湖湘针推学术流派"五经配伍"理论论治眼病

中医认为眼与五脏及经脉生理功能联系密切,本文介绍运用湖湘"五经配伍"理论治疗眼病,重视眼病的五脏、五经的辨证,分别从五脏论治,又兼顾五脏间的生克关系,全面调治,发挥中医整体辩证优势,为针灸治疗眼病提供新思路.     

四神丸对溃疡性结肠炎大鼠血清TLR4、TGF-β1及IL-10的影响

目的:探讨四神丸治疗溃疡性结肠炎(UC)的作用机制。方法:将40只SD大鼠随机分为正常组、模型组、对照组及四神丸组各10只。除正常组外,其余各组均采用2、4、6-三硝基苯磺酸(TNBS)/乙醇法复制UC大鼠模型,灌胃14 d后观察各组大鼠血清TLR4、TGF-β1、IL-10的变化。结果:模型组大鼠血清TLR4水平增高,TGF-β1、IL-10水平降低,与正常组比较,差异均有统计学意义(P0.01);四神丸组TLR4、TGF-β1、IL-10均较模型组明显改善(P0.05或P0.01)。结论:四神丸可调节溃疡性结肠炎大鼠TLR4-DC免疫耐受失调,可能是其治疗UC的作用机制之一。     

老年高血压患者长时血压变异性及降压治疗对动脉僵硬度的影响

目的 探讨长时血压变异性(BPV)和降压治疗对动脉僵硬度的影响。方法 选取2017年1月至6月于山西白求恩医院进行降压治疗及管理的原发性老年高血压患者411例,用臂踝脉搏波传导速度(baPWV)和踝臂指数(ABI)作为评估动脉僵硬度的指标。采用线性回归分析血压指数及BPV与baPWV、ABI的相关性,BPV用收缩压标准差(SBP_SD)表示。采用SPSS 26.0统计软件进行数据分析。采用t检验分析降压治疗的效果以及降压治疗对动脉僵硬度的影响。结果 通过3年降压治疗,老年高血压患者平均SBP、DBP、PP、MAP均较治疗前出现明显下降,FPG、TC、TG也较前明显下降,HDL-C较前明显升高,差异均有统计学意义[(131.78±7.36)和(142.92±17.14)mmHg(1mmHg=0.133kPa),(80.22±6.31)和(81.49±10.01)mmHg,(51.57±7.81)和(61.43±14.06)mmHg,(97.41±5.57)和(101.97±10.98)mmHg,(5.30±1.67)和(5.81±1.69)mmol/L,(3.85±0.95)和(4.42±0.90)mmol/L,(1.27±0.68)和(1.79±1.13)mmol/L,(1.35±0.31)和(1.21±0.31)mmol/L;均P＜0.05];而治疗前后LDL-C的差异无统计学意义。调整混杂因素后线性回归结果显示,在老年高血压患者中SBP、PP、MAP、SBP_SD均与baPWV呈正相关(β=10.390,5.500,14.940,11.110;均P＜0.05),与ABI呈负相关(β=-0.002,-0.001,-0.002,-0.003;均P＜0.05);而DBP仅与baPWV呈正相关(β=8.690,P＜0.05),而与ABI无相关性。降压治疗后,baPWV由(1782.70±308.87)cm/s降至(1732.43±261.73)cm/s、ABI由(1.12±0.10)升至(1.14±0.08),差异均有统计学意义(均P＜0.05);其中baPWV在性别和年龄分层分析中均表现出下降趋势,与降压治疗前相比,差异均有统计学意义(均P＜0.05);而ABI在女性患者及60~70岁患者中,与降压治疗前相比,差异均有统计学意义(均P＜0.05)。降压前后SBP差值、DBP差值与baPWV差值均呈正相关(β=3.000,3.290;P＜0.05),而与ABI差值无相关性。结论 SBP_SD是动脉僵硬度的影响因素,对老年高血压患者进行降压治疗及综合管理,可以显著改善患者的baPWV值,而降压治疗对ABI的影响尚需进一步的研究去明确。     

中西医结合治疗慢性盆腔炎56例体会

慢性盆腔炎是妇产科常见病、多发病,临床病程迁延,单纯西药治疗时间长,易复发,笔者从1993～1997年采用中西医结合治疗获得满意效果。1临床资料1．1一般资料：本组病例共56例,产后感染28例,泌尿系感染15例,上环后感染5例,经期性交感染8例,病程2～8年不等,全部病例均经妇科检查确诊。1．2治疗方法：中药治疗,金银花30g、苦参30g、蒲公英30g、地丁20g、黄茂20g、当归20g、川芎20g,水煎灌肠,每日1次,5次为1疗程,通常1～3个疗程即可取得治疗效果。如病程迁延时间较长,可适当延长疗程。西药治疗,甲硝唑加氨等青霉素静滴（氨苄青…     

Clinical study on brain-benefiting and collateral-sunblocking needling technique for chronic alcoholic gastritis complicated with depression

Objective

To observe the clinical efficacy of brain-benefiting and collateral-unblocking needling technique for chronic alcoholic gastritis complicated with depression.

Methods

A total of 92 cases with chronic alcoholic gastritis complicated with depression were included in this trial. They were randomly allocated into an observation group (n= 46) and a control group (n= 46) by random number (envelope) method. Patients in the observation group received the brain-benefiting and collateral-unblocking needling technique. Scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 23), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7) and Luoque (BL 8). Body points included Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Gongsun (SP 4), Shenmen (HT 7), Daling (PC 7), Qimen (LR 14), Xinshu (BL 15) and Taichong (LR 3). The control group only received the same body acupuncture as the observation group. The treatment was conducted once a day, 30 min for each treatment, and 10 times made up a course of treatment. The efficacy was observed after 3 courses of treatment, and there was a 2-d interval between two courses.

Results

After 3 courses of treatment, the clinical symptoms and gastroscopic features were significantly improved in the observation group than that in the control group. The clinical efficacy, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were significantly better than those in the control group (all P<0.05).

Conclusion

The brain-benefiting and collateral-unblocking needling technique can significantly improve clinical symptoms in patients with chronic alcoholic gastritis complicated with depression and substantially alleviate their gastroscopic features, anxiety and depression.