牟重临从脏腑论治顽固性咳嗽经验

古云“百病好治,独嗽难医”。许多顽固性咳嗽治疗的确非常困难,往往用清热化痰、温化痰饮、肃肺上咳等常法无效,须另辟蹊径。中医治疗有个特色,知常达变,同病异治。《素问·咳论》言“五脏六腑皆令人咳,非独肺也”。并以脏腑命名,分为肺咳、心咳、肝咳、脾咳、肾咳…等,描述各脏腑咳嗽之特点。如肺咳：“肺咳之状,咳而喘息有音,甚则唾血。”心咳：“心咳之状,咳则心痛,喉中介介如梗状，甚则咽肿，喉痹”。     

“咳而遗溺”、“咳而遗失”治验

＂咳而遗溺＂、＂咳而遗失＂为咳嗽时分别伴有小便自遗、大便自出的两种症状,二者同见于《素问.咳论》：＂肺咳不已,则大肠受之,大肠咳状,咳而遗失。……肾咳不已,则膀胱受之,膀胱咳状,咳而遗溺。＂     

咳嗽别论

咳嗽为临床常见之病,其病因复杂,治疗不易.其不易关键在病因复杂,虽《素问·咳论》中有"五脏六腑皆令人咳,非独肺也"之训,且明确指出有肺咳、心咳、肝咳、脾咳、肾咳等,更有《诸病源候论·咳嗽论》中的十咳之称,除五脏咳外,尚有风咳、寒咳、久咳、胆咳、厥阴咳.但临床上咳嗽还绝不仅只这十咳,故《医学真传》云:"诸病易治,咳嗽难医".笔者结合肤浅的体会,罗列临床上少见的儿种咳嗽,以飨同道,抛砖引玉,并为治疗难治性咳嗽提供思路.     

略谈脾胃咳及其治疗

脾咳、胃咳,《内经·咳论》早有记载:“脾咳之状,咳则右胁下痛,阴阴引肩背,甚则不可以动,动则咳剧……脾咳不已,则胃受之。胃咳之状,咳而呕,呕甚则长虫出。”脾咳、胃咳之证,可以单独发病,亦可同时发病。从脾咳发展到胃咳是一个疾病不同发展阶段的病理表现。脾胃相表里,常可互为因果,其咳能相互影响     

陈慧运用调畅气机法治疗小儿久咳经验介绍

小儿久咳诊疗棘手,陈慧主任从气机升降出入的中医学理论出发,结合临床实践,认为小儿与情志无关之久咳常见发病机制与肺、脾、胃以及三焦相关,由于这些脏腑功能皆与气机密切相关,遂总结出调畅气机法以治疗久咳,并据此归纳出肺咳、脾咳、胃咳、三焦咳,经辨证施治,最终达到调畅气机的目的,以此治疗小儿久咳,每每临床取效。     

对百日咳的辨证论治

百日咳病流行广泛,传染力强,容易诱发合并症。早期有呼吸道的症状,随后进入阵咳期,并拌有特殊的吼声。祖国医学对本病早有一定认识:由于咳嗽阵阵发作,故称为顿咳、阵咳、趸咳;由于咳嗽剧烈时,伸长颈项,并有回声,状如鹭鸶,又称鹭鸶咳;又因咳时,发生痉挛现象,又名痉咳;因咳嗽伴有呛食呕吐现象,故又名呛咳;以其具有流行传染,故又称天行咳、时行咳、以其病程较长,故称百日咳。     

晁恩祥治疗慢性咳嗽的经验

晁恩祥教授对慢性咳嗽多从“风咳”进行论治,效果显著。在复习有关“风”、“风咳”中医文献基础上,结合晁恩祥教授临床治疗风咳的验案,初步论述了风咳的中医病因证治特点,介绍了其治疗风咳的常用方药。对临床上某些慢性咳嗽,证候表现为干咳、剧咳、顿咳、咽痒即咳等辨证属“风咳”者,采用“疏风宣肺、缓急止咳利咽”治法,“若因风者,辛平解之”,往往效果较好。     

学习《素问·咳论》的体会

目的通过对《素问.咳论》学习,加深对咳的全面认识,拓宽辨证施治思路。方法对经文逐条进行纵、横向分析理解。结果认识到咳虽本于肺,但亦不止于肺,五脏六腑皆令人咳。治咳应从整体观念出发,辨证论治着手。结论临床不可见咳止咳,或见咳单一治肺;应详查咳之病因、病机,五脏主时、脏腑关系、症状、体征、传变规律等,只有辨证准确,治法得当,方能获桴鼓之效。     

五脏六腑咳与肺部X线炎症性改变的相关性研究

目的:观察五脏六腑咳之传变与肺部X线炎症性改变的相关性。方法:选取来我院就诊的咳嗽患者350例,年龄平均(54.73±25.34)岁。对筛选符合纳入标准的患者,记录其入院检查数据和肺部X线结果,根据其咳嗽病症情况分别分为肺咳、胃咳等11类,肺部X线结果按照6类划分。结果:肺咳患者肺部X线异常改变比例为76.19%,心咳患者为84.72%,肝咳患者为73.21%,脾咳患者为75.76%,肾咳患者为69.23%,胃咳患者为44.44%,三焦咳患者为78.18%。大肠咳患者和膀胱咳患者中未发现有X线改变患者,且就诊患者中无患有小肠咳证和胆咳证的患者。观察不同类型的咳嗽的X线的表现情况,其中肾咳、胃咳、大肠咳、膀胱咳这4种类型咳嗽患者X线表现情况比较一致,均是1型X线变化人数较多;肺咳X线变化比较平均,人数几乎平均分布在5种类型的X线表现中;剩下4种类型咳嗽患者X线表现趋势基本一致,变化幅度均比较明显;肾咳患者的X线变化情况,均在第1、3 X线类型人数有显著上升;其中脾咳患者变化幅度最为显著。结论:肺咳、心咳、肝咳、脾咳、三焦咳这五种咳嗽类型与肺部X线炎症性改变具有更强的相关性。     

何明教授的九咳分类法及辨治经验

中医学认为咳嗽既是一个独立的证候,又是多种肺系疾病的一个症状。咳嗽的分类历代医家立论纷纭,名称甚多。何明教授从医40年,临床工作中总结了关于咳嗽的诸多经验,尤其对咳嗽的分类和辨证论治有着自己独特的见解,提出了按病因分类的九分类法,认为咳嗽按病因可分为九种咳嗽,即寒咳、热咳、燥咳、风咳、湿咳、郁咳、食咳、痹咳、虚咳共九类。“九咳”分类法,不再拘泥于外感和内伤两端,开阔了辨证论治的思路,在临床中也取得了很好的疗效。     

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.