当代医史名家宋向元先生,一生致力于医史文献研究,在诸多文献学研究中见解独到.然其临证治验亦颇为丰富,各科病证中始终倡导辨体质,尤重脾胃;调气血,以平为期.在理法方药中为后学留下了宝贵的临证资料.该文以此作为主要论述内容,从诊法与临证角度对宋向元先生的临证特色简要介绍.

哮病多因外感六淫、饮食不当、七情所伤,或体虚病后、禀赋不足,脏腑气机失调,功能障碍,宿痰内伏所致.痰是机体水液代谢障碍形成的病理产物.由于肺、脾、肾、肝对水液代谢起着重要作用,故哮病的产生与上述脏腑功能失常密切相关.该文通过探讨“治痰先治气”的机理,结合古籍医案分析,阐明调气法在哮病治疗中的作用,以期为提高临床疗效提供理论依据.

本文通过分析“肺主皮毛”理论的实质,结合烫伤的现代病理机制和中医学病因病机,探讨用该理论指导烫伤的辨证论治.认为“肺主皮毛”理论对指导烫伤的辨证论治十分重要,从肺论治烫伤,在病机上要注重火毒内陷、火毒伤津、气血两虚、阴竭阳脱等变化;在治疗上以清解肺热、凉血通络、补益肺气、滋阴润肺、回阳救逆为法.

《黄帝内经》中关于脾所主之时令,有“脾主长夏”与“四时……各十八日寄治”两种说法,然并不矛盾.书不尽言,言不尽意,文章从脾气所在,脾胃所主;有形无形,相互推求;先天后天,所重后天;中焦脾胃,万化之源;脾主四时,意贵圆通5个主要方面论述脾主四时,以期对于脾胃功能有一个较为清晰的认识,更好地服务于临床.

中医基础理论是本科留学生的第一门专业基础课,所占地位非常重要,但因汉语水平、思维方式、学习背景和学习方式等因素,留学生容易在学习过程中产生倦怠心理,进而影响后期学习中医的信心.现就这一倦怠心理现象的成因及相关对策做一简要地分析,以期为中医留学生的教学实践过程提供一定的参考依据.

Lung disease is a kind of disease with high incidence, including cold, cough, asthma, lung abscess, etc. The spleen is the source of the phlegm, while the lung is the reservoir of the phlegm;the lung is the pivotal and the spleen is the source of Qi. The close relationship between the spleen and lung plays an important role in discussing the pathogenesis of lung diseases, and the spleen is the postnatal root of human body. A large number of experimental studies and clinical practice have proved that the lung diseases treated by invigorating the spleen has achieved good results.

古人认为妇人乃众阴所集，脾在五行中属土，又为阴中之至阴，故脾之异常与妇人疾患密切相关。脾主运化及主统血功能正常才能维持妇女经、带、胎、产正常。健脾法为常用的妇科疾病治疗方法，治疗当时刻顾护后天之本，方能达到最佳疗效。

脾阴虚证是具有阴虚证共性,且区别于脾阳(气)虚证,一种客观存在的脾虚证.脾阴虚证的现代研究,虽在动物模型、动物实验研究、病理实质、滋脾方剂作用机制、现代临床疾病应用、复方研究等方面均取得了较大的进展,但仍需要进一步拓宽思路,更完整、全面认识脾阴虚证.

Diabetes mellitus is a common clinical disease,with glucose and lipid metabolism disorder as the main performance.The physiological functionu0027s coordination of liver and spleen is the essence of water and food to ensure normal metabolism,liver stagnation and spleen deficiency easily lead to diabetes mellitus,at the same time also can further aggravate the metabolic disorders of glucose and lipid. This paper provides some ideas for prevention and treatment of diabetes disease clinical by analyzing the relationship between liver stagnation and spleen deficiency and the pathogenesis of diabetes mellitus.

《症因脉治》是明代医家秦昌遇所撰的临床型医书.脾者,乃仓廪之本,气血生化之源.通过对脾主运化观点的阐释,说明脾主运化的重要性.根据本书特点并结合《症因脉治》中的症、因、脉、治4个方面对脾主运化理论进行探讨,同时结合诸贤附论与临床实践阐明对脾主运化的理解.

As the spleen is the postnatal base of live,TCM practitioners from generation to generation have attached great importance to the health of spleen. However,each period has its own characteristics. Before Tang Dynasty,the concept of spleen governing transportation and transformation could be found in such TCM classics as Huangdi's Internal Classic,Treatise on Cold Damage and Miscellaneous Diseases and Zhongzang jing. During this period,adequate literature on alchemy such as Hanshisan and medical prescriptions were available due to the prevalence of taoism and immortal culture. The recording of spleen health,on the other hand,were scattered in the immortal and alchemy books. In Sui and Tang Dynasties,people began to pay attention to spleen and stomach health. Sun Simiao further explored the health of spleen and stomach in his works: Valuable Prescriptions for Emergency( Food Treatment),supplement to Valuable Prescriptions( Cultivation),supplement to Valuable prescriptions Retreat,and Sunzhenren Shesheng Theory. This paper aims at collecting and analyzing the spleen health from the perspective of life cultivation theories and methods.

Objective] Explore the role of the theory of nature corresponding to human being on teaching “Basic Theory of TCM”. [Method]Through analyzing the theoretical connotation, culture base of nature corresponding to human being; discussing analysis of analogy, observation method and neutralization thinking application in teaching"basic theory of traditional Chinese medicine", we would further understand the connotation of the theory of correspondence between man and nature. [Result] The theory of nature corresponding to human being occupies an important position in teaching“Basic Theory of TCM”. [Conclusion]New students shall correctly understand the scientific connotation of“nature corresponding to human being”which will not only help them know the background of the traditional Chinese culture, but also establish a solid foundation for the thinking mode of TCM.

对PBL教学医案改编问题进行整理和总结:在医案的选择上主要考虑时间、地域两大因素,并避免重复:改编原则是以问题为导向,以学生为中心,体现人文关怀,遵法而无定法;同时需集思广益,借鉴小组老师、专家及学生的反馈意见.

Diabetes is a common clinical disease, with glucose and lipid metabolism disorder as the main clinical manifestation. The spleen of middle jiao can transport and transform the essence of grain and water. It is also the source of qi and blood, which also provides material foundation for the glucose and lipid metabolism. The spleen deficiency and dampness stasis can lead to the phlegm and blood stagnation, which are closely related to high sugar, high fat, high blood coagulation and vascular endothelial damage. This article discussed the relationship between the changes of spleen function of middle jiao and glucose and lipid metabolism, and provided some theoretical methods for clinical prevention and treatment of diabetes.

The occurrence of asthma is due to the disorder of internal organs and the accumulation of phlegm caused by the invasion of six exogenous pathogenic factors or innate deficiency. The deficiency of the spleen fails to transport and transform food and drink,leading to the insufficiency of the lung or the impairment of the kidney. If the essence of food and drink is deficient,the internal organs will be affected,bringing on the disorder of water metabolism and accumulation of phlegm. Although several internal organs are involved in the process of water metabolism,the spleen deficiency plays the key role in the accumulation of phlegm. Therefore,the therapeutic principle is supporting healthy Qi and the therapeutic method is invigorating spleen to resolve phlegm and avoide water retention.

明代医家徐春甫私淑于李东垣,其所著《古今医统大全·脾胃门》,详述了脾胃病的病机、脉候、治法及方药.提出脾胃不足、百病由生,认为饮食不节,劳役所伤,以致脾胃虚弱,乃血所生病,把脾胃不足的本质与血证相联系,亦关乎阳气不足、阴气有余的病机.在临证时,主张脉证相合,治法上推崇升降浮沉之法而随证用药.

Basic theory of TCM is an introductory course, the teaching effect would directly affects the student to the subsequent course of study. Young teachers improve theirs teaching basic skills to help the students from learn what is mean to how to learn, by fully effective using the blackboard writing and multimedia technology in the course teaching. All these will help to cultivate students 'enthusiasm for knowledge of traditional Chinese medicine.

王学岭系天津中医药大学教授,从事中医教学及临床工作30年余,学识渊博,临证经验丰富,在不孕不育症的治疗方面有独到的见解.笔者在跟师学习过程中收获颇多,现举例介绍如下. 1 清热祛湿、温肾填精治疗精少及精弱不育症 鲍某,男,35岁.2012年2月5日初诊.婚后3年,性生活正常,仍未得子.配偶妇检未发现异常,性激素六项检查未见异常.该患者形体肥胖,嗜睡,平素喜熬夜,少运动.

中医传承班的成立将传统的师承教育有机地融入现代高等中医教育体系之中,为了确保院校教育和师承教育相结合人才培养模式的质量,开展了形成性与终结性考核并重评价传承班学生学业成绩的研究与实践.通过分析课程结构确定研究科目,依据教学进度设计考核方案,梳理反馈信息调整实施步骤等探索,客观评价学生学习状况,优化学业考核评价效果,激发教师教学热情,有效实现教学相长.