以毒攻毒法治疗肿瘤的认识与思考

中医药在肿瘤综合治疗中有着重要地位,以祛除毒邪为目的的"以毒攻毒"法治疗肿瘤一直受到国内外医家的重视。本文从理论基础、历史沿革及临床应用方面阐述中医关于"以毒攻毒"法治疗肿瘤的认识。     

慢性胃炎的中医辨证论治

慢性胃炎,属中医的"胃脘痛"、"胃痞"范畴。其病机错综复杂,是消化系统的常见病、多发病,病程长,迁延不愈,因此对患者的生活质量影响很大。中医运用独具特色的辨证论治,采用中医药治疗慢性胃炎已积累了丰富的经验,临床疗效显著、持久,显示出良好的前景。各医家对错综复杂的临床证候进行剖析,从不同的切入点进行辨证论治,针对性较强,形成了其独特的思维方     

中医药治疗冠心病合并糖尿病研究概况

通过搜集近年来冠心病合并糖尿病的论文著作及期刊报道等相关文献资料,整理并分析各医家对冠心病合并糖尿病的中医病因病机及治则治法方面的观点,归纳并总结中医药治疗的特色,以便于为临床诊疗提供相关参考依据。     

基于关联规则和熵聚类算法叶天士与王任之防治中风病用药规律比较研究

运用中医传承辅助系统对新安医家叶天士、王任之治疗中风方剂进行数据分析,对比两医家治疗中风用药,发现两医家在单味药用药频次、多味药组合频次、核心组合和新方组合等方面均有所不同,再分析不同点与两医家学术思想可能的相关性,对挖掘两医家治疗中风的用药特色和规律以及临床可参考的新的组方进行阐释。并通过对比研究,为中医传承,兼收并蓄,融会贯通,提高临床疗效和开发创新提供了更好的借鉴。     

中医药治疗脊髓型颈椎病的研究概况

该文回顾和总结了近些年来中医药治疗脊髓型颈椎病的进展,并介绍了中医药对脊髓型颈椎病的临床认识。从中医辨证治疗,针灸疗法,手法治疗和中医综合治疗等方面阐述了中医药对脊髓型颈椎病的临床疗效。系统分析了中医药治疗脊髓型颈椎病的优势性,有效性和局限性。     

痛风从血分论治概述

痛风是一组异质性疾病，遗传性和／或获得性引起的尿酸排泄减少和／或嘌呤代谢障碍。目前，对其治疗，由于西药治疗痛风不良反应较大，故中医药治疗该病发挥了独特的优势，有辨证施治者，亦有分阶段论治，也有专方治疗，但笔者发现，从血分论治得到许多医家的共识，现将其综述如下。[第一段]     

从历代消渴名方透析消渴病病机

中医对消渴病的认识和治疗已有2000年的历史,历代诸多医家对本病的病机与治疗从多个角度进行了阐发,多数医家认为本病的病机以＂阴虚＂为本,＂燥热＂为标,治疗则以＂清热润燥,养阴生津＂为大法。笔者认为,消渴病的病机除了阴液亏虚之外,还包含了肾阳不足、肺脾气虚两个方面,这些隐含的病机,可以从历代治疗消渴病的常用方窥见一斑,现不揣鄙陋,阐述于下。     

中医药治疗腰腿痛相关研究进展

腰腿痛属中医"痹证"、"肾虚"范畴,指因外感、内伤及闪挫伤导致腰部气血运行不畅或失于濡养所引起的腰痛伴下肢放射性麻木、疼痛等症状的一组疾病,为临床上最常见的症状之一。是中老年人的常见病和多发病。该病反复发作,病程长,缠绵难愈。但通过众多医家多年的临床研究及疗效证实,中医药在预防和治疗腰腿痛疾病方面功效卓著。     

慢性支气管炎中医药治疗规范浅析

本文分析了目前中医药在慢性支气管炎治疗方面存在的问题，提出应建立一个有效、合理、规范、有指导意义的中医规范化治疗慢性支气管炎的临床方案。     

刘艳骄教授运用促眠方治疗失眠之经验采撷

本文通过分享刘艳骄教授常用于治疗失眠的临床验方促眠方及其合方的验案,希冀对于中医药治疗失眠有所启发,以供中医临床工作者参考。     

14 家三级甲等医院中医医师脑卒中康复知识水平调查

目的了解我国三级甲等(简称“三甲”)医院中医医师对脑卒中康复知识的掌握情况。方法参照“中国脑卒中康复治疗指南”编制问卷,于2012 年5 月对全国12 省市14 家三甲医院共128 名临床中医医师进行问卷调查。结果脑卒中康复基础知识的整体正确率为66.83%;脑卒中康复评价知识的整体正确率为88.77%;脑卒中康复治疗知识的整体正确率为75.12%。结论三级甲等中医院医师对脑卒中康复知识的掌握情况尚显不足,需进一步加强康复知识的专科培训。     

芳香开窍法对急性期脑梗死患者神经元的保护作用

背景:中医认为中风病急性期治疗当以熄风、化痰、祛瘀、清热为主,并应重在开窍。目的:观察中医芳香辟秽、化痰开窍法对急性缺血性脑卒中患者神经元的保护作用。设计:对比观察。单位:北京大学医学部附属人民医院中医科。对象:选择2000-07/2001-08北京大学医学部附属人民医院急诊及中医科确诊为脑梗死且发病时间不超过72h的住院患者67例,随机分配奇数为治疗组,偶数为对照组。治疗组33例,男19例,女14例。对照组34例,男22例,女12例。方法:①病例选择标准参照脑梗死诊断标准及脑CT结果。②中医分型:治疗组痰热内闭型13例,痰浊内盛型9例,瘀血内阻型7例,气虚血瘀型4例。对照组痰热内闭型12例,痰浊内盛型13例,瘀血内阻型8例,气虚血瘀型1例。中医辩证标准及积分标准均参照国家中医药管理局脑病急症科研组颁布的《中风病辩证标准》。③治疗组使用醒脑静注射液,对照组使用丹参注射液。治疗2周前后进行血浆内皮素,肿瘤坏死因子,一氧化氮水平测定,并进行对比观察。主要观察指标:治疗前及治疗2周后空腹抽血检验血浆内皮素、肿瘤坏死因子、一氧化氮浓度及肝、肾功能。结果:脑梗死患者67例均进入结果分析。①治疗组治疗后痰热内闭证和痰浊内盛证辩证积分以及神经功能缺损评分均比治疗前有非常显著的降低[(17.94±5.22),(25.66±6.39);(17.12±4.98),(23.89±5.31),P<0.01],与对照组治疗后比较差异有显著性[(17.94±5.22),(22.37±5.24);(17.12±4.98),(23.49±4.96),P<0.05],说明醒脑静对此两证型疗效及神经功能的改善均优于丹参组。②治疗组血浆内皮素、肿瘤坏死因子、一氧化氮浓度治疗后较治疗前有显著降低。以肿瘤坏死因子下降的程度更为显著。结论:中医芳香辟秽、化痰开窍法治疗急性缺血性脑卒中患者,是通过多种途径起到神经元保护作用的.这为今后研究中医药防治缺血再灌注诱导的脑神经细胞凋亡提供了思路。     

Traditional Chinese medicine—What are we investigating?: The case of menopause

CAM researchers commonly treat traditional medicines as unchanging systems. This article questions the validity of this approach by examining the treatment of menopausal syndrome by traditional Chinese medicine (TCM). Such treatment strategies were invented in 1964 and betray a strong influence of biomedical thinking. While they determine TCM treatment of menopausal syndrome in the West, physicians in China and Japan use many other treatment strategies from within the wider Chinese medical tradition in clinical practice. Cultural variability in the manifestation of menopausal syndrome furthermore questions the usefulness of simply importing treatment strategies from China to the West. This leads me to conclude that Chinese medicine as such can never be evaluated by means of clinical research. What we can do is use Chinese medicine as a resource for thinking about illness, and for formulating clinical interventions that may then be assessed using methods of evidence based research.     

Gender-based differences in mortality and complementary therapies for patients with stroke in Taiwan

BackgroundStroke is a leading cause of death worldwide. In this retrospective study, we investigated the different effects of gender on medical behavior, medical service, medical cost, and death from stroke in Taiwan.MethodsWe collected data on the stroke-associated mortality rate according to gender and age group for the period between 2009 and 2013 from the official registry of Ministry of Health and Welfare, Taiwan. We analyzed the data related to stroke-associated medical care and costs in 2013 from the National Health Insurance Research Database (NHIRD).ResultsThe mortality rate due to stroke was higher in men than in women, despite more inpatient or outpatient medical treatment and higher medical costs, especially in patients aged <50 years. Married women showed a significantly lower stroke-associated mortality compared to married men. Women were significantly more likely to accept Western medicine combined with traditional Chinese medicine (TCM) treatment than men (81.51% of women and 74.27% of men). They had lower medical expenditure and lower mortality from stroke than men did. Combined use of integrative Chinese and Western medicine also was associated with lower mortality from stroke than use of conventional Western medicine alone.ConclusionsIn Taiwan, stroke-associated mortality is higher in men. Marriage or female sex hormone may have protective effect against stroke in women. Women also more tended to seek TCM complementary therapies combined with Western medicine. Integrated Chinese and Western medicine could thus be a potential treatment for stroke.     

Reduced risk of stroke in patients with cardiac arrhythmia receiving traditional Chinese medicine: A nationwide matched retrospective cohort study

ObjectivePatients with cardiac arrhythmia were more likely to develop stroke than general population. The therapeutic effect of traditional Chinese medicine (TCM) on the risk of stroke in patients with cardiac arrhythmia was unknown. The aim of this study is to investigate the risk of stroke in patients with cardiac arrhythmia receiving TCM.MethodsFrom the one million cohort of the Taiwan’s National Health Insurance Research Database, we identified cohort of cardiac arrhythmia included 2029 patients who received TCM treatment in 2000–2004. The matching methods with propensity score was used to select 2029 appropriate control cohort for comparison. Incident events of stroke were identified during the follow-up period at the end of 2010. Cox proportional hazard model was used to calculate adjusted hazard ratios and 95% confidence intervals of stroke associated with TCM treatment.ResultsDuring the follow-up period, patients with cardiac arrhythmia who underwent TCM treatment (11.4 per 1000 person-years) had a lower incidence of new-onset stroke than those without TCM treatment (17.7 per 1000 person-years), with an HR of 0.62 (95% CI = 0.50–0.78). The association between TCM treatment and decreased new-onset stroke was both significant in women and men. The young patients aged 45–54 years who received TCM had the lowest risk of stroke (HR = 0.48, 95% CI = 0.27–0.87).ConclusionsReceiving TCM treatment was associated with a lower risk of stroke in patients with cardiac arrhythmia. However, this study was limited by lack of information regarding lifestyles, biochemical profiles, the dose of herbal medicine, and acupuncture points used in treatments.     

中医护理适宜技术对脑卒中痉挛性偏瘫患者下肢功能的影响

【摘要】目的 观察中医护理技术对改善脑卒中后下肢偏瘫痉挛状态、患者日常生活能力的情况及患者的肢体运动功能情况,给予卒中后遗症的偏瘫痉挛状态一种有效、的护理方法。 方法 本研究采用随机对照试验,将合符纳入标准的86例脑卒中后痉挛性偏瘫患者按照随机分配原则,分为43例中医护理技术组（治疗组）和43例常规护理组（对照组）。治疗组给予常规治疗包括控制血压、控制血糖,在此基础上给予中医护理技术（走罐、中药离子导入、砭石疗法和疏经通络操）,对照组给予常规治疗以及常规护理。分别在治疗前、治疗后1个月及治疗后2个月（结束疗程）,这三个时间段对两组患者的临床痉挛指数CSI、日常生活能力情况Ashworth量表(MAS)以及肢体的运动功能简化Fugl-Meyer量表（FMA）进行评定。结果 两组患者基线资料包括性别、年龄、疾病进程等以及治疗前患者的肢体运动功能、肢体痉挛状态、日常生活能力比较均无统计学意义（P>0.05）。疗程结束后对分别评定治疗组和对照组患者的上肢偏瘫痉挛状态、日常生活能力的情况,以及患者的肢体运动功能情况,两组患者的治疗前后和组间比较差异均有统计学意义（P＜0.05）,说明两组治疗方法均有效,而且治疗组效果优于对照组。结论 中医护理技术能有效缓解患者脑卒中后偏瘫痉挛状态,比单一的治疗或护理手段更优,并具有良好的安全性,适于推广。     

“清通法”在急性出血性中风的疗效分析

目的：探索中医药治疗急性出血性中风的有效方法。方法：采用“清通法”为主的治疗法则，自拟羚蝎胶囊、开窍熄风合剂、通腑合剂等中药制剂，治疗急性出血性中风，观察颅脑ＣＴ疗效，并与西医对照组比较。结果：中医治疗组血肿吸收速度较西医对照组快，治疗后的血肿大小较西医对照组明显缩小（Ｐ均〈０．０１）。结论：“清通法”治疗急性出血性中风具有显著疗效。     

自拟解瘀化痰方治疗痰浊瘀血型偏头痛临床效果

目的:探讨自拟中药方剂解瘀化痰方治疗痰浊瘀血型偏头痛的临床疗效及安全性。方法:将在我院入院治疗的97例中医证型为痰浊瘀血型偏头痛患者作为研究对象,随机将研究对象分为两组,西药组48例采用西比灵胶囊治疗,中药组49例采用自拟解瘀化痰方治疗。比较两组治疗后中医证候积分、中医证候疗效及不良反应。结果:治疗后中药组患者的中医证候积分显著低于西药组(P<0.05);治疗后中药组患者的中医证候疗效显著高于西药组(P<0.05);两组患者未发生不良反应。结论:自拟解瘀化痰方治疗痰浊瘀血型偏头痛临床效果优越,可改善临床症状,且安全性高。     

An American clinic for traditional Chinese medicine: comparisons to family medicine and chiropractic

Patient self-selection delimits the kinds of disorders treated by practitioners of acupuncture and other traditional Chinese modalities in the United States. Based upon a questionnaire administered to 200 first-time patients in a teaching clinic for traditional Chinese medicine (TCM) in California, it was determined that practitioners of TCM attract patients whose health problems would also be appropriate for management by family physicians, chiropractors or mental health professionals. Approximately one-third of presenting complaints can be categorized as presumed organic disorders (many of which may have been medical treatment failures); one-third comprise musculoskeletal problems and headaches; and one-third appear to be psychological or psychosomatic in nature.     

中西医结合治疗脑卒中患者的吞咽障碍

目的：探讨中西医结合治疗脑卒中吞咽障碍的临床疗效。方法：将病情稳定的300例脑卒中伴吞咽障碍患者分成常规药物组、训练组、电针组、中药组和综合组各60例,分别给予相应治疗,于治疗前及治疗第3、14及28天时采用吞咽X线透视检查法（VFSS）评分评定患者的吞咽障障碍程度。结果：与治疗前比较,治疗第28天时药物组、训练组、电针组、中药组和综合组VFSS评分均显著提高;总有效率分别为40%、73.3%、70%、63.3%及100%（P〈0.05或0.01）。综合组治疗第14及28天时与其他4组比较,VFSS评分提高更显著（P〈0.05）。结论：在常规药物治疗的基础上,辅以中西结合的综合治疗是改善脑卒中伴吞咽障碍患者的最佳方案。