临床应用大方的思路与方法

探讨临床应用大方的思路和方法。从辨证的模糊性、疾病的复杂性与矛盾性和小方在临证应用中的困惑与不足等方面探讨临床应用大方的必要性,从合方而用、专方及体质辨证基础方等方面论述大方药势的处方学特点。     

Lähmung des N. hypoglossus nach operativem Eingriff – Behandlung mit Akupunktur

Acupuncture is able to accelerate the process of healing significantly when employed in cases of nerve paresis as shown in the following analysis. The patient's constant condition of speech and swallowing impediment before treatment changed relatively fast after starting acupuncture treatment. It is self evident that we took into account the primary disease (AIDS) and its problems. The simplicity of a complementary treatment with acupuncture according to the possible results should make us consider the use of acupuncture as an important way to treat paresis in the early subacute phase and if possible during clinical stay.     

方剂学科发展思路与方法

方剂学科传统模式已发生重大变化，现代方剂学以计算机和实验为重要研究手段，熔理论方剂学、实验方剂学及临床方剂学于一炉。现代方剂学科模式的建立必将培育出新的知识增长点，丰富学科内涵，促进研究方向和专业课程的调整，提高学术水平和人才培养质量，实现新世纪方剂学科发展质的飞跃。     

基于骨免疫微环境探讨补肾活血方防治绝经后骨质疏松症的研究进展

骨质疏松症（OP）是我国人群中最常见的多发病,好发于绝经后的老年妇女,增加了患者骨折的风险。绝经后骨质疏松症（PMOP）是一种以骨量减少和骨折风险增加为特征的全身性疾病,主要是绝经后雌激素水平显著降低导致的。除了雌激素缺乏对骨骼的直接负面影响外,绝经后妇女免疫状态的改变间接导致骨骼的持续破坏,因为绝经后妇女通常表现出慢性低级别炎症表型,细胞因子表达和免疫细胞谱发生改变。PMOP已严重危害我国女性健康。补肾活血方是一种应用广泛的补肾活血中药,近年来,随着我国临床医师与患者越来越重视中医药,补肾活血方被应用于多种疾患,包括骨科的多种疾病,其对PMOP的防治效果亦明显。该文基于骨免疫微环境,以骨代谢对PMOP产生影响为基础,论述补肾活血方的作用机制。     

Oxygen uptake-heart rate relationship in élite wheelchair racers

The American College of Sports Medicine (ACSM) recommends that, as a general rule for health purposes, individuals should exercise at 40%–85% of their maximal oxygen uptakes. Moreover, it has been suggested that 55%–90% of the maximal heart rate may be used as an alternative estimate of these percentage maximal oxygen uptake values. The present study examined the relationship between percentage peak heart rate (% HR_peak) and percentage peak oxygen uptake (% ) during steady-state incremental intensity wheelchair propulsion of 16 élite, male wheelchair racers (WR). Oxygen uptake was determined during each submaximal exercise stage and heart rate (HR) was continuously monitored. The was subsequently determined using a separate protocol. Linear regression equations of % HR_peak versus % for each participant included % HR_peak values corresponding to 40%, 60%, 80% and 85% . The linear regression equation, derived as the group mean of the slope and intercept terms determined for each individual, was: . The group mean of the individual correlation coefficients for the relationship was 0.99. The values of % HR_peak for each of the % values below 85% were significantly greater (P<0.01) than those suggested by the ACSM. This suggests that the ACSM guidelines below 85% , based on % HR_peak, may underestimate the relative exercise intensity (i.e. % ) in the WR population. However, in élite level WR, % HR_peak can be recommended as an alternative estimate of % at wheelchair propulsion intensities of 85% or more. Electronic Publication     

益精养血方对帕金森病大鼠多巴胺能神经元Caspase-3表达的影响

目的研究益精养血方对帕金森病(Parkinson's disease,PD)大鼠多巴胺能神经元Caspase-3表达的影响。方法将微量6-羟多巴胺(6-OHDA)立体定向注射于SD大鼠中脑右侧黑质以建立大鼠帕金森病模型,将造模成功的实验动物随机分为模型组、实验(中药)组,每组6只;另纳入6只正常大鼠为正常组。正常组和模型组大鼠生理盐水灌胃,实验组大鼠益精养血方灌胃,各30天。灌胃结束两周后进行行为学检测,免疫组织化学方法观测黑质酪氨酸羟化酶(TH)、Caspase-3的表达。结果实验组大鼠的旋转圈数比治疗前明显减少(P<0.05),实验组损毁侧与健侧黑质TH阳性细胞数量百分比较模型组显著提高(P<0.05),实验组损毁侧黑质Caspase-3表达的OD值比模型组显著降低(P<0.05)。结论益精养血方可使帕金森病大鼠多巴胺能神经元Caspase-3的表达降低,明显抑制神经细胞凋亡。     

基于古今文献对经典名方中细辛毒性的有效避减探析

目的：通过研究细辛的相关文献,对影响细辛毒性的关键信息进行梳理,为经典名方中细辛的合理应用提供依据。方法：通过文献计量学的方式,搜集细辛的古今相关文献,分析细辛毒性与药物基原、用药部位、炮制方式、药物剂型、方药配伍、服药方法及患者体质因素之间的关系。结果：在经典名方的研发过程中,细辛在当归四逆汤、厚朴麻黄汤中的用量分别为9、6 g,煎煮时间应>120 min;细辛在辛夷散、三痹汤、大秦艽汤、清上蠲痛汤种的单次用量分别为0.8、1.2、0.9、1.1 g;当归四逆汤、厚朴麻黄汤、清上蠲痛汤等应选用辽细辛的根茎,辛夷散可选择汉城细辛的根茎。在药物的炮制上,当归四逆汤、厚朴麻黄汤、三痹汤、大秦艽汤四方中的细辛可选用酒制;辛夷散、清上蠲痛汤中的细辛可选用炒制;另外,细辛的毒性与药物的配伍和患者的体质等因素均有着密切的关系。结论：该研究通过梳理有关细辛毒性的文献资料,得出了影响细辛毒性的关键信息,探析了细辛毒性的有效避减方式,为包含细辛的经典名方的合理开发和安全应用提供了更为充分的依据。     

经典名方当归补血汤的古代文献分析与考证

当归补血汤出自金元时期李东垣《内外伤辨惑论卷中·暑伤胃气论》,是一首被历代医家传承发扬的补气生血经典名方,已被收录于2018年国家中医药管理局公布《古代经典名方目录（第一批）》。通过系统梳理古籍文献及现代文献,并结合古代经典名方关键信息考证原则,对经典名方当归补血汤的历史源流、组成、剂量、炮制、制法与煎服法、功效与应用进行考证分析。共收集相关古籍文献信息604条,其中涉及中医古籍186部,其中40部（金元5部,明19部,清16部）中医古籍详细记载了组成、炮制、剂量等内容。有关当归补血汤组成,主要为当归和黄芪;根据古今剂量折算,黄芪37.3~38.1 g,当归7.5~7.6 g;黄芪宜采用蜜炙,当归为酒当归;加入水600 mL,煎至300 mL,饭前温服。该方古籍主要记载功效为血虚发热,证见肌热、燥热,烦渴引饮,目赤面红,昼夜不息,脉洪大而虚,重按无力,是补气生血名方。现代研究表明,当归补血汤常用于治疗各种贫血、糖尿病肾病、肿瘤、心脑血管疾病。上述研究结果为经典名方当归补血汤后期开发研究提供了参考依据。