本文总结1例强直性脊柱炎并发臁疮患者的中西医结合护理措施。在常规护理的基础上辨证施护,合理应用中药塌渍、艾灸、穴位按摩、耳穴贴压、膳食指导等中医特色护理技术,能有效缓解患者疼痛,促进溃疡的早期愈合。

： Objective To investigate the effects of integrated Traditional Chinese and West⁃ ern medicine nursing on treatment outcome ， quality of life and prognosis of high-risk patients with diabetic foot ， and provide evidence for more reasonable nursing intervention program. Meth⁃ ods From January 2021to January 2022 ， 200 patients with type 2 diabetes mellitus were screened ； 40 high-risk patients with diabetic foot were eligible and randomly divided in to obser⁃ vation group and control group ， with 20 cases in each group. The control group received routine care during the treatment ， and those in the observation group received integrated traditional Chi⁃ nese and Western medicine intervention based on routine care. The treatment outcome ， patient quality of life and prognosis of disease were compared between two groups. Results The overall effective rate in the observation group was higher than that in the control group （ P ＜ 0. 05 ） . Ac⁃ cording to the outcome of General Quality of Life Inventory-74 （ GQOL-74 ） assessment ， the im⁃ provement rate in the observation group was 85. 00% （ 17/20 ）， showing no significant difference compared with 65. 00% （ 13/20 ） in the control group （

目的 观察中西医结合护理干预高危糖尿病足患者的效果,及对患者生活质量及预后的影响,为高危糖尿病足患者采取更好的护理策略、制定更为合理的护理干预方案提供依据。方法 从医院2021年1月—2022年1月收治的200例2型糖尿病患者中筛查出40例高危糖尿病足患者,随机分为现察组与对照组,各20例。对照组采取常规护理干预,观察组在常规护理基础上,给予中西医结合护理干预。评价两组干预效果,以及对患者生活质量以及足部状况影响。结果 观察组干预效果优于对照组,差异有统计学意义(P＜0.05)；观察组生活质量评定问卷(GQOL-74)评分改善率85.00%(17/20),高于对照组的65.00%(13/20),但差异无统计学意义(P＞0.05)；观察组足部感染和足部溃疡发生率低于对照组,差异有统计学意义(P＜0.05),观察组无1例患者截肢,对照组3例患者截肢。结论 中西医结合护理干预能进一步提高高危糖尿病足患者的治疗效果,改善患者生活质量及预后,干预效果要优于常规护理干预。

目的:探讨耳穴贴压联合中医辨证施护对下肢静脉曲张患者术后患者疼痛程度、生活质量及康复进程的影响。方法:选取北京中医药大学东方医院2016年12月至2018年6月收治的下肢静脉曲张患者210例为研究对象，采用数字抽样法将其分为对照组和观察组，各105例。对照组患者给予常规护理干预，观察组患者在常规护理干预的基础上采用耳穴贴压联合中医辨证施护进行护理干预，调查并比较两组患者术后疼痛程度、生活质量及康复进程。结果:实施耳穴贴压联合中医辨证施护进行干预后，观察组患者的疼痛程度明显轻于对照组；观察组患者的社会功能、生理功能、躯体健康和心理健康得分均明显高于对照组；观察组患者的临床有效率明显高于对照组，差异均有统计学意义(均 P<0.05)。 结论:将耳穴贴压联合中医辨证施护应用于下肢静脉曲张患者术后的临床护理中，能有效缓解患者的疼痛程度，提升患者的生活质量，促进患者的康复进程。

Based on large sample of clinical epidemiology survey,we discussed the etiology and pathogenesis of type-2 diabetes.On the basis of Internal Classic ofHuang Di,and discussions of both ancient and modern doctors,we believed that:type 2 diabetes is just like Jueyin disease of Treatise on Febrile Disease,characterizing by adverse-rising of Qi,cold mingling with heat and deficiency mingling with access.The diseased location is spleen,and closely related with liver and lung.The pathogenesis is the failure transportation and transformation of spleen,floating of deficient five visceral essence,and turbid dampness flowing down to form yin fire syndrome.The reason for failure transportation and transformation of spleen includes depression of lung,adverse flow of liver-qi,dampness accumulation in the middle and deficiency of kidney Qi.

目的:观察基于五运六气理论运川体质平调散治疗2型糖尿病患者的有效性.方法:对2014年-2015年269例北京中医药大学东直门医院体质医学门诊全部2型糖尿病患者进行胚胎期10个月五运六气禀赋分析后,服药初期在不改变原有降糖药物或胰岛素基础上,据不同体质禀赋,给予体质平调散基本方加味干嚼服,服药3个月后评定疗效,期间进行回访并协助患者调整原有西药用量.疗效以减停西药降糖药而血糖控制良好且整体体质改善为基本前提.结果:严格遵循医嘱饮食忌口者(饱食主食、忘生冷等)降糖显效率79.5％,有效率18.8％,无效率1.7％;一直不严格忌口者,降糖显效率5.2％,有效率24.1％,无效率70.7％;先不严格后严格忌口者,降糖显效率分别为14.9％、72.3％,有效率30.9％、24.5％,无效率54.3％、3.2％.降糖显效及有效者整体体质、并发症及高血压、高血脂等合并症及相应理化指标均相应改善或至正常.结论:运用五运六气理论中药体质平调散结合饮食调整体质调理及治疗糖尿病疗效显著.

目的:探讨慢性非萎缩性胃炎证候、证素分布规律及其与幽门螺杆菌(Helicobacter pylori,Hp)感染的关系,为证候规范化研究提供参考.方法:制定统一的临床病例观察表,采集慢性非萎缩性胃炎患者的一般情况、四诊信息、C13呼气试验、胃镜检查等各方面资料,分析慢性非萎缩性胃炎的中医证候分类与证素特点及其与Hp感染的关系.结果:类肝胃不和证、类肝胃郁热证、类脾胃虚弱证、类胃热内蕴证为Hp阳性慢性非萎缩性胃炎临床常见4个证型,其分布特点为类肝胃不和证、类肝胃郁热证＞类脾胃虚弱证＞类胃热内蕴证;Hp阴性慢性非萎缩性胃炎中医常见3个证型,其分布特点为类脾胃虚弱证＞类肝胃不和证＞类肝郁脾虚证.结论:建立了Hp相关性慢性非萎缩性胃炎证候分布的因子分析及系统聚类模型,揭示了Hp相关性慢性非萎缩性胃炎的中医证候特点,为临床治疗和疗效评价提供了一定的依据和可行的研究思路.

目的:探讨反流性食管炎患者四诊信息的因子分析和复杂网络技术分布模式,为该病的中医证候研究提供新的思路和方法.方法:对200例反流性食管炎患者的临床资料进行调查,运用因子分析、复杂网络技术对其中医证候、证素分布特点进行探索性分析,总结分布特点.结果:经因子分析、复杂网络技术共同提取出证素8个,病位证素:胃、肝、脾,病性证素:气滞、热、痰湿、气虚、阳虚.结论:综合多种数理统计方法,更有利于阐释反流性食管炎的证候证素分布特点,复杂网络技术较因子分析更能直观阐释中医证候分布特点.

Objective To explore the evolvement rule of TCM syndrome types of the transformation of chronic gastritis (CG):from chronic non-atrophic gastritis (CNAG),chronic atrophic gastritis (CAG) to precancerous lesions of gastric carcinoma (PLGC).Methods Based on gastroscopy and gastrobiop-sy,altogether 592 patients included from three hospitals affiliated to Beijing University of Chinese Medi-cine Dongzhimen Hospital,(Dongfang Hospital and Third affiliated Hospital)and Wangjing hospital of China Academy of Chinese Medical Sciences from September 2013 to February 2014,were diagnosed with CNAG (338 cases),CAG (134 cases)and PLGC (120 cases).By using Epidata 3.1 the database was established,then principal component analysis,factor analysis and Chi-square test were conducted by using software SPSS 17.0.Results There were nine common syndrome types in CNAG,and the&nbsp;three leading ones were syndrome of incoordination between spleen and stomach,syndrome of heat-stag-nation in liver and stomach,syndrome of incoordination between liver and stomach.There were ten syn-drome types in CAG,and the highest frequency was syndrome of incoordination between liver and stom-ach,then syndrome of static blood in stomach collaterals and syndrome of deficient cold of spleen and stomach.The highest frequency of three syndrome of ten in PLGC were syndrome of yin deficiency in stomach,syndrome of yang deficiency in stomach and syndrome of static blood in stomach collaterals. The frequencies of location factors of CNAG from high to low were stomach,liver and spleen,the same as those of CAG;the frequencies of nature factors from high to low were qi stagnation,heat,qi deficiency, dampness and yang deficiency,which were some different from those of CAG being qi stagnation,heat, yang deficiency,dampness,blood stasis,yin deficiency and qi deficiency.With the disease progression, the frequencies of location factors of PLGC from high to low were stomach,spleen and liver,while those of nature factors were heat,yang deficiency,yin deficiency,qi stagnation,blood stasis,dampness,and qi deficiency.The distributions of location factors as well as nature factors were significantly different dur-ing the whole procedure of CG progression,CNAG,CAG and finally PLGC.Conclusion During the procedure of:CNAG turned into CAG and into PLGC in the end,the evolvement characteristic of “sthe-nia transforming into asthenia and appearing yin deficiency and blood stasis gradually”was found.

Functional dyspepsia is one of the most common clinical functional gastrointestinal disorders. The incidence rate of functional dyspepsia is gradually increased. Psychological impact is the notable factor in pathogenesis, recidivation and aggravation of functional dyspepsia. Based on syndrome differentiation and combination of disease and syndrome, professor DING Xia treats functional dyspepsia from liver based on the core of regulating the spleen and stomach qi activity, in order to regulating qi and blood, contributing to mind and body, and protecting spleen and stomach, and achieves a significant effect.

目的 把握现阶段慢性萎缩性胃炎证候分布规律研究现状,为进一步开展该病的证候规范化、标准化研究提供有益指导.方法 全面检索中国期刊全文数据库(CNKI)、重庆维普(VIP)及万方数据库自建库至2013年12月31日关于慢性萎缩性胃炎证候分布规律相关研究,纳入相关文献31篇进行分析.结果 现阶段慢性萎缩性胃炎在流行病学资料、主要症状、常见证候类型及不同证候间微观辨证相关性方面取得了一定的成果.然而仍存在病例采集纳入排除标准不统一、病例来源地局限、样本量偏小、缺少相应的专家调研以及数据挖掘方法较单一的问题.结论 慢性萎缩性胃炎证候分布规律当进行多中心、大样本、以大课题为支撑的研究,多学会联合形成统一的证候诊断标准更是该病中医规范化研究得以顺利进行的关键.

目的:明确丁霞教授治疗胃脘痛的用药规律,阐发丁霞教授治疗胃脘痛的学术思想与临床用药经验.方法:选取丁霞教授临床治疗胃脘痛自诊处方360首,详细记录首诊用药情况,确定首诊处方各药物的使用频次.采用关联规则Apriori算法,进行基于改进的互信息法的药物间关联度分析;以药物间关联度分析结果为基础,依据相关度与惩罚度约束,进行基于复杂系统熵聚类的药物核心组合分析;在此基础上运用无监督熵层次聚类算法,获得治疗胃脘痛新处方;根据结果绘制出用药关联规则网络图、新方的核心组合药物网络图及新方的药物网络图.上述操作基于中医传承辅助平台V1.1 (TCMISS)完成.结果:通过分析360首胃脘痛医案处方,提取用药核心组合46组,挖掘治疗胃脘痛新方23个,明确了丁霞教授治疗胃脘痛的处方药物的使用频次规律及药物间的关联规则.结论:丁霞教授治疗胃脘痛临证重视调胃、调肝、调脾三端,用药具有通降与清降并举、健脾与助脾并重、寓柔肝于疏肝的特点.