肾调脾敛汗方能有效缓解阴虚火旺型围绝经期汗症患者汗症症状,疗效显著,还可改善患者神经内分泌系统指标,且安全性较好.

目的 探讨涤痰通络方治疗痰瘀阻络型急性缺血性脑卒中的临床疗效,并研究其对患者神经功能的影响.方法 将2016年5月—2019年5月老年病科收治的98例缺血性脑卒中患者随机分为两组,各49例,对照组采用常规治疗方案,在对照组的基础上,观察组给予涤痰通络方治疗,两组持续治疗2个疗程.分别于治疗前后比较两组患者的临床疗效、中医证候积分、临床神经功能缺损(NIHSS量表)评分、改良Rankin量表(mRS)积分、脑血流动力学指标、神经胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、血清髓鞘碱性蛋白(MBP)、S100B蛋白水平.结果 观察组总有效率为91.8％ (45/49),对照组总有效率为75.5％ (37/49),两组比较差异有统计学意义(P＜0.05).观察组治疗后中医证候积分、mRS积分及NIHSS评分均显著降低(P＜0.05),并且显著低于对照组(P＜0.05).观察组治疗后CBV、CBF明显升高(P＜0.05),MTT、TTP明显降低(P＜0.05),并且优于对照组(P＜0.05).治疗后观察组患者GFAP、NSE、MBP及S100B均显著降低(P＜0.05),并且均显著较对照组低(P＜0.05).结论 涤痰通络方治疗痰瘀阻络型急性缺血性脑卒中临床疗效显著,促进患者脑内微循环,修复患者神经功能,值得临床推广.

目的 探讨温阳利水汤加减联合酒石酸美托洛尔对慢性心衰患者的临床疗效.方法 96例患者随机分为对照组和观察组,每组48例,对照组给予酒石酸美托洛尔,观察组在对照组基础上加用温阳利水汤加减,疗程3个月.检测临床疗效、中医证候评分、心功能指标(LVEDD、LVESD、LVEF、心率)、CRP、NT-pro BNP、不良反应发生率变化.结果 观察组总有效率高于对照组(P＜0.05).治疗后,2组中医证候评分、LVEDD、LVESD、心率、CRP、NT-pro BNP降低(P＜0.05),LVEF升高(P＜0.05),以观察组更明显(P＜0.05).观察组不良反应发生率低于对照组(P＜0.05).结论 温阳利水汤加减联合酒石酸美托洛尔可安全有效地促进慢性心衰患者心功能恢复,改善血清CRP、NT-pro BNP水平.

目的:对中国中医科学院广安门医院老年科杨戈主任临床治疗高血压的方剂进行数据挖掘研究,以期有益于临床用药.方法:规范整理后,人工录入181诊次病历,运用"中医辅助传承系统(V2.5)"的频数分析、关联规则、复杂系统熵聚类及无监督的熵层次聚类等算法对单药、对药、角药及配伍规律等进行研究.结果:杨戈主任于门诊治疗高血压最常用的单药为甘草(134次,74.03％)、天麻(121次,66.85％)、钩藤(110次,60.77％);最常用的对药是钩藤-天麻(106次,58.56％);最常见的配伍规律为牛膝,钩藤->天麻.结论:杨戈主任治疗老年人高血压主要以天麻、钩藤、牛膝合四君子汤同时配伍滋阴、行气、活血等诸药,以平肝潜阳为法,调整气血升降功能,并且注重补益后天脾胃,使气血生化有源.

目的:对中国中医科学院广安门医院老年科杨戈主任医师临床治疗健忘的处方规律进行数据挖掘,以期为临床用药提供思路和方法.方法:规范整理后,人工录入401诊次病历,运用“中医传承辅助平台(V2.5)”的频数分析、关联规则、复杂系统熵聚类及无监督的熵层次聚类等算法对单药、对药、角药及配伍规律等进行研究.结果:治疗健忘最常见单药为黄芪(336次,83.79％);最常见的配伍规律为龟甲,远志-＞石菖蒲(0.9931);龟甲,龙骨,远志-＞石菖蒲(0.9927).结论:老年人肾精亏虚,气虚不足以推动血液运行而致血瘀,堵塞脑窍可发为健忘,经过探究发现杨戈主任医师临床常以补肾填精、益气通络、开窍醒神药物治疗老年患者健忘,可以优先选择黄芪、川芎、红花、远志、石菖蒲、龙骨、龟甲、地龙、白术、葛根、甘草、大枣等药物.

Objective To study the effect of Suxiao Jiuxin Pill on myocardium blood-supplying in moderate coronary stenosis patients with blood stasis syndrome by gated myocardial perfusion imaging. Methods Totally 101 moderate coronary stenosis blood stasis syndrome patients with

目的 了解中成药坤泰胶囊对围绝经期轻中度焦虑症患者汉密尔顿焦虑量表因子分的影响.方法 选择2015年5月-2016年5月在中国中医科学院广安门医院门诊就诊的符合纳入标准的围绝经期轻中度焦虑症患者21例,给予坤泰胶囊每次4粒,3次/d,治疗8周,于服药前、服药4周、服药8周对患者进行汉密尔顿焦虑量表(HAMA)评估焦虑症状.结果 随着治疗时间的延长,HAMA总分显著降低,治疗前为(23.2±3.4)分,治疗4周为(18.6±3.9)分,治疗8周为(12.7±3.9)分,差异均有统计学意义.治疗4周时,躯体症状和精神症状的改善有效率分别为23.8％和33.3％,治疗8周时,为71.4％和90.4％,躯体症状和精神症状的改善有效率均在治疗8周比治疗4周时高,差异有统计学意义(P＜0.05).治疗4周时焦虑症状、抑郁症状、躯体神经症状、会谈表现比治疗前评分低,差异有统计学意义(P＜0.05);治疗8周时所有因子均比治疗前评分低(P＜0.05),其中焦虑症状、抑郁症状、内脏器官、泌尿生殖、以及植物神经评分比治疗4周时评分低,差异有统计学意义(P＜0.05).结论 坤泰胶囊可明显改善围绝经期焦虑症状.随着治疗时间的延长,症状改善更显著.精神性症状改善较迅速,精神性症状改善与躯体性症状改善在治疗8周时达到较好的疗效.

Suxiao jiuxin pill is considered an effective ancillary drug in patients with coronary heart disease. Although numerous small, single-center clinical trials have been conducted, the benefits and harms of suxiao jiuxin pill remain controversial. We performed a meta-analysis to clarify the efficacy of suxiao jiuxin pill on patients with coronary heart disease. Randomized controlled trials were identified by using the Cochrane Library, PubMed, Web of Science, Embase, Wanfang, Weipu, and China Knowledge Resource Integrated databases (until June 2016). Pooled relative risks (RR), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were estimated using random-effects models. Forty-one trials involving 6276 patients were included in our analysis. Administration of suxiao jiuxin pill significantly improved electrocardiogram (ECG) results when compared with other therapies (RR 1.32, 95% CI 1.26 to 1.38, and P<0.001). Subgroup analyses revealed that suxiao jiuxin pills improve ECG results more than salvia tablets (RR 1.54, 95% CI 1.41 to 1.67, and P<0.001), isosorbide dinitrate (RR 1.14, 95% CI 1.21 to 1.44, and P=0.001), nitroglycerin (RR 1.35, 95% CI 1.16 to 1.56, and P<0.001), and other drugs (RR 1.32, 95% CI 1.21 to 1.44, and P<0.001). Available evidence additionally suggests that suxiao jiuxin pills could significantly reduce total cholesterol (WMD −0.62 mmol/L, 95% CI −1.06 to –0.18 mmol/L, and P=0.005) and low-density lipoprotein (LDL) levels (WMD −1.12 mmol/L, 95% CI −1.42 to −0.82 mmol/L, and P<0.001) and increase high-density lipoprotein (HDL) levels (WMD 0.32 mmol/L, 95% CI 0.07 to 0.58 mmol/L, and P=0.014). However, no significant differences were observed in total triglyceride levels, plasma viscosity, hematocrit, and fibrinogen. No incidences of adverse reactions were observed after administration of suxiao jiuxin pill. Improvements in ECG results and lipid profiles were also observed after suxiao jiuxin administration compared to other therapies. It also decreased low-cut and high-cut whole blood viscosity without significant adverse reactions.

Objective To observe the efficacy and safety of Bushen Huoxue Prescription in the treatment of kidney deficiency and blood stasis type primary osteoporosis. Methods Totally 50 patients with kidney deficiency and blood stasis type primary osteoporosis were collected. They were given Bushen Huoxue Prescription granules twice a day, taking with water, for 12 weeks. Before and after treatment, the femoral neck, Ward's area, L1–4 bone mineral density (BMD) were measured. VAS and TCM syndrome integrals were evaluated before and 4, 8 and 12 week of treatment. The level of serum osteocalcin (OC), β-C-terminal telopeptides of type I collagen (β-CTX) and osteoprotegerin (OPG) were detected before and after treatment. Hematuria routine, liver and kidney function were under safety testing before and after treatment. Results Bushen Huoxue Prescription could significantly increase BMD of left femoral neck and Ward's triangle (P=0.001, P=0.044). L1–4 BMD increased, without statistical significance (P=0.172). The total effective rate was 60.870% (28/46) for L1–4 and left femoral neck and 58.696% (27/46) for Ward's triangle. The VAS and TCM syndrome integral decreased significantly 4 weeks treatment compared with that before the treatment (P<0.01), and the scores decreased significantly with the prolongation of treatment time (F=159.690, P<0.001; F=163.970, P<0.001). After 12 weeks, treatment, the total effective rate for TCM syndromes was 78.26% (36/46). Serum levels of OC and β-CTX showed a tendency to increase, while serum levels of OPG showed a tendency to decrease, without statistical significance (P=0.087, P=0.091, P=0.419). There was no serious adverse reaction in hematuria routine and liver and kidney function. Conclusion Bushen Huoxue Prescription has obvious clinical efficacy for kidney deficiency and blood stasis type primary osteoporosis, which can improve the patients' BMD, improve bone metabolism, relive bone pain, with high level of safety.

骨质疏松症(osteoporosis,OP)是以骨量减少、骨的微观结构退化为特征的,致使骨的脆性增加以及易于发生骨折的一种全身性骨骼疾病[1].随着人口不断老龄化,骨质疏松症的患病率正逐年增加[2].OP分为原发性骨质疏松症(primory asteoporosis,POP)及继发性骨质疏松症,POP又分为绝经后骨质疏松症和老年性骨质疏松症.骨质疏松导致的骨折好发于髋部、椎体及腕部,严重影响患者的生活质量.

目的:分析并探讨无缝隙护理对老年冠心病患者心绞痛控制及预后的效果.方法:选取我院2015年1月-2016年1月收治的冠心病患者60例作为本次研究对象,按照患者自主意愿将其分为护理组与常规组,各30例.对常规组心绞痛患者采用常规护理,给护理组心绞痛患者采用无缝隙护理,对比两组患者的护理效果.结果:护理期间,护理组患者心绞痛量表(SAQ)评分高于常规组,两组对比差异显著,有统计学意义;对患者出院后进行为期3个月随访,护理组患者的不良事件的发生率少于常规组,两组对比差异显著,具有统计学意义.讨论:对患者采用无缝隙护理,可降低心绞痛发生次数,促进疾病转归,从而提升冠心病患者生活质量.

"异病同治"是指"不同的疾病,若促使发病的病机相同,可用同一种方法 治疗"[1],"同"指的是治法相同,"异"指的是疾病相异.异病同治的基础是证同治亦同,证是决定治疗方法 的关键.骨质疏松症、动脉硬化均是衰老相关性疾病,发病率随年龄增长而上升,二者在病变发展过程中出现相同病机肾虚血瘀,故治疗时根据"异病同治"的原则,均可应用补肾活血法获效.

Objective The purpuse of the study is to evaluate the relationship between sluggish pulse and routine clinical laboratory test parameters of intermediate coronary stenosis patients. Methods Eighty patients were divided into two groups according to whether or not sluggish pulse existed.Medical history and clinical parameters of intermediate coronary stenosis patients were col ect-ed and statistical y analyzed.Results Compared with non sluggish pulse group,the value of prothrombin time(PT)in the sluggish pulse group was significantly lower,TG was higher. Regression analysis showed that only the PT into the equation (OR=0.399, 95% CI 0.181 to 0.878,P=0.022).When activation part thrombin time(APTT),fibrinogen(FIB),D dimer(D D)and other coagula-tion factors under correction,PT was stil considered to be an independent risk factor of sluggish pulse (OR=0.338,95% CI=0.129 to 0.887,P=0.028).Conclusion PT is closely related to the existence of sluggish pulse in patients with intermediate coronary ste-nosis.The potential usefulness of routine clinical laboratory test parameters in TCM syndrome diagnosis needs to be further dis-cussed.

Objective Borderline coronary lesions is a special stage for the coronary heart dis-ease. It is important to study the patterns of traditional Chinese medicine and make a strategy for treatment in clinic. Methods The literature retrieval method is used in this study. We retrieved all Chinese pub-lished research papers, and academic dissertations from January 1979 to December 2013. In these articles, coronary angiogram examination was used to distinguish the degree of coronary artery stenosis and traditional Chinese medicine syndrome differentiation was applied to study the disease. Then we summarized the pat-terns of borderline coronary lesions. Results 17 articles and 682 cases of borderline coronary lesions in total were included in the study. We found that blood stasis pattern and phlegm blocking patteren were the&nbsp;main patterens for borderline coronary lesions, which were 29. 33% and 15. 4% respectively. Pattern of heart-kidney yin deficiency, pattern of heart yang deficiency, dual deficiency of qi and yin, pattern of phlegm and blood stasis binding together also possessed certain proportions. Conclusion The blood stasis pattern and phlegm blocking patteren were the two main patterns for borderline coronary lesions.

Intermediate coronary stenosis(ICS) is a special stage of coronary atherosclerosis progress,it is at least one segment of coronary diameter stenos is 20%-70% and its etiology agents,pathologic process are the same with those of coronary heart disease(CHD).In addition,ICS is the principal cause of acute coronary syndrome(ACS).Such degree of stenosis is unlikely to reduce coronary flow sufficiently enough to cause symptoms.Histopathological studies have shown that the principal pathologic process underlying most AMI is the rupture of an atherosclerotic plaque and following thrombosis.In this article,the author generalized the research survey on ICS of western and traditional Chinese medicine and then discussed possible research method in ICS of traditional Chinese medicine.The purpose is to provide the clues to the diagnosis and treatment of ICS.

Weakness of five viscera and the imbalance of qi,xue,yin and yang are the fundamental reasons of formation of vulnerable plaque of coronary arteries.Qi dificiency,qi stagnation,blood stasis and endogenous retention of phlegm turbid are the major pathological factors.As long as the blood stasis and endogenous retention of phlegm turbid have been accumulated for a long term,the toxin of blood stasis and phlegm turbid are formed and they do harm to the Xin-collaterals.So that the fundamental therapeutic methods should be to adjust qi,promote blood circulation,dissolve phlegm turbid,detoxicate and dredge collaterals.Adjusting qi and Strengthening Body Resistance to Consolidate Constitution should run through the whole passage of stbalizing plaque.In addition,insect drugs can strengthen the capacities of detoxication and dredging collaterals.

One of main characteristics of Traditonal Chinese Medicine is syndrome identification as the basis for determining treatment.At present,identifying pattern has being based on the experience and is a course of qualitation decision.So patterns are lack of quantitative assay.After referring lots of information,the author thinks looking for the patterns' essence is the key and hypotheses the biocurrent,being living field,magnetic field and energy are the patterns' essence.When above substances are quantitative change or transform each other,all kinds of signs and symptoms will be caused.Because channels and collaterals and points spread all over the body,the author suggests the Traditional Chinese Medicine should combine with modern technology of physics,machine,biology and electron,scanning channels and collaterals and points of all over the body to induce the changes of the biocurrent,being living field,magnetic field and energy by body scanner,then contacting the related signs and symptoms to draw a finger printing of patterns which will contain integrated information and specific variance.The finger printing will provide the quantitative basis for clinical diagnosis and the evaluation of the curative effect.

冠脉临界病变是冠状动脉粥样硬化进展过程中的一个特殊阶段[1],于此阶段识别稳定斑块对防治急性冠脉综合征(ACS)等心脏事件具有不可替代的作用.目前现代医学对冠脉临界斑块的识别及干预研究相对成熟,而中医药对其研究尚未全面开展.