难治性胃食管反流病发病与多种因素相关，病程较长，反复发作。符思教授善于从肝论治难治性胃食管反流病，提出肝失疏泄是其主要病机，并细分为水不涵木、木郁化火、木火刑金3种情况，临证除以调肝为主要治法外，还相应配合补母法以滋补肾阴、泻子法以清泻心火、清金制木法以滋养肺胃之阴，此外还注重健康宣教，嘱患者调摄起居及饮食，如此综合调理，常获佳效。

探索适合中医内科学临床见习更有效的教学方法.采用PBL结合标准化病人的教学方法,对北京中医药大学中医内科学临床见习学生进行授课,采用考核、调查问卷等多种方式评价教学效果,并与传统授课方法进行比较.研究显示,PBL结合标准化病人方法在提高学习兴趣、培养自主学习能力、提高团队协作能力、对临床实用、对病例印象深刻、活跃课堂气氛、拓宽知识面、教学效果总体评价以及考核成绩方面显著优于传统教学法.PBL结合标准化病人方法的教学效果优于传统教学方法,可以在中医内科见习授课中推广.

Objective To study the effects of modified Sanxiang Decoction on gastrointestinal transmission function of patients with functional bloating (FB). Methods Sixty cases of FB patients were randomly divided into treatment group (40 cases) and control group (20 cases). Treatment group was given modified Sanxiang Decoction, while control group was given placebo granules, one bag each time. Twice a day, taking it after mixing it with water. Gastrointestinal symptoms, 48 h GITT, and adverse reactions were recorded. Results There was statistical significance in TCM symptom scores between before and after treatment in the two groups (P<0.05). After treatment, the total score of abdominal distension, belching, anorexia and TCM symptoms of the treatment group were lower than the control group, with statistical significance (P=0.000, 0.000, 0.010, 0.003). The total effective rate was 82%(33/40) in the treatment group, 30%(6/20) in thecontrol group;the treatment group was better than the control group (P<0.05). A total of 30 patients completed gastrointestinal transit test, of which delayed 48 h GITT pass rate accounted for 54% (16/30). Compared with the control group, the 48 h GITT of the treatment group was more obviously improved than that of the control group with statistical significance (P=0.002). There were no significant adverse reactions in both groups. Conclusion Most of FB patients have the problem of abnormal intestinal motility. Modified Sanxiang Decoction can improve the symptoms of patients with FB, promote gastrointestinal motility, and improve intestinal transmission function.

Objective:To explore the efficacy of Xiangsha Liujunzi Decoction combined with Zhizhu Pills in the treatment of functional dyspepsia (FD) with spleen deficiency and qi stagnation and its influence on radio nuclide gastric emptying.Methods:A randomized controlled trials was conducted.A total of 128 cases of FD patients were recruited and divided into treatment group and control group.Treatment group was treated with Xiangsha Liujunzi Decoction with combined Zhizhu Pills,while control group was treated with compound digestive enzyme capsules for 28 days.Patients' conditions,symptom integrals,and the results of radio nuclear gastric emptying were analyzed before and after treatment.Results:There was significant difference in efficacy indexes between treatment group and control group after 28 days (P＜0.05).The symptom integrals of treatment group were significantly decreased compared with control group (P＜0.05).The emptying rate was significantly increased in treatment group compared with baseline (P＜0.05).After 2 hours,the retention rate of treatment group was significantly decreased compared with baseline (P＜0.05).There was no significant difference between treatment group and control group.There were no severe side effects in both treatment group and control group.Conclusion:Xiangsha Liujunzi Decoction combined with Zhizhu Pills in the treatment of FD with spleen deficiency and qi stagnation is safe and effective,and at the same time,the gastric emptying ability of FD patients can be improved.

To explore the application of Banxia Houpu decoction in clinic, clarify its clinical efficacy. The relevant documents and materials of Banxia Houpu decoction in the treatment of digestive system, respiratory system, endocrinology department, gynaecology, ent dept, psychological psychiatricwere looked up in CNKI, and the researches were analyzed and summarized. Banxia Houpo decoction in the treatment of these diseases had satisfactory therapeutic effect. Banxia Houpo decoction has clinical value and should be further studied in order to better serve the clinic.

1 病例报告 患者,女性,43岁. 因中上腹痛20 d,黑便12 d,急性上消化道出血于2014年12月19日入院. 患者入院前20 d无明显诱因出现剑突下绞痛,多于空腹时出现,伴有反酸,进食后疼痛缓解. 就诊于外院行C13尿素呼气试验提示HP( +),予三联抗感染治疗,服药2天后因恶心、黑便停药. 后仍出现黑便,2~3次/天,每次量约200 ml. 4 d前夜间出现低热,左侧髋骨疼痛,自服洛索洛芬钠片可入睡. 1 d前出现柏油样便,7 ~8次/天,每次量约50 ml,伴有乏力、头晕,就诊于我院门诊. 血常规:RBC 4.27 ×1012,HGB 117 g/L. 生化:ALT 242 IU/L,AST 210 IU/L,LDH 1186 IU/L. 便潜血(+). 为进一步诊治收入院,入院当天黑便5次. 既往体健,近2月饮食不规律. 入院后急查胃镜:胃角、胃窦部见不规则隆起、溃疡性变,约3 .5 cm ×3 .0 cm范围,表面凹凸不平,覆新鲜血凝块,质地硬,活检5块+HP;胃窦幽门前区扭曲变形.

功能性腹胀属中医“胀满”“痞满”“聚症”等范畴，中医认为其基本病机为中焦气机不利，升降失司，多虚实夹杂，而气滞、脾虚、痰湿等病因均可致本病。重视“六腑以通为用，以降为顺”的生理特性，运用通降法治疗功能性腹胀，调整中焦气机，通过通降行积、通降祛湿、通降以佐金平木，一法多用，辅以通降兼苦辛，通降不忘扶正等方法，标本兼治，以图恢复胃肠和降功能，临床上使用符氏三香汤加减本病治疗取得较好疗效。

Objective: To observe the effect of Jiawei Sanxiang Decoction in treating intestinal qi stagnation and spleen deficiencytype of functional constipation.Methods: Eighty cases of patients with intestinal qi stagnation and spleen deficiency type of func -tional constipation were randomly divided into treatment group and control group , with 40 cases in each group.The treatment groupwas given Jiawei Sanxiang Decoction , while the control group was given orally taken polyethylene glycol 4000 powder.The durationof treatment had lasted for 14 days.Records was taken in regard to Traditional Chinese Medicine symptoms , specifically, defecationintervals, defecating time, stool characters, distending pain in the lower abdomen, chest and hypochondrium distension stuffypain, belching, lassitude and disinclination to words, and fatigue symptom, and assessed by SAS integral.Results: There are nosignificant difference in curative effect on functional constipation and improvement on stool character between the two groups .(P >0.05) However, after the treatment, TCM syndrome integral and SAS integral in the treatment group were significantly lower thanthose of the control group, and the difference was of statistical significance (P <0.05).Conclusion: Jiawei Sanxiang Decoctioncan effectively treat intestinal qi stagnation and spleen deficiency type of functional constipation and can improve the TCM syn -dromes and relieve anxiety of patients .

Ulcerative colitis is the rectum and colon of chronic nonspecific inflammatory disease whihc cause is still not quite clear.The lesions are mainly involving the rectum,the colonic mucosa and submucosa,belonging to inflammatory bowel disease.The main clinical manifestations are abdominal pain,diarrhea,mucus,pus and blood stool and the disease is a chronic recurrent process.Professor WANG Wei thinks that the occurrence of the disease is related with spleen and kidney and proposals the treatment from spleen and kidney.Invigorating spleen and kidney,clearing heat and eliminating dampness are the main treatment principles,combined with cooling blood to stop bleeding,convergence to stop diarrhea and promoting blood circulation and removing blood stasis method,have a good curative effect.

通过对近十年有关普济消毒饮运用的文献进行分析总结,将临床运用普济消毒饮治疗传染性疾病、呼吸道疾病、皮肤科疾病、口腔科疾病进行综述,以期为进一步研究及临床运用提供参考.

The general situation about objective indexes of TCM patterns of chronic superificial gastritis (CSG) in recent years were reviewed from biochemical, immune and genetic aspects in the hope of providing evidence for establishing the standard of syndrome differentiation and treatment for CSG.

Objective To observe the clinical treatment effect of integrated traditional Chinese ( TCM enema and external application of mirabilite) and western medicine on acute pancreatitis complicat-ed with paralytic ileus. Methods 70 patients with acute pancreatitis complicated with paralytic ileus were randomly divided into treatment group and control group, with 35 people in each group. Both groups re-ceived conventional western medicine treatment, and the treatment group received traditional Chinese medi-cine enema combined with external application of mirabilite in addition. The period of treatment was 7 days. The symptoms of abdominal pain, blood amylase level, clinical efficacy, and complications were ob-served. The first exhaust time, first defecation time, eating time, and hospitalization time were also recor-ded. Results On the third day of treatment, the amylase level and pain score of the treatment group were both lower than those of the control group, and the differences were statistically significant (P=0. 020, P=0. 009). In treatment group, the first exhaust time, the first defecation time, eating time, and hospitali-zation time were shorter than the control group, and the differences were statistically significant ( P =0. 000, P=0. 000, P=0. 005, P=0. 001). Both the clinical efficacy and complications were not signifi-cantly different between the two groups (P>0. 05). Conclusion The treatment of acute pancreatitis compli-cated with paralytic ileus with integrated traditional Chinese and western medicine, can quickly relieve pain symptoms of patients, decrease the serum amylase level, and can shorten the patient first exhaust defecation time, eating time and hospitalization time.

符思，主任医师，教授，北京中医药大学硕士研究生导师，中国中西医结合学会老年病专业委员会常务委员，世界中医药学会联合会消化病专业委员会理事。功能性腹胀是一种以反复出现的腹胀为主观感觉的胃肠道功能性疾病，包括功能性肠功能紊乱症状，特别是腹部胀满或憋胀感，自主性肠鸣是其伴随症状，且缺乏相关器质性胃肠道疾病的改变，也不符合功能性消化不良、肠易激综合征和其他功能性胃肠道疾病的诊断［1］。功能性腹胀是临床常见的功能性胃肠病，2003年有文献报道患病率为11．0％［2］，2008年报道发病率达到了人群的25％，其发病率有逐年增加的趋势，所以越来越受到人们的重视［3］。中医学中并无功能性腹胀之病名，但根据其疾病特点可将其归属为聚证、痞满范畴［4］。符思教授根据中医学古代文献中有关本病的论述，并结合自己多年的临床体会，从络病学角度出发，确立了以“辛香通络法”为原则的基本大法，其治法较为特殊，临床疗效显著，现将其临床经验介绍如下。

王微教授认为,临床上导致高脂血症发生的主要原因之一为饮食不当,关键病因为脾胃虚弱,不能运化水谷,重要因素为年老体虚等,并将其病机归纳为本虚标实、虚实夹杂,“脾虚”为本,“痰湿内阻”为标,并时常兼有血瘀.临证主张运用益气健脾、化痰祛湿为法,兼活血化瘀治疗.并提倡注重预防,常告诫患者要清淡饮食,调节情绪,适当锻炼.

Chinese medicine thinks spleen and stomach dysfunction is the main pathogenesis of reflux esophagitis,in the treatment of reflux esophagitis response to the pathogenesis of syndrome differentiation and treatment. For spleen and stomach dysfunction caused by reflux esophagitis,should give priority to with Pungent-open and bitter-down method,by adjusting the spleen and stomach qi activity lifts,restore the function of spleen and stomach,according to the condition at the same time,along with the syndrome to add or subtract,in order to improve curative effect. Pungentopen and bitter-down method can adjust the spleen and stomach function,make the qi running,so as to achieve the purpose of treating diseases. Representative formula of Pungent-open and bitter-down method is Banxia Xiexin decoction.

Through consulting relevant literature of Traditional Chinese Medicine treatment of globus hystericus for nearly ten years, phlegm-Qi stasis is the basic pathogenesis of Globus, and the pathogenesis is associated with emotion change. The treatment experience on globus hystericus are overviewed, from the internal treatment, external treatment, and treatment of inter-nal and external combination treatment. So that the traditional Chinese medicine has good curative effect in the treatment of globus hystericus. There are little Pharmacological studies of animal reports about mechanism of Chinese Medicine on globus hystericus, and it is back for further research.

反流性食管炎的中医证型分布,各医家主张不同,证型分类也不同.文献分析结果显示,反流性食管炎主要证型有9个,分别为肝胃郁热证、脾胃虚弱证、痰气交阻证、肝胃不和证、脾胃湿热证、肝郁脾虚证、气滞血瘀证、胃阴不足证、脾虚痰湿证.其中4个证型在临床上较常见,分别是肝胃郁热证、脾胃虚弱证、痰气交阻证及肝胃不和证.反流性食管炎的证型中实证居多,其发生与肝脾胃三脏密切相关.且中医证型与性别、Hp感染、体质类型等因素均有相关性.

Abstracts:Dawn diarrhea is a chronic and recurrent disease, mainly for the dawn cold abdominal pain or pain, bowel or diarrhea, after the diarrhea is better.The disease incidence increased year by year, in severe cases can affect the patient's work and life.All physicians u-sing oral medicine, warm acupuncture, patching and other methods of treatment, and achieved remarkable results.The present of the past few years literatures were collected, summarized the method and experience of Chinese medicine treatment of dawn diarrhea.

Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

Objective:To investigate the effects of low frequency vibroacoustic sound waves (16-160 Hz)on microcirculation and temperature of stomach meridian.Methods:The low frequency sound waves were played on the Five Shu Points of the stomach me-ridian on 30 healthy people.Then the changes of microcirculation and temperature were recorded by laser Doppler flowmetry and the effects on the points were analyzed.Results:There were different effects on the microcirculation and temperature of the stomach meridian with low different frequency acoustic waves.A1 #and A0#、A2#had peak value.And the most significant effect(P <0.05)was observed on the stomach meridian with the A1#tone (58.27 Hz)and there was significant statistical difference(P <0.01)compared with other points.A1#’s effect on the microcirculation of Neiting,Xiangu,Jiexi was significantly bigger then other points(P <0.01)and its effect on the temperature of Five Shu point had no statistical difference.Conclusion:The points of stomach meridian will selectively absorb low frequency sound waves.