彩色多普勒超声评价不同证型子宫肌瘤血流特征研究

目的:探讨不同证型子宫肌瘤血流彩色多普勒超声声像图特征及其相关性,为中医证候诊断客观指标提供前期工作基础。方法:根据诊断和辨证标准纳入不同证型子宫肌瘤患者120例,采用彩色多普勒超声检测子宫肌瘤局部血流情况,采用统计学软件对不同证型子宫肌瘤血流特征及其相关性进行分析。结果:气滞血瘀、痰湿瘀结、瘀热交阻和气虚血瘀4证子宫肌瘤内部血流特征有区别,其中"周边环绕"以气虚血瘀证所占比例较大,"内部点状"则以气滞血瘀证、痰湿瘀结证所占比例较大,"内部杂乱"以瘀热交阻证所占比例较大。4种常见证型间血流特征构成比差异有统计学意义(P0.05)。气滞血瘀证与瘀热交阻证、气虚血瘀证,痰湿瘀结证与瘀热交阻证,瘀热交阻证与气虚血瘀证的血流特征构成比差异均有统计学意义(P0.05);气滞血瘀证与痰湿瘀结证、痰湿瘀结与气虚血瘀证差异无统计学意义(P0.05)。不同中医证候动、静脉频谱和动脉收缩期峰值流速、舒张末期流速、阻力指数以及静脉流速有不同程度差异,但不同证候间差异均无统计学意义(P0.05)。结论:子宫肌瘤不同中医证候在其内部及周边血流方面具有不同程度的特征。     

探讨子宫肌瘤中医证型与B超声像图的关系

目的:探讨子宫肌瘤中医证型与B超声像图之间的关系。方法:选取125例子宫肌瘤患者为研究对象,进行回顾性分析。总结患者的病例资料,观察并记录每名患者子宫肌瘤不同中医证型与其相应B超显示的不同部位病变、回声像强度之间的关系。结果:(1)中医证型与子宫肌瘤组织不同部位的比较:湿热瘀结证、肾虚血瘀证、气滞血瘀证、痰湿瘀结证各证型在子宫组织肌壁间、浆膜下、黏膜下、混合之间的差异均无统计学意义(P0.05)。(2)中医证型与B超不同回声型之间的关系湿热瘀结证主要与B超等回声型相关,并且等回声型与其他3型之间的差异有统计学意义(P0.05);肾虚血瘀证主要与B超低回声型相关,并且低回声型与其他3型之间的差异有统计学意义(P0.05);气滞血瘀证主要与B超强回声型相关,并且强回声型与其他3型之间的差异有统计学意义(P0.05);痰湿瘀结证主要与B超混合型相关,并且混合型与其他3型之间的差异有统计学意义(P0.05)。结论:子宫肌瘤的B超声像图与中医证型之间存在一定的对应关系,有利于中医将客观微观的临床指标进行结合,指导临床辨证施治工作。     

B超声像图与子宫肌瘤中医证型的相关性研究

目的:探讨中医证型与B超声像图对子宫肌瘤诊断的相关性,为中医辨证论治子宫肌瘤提供影像学依据。方法:将所收集的4种临床常见证型肝郁脾虚、阴虚火旺、气滞血瘀、痰湿血瘀型的112例子宫肌瘤患者进行B超检查。运用统计学软件对中医辨证论治子宫肌瘤与B超诊断之间的相关性进行分析。结果:在B超声像图中,肝郁脾虚型患者以低回声型为主,阴虚火旺型患者以等回声型为主,气滞血瘀型患者以强回声型为主,痰湿血瘀型患者以混合型为主。结论:子宫肌瘤的B超声像图分型与中医证型有对应关系,对临床治疗具有指导意义。     

甲状腺结节超声特征与中医证型相关性分析

目的:探讨甲状腺结节超声特征与中医辨证分型的相关性。方法:纳入行甲状腺超声检查并检出甲状腺结节患者,判定其中医证型,超声检查记录甲状腺结节数量、较大结节最大径及平均径、结节成分、结节回声类型、结节内部回声均匀与否、结节形态、结节边缘、结节钙化、结节血流信号等信息,并根据ACR TI-RADS分类标准分级;统计分析不同中医证型的各项甲状腺超声特征之差异。结果:纳入合格病例311例,其中痰结血瘀证148例,痰湿蕴结证93例,气郁痰阻证70例。3组证型甲状腺结节边缘、形态(纵横比)、钙化比较,差异有统计学意义(P0.05),表现为气郁痰阻证组甲状腺结节呈分叶状或不规则(24.3%)、纵横比1 (27.1%)、伴钙化(37.1%),这3项超声特征的检出率均比其他2组高(P0.05);3组证型甲状腺结节数量、较大结节的最大径、平均径及结节成分、回声类型、回声均匀与否、血流信号之间的比较未发现明显差异(P0.05)。3组证型间结节ACR TI-RADS分类比较,差异有统计学意义(P0.05);两两比较发现,气郁痰阻证组与痰结血瘀证组、痰湿蕴结证组甲状腺结节ACR TI-RADS分类比较,差异有统计学意义(P0.05),表现为气郁痰阻证组的ACR TI-TADS分类集中在TR4、TR5,而痰结血瘀证组、痰湿蕴结证组的ACR TI-RADS分类集中于TR3、TR4。痰结血瘀证组和痰湿蕴结证组ACR TI-TADS分类比较,差异无统计学意义(P0.05)。结论:甲状腺结节超声特征与中医证型之间存在着一定的相关性;气郁痰阻证组甲状腺结节以结节呈分叶状或形态不规则、纵横比1及可见钙化为多见,ACR TI-RADS分类评分也较高。     

118例老年期痴呆患者中医体质特点调查研究

目的:探讨118例老年期痴呆患者的中医体质特点,为老年期痴呆的预防及治疗提供依据。方法:选取2016年3月-2017年6月在我院住院的老年期痴呆患者118例,均采用《中医体质分类与判定》量表及《中药新药临床研究指导原则》评估其中医体质及中医证型情况,统计中医体质及中医证型分布情况,并分析常见中医体质与中医证型分布情况。结果:在气滞血瘀证中,气虚质、痰湿质及阴虚质所占比例比较,差异无统计学意义(P0.05);在痰浊阻窍证中痰湿质所占比例明显高于气虚质及阴虚质,差异有统计学意义(P0.05);在心肝阴虚证中,阴虚质所占比例明显高于痰湿质及气虚质,差异有统计学意义(P0.05);在心脾两虚证中,气虚质所占比例明显高于阴虚质,差异有统计学意义(P0.05);在肾虚髓减证中,阴虚质所占比例明显高于痰湿质,差异有统计学意义(P0.05)。结论:痰浊阻窍证、肾虚髓减证及气滞血瘀证是老年期痴呆患者主要中医证型,并以气虚质、痰湿质及阴虚质为常见中医体质,故可针对患者体质行有效预防措施,减少老年期痴呆发生。     

子宫内膜异位症中医证型与IL-6和IL-8的相关性研究

目的探讨子宫内膜异位症（EMS）中医辨证分型与血清白介素6（IL-6）、白介素8（IL-8）的关系。方法350例子宫内膜异位症患者经中医辨证分为气滞血瘀、寒凝血瘀、痰湿瘀阻、热郁血瘀、气虚血瘀、肾虚血瘀6个证型组，采用双抗体夹心ELISA法检测血清IL-6和IL-8的水平。结果痰湿瘀阻、热郁血瘀、气滞血瘀、肾虚血瘀4个证型组血清IL-6和IL-8水平均高于正常对照组（P〈0．05，P〈0．01）。各个证型组之间IL-6水平比较：除痰湿瘀阻组与气滞血瘀组、热郁血瘀组与肾虚血瘀组比较差异无统计学意义（P〉0．05）之外，其余各个证型组之间比较均有统计学意义（P〈0．05）。各个证型组之间IL-8水平比较：除热郁血瘀组与肾虚血瘀组比较差异无统计学意义（P〉0．05）之外，其余各个证型组之间比较差异均有统计学意义（P〈0．05）。结论EMS的中医辨证分型与IL-6、IL-8水平存在一定的关系，提示中医证型与IL-6、IL-8介导的炎症反应和免疫功能失调有关。     

颈动脉粥样硬化中医证型与现代医学相关因素分析

目的:探究颈动脉粥样硬化中医证型与现代医学相关因素。方法:取92例颈动脉粥样硬化患者,先明确其中医证型,再比较中医证型与血脂水平关系,中医证型与硬化程度关系及颈动脉粥样硬化与相关危险因素分析。结果:各中医证型的血脂水平无统计学差异(P0.05);肝肾亏虚型患者78.57%有斑块,痰湿型患者85.71%有斑块,血瘀型患者92.31%有斑块,气虚痰瘀型患者84.61%有斑块,这几种证型有斑块率最高,颈动脉粥样硬化最为严重。其它证型患者的硬化程度较轻,各证型的有斑块率均在60%以下。所有证型有斑块率差异比较(X2=2.245,P0.05),无统计学意义。颈动脉粥样硬化与年龄、靶器官损害史、糖尿病、高血压、高胆固醇血症等因素呈现明显相关性,差异有统计学意义(P0.05)。结论:颈动脉粥样硬化存在8种中医证型:即气虚型、肝肾亏虚型、痰湿型、瘀血型、气虚痰湿型、气虚血瘀型、气虚痰瘀型、肝肾亏虚痰瘀阻络型,各证型有斑块率差异比较无统计学意义,提示颈动脉粥样硬化斑块率不能区分中医证型。     

子宫内膜异位症不同中医证型与胰岛素样生长因子-Ⅰ的关系

目的探讨子宫内膜异位症不同中医证型与胰岛素样生长因子-Ⅰ的关系。方法选取因子宫内膜异位症需行腹腔镜手术的患者242例,另22例因不孕或者盆腔良性疾病需行腹腔镜手术患者为对照组,采用ELISA检测血清中胰岛素样生长因子-Ⅰ,免疫组化检测内膜组织中胰岛素样生长因子-Ⅰ的表达情况。结果242例子宫内膜异位症患者中气滞血瘀型患者87例(36.0%),痰湿瘀阻型36例(14.9%),寒凝血瘀型33例(13.6%),热郁血瘀型24例(9.9%),肾虚血瘀型43例(17.8%),气虚血瘀型19例(7.8%)。ELISA检测结果显示,气虚血瘀组患者血清中IGF-Ⅰ含量与正常对照组无差异外,其他各组均高于正常对照组(P0.05);气滞血瘀组、肾虚血瘀组患者血清中IGF-Ⅰ含量明显高于其他组别(P0.05);免疫组化检测结果显示,不同中医证型患者组织IGF-Ⅰ阳性表达率相对于正常对照组具有统计学意义(P0.05,P0.01),气滞血瘀型组IGF-Ⅰ阳性表达率高于痰湿瘀阻组、热郁血瘀组(P0.05),气滞血瘀组在9~12评分(+++)项中表达高于其他各组(P0.05)。结论子宫内膜异位症患者中医证型中气滞血瘀、肾虚血瘀以及寒凝血瘀型与IGF-1的高表达有关。     

冠心病中医辨证分型及与TC、LDL-C水平相关性研究

目的：探讨冠心病中医辨证分型及与血脂水平的相关性。方法：138例中医辨证为气虚血瘀、气阴两虚、心肾阴虚、心肾阳虚、气滞血瘀、痰阻心脉、痰瘀互结型,并进行中医证型与血脂相关性研究。结果：气虚血瘀型较多,与其它各型比较差异具有统计学意义（P〈0.05）。不同证型间的血脂正常率从大到小依次为气虚血瘀型（52.7%）、心肾阴虚型（37.5%）、气阴两虚型（37.5%）、痰瘀互结型（18.8%）、气滞血瘀型（14.3%）,其中气虚血瘀型血脂正常率与其它各型差异具有统计学意义（P〈0.05）。结论：冠心病以气虚血瘀型较多见,且气虚血瘀型血脂水平控制较好。     

颈内动脉钙化积分与缺血性中风急性期中医证型的相关性研究

目的:探讨颈内动脉Agatston钙化积分与缺血性中风急性期中医证型的相关性。方法:将400例缺血性中风急性期患者按照中医辨证分为风痰火亢、风火上扰、痰热腑实、风痰瘀阻、痰湿蒙神、气虚血瘀、阴虚风动等7个证型;所有病例均行Siemens双源头颈CT检查,计算颈内动脉Agatston钙化积分,并根据积分划分为0分、1~199分、200~399分、400~599分及≥600分5个等级;比较缺血性中风急性期各中医证型患者的颈内动脉钙化积分情况。结果:缺血性中风急性期各中医证型患者在年龄、性别方面比较,差异无统计学意义(P0.05)。共有328例患者存在颈内动脉钙化,各证型患者所占例数从多到少依次为:风痰瘀阻证气虚血瘀证阴虚风动证痰热腑实证风火上扰证风痰火亢证痰湿蒙神证。各中医证型患者颈内动脉钙化积分比较,差异有统计学意义(P0.05);各证型的颈内动脉钙化积分级比较,差异无统计学意义(P0.05)。结论:缺血性中风急性期中医证型中分布风痰瘀阻证及气虚血瘀证占比较多;各中医证型颈内动脉钙化积分存在一定差异,以气虚血瘀证积分最高、风痰瘀阻证次之,此可为缺血性中风急性期中医辨证分型的研究提供参考。     

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.     

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     

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.     

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.     

基于ICP-MS法的加味左金丸中无机元素分析

目的 通过电感耦合等离子体质谱（inductively coupled plasma mass spectrometry,ICP-MS）法建立加味左金丸中Cd、Pb、As、Hg、Co、V、Ni、Cu、Li、Sb、Ba、Mo、Sn、Cr、Na、Mg、Al、Ca、Ti、Mn、Fe、Zn、Ga、Se、Sr、Tl共计26种无机元素的测定方法。方法 加味左金丸通过微波消解法处理后,根据相对分子质量的大小选择内标物,其中⁷Li、²³Na、²⁴Mg、²⁷Al、⁴⁰Ca、⁴⁸Ti、⁵¹V、⁵²Cr、⁵⁵Mn、⁵⁶Fe、⁵⁸Ni、⁵⁹Co、⁶³Cu、⁶⁶Zn、⁷⁰Ga、⁷⁵As、⁷⁷Se、⁸⁶Sr以⁷²Ge作为内标;⁹⁵Mo、¹¹⁴Cd、¹¹⁸Sn、¹²¹Sb、¹³⁷Ba以¹¹⁵In作为内标;²⁰²Hg、²⁰⁵Tl、²⁰⁸Pb以²⁰⁹Bi作为内标。对标准品溶液、空白溶液与供试品溶液进行分析,采用标准曲线法进行定量分析。通过ICP-MS法进行测定。结果 26种无机元素线性的相关系数r ≥ 0.999 6,检出限为0.001~1.500μg/L,定量限为0.01~5.00 μg/L,精密度与重复性试验的RSD均小于5%,平均回收率在82.64%~106.44%,RSD均小于5%。对3个厂家的12批样品进行了测定,26种元素的含量差异较大,其中Na、Mg、Ca、Fe 4种元素的含量比较高,均大于500 μg/g,Cd、Pb、As、Hg、Co、Li、Sb、Mo、Sn、Cr、Se、Tl的含量比较低,均小于1 μg/g。由结果可知,人体的常量元素,如Na、Mg、Ca的含量比较高,Cd、Pb、As、Hg等有害元素含量比较低。根据《中国药典》2020年版一部的要求,本品中Cd、Pb、As、Hg与Cu均符合规定。结论 该方法快速、准确,可以用于加味左金丸中无机元素的测定。     

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.     

Erstaunliches Ergebnis einer Schädelakupunktur nach Yamamoto bei Hemihypsarrhythmie rechts

A girl, three and a half years old at the respective date, premature in 25th week of gestation, had been presented. On day three after birth, she had had a IVH III° right and left with severe involvement of parenchyma and other multiple complications, e. a. infant respiratory distress syndrome up to the 42nd day postpartum, and epileptic attacks with apnoeic events.     

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.