《内经》汗证证治研讨

《内经》汗证证治研讨湖南中医学院（４１０００７）熊继柏关键词内经；汗证；病因病机；治法《内经》中所载汗证颇多，如魄汗、多汗、灵汗、大汗、漉汗、灌汗、寝汗、夺汗、绝汗、漏泄等。历代医家研究《内经》汗证，有按五脏分类者，有从病因分类者，有依汗出的表现特点...     

论汗证三因素

汗证三因素即汗出的动力、汗源、汗路。本文论述了汗证三因素及其生理、病理：①阳加于阴则汗，阳盛蒸迫津液则汗多，阳虚失于蒸化则无汗。②津血是汗出的物质基础，津血汗同源，津血不足则汗出不全，少汗或无汗，并可因此而阻遏表证的自我向愈。③汗路即津液从内达外的道路，与肌表、半表半里、膜原、三焦密切相关。并论述了汗路洞开与痹阻的症状与机理。     

“汗家”可发汗而不可重发汗

《伤寒论》中“汗家重发汗，必恍惚心乱，小便已阴痛，与禹余粮丸”中“重”字其音应读作zhong而不读chong，“汗家”和“常自汗出”可以桂枝汤等发汗轻剂调和营卫复发其汗，绝不是再发汗就会恍惚心乱，只是不可用麻黄汤或大青龙汤等重剂峻剂复发其汗，否则过汗易伤心气使神志无主而恍惚心乱。其本意应为警示医者汗之尺度，因此“汗家”可以发汗，只是不可用重剂峻发其汗。     

合谷、复溜治汗探析

合谷、复溜治汗探析姚玉芳（安徽中医学院针灸系，合肥２３００３８）主题词汗证／针灸疗法，穴，合谷，穴，复溜汗证是临床常见症状之一，既可表现为当汗不汗，也可表现为汗出不收；既可单独出现，也可见于许多急、慢性疾病之中。针灸治疗汗证，常以合谷、复溜为主穴。本...     

浅谈太阳病篇之“汗”

《伤寒论》太阳病篇对“汗”精辟独到的论述及对与汗相关的临床经验见解，成为后世医家的辨治准绳。篇中明确提出汗法的用法要点，如以汗出辨虚实、应汗当汗、汗法有度等，或论汗与血津液、阳气密切相关，现阐述如下：1汗与营卫相关《素问·阴阳别论》：“阳加于阴谓之汗。”出汗，反映体内阴阳的平衡与否。汗乃人体阴津阳气互相作用的产物，为阳气所主，阴津所化。营属阴，卫属阳，汗与营卫密切相关。外邪袭表，导致机体阴阳失调。如“太阳病，     

《伤寒论》汗法刍议

汗法是八法之首，主要应用于表征。《伤寒论》中有关汗法的条文约占全书三分之一而有余，与汗法有关的方剂17首，对汗法的论述，内容丰富，颇为详尽，独具特色，对后世汗法的应用深有启迪。其主要内容有如下5个方面：辛温解表，文火久煎；温服微汗，不可如水流漓；汗法应用，首分虚实；汗法禁忌，以虚为主；汗法加减，灵活多样。     

药汗刍议

药汗刍议湖北中医学院（４３００６１）梁文华主题词汗症／中医病机，汗症／中医药疗法药汗即服药后人体遍身汗出的一种调节反应，乃人体气血调和、邪气外解、病情向愈的佳兆。显然，它虽不同于正常汗出。但仍属生理调节范畴。吴鞠通《温病条辩·汗论》云：“汗也者，合阳...     

浅述《伤寒论》对"头汗出"的治疗

《伤寒论》一书奠定了中医辨证论治的理论基础。笔者在研读《伤寒论》时，以证为纲总结其治法，颇多感悟，仲师对证之描述细致准确，因证而治灵活机巧，值得效法。仅“汗出”一症，可见于《伤寒论》六经中每一经，涉及条文达三十有余，有“汗自出”、“汗出多”、“大汗出”、“漐漐汗出”、“汗出恶风”、“汗出而渴”、“汗出而喘”、“汗出而厥”(以上为全身汗出)、“手足染染汗出”、“头汗出”等描述，其治因病机不同而各异。笔者仅以“头汗出”为例，略述其不同治法，以彰其旨。     

由不汗而汗引发的思考

由不汗而汗引发的思考呼和浩特市新城区医院王建平，南成勋（０１００１０）前贤张景岳，治一叟得伤寒证，战而不汗，于其翌日发战之时，投以大剂八味地黄汤．须臾战而得汗。清代医家张锡纯常以白虎汤得汗退热，且验明王承气汤恒有发汗之能。如此不以表散发汗之剂而得汗之...     

伤寒论汗证探析

张仲景在《伤寒论》中对汗的辨证论治颇为重视，关于汗证的条文有１４０条之多，广泛涉及表证、寒证、热证、虚证、实证、药后汗出等多种病因。本文探析的则是自汗、盗汗、头汗、战汗、手足汗、黄汗、红汗、脱汗、厥汗、狂汗十种特殊汗型的病因病机及证治。     

A comprehensive review on ethnomedicine,phytochemistry, pharmacology,and toxicity of Tephrosia purpurea (L.) Pers.

Tephrosia purpurea (L.) Pers. is a well‐known plant in Ayurveda and named “Sarwa wranvishapaka” for its property to heal wounds. Traditionally, it is practiced for impotency, asthma, dyspepsia, hemorrhoids, syphilis gonorrhea, rheumatism, enlargement of kidney and spleen. It is an important component of herbal preparations like Tephroli and Yakrifti used to cure liver disorders. Various phytocompounds including pongamol, purpurin, purpurenone, tephrosin, bulnesol, tephrostachin, β‐sitosterol, and so on have been reported. Modern pharmacological studies have shown that the plant have wound healing, antileishmanial, anticarcinogenic, antimicrobial, antioxidant, hepatoprotective, antifertility, antispermatogenic, anti‐diarrheal, diuretic, and insecticidal properties. Acetylcholinesterase inhibitory action reported from this plant aids its utilization for the development of drugs for Alzheimer's and dementia neurological disorders. Among the known active compounds of T. purpurea, tephrostachin is responsible for antiplasmodial activity, tephrosin, pongaglabol, and semiglabrin exerts antiulcer activity while quercetin, rutin, β‐sitosterol, and lupeol are mainly responsible for its anti‐inflammatory and anti‐cancer properties. From different toxicological studies, concentrations up to 2,000 mg/kg were considered safe. The present review comprehensively summarizes the ethnomedicine, phytochemistry, pharmacology, and toxicology of T. purpurea. Further research on elucidation of the structure–function relationship among active compounds, understanding of multi‐target network pharmacology and clinical applications will intensify its therapeutic potential.     

杜仲化学成分、药理作用和临床应用研究进展

杜仲Eucommia ulmoides是我国特有的珍稀濒危二类保护植物,其皮、叶、雄花和种子均具有药用价值和食用价值。化学成分研究发现杜仲不同部位（皮、叶、雄花、种子）主要有木脂素类、环烯醚萜类、黄酮类、苯丙素类、萜类和甾体类等成分,具有抗骨质疏松、抗炎、神经保护、降血压、降血糖、调血脂、免疫调节、抗菌、抗病毒等药理作用,广泛应用在医药、保健食品、饲料添加剂及日化用品等多个领域。通过对2000年1月—2022年12月在中国知网（CNKI）和PubMed数据库中发表的杜仲文献进行检索,共检索到相关文献1772篇,其中有效文献188篇。综述了杜仲在化学成分、药理作用、临床研究和开发应用方面的研究进展,为后续杜仲的临床应用及相关产品开发提供参考。     

Rumex japonicus Houtt.: A phytochemical,pharmacological, and pharmacokinetic review

Rumex japonicus Houtt. (RJH‐Yang Ti) RJH has been used as a folk medicine in East Asian countries for thousands of years. It has a wide range of therapeutic effects in terms of anti‐microorganic, anti‐oxidant, anti‐inflammatory, and antitumor effects. Therefore, it is urgent to thoroughly review the existing knowledge for this herb from phytochemical, pharmacological, and pharmacokinetic perspectives. “Yang Ti” and its English, botanical and pharmaceutical names used as keywords to perform database search which included the Encyclopaedia of traditional Chinese Medicines, PubMed, EMBASE, AMED, CINAHL, Cochrane Library, MEDLINE, Science Direct, Scopus, Web of Science, and China Network Knowledge Infrastructure. Forty‐five compounds identified from RJH. Besides, the therapeutic effects of RJH have been summarized as well. The root of RJH contains derivatives of anthraquinones, phytosterols, nepodin, oxanthrone c‐glycosides, phenolic acid, cinnamic acid, flavonoid, epoxynaphthoquinol, triterpenoids, methoxynaphthalene, trihydroxybenzene, anthracene‐9,10‐dione, and other compounds. The extract of RJH and its chemical compounds showed the potentials as a complementary agent to exert antioxidant, antimicrobial, antisepsis, anticancer, anti‐haematological disease, anti‐dermatological disease, and antidiabetic activities. For the record, there is no study conducted on RJH regarding its pharmacokinetic aspect. Notably, Emodin may require additional attention due to its multiple organ toxicity concerns.     

清咽排毒颗粒的药效学研究

目的研究清咽排毒颗粒在解热、镇痛、抗炎、止咳、祛痰、体外抗菌、体外抗病毒等方面的作用,为其临床用于风热型急性咽炎提供了实验依据。方法选用2,4-二硝基苯酚致大鼠发热法、热板法、二甲苯所致小鼠耳廓肿胀法、氨水引咳法、小鼠酚红排泄法、最低抑菌浓度法和鸡胚内抗病毒法。结果清咽排毒颗粒对2,4-二硝基苯酚所致大鼠发热有显著的解热作用;对热板法引起的疼痛具有明显的镇痛作用;对二甲苯所致小鼠耳肿胀有明显的抑制作用;能明显抑制氨水引起的小鼠咳嗽,促进小鼠气管酚红排泄;对金黄色葡萄球菌、乙型溶血性链球菌、肺炎克雷伯氏菌、大肠杆菌、甲型流感病毒H1N1有一定抑制作用。结论清咽排毒颗粒具有解热、镇痛、抗炎、止咳、祛痰、体外抗菌、体外抗病毒等方面的作用。     

中药石斛黄酮活性成分研究进展

石斛是益胃生津,滋阴补虚的中药,有提高免疫力、抗氧化等功效,含有丰富的黄酮活性成分,具有较高保健价值。从多个石斛中共分离得到89个黄酮活性成分,主要分为黄酮类、黄烷酮类、黄酮醇类3种。其中黄酮类成分40个,苷元类型主要为芹菜素和圣金草素;黄烷酮类成分20个;黄酮醇类成分15个,苷元类型主要为山柰酚和槲皮素。铁皮石斛及个别种还含有二氢黄酮醇类、花色素类、查尔酮类等黄酮类型成分。含有黄酮活性成分的石斛属植物有34个种,铁皮石斛含38个黄酮成分,霍山石斛含28个黄酮成分,紫皮石斛(齿瓣石斛)含19个黄酮成分,大苞鞘石斛含12个黄酮成分,球花石斛含有5个黄酮成分,叠鞘石斛和棒节石斛各含有4个黄酮活性成分。霍山石斛中含有大量以芹菜素为苷元的黄酮活性成分,紫皮石斛中含有多数以山柰酚或槲皮素为苷元的黄酮活性成分。常见的黄酮活性成分有柚皮素、槲皮素、芦丁等,具有抗氧化、降血糖、可改善血液循环、降低胆固醇,对心血管系统具有保护作用等药理活性作用。笔者拟对中药石斛黄酮活性成分的数量、类型、生理功能等研究现状进行了综述,以期推动药用石斛业内对石斛黄酮的关注,有助于挖掘石斛属植物在药效、食品领域的价值。     

针灸治疗失眠随机平行对照研究

[目的]观察针灸治疗失眠疗效。[方法]使用随机平行对照方法,将40例门诊患者按就诊顺序号方法随机分为两组。对照组18例安定,5~10mg/次,1次/d,睡前口服。治疗组22例针灸治疗,选穴:涌泉、精明、肺俞、心俞、肾俞、脾俞、肝俞;患者平卧,75%酒精擦拭针灸部位,毫针0.3mm×40 mm;首取精明,嘱患者闭眼,以左手拇指抵住患者眼球,向外轻轻推按,右手持针沿框内侧下缘缓缓刺入0.8~1.0寸,忌提插、捻转等行针手法,留针20min,出针后以棉球按压针孔2min;针刺涌泉穴、五脏俞穴,行提插、捻转等手法,以平补平泻为主,留针20min;五脏精血亏虚,五脏俞穴可施行补法,1min/穴,留针30min。连续治疗10d为1疗程。观测临床症状、睡眠状况、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈10例,显效5例,有效5例,无效2例,总有效率90.90%。对照组痊愈3例,显效4例,有效6例,无效5例,总有效率72.20%。治疗组疗效优于对照组(P0.05)。[结论]针灸治疗失眠效果显著,值得推广。     

Effects of Silymarin on Diabetes Mellitus Complications: A Review

Diabetes mellitus is a common metabolic disorder that is caused by a deficit in the production of (type 1) or response to (type 2) insulin. Diabetes mellitus is characterized by a state of chronic hyperglycemia and such symptoms as weight loss, thirst, polyuria, and blurred vision. These disturbances represent one of the major causes of morbidity and mortality nowadays, despite available treatments, such as insulin, insulin secretagogues, insulin sensitizers, and oral hypoglycemic agents. However, many efforts have been made to discover new drugs for diabetes treatment, including medicinal plant extracts. Silymarin is a powder extract of the seeds from Silybum marianum, a plant from the Asteraceae family. The major active ingredients include four isomers: silybin, isosilybin, silychristin, and silydianin. Silymarin is indicated for the treatment of hepatic disorders, such as cirrhosis, chronic hepatitis, and gallstones. Moreover, several studies of other pathologies, including diabetes, sepsis, osteoporosis, arthritis, hypercholesterolemia, cancer, viral infections, and Alzheimer's and Parkinson's diseases, have tested the effects of silymarin and reported promising results. This article reviews data from clinical, in vivo, and in vitro studies on the use of silymarin, with a focus on the complications of diabetes, including nephropathy, neuropathy, healing delays, oxidative stress, hepatotoxicity, and cardiomyopathy. Copyright © 2017 John Wiley & Sons, Ltd.     

木果楝属柠檬苦素类似物及其生物活性的研究进展

木果楝属Xylocarpus植物中包含丰富的萜类、生物碱类、多酚类、黄酮类、甾体类等化学成分,其中具有广泛生物活性和多环体系的柠檬苦素类化合物是其最主要的次生代谢产物。柠檬苦素是一类具有独特结构的高度氧化的四降三萜类化合物,葛杜宁、andirobin、墨西哥内酯、phragmalin等多种结构类型的柠檬苦素及其类似物在木果楝属植物中普遍存在,具有抗肿瘤、抗病毒、抗氧化、镇痛、抗炎、抗焦虑、镇静、保护神经、改善睡眠等药理作用,还具有昆虫拒食、杀虫等生物活性。对2010—2021年报道的木果楝属216个柠檬苦素类化合物及其生物活性的研究进展进行综述,为丰富该类资源的新药开发提供思路。     

A comprehensive review of phytochemical profile,bioactives for pharmaceuticals,and pharmacological attributes of Azadirachta indica

Azadirachta indica L. is a multipurpose medicinal tree of family Meliaceae. It occurs in tropical and semitropical regions of the world. Different parts of this miraculous tree are used to treat pyrexia, headache, ulcer, respiratory disorders, cancer, diabetes, leprosy, malaria, dengue, chicken pox, and dermal complications. The tree is popular for its pharmacological attributes such as hypolipidemic, antifertility, microbicidal, antidiabetic, anti‐inflammatory, hepatoprotective, antipyretic, hypoglycemic, insecticidal, nematicidal, antiulcer, antioxidant, neuroprotective, cardioprotective, and antileishmaniasis properties. A. indica is also rich in various phytochemicals for pharmaceuticals such as alkaloids, steroids, flavonoids, terpenoids, fatty acids, and carbohydrates. The fungicidal potential of the tree is due to the presence of azadirachtin and nimbin. Herein, we have compiled a comprehensive review of phytochemical profile, pharmacological attributes, and therapeutic prospective of this multipurpose tree.     

附子、美西律、依那普利合用对L-NNA所致高血压小鼠的影响

目的：探讨附子、美西律、依那普利合用对L-NNA所致高血压小鼠模型的影响。方法：将雄性IcR小鼠随机分为8组：正常对照组、L-NNA模型组、L-NNA＋附子组、L-NNA＋依那普利组、L-NNA＋附子＋依那普利组、L-NNA＋附子十依那普利＋美西律组、LNNA＋附子＋美西律组、L-NNA＋美西律组。采用持续10天灌胃给予L-NNA（700mg／kg·d-1）的方法造高血压小鼠模型。造模成功后,各组持续10天分别给予0．5％羧甲基纤维素钠（CMC-Na）溶液、L-NNA、L-NNA＋附子水煎液、L-NNA＋依那普利、L-NNA＋附子水煎液＋依那普利、L-NNA＋附子＋依那普利＋美西律、L-NNA＋附子＋美西律、L-NNA＋美西律。给药10天后,测定各组小鼠的血压,血清中N0含量,心、肝、肾匀浆中N0和MDA的含量。结果：与正常对照组相比,模型组小鼠血压明显升高,血清和心、肝、肾组织中的NO含量降低,MDA含量升高,单独给予附子和依那普利的治疗组小鼠血压及生化指标显著改善,但两种药合用后降压效果消失;而在合用附子和依那普利的基础上给予美西律,其降压和升高血清、心、肝、肾中NO的效果比附子和依那普利合用有所提高。结论：附子和依那普利合用有明显的拮抗作用,提示附子的作用机制与RAAS系统有关,美西律能减弱附子和依那普利的拮抗作用。