中药注射剂治疗呼吸系统疾病用药分析

在对呼吸系统中药注射剂品种分类的基础上，主要从处方药物组成情况、主治疾病、中医证型以及安全性评价等方面，对用于治疗呼吸系统疾病的中药注射剂品种进行分析和探讨。     

中药注射剂治疗心脑血管系统疾病用药分析

中药注射剂是指在中医理论指导下，采用现代科学技术与方法，从中药、天然药物的单方或复方中提取有效物质制成的可供注入人体灭菌制剂，包括肌肉、穴位、皮内、皮下、静脉注射以及其他组织或器官注射用的灭菌制剂以及供临床前配制溶液的无菌粉末或浓缩液。主要有中药溶液型注射剂（含水针和静脉注射剂）、注射用粉针和冻干制品、注射用混悬剂和注射用乳剂。目前，中药注射剂品种的研发主要集中在治疗心脑血管、呼吸系统和肿瘤等疾病上，显示出其独特的优势。本文对用于治疗心脑血管系统疾病的中药注射剂进行分析和探讨。     

中医食疗在护理中的应用

中医食疗是指在中医理论指导下,运用食物配入药物或用食物作为药物来治疗或辅助治疗相应疾病的一门学科,为祖国医学中传统而富有特色的治疗方法之一,它充分体现了中国传统养生保健和防病治病的思想。目前食疗在国外属自然疗法,已受到高度重视。俗话说：“药补不如食补”,在临床护理工作中,对病人合理的膳食可达到治疗疾病、恢复健康的目的。     

中药膏方治疗疑难杂症验案4则

所谓膏方又称膏滋方，具有治病纠偏，滋补强身等多种作用。时下在江南一带时兴冬令以膏方进补，实际上是中药传统剂型的丸、散、膏、丹、汤、酒、露、锭八种剂型之一。由于服用方便、疗效显著，在一年四季均可服用，尤其是针对一些需长期服药的慢性病或疑难顽症，更适合以膏方来调治。现代家庭多具备冰箱冷藏的条件，这为膏剂的收藏提供了方便。因此，更可以提倡以膏方剂型来治疗诸多慢性疾病。笔者常不拘季节以膏方为主，根据辨证施治原则来治疗某些疑难病症，现撷取4则医案，以飨读者，不当之处，请多赐教为盼。     

Oplopanax elatus（Nakai） Nakai： chemistry,traditional use and pharmacology

Oplopanax elatus（Nakai） Nakai, a member of the ancient angiosperm plant family Araliaceae, is used for the treatment of different disorders in the medicine systems of China, Russia, and Korea, and was designated in Russia as a classical adaptogen. Despite extensive studies of classical adaptogens, there are comparatively few reports concerning the chemical composition and pharmacological effects of O. elatus in English. The plant is a potential source of saponins, flavonoids, anthraquinones, terpenes, and other active compounds. Experimental studies and clinical applications have indicated that O. elatus possesses a number of pharmacological activities, including adaptogenic, anti-convulsant, anti-diabetic, anti-fungal, anti-inflammatory, anti-oxidant, blood pressure modulating, and reproductive function effects. In this review, the chemistry, safety, and therapeutic potential of O. elatus are summarized and highlighted to encourage the further development of this plant.     

刘公望运用经方治疗放化疗不良反应验案2则

恶性肿瘤的致死率甚高，源自上皮组织者称为癌，源自间叶非上皮组织者称为肉瘤，二者均病情凶险，预后恶劣。目前肿瘤的治疗有外科手术治疗、放射治疗及化学治疗。在放化疗过程中往往发生毒副作用，导致患者的抵抗力下降，严重时可影响治疗的继续进行。刘公望教授巧用经方治疗放化疗后引起的毒副反应，收效良好。现举医案2则，以飨读者。     

Clinical Application of Yongquan （KI 1）Acupointd

Yongquan （KI 1） is the Jing-Well point of Kidney Meridian of Foot Shaoyin. It can be used to treat many kinds of diseases, such as parietal headache, vertigo and blurred vision, hypopharynx swelling and pain, dry tongue, voice loss, epistaxis, apoplexy and apoplectic sequela, dysufia, ungratifying defecation, epilepsy, syncope, planter fever, palpitations, lower limbs spasm, hypertension, vomiting, infantile convulsion. The author applied Yongquan （KI 1） in clinical practice and obtained satisfactory therapeutic effects. Now five cases were introduced as follows.     

Antidepressant-like effect of essential oil of Perilla frutescens in a chronic,unpredictable, mild stress-induced depression model mice

Perilla frutescens（Perilla leaf）, a garnishing vegetable in East Asian countries, as well as a plant-based medicine, has been used for centuries to treat various conditions, including depression. Several studies have demonstrated that the essential oil of P. frutescens（EOPF） attenuated the depressive-like behavior in mice. The present study was designed to test the anti-depressant effects of EOPF and the possible mechanisms in an chronic, unpredictable, mild stress（CUMS）-induced mouse model. With the exposure to stressor once daily for five consecutive weeks, EOPF（3, 6, and 9 mg·kg-1） and a positive control drug fluoxetine（20 mg·kg-1） were administered through gastric intubation to mice once daily for three consecutive weeks from the 3rd week. Open-field test, sucrose consumption test, tail suspension test（TST）, and forced swimming test（FST） were used to evaluate the behavioral activity. The contents of 5-hydroxytryptamine（5-HT） and its metabolite, 5-hydroxyindoleacetic acid（5-HIAA）, in mouse hippocampus were determined by HPLC–ECD. Serum interleukin（IL）-1, IL-6, and tumor necrosis factor（TNF）-α levels were evaluated by enzyme-linked immunosorbent assay（ELISA）. The results showed that CUMS significantly decreased the levels of 5-HT and 5-HIAA in the hippocampus, with an increase in plasma IL-6, IL-1β, and TNF-α levels. CUMS also reduced open-field activity, sucrose consumption, as well as increased immobility duration in FST and TST. EOPF administration could effectively reverse the alterations in the concentrations of 5-HT and 5-HIAA; reduce the IL-6, IL-1β, and TNF-α levels. Moreover, EOPF could effectively reverse alterations in immobility duration, sucrose consumption, and open-field activity. However, the effect was not dose-dependent. In conclusion, EOPF administration exhibited significant antidepressant-like effects in mice with CUMS-induced depression. The antidepressant activity of EOPF might be related to the relation between alteration of seroto     

Cytological and biochemical studies during the progression of alloxan-induced diabetes and possible protection of an aqueous leaf extract of Costus afer

Some plants have proven efficacy in the management of diabetes mellitus, of which Costus afer is one. This study was designed to evaluate the cytological and biochemical properties, and comparative ameliorating effects, of an aqueous extract of Costus afer Ker Gawl.（Costaceae） leaf and glibenclamide（GBM）, in liver, kidney, and pancreatic injury induced by alloxan. Thirty male albino rats were divided into six weight-matched groups. Group one served as the negative control（non-induced and non-treated, control）, while groups 2–6 were alloxan-induced diabetic groups. Group 2 served as a positive control（induced and non-treated, IC）, groups 3–5 were treated with different doses of the extract（375, 750, and 1 125 mg/kg body weight） and glibenclamide, respectively. Body weight, absolute and relative organ weights, food and fluid intake, levels of serum glucose and liver enzymes and kidney parameters were calculated and compared. Hepatocytes, renal tubules, and pancreatic cells of diabetic rats, in diabetic non-treated and treated rats were harvested and examined histopathologically. There was dose dependent amelioration on the injuries induced by alloxan on both hepatocytes, renal tubules, and pancreatic cells after treatment with Costus afer. The glucose level was reduced significantly in the Costus afer treated diabetic rats compared with the non-treated diabetic group. Costus afer leaves seem to be effective against diabetic cell injury induced in rat liver, kidney, and pancreas.     

Characteristics of Mang Needle Therapy and Its Clinical Application

Mang needle （elongated needle, 芒针） is evolved from the long needle, one kind of nine needles in the ancient times, and is primarily characterized by its long needle-body and its arrival at the deep tissues of the body. However, because of the particularity of the physiology and anatomy of some diseases, direct deep puncturing can＇t reach the due tissues, thus the treatment results are affected. Based upon the deep puncturing of Mang needle and the physiology and anatomy of the human body, professor YANG Zhao-gang, a well-known acupuncturist, has made many improvements and innovations, in his long-term clinical practice, in the manipulations and indications of Mang needle, consequently to establish a series of unique puncturing techniques of Mang needle, which work excellently on some difficult and complicated diseases. This Mang needle therapy is introduced as follows.     

Polysaccharides from Tricholoma matsutake and Lentinus edodes enhance 5-fluorouracil-mediated H22 cell growth inhibition

OBJECTIVE： Few studies have investigated the ef- fects produced by combinations of polysaccharides and chemotherapeutic drugs in cancer treatment. We hypothesized that a combination of polysaccha- rides （COP） from Lentinus edodes and Tricholoma matsutake would improve the efficacy of 5-fluoro- uracil （5-FU）-mediated inhibition of H22 cell growth. METHODS： Mice were injected H22 cells and then treated with either 5-FU, polysaccharides from Tri- choloma matsutake （PTM）, polysaccharides from Lentinus edodes （PL）, PTM ＋ PL, 5-FU ＋ PTM, 5-FU ＋ PL, or 5-FU ＋ COR The tumor weight and volume, and splenic CD4 ＋ and CD8 ＋ T cell frequencies, were determined. Additionally, splenic natural killer （NK） cell and cytotoxic T lymphocyte （CTL） activities were assessed and the serum levels of tumor necro- sis factor-a （TNF-a）, Interleukin-2 （IL-2）, and Interfer- on-y （IFN-y） were measured. RESULTS： Compared with mice from the control,5-FU, PL, PTM, PTM ＋ PL, 5-FU ＋ PL, and 5-FU ＋ PTM groups, mice treated with 5-FU ＋ COP showed： （a） significantly reduced tumor weight and volume （P〈 0.05）, （b） significantly higher serum levels of TNF-α, IL-2, and IFN-y （P〈0.05）, （c） significantly increased CD4＋ and CD8＋ 1 cell frequencies in the spleen （P〈 0.05）, and （d） significantly increased splenic NK cell and CTL activities （P〈0.05）. The tumor weight and volume in mice treated with 5-FU＋PL or 5-FU＋PTM were significantly reduced compared with mice treated with 5-FU alone （P〈0.05）. Serum levels of TNF-α, 11.-2, and IFN-y, frequencies of CD4 ＋ and CD8＋ T cells in the spleen, and splenic NK and CTL activities were also significantly increased in mice treated with 5-FU＋PL or 5-FU＋PTM compared with mice treated with 5-FU alone （P〈0.05）. CONCLUSION： Polysaccharides from Lentinus edodes and Tricholoma matsutake could enhance the efficacy of 5-FU-mediated H22 cell growth inhi- bition.     

Effect of Zhuyeshigao granule on tumor necrosis factor-a and inter- leukins serum protein levels in rats with radiation esophagitis

OBJECTIVE： To investigate the effects of Zhuyesh- igao granule （ZSG） on tumor necrosis factor-a （TNF-a）, interleukin-1 （IL-1）, IL-2, IL-6, and IL-8 in rats with radiation esophagitis. METHODS： Fifty Wistar rats were randomly divid- ed into five groups （10 rats in each group）： con- trol （without radiation）, saline-treated, and low, medium, and high-dose ISG-treated groups. Rats were given normal saline （10 mL/kg） or 1.15, 2.3, or 4.6 g/kg ZSG by intragastric administration once a day for 7 days. A rat model of radiation esophagi- tis was established by local irradiation of Co60 （490.25 cGy/min, totaling 30 Gy）. The administra- tion of ZSG was continued for another 7 days and on the 7th day post-irradiation, inferior vena cavablood was collected. The serum was separated, and TNF-a, IL-1, IL-2, 11_-6, and IL-8 protein levels were determined. RESULTS： Inflammatory response factors were found in the serum of each group. However, levels in ZSG-treated groups were significantly lower than in the saline-treated group （P〈0.05）. CONCLUSION： ZSG may prevent the development of radiation esophagitis, perhaps by inhibiting the generation and release of the inflammatory re- sponse factors TNF-a, IL-1, IL-2, IL-6, and IL-8.     

中西医结合辨治精神焦虑症

精神焦虑症是以精神焦虑、心中烦躁、心悸不安、情绪易于波动为主要表现的一类疾病。采用口服西药舒乐安片加中药百合莲子甘草大枣方治疗该病，取得良好效果。     

Efficacy of Saam acupuncture treatment on improvement of immune cell numbers in cancer patients： a pilot study

OBJECTIVE： To collect preliminary data on the effects of Saam acupuncture with regard to the immunity in cancer patients.METHODS： Ten cancer patients were analyzed for improvements in immunity. Acupuncture was applied at the 5 acupuncture points, Jingqu（LU 8）, Zutonggu（BL 66）, Yanggu（SI 5）, Yangchi（TE 4）, and Zhongwan（CV 12） for 2 weeks with 4 sessions. We assessed the effect of Korean Saam acupuncture on the immune system in cancer patients by measuring particular blood cell subsets, including CD3 ＋,CD4＋, CD8＋, CD19＋, and CD56＋ cells, as well as total white blood cell count, absolute neutrophil count, and fatigue score. The measurement was performed before and after acupuncture and at a 2-week follow-up.RESULTS： There was a statistically significant increase in the number of CD3＋（P=0.023） and CD8＋ cells（P〈0.001） and T-cell subsets, as well as a decrease in the fatigue severity scale（FSS） score（P=0.001） after Saam acupuncture using the 5 acupoints.CONCLUSION： Acupuncture may improve the immune system by increasing the counts of a few immune cells and relieve fatigue in cancer patients by decreasing FSS scores. Although this was a non-controlled study, it constitutes preliminary research investigating the potential effects of Saam acupuncture in increasing the counts of several immune cells in cancer patients.     

Effect of pulsatile perfusion during cardiopulmonary bypass in terms of radial artery sphygmogram

OBJECTIVE： To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass（CPB）.METHODS： A total of 34 adults with heart disease who underwent open-heart surgery between April2010 and January 2011 were randomized into a pulsatile perfusion group（n=17） and a non-pulsatile perfusion group（n=17）. Radial arterial pulse waveforms of pulsatile and non-pulsatile perfusion patients were observed and compared before and during CPB.RESULTS： No pulse waveform could be detected at patients＇ radial artery in both groups when the aorta was cross-clamped. Pulse waveforms could be detected at pulsatile perfusion patients＇ radial artery, but could not be detected at non-pulsatile perfusion patients＇ radial artery during CPB. Additionally, patients＇ pulse waveforms during pulsatile perfusion were lower than those before the operation.CONCLUSION： Our findings indicate that radial artery sphygmogram can be used as a valid indicator to evaluate the effectiveness of pulsatile perfusion during CPB.     

Correlativity between blood measures related to blood stasis block- ing collaterals and gene expression of angiotensin-converting en- zyme of renal cortex in diabetic rats and effect of stasis removing and collaterals dredging

OBJECTIVE： To investigate the correlativity between the changes of blood measures related to blood stasis blocking collaterals and gene expression levels of angiotensin-converting enzyme（ACE）and ACE2 ofrenal cortex in diabetic rats with stasis blocking collaterals syndrome, as well as the effectof stasis removing and collaterals dredging.METHODS： Male Sprague-Dawley rats were divided randomly into normal control group（C group）,high-carbohydrate-fat control group（H group） and streptozotocin（STZ）-injecting group. The diabeticrats were induced from rats in the STZ-injecting groupby high-carbohydrate-fat diet combined with STZ intraperitoneal injection, with sustained high-carbohydrate-fat diet fed afterwards, and were further divided into model group（M group）and Chinese medicine of stasis removing and collaterals dredging group（Z group）. Rats in the Z group were fed with stasis-removing-and-collaterals-dredging herbal granule suspension intragastrically daily for 16 weeks, while drinking water of corresponding volume was administrated to the rats in other groups. At the end of the 16 th week after successful establishment of models, the ultrastructures of glomeruli in different groups were detected by a transmission electron microscopy; and blood measures related to blood stasis blocking collaterals, including lipid profile and blood viscosity measures, were tested, as well as the relative gene expressions of ACE and ACE2.RESULTS： Changes in ultrastructures of glomeruli in the M group were characterized by lack of clarity in structure and occasional thickening of glomerular basement membrane and extensive fusion in foot processes. The correlation analysis showed that there were positive correlations between lipid profile, blood viscosity, and the ACE mRNA expression levels in the M group（P〈0.05）, except for cholesterol. And except for triglyceride, the blood measures were in negative correlation with the ACE2 mRNA expression levels in the M group（P〈0.05）.Compared with the C     

更年期综合征辨治3则

更年期综合征是指妇女绝经前后，由于卵巢功能衰退而出现的一系列以自主神经紊乱为主的系列症状，如月经紊乱、烘热汗出、面红潮热、心悸怔忡，甚或情志异常，或面目肢体浮肿、尿频失禁、腰膝酸软等。笔者采用中医药疗法治疗更年期综合征，疗效较好。现举例如下。     

秦玉龙辨治闭经验案1则

秦玉龙教授曾师从北京中医药大学任应秋教授，现系天津中医药大学中医各家学说教研室主任，博士生导师，从事临床30余年，擅长糖尿病、心脑血管疾病等内科杂证及妇科疾病治疗。笔者有幸在秦玉龙教授身边侍诊，受益匪浅。今录其治疗闭经案1则并探讨其临证中辨证及用药思路。