中药复方抗食管癌研究进展

食管癌是恶性程度高、侵袭能力强、预后较差的一类上消化道恶性肿瘤，属中医学“噎膈”范畴。中药复方在抗肿瘤方面具有显著优势。通过查阅国内外相关文献，获知构成食管癌（噎膈）的证素包括气滞、痰、气虚、血瘀、阴虚等，中医临床辨证多分为痰气交阻、气阴两虚、津亏热结、气虚痰湿、痰热互结、痰瘀互结、热毒瘀结、正虚毒蕴等，大半夏汤、启膈散、旋覆代赭汤、六君子汤、沙参麦冬汤、通幽汤等为临床常用方剂，其中启膈散、六君子汤、通幽汤等经体内外实验研究已证明可通过直接抑制肿瘤细胞增殖、或促进凋亡、影响肿瘤微环境、调节细胞能量代谢、抑制血管生成等机制发挥抗食管癌作用，且中药复方通过靶向非编码单链RNA分子（microRNA）发挥抗食管癌作用的研究越来越多，发现临床收效良好的复方大半夏汤、参赭培气汤、小陷胸汤、人参半夏汤、六神丸等尚无深入的机制研究，古籍所载的吴茱萸汤、通关散等复方却于现代少有应用。因此，该文将中医经典古籍中专药专方、现代临床常用复方及实验研究进行梳理，以期推广中药复方抗食管癌的治疗方法，发挥中西医结合治疗的协同优势。     

Going to the doctor with enhancement in mind – An ethnographic study of university students’ use of prescription stimulants and their moral ambivalence

Aims: The aim of this qualitative research is to show how the alcohol socialization process – i.e. the ways children and young people get acquainted with alcohol – can generate very diverse experiences and meanings in different cultural contexts.

Method: A total of 16 focus groups were conducted in Italy and Finland, divided by age (4 groups), gender and socio-cultural level. A total of 190 participants took part in the study.

Findings: The findings support the hypothesis that the alcohol socialization process takes place in very different ways and assumes diverse meaning in the two countries involved in the study. In Italy the relationship with alcohol takes place as part of a gradual process and participants’ first memories of drinking alcohol are connected to positive values. In Finland, on the other hand, often the first experiences of drinking overlap with the first experiences of intoxication and alcohol images reflect an ambiguous relation with this substance, closely related to its intoxicating effects.

Conclusions: Results show that the alcohol socialization process can take very different forms and meanings according to a specific drinking cultures. Thus, further comparative research should take into more consideration the implication of these substantial differences.