现代中医药发展战略思考

建国几十年来，由于党和政府的大力提倡和扶持，中医药得到了很大发展，但相对于西医的发展势头仍显不足。尤其是近10多年来，由于现代科技及现代管理学的有力推动，西医获得了突飞猛进的发展，然而，中医却由于种种原因发展相对缓慢。在这各行各业竞相发展的现代社会，中医要生存，就蓝须发展，中医要发展，就妊须总揽全局，从战略高度克服中医药发展的各种不利因素，充分发挥各方面的有利条件。     

Pretreatment with Tongxinluo protects porcine myocardium from ischaemia/reperfusion injury through a nitric oxide related mechanism

Background The traditional Chinese medicine Tongxinluo can protect myocardium against ischaemia/reperfusion injury, but the mechanism of its action is not well documented. We examined the involvement of nitric oxide in the protective role of Tongxinluo. Methods Miniswine were randomized to four groups of seven: sham, control, Tongxinluo and Tongxinluo coadministration with a nitric oxide synthase inhibitor Nω-nitro-L-arginine (L-NNA, 10 mg/kg i.v.). Three hours after administration of Tongxinluo, the animals were anaesthetised and the left anterior descending coronary artery ligated and maintained in situ for 90 minutes followed by 3 hours of reperfusion before death. Area of no reflow and necrosis and risk region were determined pathologically by planimetry. The degree of neutrophil accumulation in myocardium was obtained by measuring myeloperoxidase activity and histological analysis. Myocardial endothelial nitric oxide synthase activity and vascular endothelial cadherin content were measured by colorimetric method and immunoblotting analysis respectively.Results Tongxinluo significantly increased the local blood flow and limited the infarct and size of no reflow. Tongxinluo also attenuated myeloperoxidase activity and neutrophil accumulation in histological sections and maintained the level of vascular endothelial cadherin and endothelial nitric oxide synthase activity in the reflow region when compared with control group. The protection of Tongxinluo was counteracted by coadministration with L-NNA. Conclusions Tongxinluo may limit myocardial ischaemia and protect the heart against reperfusion injury. Tongxinluo regulates synthesis of nitric oxide by altering activity of endothelial nitric oxide synthase.     

三联药物治疗未破裂异位妊娠的临床研究

目的 :观察甲氨蝶呤(Methotrexate,MTX)、米非司酮(Mifepristron,Ru486)及中药三联用药治疗未破裂型异位妊娠的临床疗效。方法 :对171例未破裂型异位妊娠病人 ,按药物治疗方法不同分为两组进行对照研究 :A组使用MTX注射 +Ru486口服 +中药联合治疗。B组单独使用MTX注射治疗。测定法定期测定两组病人血HCG值以监测血HCG下降情况 ,测量异位妊娠包块三径线值以监测病灶包块缩小情况 ,同时观察临床症状持续时间、副反应发生率及总有效率。结果 :血HCG下降及病灶包块缩小A组较B组明显 ,差异有显著性(p<0 05,p<0 01);临床症状持续时间A组较B组短 ,差异有显著性(p<0 05);副反应发生率两组间无显著差异(p>0 05);A、B两组的总有效率分别为 :95 74%和71 43% ,A组较B组高 ,差异有显著性(p<0 05)。结论 :三联使用甲氨蝶呤、米非司酮及活血化瘀消包块杀胚的中药既有很强的杀胚功能 ,又能消除病灶包块 ,保留生育功能。三联药物联合治疗未破裂异位妊娠具有疗效肯定、安全     

陈士铎《辨证录》辨证论治特点浅析

《辨证录》成书于清·康熙二十六年,是陈士铎现存著作中篇幅最长,于临床见证记述最全的一部书。全书在辨证论治上取古人意而不泥古人法,在辨证求因、审因论治上多有卓见。特点为:只言辨证不言辨脉;审查病机,同中求异,鉴别分明。辨证方法的选择,配伍应用有其自身特点:病种不同,侧重有别;辨证方法单独使用者少,配伍使用者多;以脏腑辨证为核心。     

复方麝香注射液联合脑血肿引流术治疗中老年高血压脑出血疗效观察及费用对比

目的:探讨复方麝香注射液联合微创手术治疗中老年高血压脑出血的临床疗效.方法:将78例接受微创治疗的患者随机分组,两组均采用内科综合治疗.手术对照组在综合治疗基础上加用微创手术进行脑血肿引流;中西医结合组在微创手术治疗后加用复方麝香注射液(10～20 ml/d)静脉滴注1周.结果:中西医结合组显效率(66.67%)、有效率(82.05%)均明显高于手术对照组(46.15%和69.23%,P均<0.05),存活患者日常生活能力也明显优于手术对照组(P<0.05),意识恢复时间明显短于手术对照组(P<0.05),并发症的发生率(15.38%)明显低于手术对照组(38.46%,P<0.01),病死率(5.13%)明显低于手术对照组(10.26%,P<0.01),平均住院天数[(18.29±4.93)d]明显少于手术对照组[(26.23±5.82)d,P<0.05],平均住院费用[(5 916.23±826.39)元]明显少于手术对照组[(8 168.35±1 021.21)元,P<0.05].结论:脑血肿引流术后加用复方麝香注射液治疗中老年高血压脑出血,可降低病死率,减少并发症,降低病残程度,提高生存患者的生活质量,缩短住院时间,降低治疗费用.     

BUERGER'S DISEASE IN HONG KONG: A REVIEW OF 89 CASES

Background : A retrospective analysis of 103 case records from 1978 to 1996 with a provisional diagnosis of Buerger's disease was undertaken at the Department of Surgery, University of Hong Kong, Queen Mary Hospital. The aim of the study was to elucidate the clinical course and evaluate the results of surgical intervention of Buerger's disease in Hong Kong Chinese people. Methods : Fourteen patients were subsequently excluded from the study because of inability to fulfil our diagnostic criteria. Data on clinical presentation, investigations, indications and results of surgical intervention were reviewed. Sympathectomies and arterial reconstructions were performed on 42 and four patients, respectively, for critical ischaemia or rest pain. Outcome was analysed with respect to the rate of ulcer healing, pattern of recurrence and limb loss. Results : The patients were all young male heavy smokers with a mean age of 36.5 years. The majority of patients (80%) presented with ischaemic ulceration or gangrene. Vascular reconstruction was undertaken in four patients and satisfactory long-term results were obtained in three patients. Sympathectomy was able to relieve symptoms in 87% of operated patients and ischaemic ulceration healed in 2.6 (mean) ± 1.7 (SD) months after the operation. If the patient continued to smoke, surgical intervention did not exempt the patient from a relapse or amputation. Conclusion : Sympathectomy provides short-term pain relief and promotes ulcer healing in patients with Buerger's disease but carries no long-term benefit. Complete abstinence from smoking is the only means of arresting the progression of the disease.     

中草药红背丝绸不同成分对内皮素-1效应拮抗作用的研究

本文用中草药红背丝绸醇提物、乙酸乙脂提取物和单体ＣＡ－１２０１ 三种不同成分对ＥＴ－１ 在动物整体及离体水平生物学效应的拮抗作用进行了研究。结果发现：这三种成分对ＥＴ－１ 致小鼠进行死亡有保护作用，使得小鼠的死亡率及死亡数下降；并可拮抗ＥＴ－１ 致胸主动脉的缩血管效应，醇提物和乙酸乙脂提取物（１０－ ７母液）拮抗ＥＴ 缩血管效应分别为５７．２７％ 和５８．６１％ ；ＣＡ－１２０１ １０－ ８和１０－ ９ Ｍ 亦能拮抗ＥＴ－１ 的缩血管效应；醇提物和乙酸乙脂提取物口服及ＣＡ－１２０１ 静脉注射后能拮抗ＥＴ－１ 的升压作用，拮抗ＥＴ－１ 作用均呈现明显的剂量依赖性。提示中草药红背丝绸不同成分可拮抗ＥＴ－１ 的生物学效应。     

理气类中药对大鼠离体胃平滑肌条的作用

目的：观察理气类中药对大鼠离体胃平滑肌条运动的影响。方法：将肌条放置在灌流肌槽中，用生理记录仪记录肌条的收缩活动。结果：陈皮、枳实对胃各部位平滑肌条均为抑制效应，香附、薤白、木香、柿蒂、乌药对胃底肌条为兴奋效应，但对其他部位肌条则表现为兴奋或抑制不同的效应，沉香仅降低胃窦环行肌收缩波平均振幅，对其他肌条无影响。结论：理气类中药对大鼠离体胃平滑肌条既有兴奋作用，也有抑制作用。