宋康教授治疗肺癌常用药对总结

[目的]总结分析导师宋康教授治疗肺癌常用药对的组成、配伍特点。[方法]通过跟师临证学习,搜集整理宋师治疗肺癌的医案,总结宋师临证治疗肺癌的常用药对、配伍特色、用药规律及常用剂量,探讨药对作用机制,同时附验案一则。[结果]宋师认为,肺癌的形成是由正气亏虚,气机失调,痰、毒、瘀等阻塞肺络,日久成积所致,正虚与邪实是其两大病机,因此扶正与祛邪是其治疗总纲,清、消、补为其常用治疗三法。宋师在辨证论治基础上,望闻问切,四诊合参,对于正气不足的肺癌患者,常用补益中焦、益气养阴、补肾益精等药对扶助正气;属邪实者,针对其痰、瘀、毒等不同致病因素,常用清热解毒祛瘀、化痰散结通络等药对以祛除实邪。所举病案,病属肺癌之痰瘀互结证,治以宋师常用降气化痰、解毒祛瘀之药对,疗效真实肯定。[结论]宋师运用药对治疗肺癌,选药精当,用药精准,疗效良好,值得深入学习与推广。     

舒琦瑾教授治疗肺癌常用药对总结

[目的]总结浙江省名中医舒琦瑾教授临证治疗肺癌的常用药对机制。[方法]跟随舒琦瑾教授临诊学习,搜集舒琦瑾教授的肺癌医案,总结其临证治疗肺癌的用药规律和常用药对,并探讨其机制,并附验案1则。[结果]舒师认为,中医药治疗肺癌属于多靶点疗法,药对虽短小,肺癌病机亦复杂,然对药对于肺癌某个靶点的针对性强,若组合恰当,定能执简化繁,明察洞悉。针对肺癌晚期患者出现的正气不足症状,舒师常用太子参-黄芪、党参-白术、北沙参-麦冬等药对以扶正抗癌;属痰毒互结者,舒师常用蛇舌草-蛇六谷、半边莲-半枝莲、南方红豆杉-虎杖根等药对以解毒散结;属瘀血内阻者,舒师常用三棱-莪术、三七-赤芍等药对以活血祛瘀。舒师临证治疗肺癌时,在辨证论证的基础上,辨明病因、病位、病性、病势,并掌握中药的四气五味、升降浮沉,运用药对,临证加减,遣方用药,取得较好的临床疗效。[结论]舒师运用药对精当,疗效确定,其用药机制有较高临床参考价值,值得深入学习和推广运用。     

周恩超教授从毒论治慢性肾衰竭常用药对介绍

[目的]总结周恩超教授治疗慢性肾衰竭的常用药对,以推广其用药经验。[方法]通过跟随周恩超教授门诊及查房,整理其治疗慢性肾衰竭的医案,阅读其相关著作论文,从古代文献认识、现代药理研究、周恩超教授个人见解等方面,阐述周恩超教授治疗慢性肾衰竭的用药经验,总结其常用药对。[结果]周恩超教授治疗慢性肾衰竭,除了顾护正气外,特别强调从毒论治,治法上突出解毒排毒,擅用药对,认为药对有协同增效、监制防弊的优点。其常用药对有:苏叶配黄连解湿毒;半枝莲配白花蛇舌草清热毒;土茯苓配六月雪泄浊毒;土鳖虫配桃仁破瘀毒;牡蛎配大黄化痰毒;黑大豆配晚蚕沙祛风毒;茵陈配失笑散通逐湿、热、瘀毒。[结论]周恩超教授从毒论治慢性肾衰竭,使用药对治疗的经验临床上行之有效,具有推广应用的价值。     

姚新苗“温阳祛瘀”法治疗足痹经验探析

[目的]总结国家级名老中医张杰教授辨治慢性萎缩性胃炎的经验。[方法]通过临床跟师、收集病例,对张杰教授治疗慢性萎缩性胃炎的中医理论创新及临床思路进行分析总结,并列举医案验证。[结果]在慢性萎缩性胃炎诊治方面,张教授认为脾胃亏虚为本,内外合毒为因,胃络瘀阻为标,虚、毒、瘀互结,并独创"肝脾建中、脾阳为本"理论指导临床,主张以肝脾同建、顾护脾阳为主要治法,兼顾解毒化瘀、扶助正气,临证重视舌脉合参,遣方用药遵循经方。所附医案,张教授辨为肝胃气滞、毒瘀互结,治宜肝脾同建、行气宽中、解毒化瘀,以柴平汤、胃痞汤两方加减治疗,获得良好疗效。[结论]张杰教授治疗慢性萎缩性胃炎,注意肝脾同建、顾护脾阳,兼顾解毒化瘀、扶助正气,临证时重视舌脉,遵循经方,其经验值得临床借鉴学习。     

林胜友教授治疗肺癌的常用药对举隅

[目的]总结林胜友教授治疗肺癌常用药对。[方法]通过跟师临证,分析整理林师治疗肺癌临床病案,从配伍特色、用药规律及常用剂量等方面总结其经验。[结果]林师认为正气虚损是肺癌的病理基础,癌毒、热毒、药毒相互影响致机体阴阳失衡,寒热错杂；正气不足者,常用益气养阴、健脾补肾等药对扶助正气；属邪实者,予清热解毒、化痰散结等药对以祛除邪实。[结论]林师治疗肺癌强调分清正邪的主次关系,重视固护脾肾,整体调护,临床疗效显著,值得借鉴。     

周仲瑛教授治疗肝癌的临床经验

[目的]总结国医大师周仲瑛教授治疗肝癌的临床经验。[方法]通过跟师学习、分析研究周仲瑛老师肝癌临床病案,从病因病机、辨证论治、经验用药等方面总结老师治疗肝癌的学术思想和临证经验,并举验案佐证。[结果]周仲瑛教授认为正气亏虚是肝癌发生、发展、转移的基础,癌毒内生是肝癌发生的关键,癌毒因素在于气滞湿热瘀毒互结,治疗上周老师主张扶正祛邪,解毒抗癌,注重对于气滞、瘀毒、热毒、痰毒的辨证治疗,结合辨证适当运用解毒攻毒及虫类药物,临床上常获良效。[结论]周仲瑛教授治疗肝癌临证经验丰富,疗效显著,其学术经验值得推广。     

陆渊雷治血证之特色探析

[目的]研究中西汇通派大家陆渊雷治疗血证的学术思想与临证用药特色。[方法]通过研读《陆渊雷医案》及《伤寒论今释》、《金匮要略今释》,探讨陆渊雷对血证治法的科学性认识,并归纳陆渊雷治咳血证所累积的治疗特色与用药经验,扼要分析其医案;总结陆渊雷对便血证的诊断与证治,以及黄土汤的临证运用。[结果]陆渊雷论治血证有五大特色:论治血证有三个阶段;论治血证有病气病血之说;临证注重正气为转归;根据病证善用柴胡;注重止血不留瘀,有3组常用止血专药的药对。其医案注重辨证,善用经方,用药精简有验。对于便血证的诊治,陆渊雷提出鉴别肠出血的三大独到见解,并针对病机,灵活运用黄土汤加减治疗。[结论]陆渊雷对血证治疗经验丰富,善治咳血证与便血证,其宝贵的诊治思想与临证用药经验,既突显其中医科学化的学术观点,亦对后世医家有重要启发。     

刘胜教授治疗三阴性乳腺癌经验

[目的]总结刘胜教授运用健脾补肾、解毒祛风法治疗三阴性乳腺癌的经验,为三阴性乳腺癌的辨证治疗提供新的思路。[方法]通过整理刘胜教授门诊病例资料,探析其个人协定方及用药规律,归纳出五脏亏虚为三阴性乳腺癌的发病之本,风、痰、瘀、毒,邪实胶着为其病机特点,并列举一则医案佐证。[结果]刘师在以往辨证治疗其他类型乳腺癌的基础上,着重阐述了三阴性乳腺癌正虚邪实、痰瘀毒化热、风挟毒邪流窜的病机特点,因此形成了健脾补肾、解毒祛风的治疗方法,并以此组成个人协定方。所举病案中刘胜教授运用健脾补肾、调摄冲任法调和五脏气血,辅以解毒祛风法预防复发转移,使患者在提高生活质量的基础上延长生存期。[结论]刘师以健脾补肾、解毒祛风治疗三阴性乳腺癌能有效改善患者术后症状,提高生活质量,值得临床推广。     

霍介格运用风药治疗放射性肠炎经验撷菁

[目的]总结霍介格教授运用风药治疗放射性肠炎的临床经验。[方法]介绍霍师对放射性肠炎病因病机的认识,阐述风药的源流以及功效,分析霍师临床运用风药治疗放射性肠炎的依据,并附案例加以验证。[结果]霍师认为放射性肠炎是癌瘤消耗气、血、阴、阳的同时,放射线之“火、热、毒”邪入侵人体,损伤脾胃及肠道所致。病机总属本虚标实,病位在肠腑,病理因素为湿、气、毒、瘀、虚,且多夹杂并见,临证遣方可配伍风药祛风燥湿、疏肝理气、开阖玄府、化瘀通络、升阳举陷,针对放射性肠炎复杂的病因病机进行治疗,临床上收效甚佳。所举案例,霍师辨为脾气亏虚、湿毒内聚,治以健脾益气、祛风化湿解毒,以胃苓汤加减利水止泻、健脾祛湿,配伍白芷、升麻、羌活等风药,升举阳气的同时可防渗利太过,在整个组方中起到了画龙点睛之效。[结论]霍师治疗放射性肠炎,谨守病机,辨证选方的基础上灵活运用风药,为放射性肠炎临床治疗提供了新思路,值得学习效法。     

陈卫建中药配合火针治疗直肠癌术后泄泻经验

[目的] 总结分析陈卫建教授中药配合火针治疗直肠癌术后泄泻的临床经验。 [方法] 通过跟师学习,整理医案,从病因病机、遣方用药规律和针刺原则等方面对陈师治疗直肠癌术后泄泻的经验进行归纳总结,分析其临证思路和治疗原理,并举验案一则佐证。[结果] 陈师认为,直肠癌术后泄泻总属虚中夹实,病机在于脾肾两虚,兼有湿热痰瘀郁毒等余毒未清,故治疗上多以经验方调补脾肾、清解余毒,再根据患者病情进一步辨证分析,化裁运用;配合火针针刺八髎穴以调畅气血、益肾温阳、除湿解毒,临床疗效显著。所附医案证属脾肾亏虚、瘀毒内阻,法当调补脾肾、散瘀解毒,通过经验方加减配合火针治疗,患者泄泻明显减轻。[结论] 陈师以中药联合火针治疗直肠癌术后泄泻,疗效甚佳,值得学习借鉴。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.