陈瑞春临证合用经方与时方经验举隅

经方因其药物少、配伍精,疗效显著而备受临床医生的推崇.陈瑞春老先生崇尚仲景,临证喜用经方,且擅用经方.陈老认为[1],尊崇经方并不是一味执守原方不加减化裁,而是要在深究方规的基础上灵活化裁应用.时方多在经方的基础上演变而来,其特点是药物繁多,功效脏腑化,方剂配伍关系没有经方精当,但疗效却有其独到之处.陈老临证常将经方与时方合而用之,取两者之长,优化组合,以取得更佳的疗效.以下摘录几则陈老经方与时方合用的经验.     

方书源流述略

中国医学源远流长,历代名医辈出,医学文献汗牛充栋。在浩如烟海的各类医学典籍中,方书文献以其数量巨大且富实用价值,尤为引人瞩目。所谓方书,即方剂学著作,传统上习惯称为“方书”,意即专门收载方剂的著作,或以方剂为主要内容的著作。汉代将方书归入“经方”范畴,班固在《汉书·艺文志》中将医学书籍分为医经、经方、房中、神仙四类。谓：“经方者,本草木之寒温,量疾病之浅深,假药味之滋,因气感之宜,辨五苦六辛,致水火之齐（剂）,以通闭解结,反之于平。”可见“经方”是记述具体治疗方法的著作,有别于专谈理论的“医经”…     

张锡纯用药特色初探

张锡纯善用经方，突出通变。一是在经方基础上加减，从而组成新方，如加味苓桂术甘汤。二是根据经方立意化裁创制新方，其意其法均遵原方，但又有所不同，如荡胸汤、犹龙汤等。同时组方配伍创制多药联用新结构，如山药配牛蒡子、黄芪配知母等。     

李明权经方合用治疗疑难病验案撷萃

通过列举小柴胡汤合清胃散化裁治疗重度痤疮案,理中丸合甘姜苓术汤、四妙丸化裁治疗重症恶寒案,当归芍药散合五苓散化裁治疗难治性肾病综合征案,介绍四川省名中医李明权教授灵活运用经方治疗疑难病的经验,为后学者应用经方提供借鉴。     

经方临床验案3则

经方一般是指汉代以前经典医药著作中记载的方剂,以张仲景的方剂为代表.经方是“医方之祖”.后世中医学家称《伤寒杂病论》为“活人之书”“方书之祖”,赞誉张仲景为“医圣”.古今中外的中医学家常以经方作为母方,依辨证论治的原则而化裁出一系列的方剂.经方辨证简单,药少力专,疗效显著,药价又较为低廉,适用于广大群众.     

谈《伤寒论》汤方之加减化裁

《伤寒论》所创立的103方,世称“经方”被推崇为众方之祖。由于本论方药组合法度严谨,不但为后世制方建立了轨范,而且也提示了汤方加减化裁的准则。现谈谈个人的学习体会。一、主方及加减化裁原则伤寒六经,各经主证均有其主方。在临床具体运用上,应如何掌握各方的加减化裁     

“经方”之名探讨

“经方”之名由来已久 ,在临床实践中 ,以“经方”加减治疗各类病证疗效卓著。然而“经方”的解释说法却很多 ,见仁见智 ,难于统一。在文献报道中 ,所使用的“经方”也取自于范围较大的各种古典医籍 ,造成不少的歧义 ,因而有必要对“经方”之名有一个全面的了解 ,以求共识。1　“经方”的含义目前“经方”之含义大致有 3种。1 1　经方者 ,经验之方也　在春秋战国时期 ,我国的社会制度经历着巨大的历史性变革。随着生产力得到极大的发展与提高及代表不同阶级利益与要求的各种学派———诸子百家的出现 ,祖国医学的发展也得到了有力的推动。这…     

仲景“同方异用法”初探

仲景《伤寒杂病论》中的方剂组方谨严,遣药精当,化裁有制,加减有法,若用之得当,则效如桴鼓,因此,被后代医家称之为“经方之祖”。这和他“留神医药,精究方术”是分不开的,对于仲景的用方之术,前人曾作过不少深刻的研究,但对于他的同方异用之法,却未见有人作系统的阐述,本文试就这个问题,谈点个人的肤浅之见。     

漫谈经方的加减

正临床使用经方是否需加减化裁是目前较为热门的话题。从常识而言,可辨证施治即因人而异再加以量体裁衣。若药方不加减化裁而使用原方,便有刻舟求剑、对号入座之虞。笔者认为经方临床使用是否需加减化裁,值得研究。在疾病发展过程中,某一个阶段显现的方证是否典型,何去何从全由临床现场的脉症所决定。借用徐     

经方治疗哮喘的临床应用进展述评

经方指中国汉朝张仲景所著《伤寒杂病论》所记载之方剂.经方因其法度严、配伍妙、用药精、疗效宏而倍受临床推崇.古今医家常以经方作为母方,依辨证论治的原则而化裁出一系列的方剂[1].经方在治疗哮喘病中的运用,越来越引起医家们的重视,现就近年来应用经方治疗哮喘病的文献报道作一综述.     

叶景华运用滋肾通关丸治疗泌尿系统疾病经验

介绍叶景华运用滋肾通关丸治疗泌尿系统疾病的经验，并附验案5则。     

唐祖宣应用真武汤治疗外科疾病经验

唐祖宣（1942-），男，河南邓州人，主任医师，中华中医药学会血栓病分会副主任委员，中华全国张仲景研究会常务理事，中国中西医结合学会周围血管病专业委员会理事，中华中医药学会河南分会常务理事，河南省高级职称评审委员会委员，河南省名老中医，全国继承名老中医专家学术经验指导老师，国家级有突出贡献专家。从医50余年，临床经验丰富，推崇仲景典籍，擅用经方，在诊治周围血管病方面有独到阐发，尤其是对血栓闭塞性脉管炎（脱疽）、深静脉血栓、静脉炎的辨证和治疗。其研究成果曾获河南省科技进步一等奖1项，重大科技成果奖1项，河南省卫生厅科技进步二等奖1项，南阳地区科技进步奖6项。撰写学术论文200余篇，编著《唐祖宣医学文集》《唐祖宣医学六书》等14部著作。     

Effects of Chinese herbs combined with in vitro fertilization and em- bryo transplantation on infertility： a clinical randomized controlled trial

OBJECTIVE： To assess the effects of using Chinese herbs in assisted reproductive technology. METHODS： Four hundred and thirty-three subjects aged less than 42 years with infertility due to Fallo- pian tube or male-related factors who were willing to undertake in vitro fertilization and embryo trans- plantation were randomly allocated to a Chinese herb intervention group （n=216） or a conventional treatment control group （n=217）. All subjects re- ceived one of four routine ultra-ovulation-promot- ing therapies at the Reproductive Center in the Third Hospital Affiliated to Beijing University ac- cording to their physician＇s assessments. The sub- jects in the intervention group received various Chi- nese herbs depending on their conventional treat- ment. Endometrial thickness, number of acquired eggs, and rates of normal fertility, high-quality em- bryos, biochemical and clinical pregnancy of sub- jects were assessed in both groups.RESULTS： The high-quality embryo rate of 51.9%, biochemical pregnancy rate of 51.0%, clinical preg- nancy rate of 44.2% and endometrial thickness of （10.84± 1.75） mm in the intervention group were all significantly higher than those in the control group [48.7%, 38.9%, 34.8%, and （10.52±1.50） mm, respec- tively; P〈O.05]. The normal fertility rate of 58.5% in the Chinese herb group was also significantly supe- rior to the 54.7% achieved in the control group （P〈 0.01）. There were no statistically significant differ- ences （P〉0.05） in the average number of acquired eggs within a single cycle, incidence of excessive stimulation of ovary, rates of embryo transplanta- tion or early abortion and birth of living babies be- tween the two groups. CONCLUSION： Our findings indicate that Chinese herbs increase endometrial thickness, improve the quality of fertility and embryo, and promote embry- onic nidation, thus enhancing the success rate of in vitro fertilization/intracytoplasmic sperm injec- tion-embryo transplantation cycle. Using Chinese herbs improves th     

乳癖散结胶囊治疗乳腺病的临床疗效观察

乳腺病俗称乳腺增生，是妇女目前最常见的乳腺疾病，可发生于青春期开始以后的任何年龄妇女，治疗以口服药物为主。我院采用乳癖散结胶囊治疗乳腺病120例，取得良好疗效，现报告如下。     

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.     

Roles of Chinese medicine bioactive ingredients in the regulation of cellular function of endothelial progenitor cells

To improve the function of endothelial progenitor cells （EPCs） is one of the goals in Chinese traditional therapy to treat various cardio-celebrovascular diseases. In the past decades, scholars in the field of traditional Chinese medicine （TCM） have found fifteen active compounds to regulate the function of EPC. These metabolites are extracted from thirteen, plant-based Chinese medicine, with majority of them as potent reductive or oxidative hydrophilic molecules containing phenyl groups. These active compounds either enhance the mobilization of EPC, or inhibit their apoptosis through different signaling pathways. In this review, the molecular structure, biophysical properties, and the plant sources of these active ingredients and their regulatory effects on the function of EPC are summarized, aiming to reveal the modem basis of Chinese medicine for promoting blood circulation and removing blood stasis at the progenitor cell level.     

胃食管反流病的中医治疗对策

胃食管反流病（GERD）是指胃内容物反流入食管引起不适症状和（或）并发症的一种疾病。GERD可分为非糜烂性反流病（NERD）、糜烂性食管炎（EE）和Barrett食管（BE）等3种类型，其典型和常见的症状是烧心和反流，其他症状包括上腹痛、胸痛、暖气、腹胀、上腹不适、咽喉异物感、吞咽困难以及食管外症状（如慢性咳嗽、咽喉炎、哮喘）等。本病属中医学“吐酸”“嘈杂”“胃痛”“结胸”等范畴。病位在食管，与脾、胃、肝、     

Relationship between Renying pulse augmentation index and Cunk- ou pulse condition in different blood pressure groups

OBJECTIVE： To explore the relationship between Renying pulse （carotid） augmentation index （AI） and Cunkou pulse condition in different blood pres- sure groups, and the clinical significance of Reny- ing and Cunkou pulse parameters to reflect vascu- lar function. METHODS： Eighty-six patients with essential hyper- tension （EH） and 52 individuals with normal blood pressure （control group） between and January 2012 were included September 2010 this study. Reny- ing pulse AI was examined by a new diagnostic tool （ALOKA ProSound Alpha 10） --wave intensity （Wl） that is calculated as the product of the deriva- tives of the simultaneously recorded blood pres- sure changes （dP/dt） and blood-flow-velocity changes （dU/dt）, while Cunkou pulse condition was detected by DDMX-100 Pulse Apparatus inboth EH and control groups. A multifactorial corre- lation analysis was performed for data analysis. RESULTS： After adjusting for potential confound- ing variables, in the EH group, AI was positively cor- related with ts, w2/t （rts=0.225, P〈0.05; rw2/t=0.230, P〈 0.05） and negatively correlated with hs, hs/hl and w2 （rhs=- 0.393,P〈0.01 ;rhs/l=- 0.444, P〈0.01 ;rw2=- 0.389, P〈0.01）. In the control group, AI was positively cor- related with t3, t4, ts and w, （rt3=0.595, P〈0.01; r,4= 0.292, P〈0.05; rt5=0.318, P〈0.05; rw1=0.541, P〈0.01） and negatively correlated with h1, h2, h3, Ad and A （rh1= - 0.368, P〈0.05; rh2= - 0.330, P〈0.05; rh3= - 0.327, P〈 0.05; rAd=- 0.322, P〈0.05; rA=- 0.410, P〈0.01）. In the total sample group （EH plus control group, n= 138）, AI was positively correlated with t, ts, w1 and w, （rt=0.257, P〈0.01; rt5=0.266, P〈0.01; rw1=0.184, P〈 0.05; rw/t=0.210, P〈0.05） and negatively correlated with hs, hs/hl, w2 and Ad （rhs= - 0.230, P〈0.01; rh5/h1= - 0.218, P〈0.05; rw2= - 0.267, P〈0.01; rAd= - 0.246, P〈0.01）. Multiple linear regression analysis was car- ried out to model the relationship （F=7.887, P〈 0.001）.CONCLU     

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     

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.