悟透寒热说辨证--医案连载（六）

2015年4月29日初诊：一身痛，感觉手臂、大腿常有一处处结成块垒疼痛，揉搓后慢慢消散；膝关节上下楼时痛重，按摩后可以缓解；晚上有点口苦，怕冷，手心发热；月经去年开始不规则。脉微滑，舌极浅淡，胖，齿痕深，苔少。处温阳化湿汤加减：炙黄芪40 g,红参10 g,麻黄6 g,附子15 g,羌活10 g,砂仁10 g,干姜10 g,细辛3 g,炒白术30 g,茯苓20 g,当归15 g,川芎25 g,黄连3 g,威灵仙10 g,薏苡仁30 g。     

悟透寒热说辨证——医案连载(五)

正病案14晚上手心发烧20年彭某某,女,69岁。2015年12月25日初诊:晚上手心发烧20余年,但脚不发烧,失眠,精神尚可,偶尔头痛;有时牙痛,服牛黄制剂和红霉素无效,吃饭稍多就腹胀。脉沉细,舌浅淡、润,苔薄白。温阳益气汤加减:炙黄芪     

悟透寒热说辨证医案连载（四）

病案11四肢水肿（帕金森病）
　　谢某某,男,71岁,某寺僧人。
　　2015年8月17日初诊：检查诊为帕金森病。四肢严重水肿,双腿浮肿如桶,双前臂及手指均浮肿,手抓不拢,握不了拳,行动迟缓,倦怠乏力,食欲尚可,夜尿多。脉微细,舌极浅淡润,齿痕深,苔少。温阳建中汤加减：炙黄芪60 g,红参30 g,附子20 g,砂仁10 g,干姜10 g,桂枝10 g,白术30 g,丹参15 g,川芎15 g,黄连3 g,炙甘草10 g。     

清喉汤的临床应用

清喉汤是三部六病的局部病方,用于治疗急慢性喉炎、扁桃体炎等咽喉部疾病,其临床疗效满意。现介绍如下：
　　1清喉汤组成
　　葛根30 g、薄荷10 g、金银花30 g、连翘15 g、桔梗15 g、元参30 g、郁金15 g、芦根15 g、甘草10 g。     

悟透寒热说辨证——医案连载(九)

病案29 夜尿腰酸 寅时发热 身冷乏力案 李某某,女,69岁. 2014 年11 月24 日初诊:夜尿多,晚上起夜3次以上,站久了就腰发酸,累不得,冷不得,每天夜间4~5点时感觉发热. 有糖尿病、痛风. 脉细滑,舌淡紫胖,少津,苔少.处温阳益气汤加减:黄芪50 g,红参 10 g,附子 10 g,砂仁 6 g,干姜 10 g,细辛3 g,桂枝10 g,炒白术30 g,当归15 g,青蒿6 g,白芍20 g,川芎15 g,黄连3 g,吴茱萸6 g,枳实10 g,甘草10 g.     

悟透寒热说辨证医案连载（三）

病案6虚劳（肺结核）
　　欧某某，女，46岁。
　　2013年11月18日初诊：六年前患结核病，刚从医院检查出来，认为左下肺病灶尚处于进展期，但不咳嗽不吐痰，面色灰黯无泽，面部遍布暗红疹，不太痒，月经期加重，化脓，去年开始长。脉细，舌极浅淡，齿痕，苔薄白。阳和汤加味：黄芪30 g，银花12 g，白附子6 g，麻黄10 g，熟地黄12 g，炮姜12 g，桂枝10 g，白芥子15 g，浙贝母10 g，黄连5 g，蝉衣12 g，通草6 g，甘草10 g 。     

自拟方治疗肝胆管结石的临床体会

《脉经》云：“肝余气泄于胆,聚而成精。”肝属木,性喜条达而恶抑郁,治疗肝胆病,当宗条达疏通为原则。在临床治疗肝胆管结石中,总结出如下方药：金钱草30卧大黄20g、鸡内金15g、郁金20g、木香15g、柴胡15g、枳实15g、虎杖15卧芒硝15g、元胡15卧川楝10g、龙胆草10g、菌陈20g、前仁20g（包煎）、甘草10g、琥珀6g（冲服）。熊去氧胆酸2片,3次／d。     

经期治疗尿路结石48例临床体会

目前体外震波碎石虽在临床中广泛运用,但中药疗法以其疗效肯定、无创伤性等优点被众多患者所接受。
　　1临床资料
　　笔者搜集自2001年1月～2002年12月期间女性尿路结石患者48例(不含肾结石),年龄最大45岁,最小16岁。
　　2用药方法
　　患者在月经来潮第一天给予“经期排石汤”：金钱草30克,鸡内金10克,海金砂20克,桃仁6克,红花6克,熟地10克,当归10克,白芍15克,川芎6克,淮牛膝10克,益母草15克,元胡12克。上方每日一剂,日服3次,每次150毫升,连用5剂。每个月经期为一个疗程,三个月经期为一个周期。治疗期间每日搜集小便过滤处理,以观察砂石的排出情况。     

悟透寒热说辨证医案连载（二）

病案3身冷自汗偏头痛蔡某某，男，40岁。2014年1月13日初诊：周身发冷，容易感冒，右侧偏头痛，双腿、腰部感觉凉飕飕的，容易发困，容易出汗。脉微细，舌极浅淡，苔少。处方：炙黄芪50 g，红参15 g，麻黄10 g，附子30 g，砂仁15 g，干姜30 g，淫羊藿15 g，细辛3 g，桂枝10 g，炒白术30 g，牛膝30 g，当归15 g，黄连3 g，吴茱萸6 g，枳实10 g，炙甘草10 g。     

中医辨证治疗消化性溃疡60例分析

资料与方法 一般资料：60例中，男51例，女9例。其中20～30岁18例，30～40岁39例，40～60岁3例。病程3年以内36例，4～6年12例，6～15年12例。诊断：上腹规律性疼痛，胃区压痛，胃钡餐X线检查发现龛影或纤维胃镜发现溃疡灶。治疗方法：基础方：乌贝散6g（冲服），甘草12g，黄芪12g，延胡10g，砂仁6g（后下）。乌贝散是由85％乌贼骨加15％浙贝炒脆打成粉。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.