升阳益胃汤“异病同治”验案三则

本文为总结王兴臣教授临床应用升阳益胃汤辨证论治的临床经验,通过分析其临证运用升阳益胃汤的诊疗思路,并选取耳鸣、重症肌无力、腰痛等典型医案3例进行论述。从该方药物组成及方证证候分析,升阳益胃汤方证病机为脾胃虚弱,湿热中阻,清阳不升,浊阴不降,内化郁热,王兴臣教授运用升阳益胃汤灵活多变,效果肯定,值得学习与推广。     

金杰教授运用升阳益胃汤验案举隅

升阳益胃汤首载于《内外伤辨惑论》,是李东垣治疗"肺之脾胃虚"的常用方。金杰教授临床中扩大了其应用范围,常常应用升阳益胃汤治疗证属脾胃虚弱,湿热阻滞所致清阳不升的诸多疾病,取得了满意疗效。     

升阳益胃汤新用

升阳益胃汤出自李东垣《内外伤辨惑论》,由黄芪、半夏、人参、甘草、独活、防风、白芍、羌活、橘皮、茯苓、柴胡、泽泻、白术、黄连、生姜、大枣等组成,功能升阳益胃,主治脾胃虚弱,怠惰嗜卧,口苦舌干,饮食无味,大便不调,小便频数等。笔者用于治疗慢性疲劳综合征、抑郁性神经症、自汗等病症,疗效满意。现报道如下。     

升阳益胃汤新用

升阳益胃汤新用贺自强李东垣所制升阳益胃汤，由黄芪、人参、白术等１６味药组成，功能补气健脾，升阳益胃，适用于脾胃虚弱、神疲食少、肢体困重、关节痛等症；药味虽多，但布阵有法。近年来笔者以此方辨证化裁治疗顽固缠绵之疾如带下、风疹块及老人久嗽，取效甚捷。举病...     

升阳益胃汤治疗脾虚型慢性胃炎74例

升阳益胃汤治疗脾虚型慢性胃炎７４例济南市中医院（２５００１２）董桂英，赵世珂关键词慢性胃炎，升阳益胃汤，疗效观察自１９９３年１０月以来，我们应用李东垣的升阳益胃汤治疗脾虚型慢性胃炎７４例，疗效满意。１临床资料病例选择参照《中药新药临床研究指导原则》中...     

经典名方当归六黄汤的历史源流与现代临床应用分析

当归六黄汤是国家中医药管理局首批公布的百首经典名方中的第47方,被誉为“治盗汗之圣药”。笔者采用文献计量学的方法,搜集记载当归六黄汤的古籍,筛选出有效数据269条,涉及中医古籍156部。从当归六黄汤的历史源流、主治病证与病机、药物组成与剂量、制法用法及药物炮制等方面进行分析,发现经典名方当归六黄汤源于李东垣《兰室秘藏》,由当归、生地黄、熟地黄、黄柏、黄芩、黄连、黄芪7味药物组成,有滋阴降火、固表止汗之功,主治阴虚火旺之盗汗证。后世治疗病证多承李东垣之说,并有所扩展,达30余种（共计339次）,其中盗汗（208次）最多,占总病证的61.36%;其次为自汗（38次）,占11.21%。同时,发现当归六黄汤现代临床应用广泛,用于多科病证,内分泌科（77次）最多,占28.21%;其次为妇科病（48次）,占17.58%;再者为儿科病（24次）,占8.79%。其治疗病证范围虽广,但病机总属“阴虚火旺”。通过对记载当归六黄汤古籍文献的系统挖掘及现代临床应用的梳理分析,探明其历史沿革,确定其关键信息,为经典名方的研发申报提供更详实的文献依据。     

升阳益胃汤临床应用研究进展

升阳益胃汤是李杲创制的治疗"肺之脾胃虚"的常用方剂之一,功效健脾益胃、升阳益气除湿,主治脾胃虚弱、湿热内郁所导致的病症。现代临床扩大了其应用范围,不仅能治疗慢性胃炎、肠易激综合征等消化系统疾病,还能治疗如慢性疲劳综合征、原发性低血压等,临证只要切合病机,皆可随证加减应用,并不局限于肺之脾胃虚证,是一首扶正祛邪、标本兼治的常用方剂。     

升阳益胃汤治疗慢性胃炎83例

目的:观察升阳益胃汤治疗慢性胃炎的临床疗效。方法:83例慢性胃炎患者用升阳益胃汤:黄芪、党参、陈皮、柴胡、白术、半夏、羌活、独活、防风、泽泻等治疗,疗程4～6周,结果总有效率96.4%。结论:升阳益胃汤具补脾益肺,和胃化湿之功效,治疗脾胃虚弱、湿热内郁型的慢性胃炎,疗效满意。     

升阳益胃汤临床运用举隅

升阳益胃汤系李东垣《脾胃论》中方剂,主治脾胃虚弱,功效为“健脾化湿,益升浮之气而滋其胃气”,使清阳得升,浊阴得降。笔者依据异病同治治则,应用升阳益胃汤治疗诸多由脾胃虚弱引起的疾病,收效显著,现列举3例如下。1　口腔溃疡王某,女,37岁。19960417就诊。患者素体虚弱,形体消瘦。反复发作口腔溃疡20余年,1～2个月为1个发作周期。曾多方求治,诸医多从胃热和肝胆湿热论治,病无好转。此次口腔溃疡发作4日,齿龈和舌面有多个大小不等的溃疡面,覆有白色分泌物,疼痛难忍,舌体肿大,舌边齿痕明显,伴腹胀、大便干燥。予清热泻火通便治疗,大便仍排出…     

张怡运用升阳益胃汤验案3则

升阳益胃汤出自李东垣《内外伤辨惑论》卷中“肺之脾胃虚证”,主治脾胃虚弱,怠惰嗜卧,四肢不收;时值秋燥令行,湿热方退,体重节痛,口苦舌干,不欲食,食不消,饮食无味,大便不调,小便频数;     

微波消解-电感耦合等离子体质谱法测定脉络宁注射液中25种矿物质元素

目的建立微波消解-电感耦合等离子体质谱(ICP-MS)直接稀释测定脉络宁注射液中25种矿物质元素(Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V、As、Cd和Hg)的方法。方法分别对微波消解条件和测试条件进行考察;样品经微波消解后,采用电感耦合质谱仪测定25种矿物质元素,并对测定方法学进行考察。结果确定最佳消解条件为3步缓慢升温:400 W 80℃升温10 min,保留5 min;600 W 120℃升温10 min,保留5 min;900 W 200℃升温20 min,保留20 min;25种矿物质元素在各自的线性范围内线性关系良好,r≥0.999 6,精密度、稳定性和重复性试验的RSD均符合定量分析要求;加标回收率为94.7%~106.1%,RSD在0.34%~2.79%。脉络宁注射液中检测出Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V,未检出As、Cd和Hg。结论该方法简便、迅速、准确,适用于脉络宁注射液中25种矿物质元素的同时测定。     

Die Lateralität und Lateralitätsinstabilität in der Diagnostik und Therapie

The disturbance and instability of laterality are obstacles to diagnostics and therapy. Correction prior to starting therapy is required. They also predispose toward defined health problems and unspecific diseases. Numerous research activities provide evidence of the relevance of undisturbed laterality in diagnostics and therapy. Techniques of testing and therapeutic corrections will allow for optimized therapy success.     

Journal of Acupuncture and Tuina Science Instructions for Authors

The Journal of Acupuncture and Tuina Science, a journal with an international scope （IS SN 1672-3597, CN 31-1908/R, Bimonthly）, is embodied by ＇Springer Verlag＇ Database, Index Copernicus （IC） and Chinese Scientific and Technical Paper and Citations Data （CSTPCD）. You can search full text on http：//www, springerlink, com/content/1672 -3597.     

Yerba Mate or Paraguay Tea

正Beverages based on Ilex paraguariensis A.St.-Hil.are used in the south Brazil and other Latin American countries located at the so-called southern cone.It is known as chimarro or mate in south and southeast Brazil,tererêin     

Ethnopharmacologic study of chinese rhubarb

This paper deals with an interdisciplinary study covering historic, botanical, phytochemical, pharmacological and clinical aspects of rhubarb and related species, to lay stress on the correlation between plant phylogeny, chemical constituents and purgative activity.

It was found that the official rhubarbs were exclusively restricted in the Sect. Palmata e.g. Rheum palmatum R. palmatum var. tanguticum R. officinale; the following criteria may serve as their standard, viz., the presence of sennoside derivatives and rhein, the occurrence of the reduced form of rhein and aloe-emodin, the leaves with any kind of palmate incision. Comprehensive multivariate analyses showed that there is a very close relationship between the leaf incision, existence of sennosides or rhein and purgative activity.     

Wirksamkeit der Akupunktur bei der Therapie von idiopathischen Schmeckstörungen: Eine randomisierte Placebo-kontrollierte Studie

Background

At present, the state-of-the-art medication in treating idiopathic taste disorder (gustatory dysfunction) is zinc. If zinc medication was unsuccessful, not tolerated or if it is contraindicated the persons affected can hardly be helped.

Objectives

In a randomized placebo-controlled clinical trial an attempt was made to determine the efficacy of acupuncture.

Methods

The treatment group was treated with acupuncture needles, the placebo group with an inactive acupuncture-laser. Endpoints of the study were changes in the taste test, the quality of life and the severity of symptoms of depression (BDI) as well as mood changes (ZMS). Satisfaction with the success of the respective therapy was also evaluated. Data were collected before and after therapy and again for the treatment group 10 weeks after completion of the treatment period.

Findings

Treatment with real acupuncture showed a significant improvement in gustatory function as well as a significant improvement in psychological symptoms. Greater satisfaction with the treatment results was evident in the treatment group. The treatment results of acupuncture remained stable over a period of ten weeks after completion of the treatment.

Conclusion

Acupuncture was effective in the therapy of idiopathic taste disorders and therefore it is an effective alternative when zinc medication is not tolerated or unsuccessful. But it is also suitable as a therapy of first choice. Acupuncture can be considered as an extension of the therapeutic spectrum in the difficult treatment of taste disorders.     

Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.     

瑞香科五属植物中酚性聚合物的结构特征、分布及药理活性研究进展

瑞香科植物广泛分布于世界热带和温带地区,其中多种植物可供药用。在对该科植物的研究中发现,黄酮类、木脂素和香豆素等酚性化合物的低聚体为其重要的特征性成分,药理活性主要表现在抗肿瘤、抗炎、抗氧化、抗菌和抗病毒等方面。对已发现的酚性聚合体的化学结构、植物来源及药理活性进行综述,为瑞香科植物今后的研究和开发利用提供参考。     

HPLC法同时测定沉香化滞丸中11种成分

目的采用HPLC梯度洗脱法同时测定沉香化滞丸中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚11种成分。方法采用Thermo Syncronis C18色谱柱(250 mm×4.6 mm,5μm),流动相为水-乙腈,梯度洗脱:0～10 min,20%乙腈;10～20 min,20%～40%乙腈;20～24 min,40%乙腈;24～26 min,40%～52%乙腈;26～30 min,52%乙腈;30～31 min,52%～90%乙腈;31～35 min,90%乙腈;35～40 min,90%～100%乙腈;40～43min,100%乙腈;43～45min,100%～20%乙腈;检测波长215nm,体积流量1.0m L/min,柱温30℃,进样量20μL。结果各成分在43 min内分离良好,沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚的线性范围分别为1.4～13.6、10.0～200.0、31.5～315.0、1.0～120.1、1.8～50.6、0.93～10.1、1.8～30.0、0.2～40.3、1.8～18.1、1.7～25.0、0.45～10.70μg/mL;样品中各成分的平均回收率均在98.90%～100.87%;11种成分精密度RSD在0.55%～1.54%;供试品溶液在30 h内稳定性良好,RSD在0.75%～1.94%;重复性RSD在0.39%～1.73%。6批次样品中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚质量分数分别为92.0～201.0、511.5～9 033.0、5 475.0～12 635.5、54.5～5 095.5、192.0～2 137.5、117.0～391.5、106.5～1 281.5、13.0～136.5、93.5～199.0、177.0～1 207.0、33.5～251.5μg/g。结论本方法准确、快速、简便,重复性好,精密度高,适用于沉香化滞丸中多种活性成分的定量分析。