焦虑障碍广泛存在,并且是诸多躯体疾病的重要因素之一.现代社会的节奏加速了焦虑障碍疾病发展,西药治疗不良反应较大,中医诊断及治疗多从疏肝解郁入手而病情反复,多易复发.文章创造性提出焦虑障碍特征性舌象,并探讨中医"化痰热-开玄府-引阴火"三步法治疗焦虑障碍的经验.对玄府学说和临床应用也有较大创新,为中医辨治焦虑障碍进行了系统梳理,并为该病的辨证及治疗标准化研究提供了可靠的思路.

目的:建立超高效液相串联-四极杆静电场轨道阱质谱(UPLC-Q-Orbitrap)与多种数据解析方式对玉竹化学成分进行快速鉴定,为进一步阐明其药效物质基础和全面质量控制提供参考.方法:采用Thermo Scientific Hypersil GOLD aQ(2.1 mm×100 mm,1.9μm)色谱柱在0.1％甲酸乙腈溶液(A)-0.1％甲酸水溶液(B)流动相中进行梯度洗脱;以电喷雾离子源搭配静电场轨道阱(Orbitrap)检测器正负离子模式对玉竹中的化学成分进行检测.根据一级高分辨率质谱精确质荷比数据、二级高分辨率质谱碎片离子、Thermo Scientific中药成分数据库和mzCloud网络数据库并结合文献报道,对化学成分进行鉴定.结果:从玉竹中共分析鉴定了37个化学成分,其中包括生物碱类9个,黄酮类8个,氨基酸类4个,糖苷类3个,木脂素类2个,萜类1个,有机酸类1个,其他类成分9个.结论:应用液质联用结合数据库对玉竹进行全成分分析,可为进一步研究玉竹的全面质量控制方法、体内吸收和代谢过程以及药效物质基础提供了科学依据.

便秘为临床常见病,国内外学者对其理论研究和临床研究成果颇多,作者重新梳理了慢性便秘的证治分型和临床治疗方案,从中医玄府理论角度论述慢传输型便秘的病因与治疗,拓展玄府学说理论,提出“五脏六腑皆有玄府”学术思想,并将其理论基础和临床阐释系统化,介绍应用该法治疗慢传输型便秘经验,以利于本病的治疗和治疗思维的推广.

OBJECTIVE:To compare the difference in the clinical therapeutic effects on slow transit constipation (STC) among the combined therapy of acupuncture and herbal medicine, simple use of herbal medicine and simple use of western medication.METHODS:Ninety patients of STC were randomized into three groups, 30 cases in each one. In the combined therapy group, acupuncture was used in combination with the modified weitong xiaopi formula. In the Chinese herbal medicine group, the modified weitong xiaopi formula was adopted. In the western medication group, mosapride citrate capsules were used. The duration of the treatment was 28 days. Before and after treatment, the colonic transit test was applied, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were selected for assessment. The clinical therapeutic effects were compared among the three groups.RESULTS:The total effective rate was 96.7% (29/30) in the combined therapy group, better than 90.0% (27/30) in the Chinese herbal medicine group and 76.7% (23/30) in the western medication group (P<0.05). In each group, before and after treatment, the residual marker amount was reduced apparently in the colonic transit test (all P<0.01). After treatment, the residual marker amount in the combined therapy group was less than that in the Chinese herbal medicine group (P<0.05) and that in the western medication group (P<0.01). The residual marker amount in the Chinese herbal medicine group was less than that in the western medication group (P<0.01). Compared with those before treatment, the scores of SAS and SDS were decreased in the combined therapy group and Chinese herbal medicine group (both P<0.01). After treatment, the scores of SAS and SDS in the combined therapy group were lower obviously than those in the other two groups (both P<0.01).CONCLUSIONS:Under the guidance of xuanfu theory, the combination of acupuncture and Chinese herbal medicine improve appa-rently colonic function and relieve the conditions of anxiety and depression in STC patients. The therapeutic effects are better than those treated with simple use of Chinese herbal medicine and simple use of western medication.

Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai (EX-UE 2) and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle (SEIRIN pyonexes) were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale (VAS) values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.