基于经典医籍挖掘唐宋以后中风病“外风致中”思想

中风病是中医临床治疗中具有明显优势的疾病之一,早在《内经》时代就有较为系统的阐述。唐宋以前多认为中风病因外风而致,唐宋以后多主张内风致病。外风致病向内风致病理念的转变是对于早期理论的纠错,还是病因病机理论的延伸,一直以来存在着争议。笔者认为这一观念的转变是对于中风病病因病机分析的细化,唐宋以后"外风致中"思想与"内风致中"理论并行。本文通过对历代中医古籍文献的梳理,重点分析唐宋以后"外风致中"思想的相关研究,并通过现代相关实验研究的整理证实该理论的发展,为中风病中医研究与临床治疗提供理论参考。     

基于CiteSpace的中医体质辨识研究可视化计量分析＊

目的 以“中医体质辨识”为主题开展系统的可视化分析，探索中医体质辨识领域的发展现状、研究热点、发展趋势，为后续研究提供借鉴。方法 以中国知网（CNKI）数据库为数据源检索相关文献，并将所得数据文件导入CiteSpace软件，对作者、机构和关键词进行共现分析并得到相关知识图谱。结果 共纳入1099篇文献，通过CiteSpace共现分析找到中医体质辨识领域研究的高产机构、具有代表性的研究者以及高频关键词。研究发现各个研究者及机构缺乏沟通合作，研究热点主题有体质研究、治未病、健康管理、与现代生物医学相结合。结论 中医体质辨识领域的研究逐年增加，知识图谱揭示了中医体质辨识在健康管理、与现代生物医学相结合将是未来的研究趋势。     

雷根平主任辨治难治性体表痰核验案两则

难治性体表痰核,好发于各年龄段,病程旷久,病情多发,易复难愈。在此疾病的治疗上,中医学以显著的疗效与极低的复发率,较西医学具有明显优势,故在临床上应用甚广。根据本病的发病特点,雷根平主任指出本类疾病的病机主要有脾虚生痰湿、气虚致血瘀、阳虚而寒凝等,总属虚实夹杂,且虚实病机之间互相影响;同时提到了痰湿病机贯穿于整个病程,在治疗上采用化痰、活血、散结、温阳等治法,于临证时灵活处方,主张必要时须用重剂起沉疴,收效甚佳,列举验案两则,以飨读者。     

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China

ObjectiveSeveral COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.MethodsA retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.ResultsOverall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30–6.32), type 2 diabetes (T2DM) (3.57, 2.32–5.49), cardiovascular disease (CVD) (3.78, 1.81–7.89), fatty liver disease (7.53, 1.96–28.96), hyperlipidemia (2.15, 1.26–3.67), other lung diseases (6.00, 3.01–11.96), and electrolyte imbalance (10.40, 3.00–26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89–12.75), CVD (8.47, 6.03–11.89), and electrolyte imbalance (19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46–29.64) within two weeks.ConclusionBesides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.     

脑栓通胶囊对缺血性中风患者随访半年生存质量指标评分变化的影响

针对上市药脑栓通胶囊开展上市后再评价,观察其对缺血性中风患者随访6个月后生存质量的影响并对其不良反应进行监测,为缺血性中风患者恢复期二级预防治疗提供借鉴和参考。696例患者来自全国12家三级甲等医院,通过中央随机系统,随机分为2组,试验组344例、对照组352例。试验组给予脑栓通胶囊+肠溶阿司匹林治疗,对照组给予肠溶阿司匹林治疗。连用6个月后观察患者生存质量,同时观察两组不良事件发生率及治疗前后实验室检查结果。结果提示脑栓通胶囊可用于缺血性中风患者恢复期二级预防治疗,较单独使用阿司匹林在患者生存质量的改善方面具有一定的优势,且未发生与脑栓通胶囊相关的不良事件。脑栓通胶囊在治疗缺血性中风恢复期方面是安全有效的。     

从太阴经论治眩晕经验浅析

眩晕作为一种常见疾病,源流久远,治法各异,文章着力于分析肺脾两脏在生理、病理上的关系,临床应用主张宣理肺气、调治中土、肺脾同治,效显甚益。文章将论述从太阴经治疗眩晕的相关学术观点及临床经验,并列举验案1则以兹说明。     

circRNA在肝细胞癌发生发展中的作用及机制

肝细胞癌（HCC）是原发性肝癌最常见的病理类型,病死率高。HCC发病机制复杂,具体发生发展机制仍处于探索阶段。circRNA是一种特殊的内源性非编码RNA,主要在转录和转录后水平上参与基因表达调控,通过调控基因转录,充当miRNA的分子海绵,参与蛋白质翻译,与结合蛋白RBP相互作用等方式发挥生物学功能。circRNA参与HCC的发生发展,在HCC细胞中的异常表达与HCC组织的病理特征相关,调控下游靶基因、miRNA和蛋白质的表达,参与HCC细胞的增殖、迁移、侵袭和凋亡,调控肿瘤微环境和信号通路等,提示circRNA可能是HCC诊断和预后潜在的新型生物标志物和治疗靶点。本文就近年来circRNA的生物学机制及其在HCC中发挥的作用、诊治研究进展等进行综述。     

雷根平主任辨治难治性体表痰核验案两则

难治性体表痰核,好发于各年龄段,病程旷久,病情多发,易复难愈。在此疾病的治疗上,中医学以显著的疗效与极低的复发率,较西医学具有明显优势,故在临床上应用甚广。根据本病的发病特点,雷根平主任指出本类疾病的病机主要有脾虚生痰湿、气虚致血瘀、阳虚而寒凝等,总属虚实夹杂,且虚实病机之间互相影响;同时提到了痰湿病机贯穿于整个病程,在治疗上采用化痰、活血、散结、温阳等治法,于临证时灵活处方,主张必要时须用重剂起沉疴,收效甚佳,列举验案两则,以飨读者。     

粘液性/非粘液性结直肠癌MSCT征象及鉴别诊断价值研究

目的 研究粘液性/非粘液性结直肠癌多层螺旋CT(MSCT)征象及鉴别诊断价值.方法 选取本院2016年2月至2019年9月收治的130例结直肠癌患者作为研究对象,分析粘液性和非粘液性结直肠病灶的直径、密度、形态等MSCT征象及MSCT鉴别诊断粘液性和非粘液性结直肠癌的灵敏度、特异度及准确度.结果 粘液性与非粘液性结直肠...     

四君子汤治疗溃疡性结肠炎研究进展

四君子汤是临床常用的补益剂,现代研究发现四君子汤可从调节免疫、保护肠黏膜屏障、抗氧化应激、降低γ-氨基丁酸(GABA)水平、增加端粒活性、调节肠道菌群等方面对溃疡性结肠炎(UC)起到治疗作用。