从《内经》血枯证治理论谈妇科闭经病的证治

收集了《内经》有关血枯经闭方面的相关阐述，从而探讨血枯闭经的病因、病机、症状与治疗，其理论对当今临床医学具有重要的指导意义。     

治疗闭经46例的临床体会

闭经是妇女常见的病患之一。祖国医学古典医籍中,对此证早有论述,如《内经》中提出“二阳之病发心脾,有不得隐曲,女子不月”、“月事不来者,胞脉闭也”、“病名血枯……气竭肝伤,故月事衰少不来也”。后世对此也多有阐发,诸如《金匮要略》中谓:“妇人之病,因虚积冷结气,为诸经水断绝”,《傅青主女科》中也谓:“女子七七而天癸绝,有年未至七七而经水先断者,人以为血枯经闭也,谁知是心肝脾之气郁乎”。历代医家不仅从     

中西医结合治疗卵巢早衰

卵巢早衰属中医的“经闭”范畴,其病因中医文献早有记载,如《素问.阴阳别论》说:“二阳之病发心脾,有不得隐曲,女子不月。”东汉张仲景指出,经闭有血枯与血隔之别。其曰:“血枯与血隔,本自不同,盖隔者、阻隔也,枯者、枯竭也。因邪气之隔滞,血有所逆也。枯竭者,因冲任之亏败,源断其流也。”综上所述,闭经病因不外乎虚实两端。虚者,多因肝肾不足、精血两亏,或因气血虚弱,血海空虚无余可下。实者,多因气滞血瘀,痰湿阻滞,冲任不通,经血不得下行而致闭经。1中医辨证要点闭经一证,中医有“血枯”、“血滞”之别,辨证尤其详审。血虚血枯之虚证者多…     

《内经》方医案三则

从心悸、失眠、经闭三则典型案例,举例阐述《内经》方在临床的指导意义。     

闭经不孕重在调理脾胃

闭经无论虚、实,都与脾胃的功能至关密切。脾虚能致经闭,首先记载于汉代《金匮要略》："脾气衰则骛溏,胃气衰则身肿;少阳脉卑,少朋脉细,男子则小便不利,妇人则经水不通"。说明脾胃虚弱,化源不足,能引起经闭不孕,所以在治疗此疾病时,除查病因辨病候外,还应重点调理脾胃。1肾虚闭经不孕先天不足,禀赋素弱,肾气虚衰,月经不按期而至,或团早婚、房事不节,损伤肾气,以至经亏血少,冲任虚损,遂致闭经。冲任二脉不能自养,赖以肾精为根本,又以后天脾胃为基础。肾气盛,任脉通,太冲脉盛,脾胃健,冲任之气盛,源流不断,经水按…     

活血化瘀法在妇科疾病中的应用

“瘀血”二字在祖国医学中的含义比较广泛 ,它既是某些病因所导致的病理结果 ,又可成为各种疾病的致病因素。妇女由于有月经、妊娠、生产、哺乳等生理特点 ,与血密切相关 ,因此古人有女子以血为本、以血为用的理论 ,妇科疾病中妇女血瘀证较为常见 ,活血化瘀是治疗瘀血证的一种古老而又富有生命力的特有疗法 ,在妇科领域应用广泛。1　祖国医学对血瘀的认识《内经》对瘀血证有较多的记述 ,有“恶血”、“血”、“脉不通”等多种病名 ,同时记载了治疗血枯经闭的第一药方一四乌贼骨芦茹丸。《神农本草经》中共收集药物 36 5种 ,其中有活血化瘀…     

论《内经》梦理论及临床意义

关于梦的内涵、外延及其在人类的意义,古今中外论述与专著繁多,现通过整理《内经》相关原文,并在《内经》藏象理论指导下,揭示《内经》梦理论是以脏腑、经络、气、血、阴阳作为物质基础,以病因病机和临床诊断、治疗作为阐释对象,在分析整理《内经》梦理论的同时,将其临床意义一一陈述,并附有临床实践病例。     

闭经的辨治体会

闭经的辨治体会镇江市第一人民医院徐太华月经的产生是脏腑经络气血作用于胞宫的正常生理现象，如《素问．上古天真论》中所说＂女子二七而天癸下，任脉通，太冲脉盛，月事以时下。＂反之如果肾气虚。冲任二脉气血不足，心肝脾功能失调、便导致月经不调甚而经闭。１经闭发...     

《内经》杂法治病说略

《内经》杂法治病说略陈明（北京中医药大学北京１０００２９）关键词：内经，治疗方法，中医学理论《内经》是总结秦汉以前中国医学成就的一部辉宏巨著，所载内容，包罗万象，单就治疗方法上，除推行针灸、药物内服疗法外，还使用祝由、按摩、导引、药熨、渍浴、刺血、饥...     

唐容川《血证论》治疗经闭学术思想探究

通过对唐容川《血证论》中有关经闭的系统研究,探究其治疗经闭的理论思想来源,分析其治疗经闭的特色与用药、用方特点,旨在拓展临床对于经闭的治疗思路与方法,以增强其在临床实践中的指导作用。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.