名老中医万小明教授治疗腰椎间盘突出症的经验浅谈

腰椎间盘突出症是骨科常见病、多发病,病情易反复发作,迁延难愈,据相关统计,我国腰椎疾病的患者超过2亿人,而腰椎间盘突出症占腰椎疾患可达15.2%,并且有由中老年向青壮年扩展的趋势,中医可归属于“腰痛”“腰腿痛”“痹证”等范畴。该文总结第六批全国名老中医学术经验继承指导老师、江西省名中医万小明主任在治疗腰椎间盘突出症方面的临床经验,对其治疗方法加以整理,并归纳成文以对临床工作有所指导。     

姜松鹤教授治疗泄泻经验

姜松鹤教授是第四批全国老中医药专家学术经验工作指导老师、博士生导师,是大连市中医药学会顾问,大连大学中医研究所所长以及中华中医药学会内科专业委员会委员,从事临床工作50余年,对《黄帝内经》《伤寒论》等中医经典精研不辍,临床治疗内科、妇科等疑难杂症屡获奇效,尤其精通脾胃病的诊治,对于泄泻的治疗,姜教授重视脏腑辨证,并认为“五脏六腑皆令人泻,非独脾也”。     

中药材产业扶贫现状经验探讨及可持续发展建议

中药材产业扶贫是《中共中央国务院关于打赢脱贫攻坚三年行动的指导意见》中提出的重要扶贫举措。通过梳理各地中药材产业扶贫政策及现状、总结主要扶贫模式,发现政府及相关部门在脱贫攻坚战中起到至关重要的引领作用、产业扶贫成功案例起到示范带动作用、科技支撑为脱贫攻坚保驾护航;同时也应看到,中药材产业扶贫还存在中药材种植规模迅速扩大、风险来源多、脱贫的可持续性有待加强等突出问题;建议在脱贫攻坚的关键时期,要更加注重贫困地区中药材产业的科学规划和全面布局、规范药材种植、提升药材品质、推动产业融合发展、加强科技和人才扶持,增强中药材产业扶贫的可持续性。     

白虎加人参汤辨治消渴病理论探微

白虎加人参汤为清热、益气、生津之主方。现从白虎加人参汤主治及消渴病病机入手,探讨白虎加人参汤治疗消渴病的特点;并通过配伍关系,现代医家应用举隅及其拆方及成方的现代药理研究,阐释白虎加人参汤治疗消渴病的可能作用机制;并通过使用注意指导临床,以期为加强对白虎加人参汤的理解及为消渴病的治疗提供参考。     

云南省中医药民族民间经验方、经典名方的开发思路

云南中医民族药源远流长,造就了大量民族民间经验方和经典名方,在临床医疗和相关科研工作中有不可或缺的作用。通过对云南省的民族民间经验方、经典名方的整理情况,发展现状及存在的问题,二次开发研究情况分析,得到云南中医药民族民间经验方、经典名方启示开发思路。制约民族民间经验方、经典名方的主要问题为:资料收集整理不齐,临床应用缺乏相应的质量考评标准和系统的安全性总结;现行法律法规对民族民间经验方、经典方有效性及合法产权界定尚不完善;二次开发利用不创新等。对流落民间,口耳相传但尚未被整理在册的药方应该及时保存记录,妥善保护,建立安全性,有效性评价标准;建立云南民族医药数据库,完善民族医药保护制度;对现有民族民间经验方、经典名方进行创新及二次开发。     

李曰庆教授辨证治疗前列腺疾病经验

李曰庆教授从医50余载,在中医外科和泌尿男科领域辛勤耕耘,勇于创新,取得了令人瞩目的成就,并在临床中应用中西医结合的治疗方法对泌尿男科等疾病进行治疗,经过多年临床积累了很多极具特色的用药经验。在慢性前列腺炎的诊疗上李曰庆教授强调辨证与辨病相结合,因证施治,综合治疗。在前列腺增生的治疗上,李教授提出从肾虚、血瘀、痰浊论治的辨证思路,采取温肾、活血及化痰的治疗方法。主要围绕李曰庆教授治疗前列腺疾病的理论及思路展开论述,旨在更好地指导临床。     

Validation of the classification of migraine without aura (IHS A1.1) proposed in ICHD-2

OBJECTIVE: This study attempts to validate the alternative criteria for classification of migraine without aura (International Headache Society [IHS] A1.1) proposed in the appendix of The International Classification of Headache Disorders, 2nd edition. This method uses at least two of the associated symptoms (nausea, vomiting, photophobia, phonophobia, and osmophobia) in category D of the IHS classification. BACKGROUND: In the appendix of The International Classification of Headache Disorders, 2nd edition, an alternative method of classification of migraine without aura is proposed. This method of classification has never been validated. METHODS: A total of 1480 consecutive headache patients in a tertiary care setting were evaluated at first visit. Headache-associated features, such as intensity, lifetime duration, frequency per month, duration, triggers, prodrome, percentage recurrence, and postdrome frequency, were recorded. In addition, medication satisfaction, acute and monthly disability, grading of headache days, sleep normality, mood, and habits were documented. RESULTS: Of the 1480 patients, 901 were initially classified as having migraine IHS 1.1. Using the proposed alternative method (IHS A1.1), 885 (98.2%) of these patients were reclassified as having migraine. The remaining 16 (1.8%) patients not classified had only nausea and none of the other specified associated symptoms. They also exhibited different characteristics from the IHS migraine population as a whole regarding their headache and other features. CONCLUSIONS: This classification of migraine in a headache center population shows that the proposed use of any two of nausea, vomiting, photophobia, phonophobia, and osmophobia in category D of the classification may be a valid alternative method of classification. This study also demonstrates that the standard IHS methodology includes a very small group of patients who appear to be different from other migraine patients.     

Leading interprofessional practice: a conceptual framework to support practitioners in the field of learning disability

One of the key challenges for practitioners in present day health and social care has been responding effectively in the interprofessional teamwork setting, where collaboration is at the centre of professional activity. For whilst practitioners are expected to work interprofessionally there often remains limited attention to the actual process of interprofessional practice itself, within organizational strategy, local workforce development planning and individual continuing professional development. These concerns were a driver for this research with practitioners in the field of learning disability which resulted in the development of a conceptual framework for interprofessional practice. This paper sets out the process of conceptual framework development, underpinned by the concepts of knowledge of learning disabilities, contextual socialisation, empowerment, conflict management, transforming capability and interprofessional reflection on action. The researcher suggests that the framework may offer clinical leaders in learning disabilities and a range of other practice settings a tool to facilitate individual practitioner development, enabling as it does, the identification of a range of critical factors which impact on the outcomes of interprofessional practice intervention.     

国医大师徐景藩治疗消化道肿瘤经验探要

消化道肿瘤是目前难治的肿瘤之一,其病机复杂,国医大师徐景藩教授认为其病机主要责之正气不足,气血病理是其发病基础,虚实和寒热相互关联。对于消化道肿瘤患者,尤其是术后患者,素体脏腑功能失调,气血阴阳紊乱,瘀毒存于体内,再次损害机体脏腑,进一步产生瘀血痰浊等其他邪毒。正虚邪实多为此类患者的共同病机特点,应以扶正祛邪,健脾益气为治疗大法。治疗上注重顾护脾胃后天之本,用药时强调刚柔结合,适当给予心理疏导,调节情绪,疗效显著。     

王平从培调元气论治中风后遗症的经验

中风是中老年人群的常见病,中风患者经治疗后往往遗留有不同程度的后遗症。这些后遗症轻者影响其日常生活,重者使其生活不能自理,给患者和家庭带来了痛苦和负担。王平教授是全国老中医专家学术经验继承工作指导老师,在中医元气理论的研究和临床应用方面颇有建树。文章总结了中风后遗症的病因病机,介绍了王平教授以培补元气为主,兼理气化痰、祛瘀通络来治疗中风后遗症的经验,并将结合相应的病案加以阐述,以期为临床治疗提供一定的理论依据。