失眠中医证型和方药分析

目的:对1987年6月至2007年6月中国期刊全文数据库(CNKI)收录的中医诊治失眠文献,通过频度分析总结证型和方药特点,以探讨失眠中医辨证论治规律.方法:对所选文献进行证型、方剂统计及药物整理分析,并总结归类,观察各药物、证型引用频次及所占比例.结果:失眠证型45个,痰火扰神、心脾气血虚、肝郁气滞、阴虚火旺、肝火炽盛和心肾不交为常见证型,占57.13%;证候病位主要在心和肝,虚证实证病机比例相同.共得方剂104首,补益剂、安神剂、清热剂、和解剂、祛痰剂和理血剂共占80.3%,疏肝解郁方和活血祛瘀方居常用方之列.用药206味,按功能归为41类,进一步合并为17大类,补虚、安神和清热类药物使用频次占57.0%,补虚药为第一位,主要是补气、补血和补阴药,清热药次之,其他泻实之药也较常用,安神药酸枣仁使用频次位于所有用药之首.结论:中医诊治失眠证型特点和方药规律的分析可为目前失眠辨证论治提供参考依据.对失眠要从多方面进行辨证,尤其应注意心肝、虚实并重;对失眠施治在运用补益、安神和清热剂的同时,特别要重视疏肝解郁和活血祛瘀方的选用.     

刘燕池教授对《内经》“肝藏血,血舍魂”临床应用研究

目的:通过对刘燕池教授治疗失眠及高血压用药特点进行分析,以探讨刘老对《内经》"肝藏血,血舍魂"的应用。方法:共收集经刘燕池教授诊治的失眠及高血压患者145例,其中失眠患者70例,高血压患者75例。利用Excel软件录入数据,并采用SPSS20.0软件进行描述分析。结果:失眠:使用频次排在前十位的药物依次为酸枣仁、百合、茯神、远志、石菖蒲、合欢皮、柴胡、麦冬、当归、石斛;使用频次排在前5位的药物类别依次为补虚药、清热药、安神药、利水渗湿药、活血化瘀药;高血压:使用频次排在前十位的药物依次为薄荷、葛根、菊花、天麻、夏枯草、杜仲、珍珠母、石决明、地龙、当归。使用频次排在前5位的药物类别依次为清热药、补虚药、解表药、平肝熄风药、活血化瘀药。结论:刘燕池教授对《内经》"肝藏血,血舍魂"的应用主要体现于善用滋阴清热之品,使肝血肝阴得调,肝血舍魂,魂安入肝,阴阳平和,这与刘老重滋阴的学术思想是相符的。     

中药复方对脑梗死后情志变化治疗用药规律分析

目的:探索中药复方对脑梗死后情志变化治疗的用药规律。方法:总结分析近十年中药复方治疗脑梗死后情志变化的用药情况。结果:脑梗死后失眠临床常用药物为甘草、牡蛎、黄芪、白芍、酸枣仁等,其治疗以补虚、清热、安神为主。脑梗死后抑郁临床常用药物为川芎、柴胡、当归、郁金、石菖蒲等,其治疗以补虚、活血化瘀、安神为主。结论:脑梗死后情志变化主要为失眠与抑郁,临床治以补虚为主,根据不同证型配合以不同药物。     

不同历史时期失眠方药的沿革

系统分析不同历史时期失眠方药的沿革 ,揭示失眠方剂的组方配伍规律 ,为提高临床失眠证的治疗提供参考。通过统计分析表明 ,补益、安神、清热药是构成历代失眠方的主要药物种类 ,安神药是治疗失眠证的特异性药物。不同历史时期失眠方药的发展演变 ,体现了中医治疗失眠证学术思想的不断完善。     

王锦鸿治疗消化系统肿瘤用药经验

目的:探讨王锦鸿治疗消化系统肿瘤的用药经验。方法:收集王锦鸿治疗消化系统肿瘤的医案,将处方中的数据经规范化处理后,运用统计学软件进行频数分析和关联规则分析,对主要药物、药对及其学术思想进行探讨。结果:使用频次较高的药物是党参、当归、白术、茯苓,用药类别以补虚药、清热药为主,支持度较高的药组为补虚药+消食药、活血化瘀药+消食药、化痰止咳平喘药+清热药+补虚药等。结论:王锦鸿治疗消化系统肿瘤以健脾益气、养血扶正为主,辅以清热解毒、理气化痰、活血化瘀,注重消食运脾,用药强调平和,审慎攻伐。     

基于数据挖掘技术的韩明向治疗失眠用药规律研究

目的:运用数据挖掘技术总结韩明向临床辨治失眠的用药规律.方法:通过门诊跟诊,对收集的韩明向诊治的101例失眠病案的方药信息进行数据化处理,使用SPSS Statistics 21.0软件进行频次分析、关联规则分析、系统聚类分析、复杂网络分析.结果:就诊的失眠患者中以中青年男性与更年期前后女性为多见.韩明向临床治疗失眠的高频药物分别为合欢皮、陈皮、当归、茯神、酸枣仁、白术、黄芪、柴胡、栀子、浮小麦等30味药.按功效大致可归理气药、清热药、补虚药、活血化瘀药、安神药等.聚类分析得出灵芝-珍珠母-龙胆草-山药-知母-半夏-石斛-煅牡蛎-夏枯草-川芎-熟地黄,麦芽-黄连-党参-黄芩等6个聚类方.提取的核心处方为柴胡、栀子、黄芪、陈皮、茯神、白术、合欢皮、酸枣仁、当归、浮小麦.结论:数据挖掘分析结果结合临床经验得出韩明向临床治疗失眠从郁、瘀、虚出发,形成了以疏肝理气,补血安神为治则的临证经验和学术思想.     

从数据挖掘角度看中医药治疗健忘与痴呆

目的：对中医治疗健忘或痴呆的中药方剂进行用药规律分析。方法：以痴呆或健忘为关健词．从中国方剂数据库中收集数据。除描述性分析外,采用购物篮分析来探讨药物配伍。购物篮分析部分采用SAS 9．1 for Windows中的Enterprise Miner模块为挖掘工具。结果：中医治疗痴呆的药物共23类．其中占最多的是补虚药,共有50种,其次为其它类（47次）、清热药（25次）、解表药（18次）及收敛固涩药（14次）。用药频次前了位为补虚药（669次,29％）、安神药（340次,14．8％）和清热药（238次,10.3％）。补虚药的核心药物为人参、当归及熟地：安神药的核心药物为远志、酸枣仁及朱砂;清热药的核心药物为甘草、生地及黄连。二味药购物篮分析表得出,交易数最大的前七种关联规则为：茯苓==〉远志;茯神==〉远志;茯苓==〉人参;石菖蒲==〉远志;熟地==〉远志;酸枣仁==〉远志;酸枣仁==〉人参。结论：根据用药频次统计及数据挖掘发现中医治疗健忘或痴呆．其基本思路是从心不藏神来论治,中医认为此等病症病理上属本虚标实,故尤重补虚药、安神药、清热药之使用。     

失眠症治疗方剂用药特点浅析

目的：通过统计分析失眠症治疗方剂中的常用药物使用频数,总结归纳失眠症的主要病机及用药特点。方法：收集《中医方剂大辞典》中治疗失眠症方剂286首,对其进行整理分析和研究。结果：补虚药、安神药、清热药、及利水渗湿药、化痰止咳平喘药、解表药、理气药、活血化瘀药是中医治疗失眠症的常用药物,初步推测失眠症的主要病机是正气亏虚,阴虚火旺,痰湿内生,气滞血瘀等,基本病理变化为阳盛阴虚,阴阳失交,虚实夹杂。     

349例原发性高血压不同证型用药规律分析

目的:探讨中药复方治疗原发性高血压不同证型的用药规律。方法:收集现代原发性高血压医案,建立原发性高血压中药复方数据库,从辨证用药规律方面进行频数和频率分析。结果:①常见证型和药物为:肝火上炎:菊花、白芍;阴虚阳亢:菊花、生地黄、白芍、石决明;阴阳两虚:甘草、黄芪;痰湿壅阻:茯苓、甘草、陈皮。②常见证型和药物种类为:肝火上炎:补虚药、清热药;阴虚阳亢:补虚药、清热药;阴阳两虚:补虚药、解表药;痰湿壅阻:补虚药、清热药。结论:原发性高血压基本病机为本虚标实,不同证型治疗应以补虚为主,辅以清热、平肝熄风、解表、活血化瘀。     

基于古籍文献分析癫痫临证方剂用药规律的研究

目的 通过对《中医方剂大辞典》中癫痫临证方剂用药规律的研究,为临床治疗癫痫的处方遣药提供参考.方法 收集、整理《中医方剂大辞典》中有关治疗癫痫的古籍文献534条,收录有效方剂532条,对方剂中药物名称进行规范化整理,建立中药数据表,利用数据表对其用药情况进行统计分析.结果 共统计核心药物34味,将其按功效分为12类.其中,使用频次较高的前10味药依次为朱砂、甘草、人参、牛黄、麝香、胆南星、远志、黄芩、半夏、大黄;使用频次居前6位的药类依次是补虚药、安神药、平肝息风药、清热药、化痰药、开窍药.结论 在《中医方剂大辞典》中,以镇心安神为主要功效的朱砂是癫痫临证用药中最常用的药物;补虚类药是治疗癫痫最常用的药类;安神药、平肝息风药、清热药、化痰药、开窍药是中医治疗癫痫的重要增效配伍药类.此规律体现了中医“治病求本”的原则,基本与临床实际用药一致,故可作为临床医师治疗癫痫选方用药的理论支持.     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…