基于数据挖掘技术的中医药治疗浆细胞性乳腺炎用药规律研究

目的运用数据挖掘技术,分析中医药治疗浆细胞性乳腺炎的用药规律。方法检索国内主要中文文献数据库,搜集近20年间公开发表的有关中医药治疗浆细胞性乳腺炎的文献,经相关标准筛选后,采集相关方剂用药信息,建立数据库。采用关联规则、频数分析等方法对中药复方进行数据挖掘,探讨治疗浆细胞性乳腺炎的主要药物及药对、药组规律。结果 (1)"一方通治"文献中,高频中药依次为柴胡、蒲公英、赤芍等,最常用清热解毒药及寒凉药;置信度较高的药对有"麻黄-熟地黄""瓜蒌-金银花"等,药组有"丹参-赤芍-蒲公英"等;可信度较高的药对有"柴胡-赤芍""柴胡-蒲公英"等,药组有"赤芍-蒲公英-当归"。(2)"分期论治"文献中,高频中药依次为柴胡、蒲公英、白花蛇舌草等(肿块期),或金银花、蒲公英、当归等(脓肿期),或当归、黄芪、丹参等(瘘管期),或当归、赤芍、柴胡等(围手术期);所有分期最常用均为寒凉药,肿块、脓肿、瘘管期最常用清热解毒药,而围手术期最常用补血药。置信度较高的药对肿块期为"郁金-柴胡"等,脓肿期为"蒲公英-赤芍"等,瘘管期为"白芥子-炮姜"等,围手术期为"赤芍-当归"等;药组肿块期为"延胡索-蒲公英-柴胡"等,脓肿期为"丹参-赤芍-蒲公英"等,瘘管期为"白花蛇舌草-丹参-当归"等,围手术期为"柴胡-赤芍-当归"等。可信度较高的药对肿块期为"白花蛇舌草-蒲公英"等,脓肿期为"瓜蒌-皂荚刺"等,瘘管期为"丹参-当归"等,围手术期为"当归-赤芍""柴胡-赤芍"等;药组肿块期为"白花蛇舌草-蒲公英-柴胡"等,脓肿期"赤芍-蒲公英-丹参"等、瘘管期"白花蛇舌草-丹参-当归"等,围手术期为"柴胡-赤芍-当归"等。结论浆细胞性乳腺炎常用治法为疏肝凉血、清热解毒,柴胡和清热解毒类中药是治疗本病必不可少的药物;数据挖掘在宏观层次上探索中药复方配伍特点,对中医临床辨证论治组方具有一定的指导意义。     

中西医诊断与治疗糖尿病胃轻瘫

糖尿病胃轻瘫西医诊断包括糖尿病病史,存在持续性嗳气、饱胀、腹痛、厌食、恶心、呕吐等临床症状等,西医治疗包括药物治疗和非药物治疗。中医将糖尿病归为"消渴病"、"消瘅"范畴,根据糖尿病性胃轻瘫呕吐食物、痰涎诸物或干呕无声的临床特点,归属于"消渴"兼"痞满"、"恶心"、"呕吐"、"反胃"、"积滞"、"胃缓"等范畴,中医治疗包括辨证论治、中药复方、针灸治疗等。未来将新技术、新方法逐步运用到糖尿病胃轻瘫的中西医研究中,找出最佳诊治途径。     

贾英杰教授治疗肺癌经验

肺癌是常见的恶性肿瘤之一,属中医学"肺积"、"咳嗽"、"咯血"、"胸痛"等范畴。对于肺癌的治疗,西医以手术、放化疗为主,但对于肿瘤患者的生存质量、疗效及毒副反应等方面,存在着不     

中医辨证施治结合牵引治疗颈椎病经验

颈椎病属中医学"痹症"、"颈间痛"、"项强"、"眩晕"等范畴。现代医学认为,颈椎病是由于颈椎骨质增生,颈项韧带钙化,颈椎间盘退化等病理改变,刺激和压迫邻近组织引起的各种症状,如头、颈、肩、臂等处疼     

《金匮要略》湿邪致痹理论辨析

论述了《金匮要略》以湿邪致痹理论辨治"风湿"、"湿痹"、"风湿相搏"、"历节病"等痹证的学术思想。对于因湿邪留著病位之深浅以及与风寒热邪不同组合而导致的,以身重、一身尽疼、骨节烦疼、关节不可屈伸、脚肿如脱等为表现的多种"风湿"、"历节"等,进行了详细方证阐述。     

新年献辞

2008年,我国经历了"雪灾"、"地震"等天灾带来的震惊与悲痛,"奥运"、"神七"等人和创造的成功与辉煌,是令人难忘、令人振奋的一年.     

包晓星辨治成人紫癜性肾炎经验

紫癜性肾炎是过敏性紫癜所致的肾脏损害,临床主要表现为血尿、蛋白尿等肾脏损害,以及皮肤紫癜、关节痛、水肿等,属中医"葡萄疫"、"肌衄"、"尿血"、"水肿"病范畴,多发生于青少年、但近年来成人发病有增高趋势。     

例谈中药治疗几种常见肝硬化的体会

肝纤维化、肝硬化可归属于中医的"缀积"、"肝积"等疾病范畴.中医认为"瘢积"、"肝积"等的病机本质以血瘀痰结为主.随着生活水平的提高,人们膳食结构的改变,脂肪肝、肝硬化等肝脏疾病也越来越普遍.     

金海生治疗慢性胃炎的经验

慢性胃炎指由外感内伤等诸多不同的原因引起的胃黏膜的慢性炎症或萎缩的病变。中医对本病的认识主要见于"胃脘痛"、"胃胀"、"纳呆"、"呕吐"、"痞满"、"反酸"、"嘈杂"等。金海生老中医对本病的诊治特点是:抓住"四纲"、"一中心"、"两疏通",通过精细辨证,合理疏方,因此屡获良效。     

推拿辨证治疗失眠101例体会

失眠是指不能获得正常的睡眠,并伴有头痛、头晕、心悸、健忘等症.失眠症在祖国医学中被称为"不得卧"、"目不瞑"、"不得眠"、"不寐"等.     

章永红运用动物类药治疗恶性肿瘤经验探析

导师章永红教授系江苏省名中医,南京中医药大学教授、博士生导师,江苏省中医院肿瘤科主任医师。章师业医30余载,在辨治恶性肿瘤及疑难杂病方面临床经验丰富,尤其擅用动物类药,认为对于恶性肿瘤,只要辨证准确,适当运用动物类药常能取得意想不到的疗效。     

张琪对王清任学术思想的临床应用与创新

张琪教授是首届国医大师,学术上兼容并蓄,善于吸收各医家学术精华而自成一派;临证善于治疗内科疑难病,尤其是疑难肾病。笔者有幸成为同济大学＂中医大师人才传承培养计划＂学员,听张老授课、随张老临证,收益颇多。现就张老对清代名医王清任学术思     

张云鹏治疗杂病经验举隅

张云鹏（1930-），主任医师，首届“上海市名中医”，“全国名老中医药专家学术经验继承工作优秀指导老师”，“全国优秀中医临床人才研修项目”上海市专家指导组成员，享受国务院政府特殊津贴。张主任从事中医理论研究及临床实践逾半个世纪，对中医内科常见病及疑难杂症的治疗有很源的造诣。笔者有幸跟师随诊，受益良多，现结合验案将其辨治自汗、斑秃、耳鸣等杂病的经验介绍如下。     

从脉气、脉质浅述张西俭脉诊经验

脉诊是中医望、闻、问、切四诊中最为玄妙和最难掌握的技术,如<脉经>所云:"脉理精微,其体难辨……在心易了,指下难明."这是因为前人记载的仅单种脉象就有27种(或34种)之多,加之怪脉、真脏脉以及复合脉、兼脉等,使医者如坠云雾[1];近代学者从位、数、形、势对不同脉象进行归纳与分类,依然令初学者难得要领[2].     

Effects of feeding tyrosine and phenylalanine on the accumulation of phenylethanoid glycosides to Cistanche deserticola cell suspension culture

AIM： To investigate the effects of feeding phenylalanine （Phe） and tyrosine （Tyr） on the accumulation of total phenolic compounds and four phenylethanoid glycosides （PeGs） to a cell suspension culture of the parasitic plant Cistanche deserticola.METHOD： A cell suspension culture of C. deserticola was established and precursors of different concentrations were fed. In each group, the cell was sampled at the 24^th day after inoculation. The content of total phenolic compounds and four PeGs compounds were determined using the Folin-Ciocalteu method and an HPLC method, respectively.RESULTS： In the Phe fed cells, the maximum PeGs yield was achieved when Phe was fed at 1.5 mmol·L^-1 and the yield reached 1.13 times the control cell concentration. In the Tyr fed cells, the maximum yield of PeGs was 1.60 times of control when 0.75 mmol·L^-1 Tyr was fed to the cells. Furthermore, it was found that the salidroside yield was 4.01 times of control group when 5 mmol·L^-1 Tyr was fed.CONCLUSION： Tyr is a better precursor for PeGs accumulation compared with Phe, and the rate limiting enzymes might be involved in the Tyr branch.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE; To observe capillary blood flow at acu- points during acupuncture treatment of primary dysmenorrhea and gain new insights into its anal- gesic mechanism. METHODS： Patients with primary dysmenorrhea were enrolled and randomly assigned to a treat- ment or control group. Subjects＇ symptoms were differentiated into various Traditional Chinese Medi- cine （TCM） syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu （LI 4）, adding other acupoints based on syndrome. Laser speckle was used tocompare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu （LI 4） be- fore and during the treatment. Each subject was re- quired to finish the period pain symptoms observa- tion form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxi- ety scale, and numerical rating scale before and af- ter treatments. RESULTS： After 10 sessions, the symptom scores, pain index （PI）, and visual analog scale （VAS） de- creased significantly in treatment group. The vol- ume of blood flow in Hegu （LI 4） declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vaso- motor amplitude at Hegu （LI 4） increased remark- ably. CONCLUSION： Acupuncture can increase the capil- lary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

Curative effect of Xuebijing injection on severe pulmonary contu- sion

OBJECTIVE： To investigate the curative effects of Xuebijing （XBJ） injection, a Chinese patent medi- cine, on severe pulmonary contusion （PC）. METHODS： Sixty-three patients with PC were ran- domized to conventional therapy plus XBJ injec- tion （n=33） or conventional therapy alone （n=30）. Between groups differences in corticosteroid treat- ment, immune regulation therapy, hemofiltration, infusion volume, transfusion volume and antibiotic period were measured, as were intensive care unit（ICU）-free time, ventilation time, 28-day mortality rate and incidence of ventilation-associated pneu- monia （VAP）. Serum concentrations of procalcito- nin （PCT）, tumor necrosis factor-a （TNF-a）, interleu- kin （IL）-6, and 11_-10, white blood cell （WBC） counts and percentages of human leukocyte antigen DR/ CD14＋ （HLA-DR/CD14＋） peripheral blood mononu- clear cells were compared. Markers of ventilation were determined by blood gas analysis and ventila- tor parameters. RESULTS： WBC counts and serum concentrations of PCT, TNF-a, 11.-6 and IL-10 were reduced signifi- cantly more quickly, and CD14＋ percentage was in- creased significantly earlier, in the XBJ group than in the control group （P〈0.05 each）. The level of ven- tilation and oxygenation index were ameliorated earlier in the XBJ than in the control group （P〈 0.05）. XBJ treatment significantly reduced ICU-free time, ventilation time and incidence of VAP （P〈0.05 each）, but had no effect on 28-day mortality rate （P〉0.05）. CONCLUSION： XBJ treatment can shorten ICU-free and ventilation times and reduce the incidence of VAP, improving outcomes in patients with severe PC. XBJ may act by regulating inflammation and im- munity, alleviating systemic inflammatory response syndrome induced by trauma.     

Combinatorial effects of conception and governor vessel electroacu- puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE： To investigate the combinatorial ef- fects of conception and governor vessel electroacu- puncture （EA） and human umbilical cord blood-de- rived mesenchymal stem cells （HUCB-MSCs） on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS： With the HUCB-MSCs isolated, cultured and identified and the models of cerebral isch- emia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted andthe EA at conception and governor vessels was ap- plied. The pathomorphologic lesion by hematoxy- lin-eosin staining and the cellular apoptosis by ter- minal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic fo- cus were observed. RESULTS： The cultured adherent HUCB-MSCs ex- hibited a spindle shape and expressed MSC-specif- ic markers, with the cell purity and proliferation rate significantly increasing after the primary pas- sage. HE staining showed that there were no patho- logical changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs trans- plantation ＋ EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treat- ment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION： HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs trans- plantation.     

Effects of Chinese herbs in children with Henoch-Schonlein purpura nephritis：a randomized controlled trial

OBJECTIVE： To research the curative effect of Chi- nese herbs for clearing away heat, promoting diure- sis, nourishing the kidney, and consolidating es- sence in children with Henoch-Schonlein purpura nephritis（HSPN） with internal accumulation of damp-toxin using randomized controlled observa- tions on large samples. To seek the mechanism of the therapy and its scope of indications. METHODS： Overall, 186 children with HSPN were randomly divided into two groups： treatment group（n=126） treated with Chinese herbs for clear- ing heat and promoting diuresis and a control group（n=60） treated with Western Medicine. The treatment was carried out for three courses of 4 weeks each. We recorded changes in patient urine routines, 24 h urinary protein, blood-coagulating series, immunoglobulin and T-cell subgroups, and improvements in main symptoms. We evaluated the alleviation of clinical symptoms and the im- provement of proteinuria, hematuria, and other lab-oratory test results. Finally, we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect. RESULTS： Damp-heat syndrome improved in the treatment group, with a significant difference in to- tal effective rate after a 4-week treatment（χ2= 13.5220, P=0.0002） and in curative rate after a 12-week treatment（χ2=6.3410, P=0.0118）, com- pared to those in the control group.The curative ef- fect in the treatment group was greater than that in the control group but there was no statistical dif- ference between the two groups. The curative ef- fect after a 4-week treatment of patients in the treatment group weighing 30 kg or less based on Traditional Chinese Medicine（TCM） signs and uri- nary protein was significantly greater than that in the control group. However, there was no statistical difference in the curative effect on urinary red cells and various indexes after a 12-week treatment be- tween the two groups. CONCLUSION： Therapy for clearing away heat, pro- moting diuresis, nourishing the kidney, and consoli- dating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin. The therapy is especially suitable for patients weighing 30 kg or less. The curative effect may be related to the improvement of immune function and blood-coagulation.