肩关节周围炎简称肩周炎,是指肩关节及其周围的肌腱、韧带、腱鞘、滑囊和关节囊等软组织的急慢性损伤,或退行性病变,导致局部慢性炎症渗出,产生粘连,限制了肩关节活动,引起肩部疼痛、活动功能障碍的病症.本文以国医大师、各省市名中医为研宄对象,从理、法、术三方面对手法治疗肩周炎经验的文献进行梳理,总结其方法共性,提炼其核心治疗理念,旨在传承名中医学术思想、特色手法,提高手法治疗肩周炎的临床效果.

The theory of “left liver and right lung” stems from Yellow Emperor’s Inner Classic. Since it is different from the anatomic knowledge that the liver is in the right and lungs are with two lobes ,this theory is criticized by opponent of traditional Chinese medicine(TCM). In fact,“left liver and right lung” and “left ascending right down” embodies the ascending and descending of qi activity ,physiology and pathology the liver and lung. Both are Abstract functional paradigm ,and not the real anatomical concept. In the circular movement paradigm of TCM,this theory is of great importance for the simplifying TCM theory,physiology and pathology,but it does not equal to that liver is located in the left and lung is located in the right. In qi movement,qi ascends on the left and descends on the right. Hence,liver disease(abnormal qi’s ascending) is on the left,lung disease(abnormal qi’s descending) is on the right. The correct understanding of “left liver and right lung” and “left ascending right down”,is the correct understanding of the theory of TCM ,and it could avoid the mechanical anatomical thought.

周平安教授运用表里和解法治疗流行性感冒(简称:流感)取得了较好临床疗效,在抗病毒方面与退热方面具有明显的优势,其中清肠保肺法是周平安教授表里和解法的重要组成部分,本文通过理论探析与临床应用及方药探析两个方面对其进行介绍. 理论探析包括:温邪上受,首先犯肺——风热疫毒犯肺是病因病机的核心;肺与大肠相表里——肺与大肠生理病理相联系;分消走泄是温病的基本治则;温病下不厌早:可以截断病邪传变,缩短病程,提高临床疗效;清肠保肺法于流感危重症行之有效. 临床应用及方药探析包括:流感的治疗泻下药物应该早用;流感危重急症予高位灌肠有卓效.

“表里双解法”是周平安教授针对流感“表寒里热证”提出的,后来又与“和”的思想相融合,提出了“表里和解法”,此时“表里和解法”已不再仅仅针对“表寒里热证”,而是有了更加广泛的应用范围.“表里和解法”的内涵为:使用表里同治的方法(调理上下内外气机、解表以除里邪、泻里以散表实、补里以助表虚、补里以除表实),遵循“和”的原则(不和则为病、治病以求和),以“和”为目的(表里之邪解、正复而人安和)来治疗特定证候(表实证、里实证、表里俱实证、表实里虚证、表虚证、里虚证、表里俱虚证)的方法.此法既是治则,也是治法.

发热性疾病，既是一个常见病，同时又存在原因复杂、有时治疗效果不佳、抗菌药物耐药等问题。本案患者曾先后就诊于多家医院，多发、多重感染，病史长，累及多系统，曾使用多种抗生素、抗结核药物、激素等治疗，效果不佳。笔者将该病例辨为：真阴不足，脾肾阳虚证，使用《景岳全书》理阴煎加减治疗，取得了满意的疗效。

The comprehension and clinical application of present physicians on mediation method. The majority deem that there is generalized mediation method and narrowly mediation method, but the category is inconsistent;mediation method is widely used, and mostly on chronic diseases; The mediation method includes the classical regulation of Ying and Wei and reconciliating shaoyang, treat the syndrome of relative disease location and opposite property, gentely used, combination of multiple prescription or method for complex syndrome;the nature of disease is the disharmony of Yin and Yang, and the treatment of diseases is to regulate the disharmony and takes the harmony as the treating direction. The categorization of formulas of mediation method and its clinical application are also based on the above understanding.

Therapy based on syndrome differentiation includes two stages:syndrome differentiation and treatment.Syndrome differentiation is done according to four diagnostic methods,and drugs chosen or used must conform to certain syndrome.Pathogenesis means the process of certain syndrome and specific symptoms and signs of certain syndrome due to causes,so the analysis of pathogenesis is the analysis of the process.Pathogenesis is mainly embodied in the process during which there are specific symptoms and signs of certain syndrome,and therapy based on syndrome differentiation revolves around the process,which means doctors examine symptoms to find syndromes and choose and modify proper prescriptions based on syndromes by using four diagnostic methods (inspection,listening,inquiry and pulse-taking and palpitation);And the key is pathogenesis.At present the reason for decrease in TCM clinical effect is mainly due to ignorance of TCM characteristics and thinking.If Western medicine is used in TCM,the clinical effect is surely not satisfactory.Therefore,as long as TCM doctors insist on TCM characteristics and thinking,can they obtain satisfactory clinical effects and improve the confidence to cultivate qualified TCM experts.

对于中医学的本质研究始于现代医学进入中国的近现代。目前，虽然经过很多学者的思考与研究，但对于中医学的本质还未形成统一的认识。本文结合中医经典以及临床思维，参照西医学特点，对中医本质进行了思考：中医学的本质是抽象的物理哲学。对中医学本质的认识有利于院校学生与临床工作者对中医的认识、学习、学术传承与科学研究，不至于舍本逐末，从而可以避免中医临床水平的下降以及中医西化等问题的发生。另外，从中医的本质可以知道运用现代医学研究方法来研究与评价中医学是不恰当的；对于中医学的学习、传承、研究应重点落实到中医的本质上。

对"广义和法"进行了探讨、规范,以求能够明确其概念、含义,以及将"狭义和法"与"广义和法"进行相互辨析:"狭义和法"与"广义和法"的层次不同,前者属于低一层次,属于治法范畴,后者属于治则范畴. "狭义和法"属于八法之一,又不同于其他七法,属于调和,兼用其他七法,可以定义为:其他七法中的两种以上治法相兼使用,以治疗表里、上下等相对病位并且寒热、虚实、升降、润燥等相反病性的病证(上热下寒证、表实里虚证、上实下虚证等)的治疗方法. "广义和法"可以指导对所有疾病的认识及治疗,包括:不和则为病,治病以求和.

治则治法是“辨证论治”体系中联系“证”和方药的桥梁，对于治则治法的理解将直接影响到临床的疗效。教材上的描述过于抽象笼统，所以学生学习理解不够深刻，另外，学术界对治则治法认识不统一，甚至存在着治则治法混用的情况。治则与治法的鉴别应该主要从构成角度来区分，即：治则总是由某种病证情况紧跟某种解决方法，一级治则跟的是抽象的方法，二级治则跟的是具体的治法；治法由单一的一个动词或者动词紧跟宾语，一级治法后面不跟宾语或者是抽象的宾语，二级治法跟的是具体的宾语(具体的正气或邪气)。通过提纲挈领掌握治则治法的鉴别要点，则可以准确地将二者进行区分，不仅有利于中医的教学，而且也有助于名老中医经验的传承研究。

Objective: To investigate the effects of curcumin on micronuclei formation frequency and chromosome aberration induced by cyclophosphamide. Methods: Mice were divided into six groups, the control group was treated with saline, model group was treated by intraperitoneal injection of cyclophosphamide (50mg/kg) twice every 24h before sacrifice, curcumin group was gavaged with curcumin suspension at 100mg/kg d and three treated groups were injected by cyclophosphamide combined with curcumin 50 mg/kg cyclophosphamide was given twice by intraperitoneal injection to each mouse every 24h before sacrifice. The dosage of curcumin was 200mg?kg-1?d-1, 100mg?kg-1?d-1, and 50mg?kg-1?d-1 body weight, respectively. The treatment period for all groups was 28 days. Half of all mice were given 0.04% colchicine/10g body weight 2-3h before sacrifice. The micronucleus assay in mice marrow PCE and chromosome aberration assay in mice marrow cells have been used to analyze micronuclei formation frequency and chromosome aberration rate in different groups. Results: The results showed that curcumin not only reduce the micronuclei formation frequency but also down regulate the chromosome aberration rate significantly. Conclusion: These results obtained from our experiments suggested that curcumin had protective effects against micronuclei formation and chromosome aberration.