经典名方清胃散的研究进展

清胃散方记载于金代李东垣所著《兰室秘藏》,由当归（身）、生地黄（酒制）、黄连、牡丹皮、升麻5味中药组成,是治疗胃火牙痛的常用方剂。近年来,临床研究表明该方应用范围十分广泛。通过查阅文献,从处方来源、功效主治、化学成分、药理研究、临床应用方面进行综述,以期为新药研发提供依据。     

Understanding the underutilization of cervical brachytherapy for locally advanced cervical cancer

PurposeTo understand the reasons behind current low utilization of brachytherapy for locally advanced cervical cancer in the United States.Methods and MaterialsA 17-item survey was e-mailed to the American Brachytherapy Society (ABS) listserv of active members in 2018. Responses of attending physicians in the United States were included in the analysis.ResultsAmong a total of 135 respondents, 81 completed the survey. Eighty-four percent agree/strongly agree that cervical brachytherapy is underutilized, and 46.9% disagree/strongly disagree that residents are receiving adequate training for brachytherapy; 75.3% agree/strongly agree that inadequate maintenance of brachytherapy skills is a major obstacle to brachytherapy use; and 71.6% agree/strongly agree that increased time requirement constitutes a major obstacle. Over 97% will recommend brachytherapy for most patients with cervical cancer if given access/time; 72.8% always perform their own brachytherapy, whereas 29.6% reported some type of barrier exists in performing brachytherapy themselves, with time required to perform brachytherapy (9.9%) being a leading factor. A quarter (24.7%) routinely refer to other radiation oncologists for brachytherapy. Even among ABS members, 37.0% reported that they would perform an intensity-modulated radiation therapy or stereotactic body radiation therapy boost in specific scenarios in potentially curable patients. The most common scenario is inability to place a uterine tandem (56.7%).ConclusionsThe underutilization of brachytherapy in cervical cancer is widely recognized by ABS members with inadequate training during residency and inadequate maintenance of skills being possible major contributing factors. Even among ABS members, there are identifiable barriers. Continued advocacy and future initiatives in enhancing access to brachytherapy training and efficiency are needed.     

真武汤合生脉散治疗慢性充血性心力衰竭28例临床观察

目的:观察真武汤合生脉散治疗慢性充血性心力衰竭的临床疗效。方法:选择56例诊断明确的慢性充血性心力衰竭患者,经知情同意后,随机分为治疗组与对照组,各28例。对照组运用西药常规进行治疗,治疗组在对照组基础上加用真武汤合生脉散水煎剂治疗,疗程4周。结果:治疗组临床症状改善总有效率为82.14%,对照组64.29%;心衰计分治疗组有效率85.71%,对照组有效率67.85%。结论:真武汤合生脉散可较快缓解慢性充血性心力衰竭临床症状,改善心功能。     

四逆散冻干粉改善大鼠睡眠作用机制研究

目的研究四逆散冻干粉改善大鼠睡眠作用机制。方法按照随机数表法将SD雄性大鼠随机分为5组:空白对照组、阴性对照组、阳性对照组、四逆散冻干粉组,混合物组,每组10只。阴性对照组的大鼠灌胃0. 9%Na Cl;阳性对照组的大鼠灌胃盐酸帕罗西汀溶液4. 2 mg·kg^-1;四逆散冻干粉组的大鼠灌胃四逆散冻干粉水煎液2. 41 g·kg^-1;混合物组灌胃混合物(辛弗林-芍药苷-柴胡皂苷C-甘草次酸=8. 5∶1. 0∶1. 5∶6. 5) 206 mg·kg^-1。每日灌胃1次,连续给药1周。用高效液相色谱(HPLC)法测定脑脊液移行成分。结果四逆散冻干粉在脑脊液中除戊巴比妥钠成分外,并无血中移行成分的进入;给予四逆散冻干粉后,脑脊液中成分峰面积约是空白脑脊液峰面积的12. 5倍;血清中四逆散的移行成分(辛弗林、芍药苷、柴胡皂苷C、甘草次酸)均可以使脑脊液中该内源性物质峰面积高于空白脑脊液峰面积,但不如四逆散整方作用;混和物组增高脑脊液中内源性物质峰面积是四逆散组的3. 2倍,该内源性物质是5-羟色胺。结论四逆散冻干粉是通过促进脑脊液中内源性物质5-羟色胺的分泌达到改善睡眠作用的。     

逍遥散抗抑郁代谢特征综合分析及其调节能量代谢和神经递质机制研究

目的通过对多种生物样本中内源性代谢物特征进行综合分析,阐释逍遥散抗抑郁的作用机制。方法对慢性不可预知温和刺激(chronic unpredicted mild stress,CUMS)抑郁大鼠模型的血液、尿液、海马、肝脏、盲肠、粪便和临床患者的血浆、尿液等生物样本中逍遥散具有显著调节作用的差异代谢物进行代谢特征综合分析,归纳总结逍遥散在不同生物样本中调节的关键差异代谢物和代谢通路。结果逍遥散在不同生物样本中调节的相同差异代谢物有34个,其中11个变化趋势一致,涉及的关键代谢通路为能量代谢和神经递质通路等。结论逍遥散能够通过调节体内代谢平衡所在的代谢通路发挥抗抑郁作用,为系统挖掘逍遥散抗抑郁代谢机制提供依据。     

当归芍药散对糖尿病认知障碍性疾病的研究进展

经典古方当归芍药散最初记载于《金匮要略》,主要用于治疗妇科疾病。现代方剂学将其归入理血剂中,当归芍药散的临床使用范围已经大大拓宽。本文总结了当归芍药散治疗糖尿病认知障碍性疾病的研究,从其对胰岛素代谢,细胞凋亡,炎症损伤,糖尿病心肌病,雌激素的影响以及抗氧化作用,降血糖作用和对神经保护等方面进行了综述研究。     

银翘散君药之辨

银翘散为《温病条辨》代表方剂之一,该方具有辛凉透表,清热解毒之功效,主治温病初起,风温之邪侵袭肌表,组方配伍严谨精妙,也具有很高的学术价值和临床意义。分析条文解读吴鞠通的辨治思路,从配伍、治法多角度阐述银翘散应以辛凉解表药为君药,以解表透邪为立法,对指导临床辨证和选方用药有重要意义,以此能更好继承和发扬古代名医吴鞠通的思想精神。