用辩证反治法治疗功能性子宫出血的体会

<正> 功能性子宫出血是妇科常见病之一,其主要症状是月经量增多,经期延长或不规则出血,而妇科检查并无明显的器质性病变,故称功能性子宫出血。由于长期和反复子宫出血,常引起严重贫血或体力衰弱,影响工作和学习,给患者带来很大痛苦。 功能性子宫出血属于祖国医学中的崩漏范畴。病势急,经血暴下者为溃,病势慢,经血淋漓不断者谓之漏,但大多数人认为崩漏不分。《济生方》记载“崩漏本乎一症轻者谓之漏下,甚者谓之崩中”,古人认为“漏者崩之渐,崩者漏之甚”,所见崩和漏仅是经血程度上有所不同,并无本质的区别,临床上也常见到同一病人崩漏交错发生,时而为崩,时而为漏,延绵时久而不得止者,崩漏可以不必细分。     

益气化瘀止崩汤治疗崩漏96例的临床体会

目的通过观察口服中药益气化瘀止崩汤治疗气虚血瘀虚型崩漏的疗效.方法选择96例符合标准的崩漏患者,采用口服中药自拟益气化瘀止崩汤的治疗.结果治愈72例,好转19例,无效5例,总有效率达94.8%.结论益气化瘀止崩汤治疗崩漏效果显著.     

对“崩漏”辨证治疗的初浅体会

“崩漏”是妇科常见疾病,常影响妇女身体健康。功能性子宫出血属中医崩漏范畴。《内经》:“崩是指经水忽然暴下,漏是指月经淋漓不断。”《诸病源候论》说:“妇人月水非时而下,淋漓不断,谓之漏下,忽然暴下,谓之崩中。”崩与漏同属血证。它们之间可以互相转化。“久崩不止,气血耗竭,必致成漏,久漏日久,病势日进,亦将成崩”。其病因病机,可由于精神郁怒伤肝,肝郁化火,或房室伤肾,相火妄动,或素体虚弱,气血亏损,以及气虚不能摄血或血虚不能制约,致冲任损伤,不能固涩经血而成崩漏。     

赵昌基老中医妇科治验

1 崩漏 崩漏是指经血非时暴下不止或淋漓不尽,前者称崩中或经崩;后者称漏下或经漏。因二者交替出现,故统称崩漏。崩漏既是妇科常见病,亦是疑难重症。故家父认为治疗本病必灵活掌握塞流、澄源、复旧三法。自拟其基本方为固冲止崩汤:党参、黄     

艾灸隐白配合中药治疗功能性子宫出血27例

目的:观察艾灸隐白穴配合止崩汤内服治疗功能性子宫出血的疗效。方法:27例病例均用艾灸隐白穴配合止崩汤加减治疗。结果:所有病例经治疗后治愈率为77.8%,总有效率100%。结论:艾灸隐白穴配合止崩汤加减治疗功能性子宫出血疗效确切,值得在临床上推广应用。     

固冲止崩汤联合妈富隆治疗更年期功能性子宫出血的效果观察

目的探讨更年期功能性子宫出血采用妈富隆联合固冲止崩汤治疗的临床效果。方法所选研究对象为本院收治的更年期功能性子宫出血患者,病例选择时间范围为2015年10月至2016年10月,共纳入病例数为92例。对于92例患者的一般资料,均通过回顾性分析的方法进行调查。将92例患者按照1:1比例,随机分为研究组(妈富隆+固冲止崩汤)与对照组(妈富隆)。对比两组治疗效果。结果研究组、对照组有效率分别为97.8%(45/46)、84.8%(39/46),差异显著(P0.05);治疗后,两组月经恢复正常时间、控制出血时间、子宫内膜厚度对比,差异显著(P0.05)。结论在更年期功能性子宫出血患者的临床治疗过程中,采用妈富隆与固冲止崩汤联合治疗的效果显著,值得推广应用。     

风花升阳治疗崩漏的体会

倡导风药升阳治疗崩漏者 ,应该说功在金元名家李东垣 ,在其所创的“升阳除湿汤”、“凉血地黄汤”等近 10首治疗崩漏的方剂中 ,都不同程度体现了这一点。至于其机理 ,李氏认为“用风胜湿 ,为胃下陷而气迫于下 ,以救其血之暴崩也”。证之临床却有良效 ,盖阴血为有形之物 ,应经而下 ,是阴中之阴 ,阴尽则阳生 ,经后一阳复生 ,蒸蒸而上 ,经血应而止 ,然崩漏不止者 ,正阳气不生 ,阳陷阴中 ,春升之令不行 ,有降无升。风药能胜湿 ,能升发脾胃清阳之气 ,行肝胆春升之令 ,正扶下陷之阳气 ,实止崩漏之妙法 ,与崩漏发生的病机切切相恰。我在临床治疗崩…     

安冲汤在月经不调治疗中应用现状

安冲汤为张锡纯所创的经效良方,全方共奏益气固冲,止血调经。气虚为妇科疾病的重要病机,气虚血失统摄,冲任不固,经血失去制约,可引起月经过多、经期延长、崩漏等多种疾病。临床以安冲汤治疗,效果显著。后世医家每每在其基础上临床加减用以治疗多种月经不调的病症。     

导师王翠霞教授治疗肾阴虚型崩漏经验总结

崩漏是妇科临床常见病,为妇科危急重证之一。其病机复杂,有虚有实或虚实夹杂,但临床上以肾阴虚型多见。导师循古籍结合临床经验认为肾阴虚型崩漏是以肾阴虚为本,血热血瘀为标的本虚标实证。其基本病机是：阴虚内热迫血妄行,冲任不固;气随血脱,热灼津液而致气虚血瘀。临床运用补肾滋阴、益气化瘀法治疗该型崩漏,疗效显著。     

固崩止漏汤治疗功能性子宫出血98例效果分析

目的分析功能性子宫出血患者服用固崩止漏汤治疗的临床效果。方法本次研究者为98例功能性子宫出血患者,研究时间段为2017年6月至2018年6月,分组方式选择是随机原则,对照组常规治疗,观察组固崩止漏汤治疗,对比其疗效。结果对照组患者中有27例痊愈,13例好转,总有效率为81.63%,观察组患者中有32例痊愈,16例好转,总有效率为97.96%,两组间差异性较大,P 0.05,有统计学意义;治疗前两组患者月经周期、行经天数与出血量差异比较并无统计学意义,在接受治疗后,上述指标均有良好改善,同时观察组各指标变化更好于对照组(P0.05)。结论功能性子宫出血的患者服用固崩止漏汤进行治疗,其疗效显著。     

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.     

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.     

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.