中药黄芪防治寄生虫病研究进展

寄生虫病是一种严重影响人类健康和畜牧家禽产业的疾病,甚至可威胁到人类的生命。现在临床上使用的治疗寄生虫病的药物作用靶点单一且反复使用可能促进抗性虫株的产生。黄芪是一种常用的中药,具有提高免疫力、抗氧化、抗肿瘤等作用,一些研究表明黄芪可能对寄生虫病的防治具有一定的效果。该文就近年来对黄芪抗寄生虫病的研究进展进行综述,为后续研究提供参考。     

偏头痛药理实验模型研究进展

偏头痛是困扰人类身心健康的疾病.近年来偏头痛的药理实验模型不断发展,有利地促进了偏头痛药物的研究与开发.根据中医证候特点建立的偏头痛模型为阐释中医药防治偏头痛的药效及机制奠定了基础.本文对常用的偏头痛模型进行归纳总结,包含实验模型的建立机制、造模方法、评价标准与特点,为后续中医药研究提供参考.     

Research and Development of Neurological and Psychiatric Drugs Supported by National Science and Technology Major Project of “Major New Drugs R&D”

National Science and Technology Major Project of "Major New Drugs R&D" have made great achievements during nearly 10 years since it was launched in 2008. In major drug research and development, a batch of innovative drugs for treatment of major diseases which seriously endanger the health of our people, such as cancer, cardiovascular disease, inflammatory disease, bacterial and virus bacterial infection diseases, etc., have been successfully developed. On the other hand, a number of common clinical drugs have been reformed technically and the qualities of them are improved significantly, aiming at the requirements of clinical medication. The research and development of new drugs of neuropsychiatric diseases are one of the important field supported by "Major New Drugs R&D" project. Up to now, more that 180 new drug projects of neuropsychiatric diseases in different research and development stages have been supported by the project, and some of them have made significant progresses and show potential and good prospects for development. For example, Morinda officinalis oligosaccharides, an antidepressant, has been approved and available to the public. 971, a new drug for treatment of Alzheimer's disease, has completed phase III clinical trials and obtained very good and encouraging results. Orcinoside, an antidepressant, is undergoing Phase II clinical trials. The research of sustained-release microsphere of antipsychotic drug, risperidone, has made significant progress.
The period of the 13th Five-Year Plan is the final five years and final stage for implementation of "Major New Drugs R&D" Project. With the economic and social development, the demands of protecting health and improving people's livelihood are even greater and stronger. Thus, it is of great significance to implement "Major New Drugs R&D" Project better and faster. During the 13th Five-Year Plan, the project fully implements the innovation-driven development strategy, and further focuses on its purpose, emphasizes the key points and accelerates implementation according to the principle of focus development. Further more, the project focuses on new drug research and development and the related key technology studies, and strengthens the construction of innovation capabilities. The main tasks have been arranged according to the “Three Importance” principle which means research and development of major new drugs, meeting important needs and solving important problems, so that to make the aims and tasks of the project more focused and clearer. Next, the development strategy study of the14th Five-Year Plan for "Major New Drugs R&D" project will be initiated. The research and development of neuropsychiatric drugs would still be a major field in the project. On one hand, "Major New Drugs R&D" project would further advance of technological innovation and research innovative drugs. Meanwhile, based on long-term development, the project would support and strengthen the related basic research of neuropsychiatric disease, translate and apply the results of basic research to provide rich knowledge for new drugs research and development. On the other hand, fully taking advantage of traditional Chinese medicine to discover and develop new neuropsychiatric drugs from traditional Chinese medicine is of great significance with a broad application perspective.     

HIV感染者中西医协同治疗专家共识

中西医结合治疗人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者意义重大。现代医学抗病毒治疗在抑制病毒方面有明显优势,目前国际上共有6大类30多种药物(包括复合制剂),分别为核苷类反转录酶抑制剂、非核苷类反转录酶抑制剂、蛋白酶抑制剂、整合酶抑制剂、融合酶抑制剂及CCR5抑制剂。中医药在提高免疫功能、改善症状体征方面有显著疗效,中西医结合可优势互补。"病证结合"是目前中医临床诊疗常用的一种方法。HIV感染者通过现代医学手段明确诊断以辨病,中医辨证分型主要为脾气亏虚证、气阴两虚证、湿热壅滞证。在真实世界临床实践活动中,突出了中医学"同病异治、异病同治"的特点。     

肛肠疾病术后疼痛研究进展

疼痛是肛肠疾病手术后最常见并发症,缓解肛肠疾病术后疼痛,目前已成亟待解决的重要问题.中医认为"不通则痛"是术后疼痛症结所在,西医认为组织损伤导致"致痛因子"释放引起神经痛觉超敏,产生持久性疼痛.现代医学中镇痛药物效果存在种种使用限制和毒副作用,而中药熏洗和针灸耳穴等手段可以有效的缓解术后疼痛,故而应提倡中西医结合治疗肛肠疾病术后疼痛.     

中医全科医学在心血管疾病防治中的作用与模式

目前中国基层医疗卫生服务机构在防治心血管疾病方面仍存在瓶颈,而中医全科医学作为社区基层卫生服务的主力,在其中发挥着关键性作用。在我国中医与西医并存的国情下,中医全科医学在保持传统中医学“全科”特色及优势的基础上,运用中医独特的理论体系、思维方法、临床经验,不断探索实践,融合现代医学的模式及经验技术,以满足社区卫生服务的需要,为社区居民解决身体健康问题。本文全面阐述了中医全科医学在中医“整体观念、辨证论治、治未病”理论指导下,提倡以“人”为中心,充分发挥中医药及全科医学优势及特色,通过中西医结合治疗方式防治心血管疾病;分析了中医全科医学在防治心血管疾病中的作用及模式,运用未病先防、既病防变、病后防复等中医“治未病”医疗措施,对心血管疾病进行诊疗、康复、预防及保健,减少心血管疾病给人体带来的危害,以缓解心血管疾病所带来的医疗压力。中医全科医生作为中医学的传承者、实践者及社区居民健康的服务者,为居民提供以预防为导向的、连续综合的、便捷有效的社区卫生医疗服务。在国家基层医疗建设的大力支持及中医全科医生的不懈努力下,中医全科医学将成为未来中国防治心血管疾病的中坚力量。      

市级医院合作建立个体化用药基因检测院士站的思考

医学是以“疾病”为研究重点的，很多医疗机构侧重于研究人的“病”，忽略了研究病的“人”。然而，人体内在因素因遗传、年龄、性别、体质、心理素质、生活方式或习惯等个体差异的影响，表现为个体差异对疾病的发生和治疗影响程度而各有不同。为什么处在同样的环境下，有些人发病，有些人不发病？为什么同一种疾病在不同人身上会有不同表现？在治疗上也经常会出现对于同样一种药物，有的患者有效，有的患者无效，有的患者甚至可能会发生过敏等不良反应的情况。本文以郑州大学附属郑州中心医院建立个体化医学基因检测院士站为例，提出以个体基因为导向，实行一人一药一量，因人下药，改变千人一药、千人一量的传统用药方式，这是未来医学的发展趋势。鉴于此，现代公立医院必须对自身的管理模式进行创新，以此来满足社会发展的需要。     

重视基础理论研究,推动中医现代化进程

中医临床的精髓是辨证论治,其核心是脏腑辨证,但“证”的客观化诊断依据较少,不利于临床和科研工作,严重制约了中医理论的发展,是造成当前中医理论和临床迟滞不前的主要症结,建议遵循“继承与发展”的原则进行证候规范化工作,首先是“继续”,即在梳理古典文献和现代研究成果的基础上,建立一套比较规范的症状和证候诊断标准,不必求全但求实,借鉴循证医学,开展多中心,大样本临床研究,重新评价中医临床工作,重新评价中药和中成药疗效,加强中西医结合研究,提高中医临床疗效,病,证,药结合,先确定西医疾病,然后辨证分型,再选择中药治疗。     

精准治疗中2个相互依存的元素：精准医学和纳米医药

以基因组测序、生物信息和大数据库为基础,寻找到个体疾病原因、治疗靶点和精确分类的精准医学(precision medicine)为肿瘤治疗带来了新的希望,但真正的精准治疗(precision therapy)还包括如何将所筛药物精准递送并按剂量适时释放到治疗靶点,这也是临床上实现抗肿瘤精准治疗时面临的系列问题,具体包括如何突破体内生物屏障将药物安全递送到病灶、如何增加药物的瘤内富集、如何促进靶细胞的内吞,以及如何将药物精准递送到细胞内的作用靶点等.基于纳米技术的纳米医药(nanomedicine)能有效解决这些问题:通过精细设计和纳米载体裁剪,实现将治疗药物分子精确高效地递送到靶器官、靶组织、靶细胞和靶细胞器,并在病灶部位的刺激下按需控制药物剂量.精准医学和纳米医药的结合能够实现真正意义上的精准治疗,即从肿瘤分子分型、药物筛选、药物精准投递、控制释放到治疗.因此,基于精准医学对疾病进行精准诊断和药物靶点筛选,其可被形象地称为肿瘤精准治疗的“先遣部队和侦察兵”;而通过纳米医药可实现将筛选的抗肿瘤药物精确递送和释放到治疗靶点,可将其比喻为肿瘤精准治疗的“精准战略轰炸”,精准医学和纳米医药是精准治疗中2个相互依存且必不可少的元素.     

Research Progress on Prevention and Treatment of Glucolipid Metabolic Disease with Integrated Traditional Chinese and Western Medicine

Hyperlipidemia,type 2 diabetes mellitus,nonalcoholic fatty liver and many other metabolic disorder are frequently co-existing in patients.In addition,these diseases are closely related in pathophysiological settings.However,increasing of the disease incidence,lacking of comprehensive prevention and control measurements against the key pathology point concomitant occurrence with the pattern of the single disease,single target therapy,that is leading therapeutic strategy for these metabolic disorders in the setting of Western medicine(WM).On the basis of the combination of the advantages of integrated Chinese medicine(CM) and WM,with unified understanding of such diseases,the new concept of glucolipid metabolic disease(GLMD) is introduced.In this new concept,disorders in glucose and lipid metabolism are recognized as the key trigger and major driving force for the progress of GLMD.The key points of pathology included dysfunction of neuronal-endocrine-immune system,insulin resistance,oxidative stress,inflammation and intestinal flora imbalance.In the core pathogenic perspective of CM,it can be explained as "Gan(Liver) Shi Shu Xie"(dysfunction of Gan in metabolism and emotion regulation) that will lead to the occurence/production of endogenous dampness and phlegm,blood stasis and turbid.This leads to the new concept of "Liver-based regulatory system for metabolic homeostasis" to be introduced further.The comprehensive prevention and control strategy "Tiao Gan Qi Shu Hua Zhuo"(modulating Gan,trigging key metabolic system to resolve pathogenic factors such as phlegm retention and dampness).Its representative formula Fufang Zhenzhu Tiaozhi Capsule(复方贞术调脂胶囊) is innovated under such rationales.Comment for some commonly-used CM GLMD therapeutic drugs was presented.High-level evidence-based and epidemiological and mechanism studies should be carried out to further interpret and explain of the scientific connotation of GLMD.