《针灸大成》关于气海穴临床应用的文献研究

目的:通过检索《针灸大成》中与气海穴治疗作用相关的文献条文,总结气海穴在治疗各系统疾病中运用频次较高的疾病及其配穴规律,为临床针灸对气海穴的使用提供理论支持。方法:以《中华医典》(第五版)中《针灸大成》作为文献检索来源,将气海穴及气海穴的别称“脖胦”“下肓”“丹田”“肓之原”“肓原”“下言”和“气泽”为检索词,用计算机检索工具及人工检索相结合的方法检索符合要求的文献条文,通过建立本研究的数据库,频次分析、条形统计图比较分析等方法,总结出气海穴在治疗各系统疾病中的运用频次及其配穴规律。结果:在《针灸大成》所涉及的条文中,气海穴尤善治疗内科疾病,在治疗内科疾病中排名前3位的是脾胃系病症、气血津液疾病、肾系病症和妇科疾病,气海穴配穴习惯为上下配穴法,同名经配穴法,以及前后配穴法,其中主要为前后配穴法和同名经配穴法。结论:气海穴《针灸大成》中单穴应用占比最高,而在气海穴众多配穴中,运用了本经配穴法、上下配穴法、前后配穴法,配穴归经主要来自任脉和足太阳膀胱经。同名经配穴法,同气相求,可增加疗效;与气海穴配伍较多的足太阳膀胱经以背腧穴为主,此为前后配穴法,亦称腹背阴阳配穴法,腹部为阴,腰背为阳,前后配穴法可起到“从阳引阴”亦可“从阴引阳”的作用,以达到调节阴阳,调和脏法,调畅经络的目的。     

Exploring the impacts of organisational structure,policy and practice on the health inequalities of marginalised communities: Illustrative cases from the UK healthcare system

This paper explores how organisational structure, policies and practices in healthcare can inadvertently disadvantage marginalised populations (e.g. individuals from ethnic minority backgrounds) and reinforce health inequalities. We draw upon three diverse UK healthcare settings (long term care institutions, high security hospitals and community pharmacies) to illustrate how systemic injustices negatively impact on access to care, treatment and health outcomes. The first case study considers the care of older people within nursing homes; specifically the disempowering effects of this service structure and impacts of choice reduction upon health and their access to health provision. The second case study explores the impact of security restrictions upon patients within high security hospitals, focusing particularly on the maintenance of relationships and support networks outside of the hospital. The third and final case study, draws upon a national community pharmacy medicine management service to illustrate ways in which policies and guidelines inadvertently obstruct patients' engagement with the service within a community setting. We draw upon these settings to highlight inequalities within different contexts and to illustrate the ways in which well intended services can inadvertently disadvantage marginalised communities in multiple ways.     

基于“中医传承辅助平台”软件挖掘年莉教授治疗糖尿病肾病的用药规律

[目的] 采用"中医传承辅助平台"软件，探讨年莉教授治疗糖尿病肾病的用药规律。[方法] 将2016年11月-2019年4月年莉教授治疗糖尿病肾病的中药处方信息输入中医传承辅助平台系统，采用频次分析、组方规律分析方法挖掘、探讨年莉教授治疗糖尿病肾病的临床用药特点。[结果] 对年莉教授治疗糖尿病肾病158首处方进行分析，涉及中药207味，使用频次在前10位的药物分别为白芍、川芎、当归、半夏、刺蒺藜、丹参、泽泻、牛膝、厚朴，白术获得9组药对、3组核心药物组合。[结论] 年莉教授治疗糖尿病肾病经验丰富，高频药物的配伍体现了年莉教授多采用平肝疏肝，补血养阴，活血化瘀的治疗原则。期望能为临床治疗和药物研发提供参考，并为糖尿病肾病在泰国的治疗提供新的理念和借鉴。     

The spatial dimensions of medication management by home-dwelling older adults after hospital discharge

Ageing in place raises pressing questions about medication practices at home. Understanding how medication practices are integrated into older adults’ domestic settings requires an interest in where activities linked to medication take place and why. This study aimed to describe the medication practices and spatial dimensions of medication management for home-dwelling older adults after hospital discharge, using a qualitative research design. Semi-structured interviews were carried out with ten older adults aged 65 years old or more and discharged home from hospital, together with nine informal caregivers. Thematic content analysis identified two main themes dealing with the spatial dimensions of medication management in this specific context: the process of integrating medication changes into routines and familiar spaces, and the individual and collective management of medication changes linked to a renegotiation of the boundaries between public and private spaces.     

基于数据挖掘的国医大师治疗心悸用药规律探讨

目的:基于中医传承软件系统探讨国医大师治疗心悸的用药规律。方法:收集整理《国医大师验案良方·心脑卷》中治疗心悸的病案并录入中医传承辅助平台,采用规则分析、改进互信息法、复杂系统熵聚类等数据挖掘方法,统计分析其中的用药规律。结果:分析纳入的83个病案得出149味中药,所用中药性味多为甘温,主要归心、肺、脾三经,包括丹参、黄芪、炙甘草、麦冬等高频次中药。提取置信度为1的丹参,五味子→麦冬组合,可窥见生脉饮的雏形并衍生出10个新方,新方可分为五类,分别为行气化痰类、滋阴养血类、温通心阳类、益气活血类和化痰祛瘀类。结论:国医大师治疗心悸有规律可循,主要以“益气通阳”“养阴补血”“化痰祛瘀”为组方规律,标本并治。     

艾灸联合弥可保治疗糖尿病周围神经病变40例

目的评价艾灸联合弥可保治疗糖尿病周围神经病变的疗效。方法对糖尿病周围神经病变患者80例按1∶1比例等分为联合组和对照组,两组基于等同的基础治疗之上,联合组用艾灸联合弥可保治疗,对照组单纯用弥可保治疗,疗程3个月,比较治疗前后的神经传导速度变化和症状改善情况。结果联合组和对照组神经传导速度均改善,以联合组改善更明显;联合组和对照组显效、有效、无效分别是52.5%、32.5%、15.0%和35.0%、27.5%、37.5%,组间差异有统计学意义(P<0.01或P<0.05)。结论建立于基础治疗之上的艾灸联合弥可保治疗糖尿病周围神经病变优于单纯弥可保治疗。     

不同种的金银花中微量生物元素的分布规律

本文报告不同种的金银花中微量生物元素的分布规律:不同种的金银花中微量生物元素含量的对数与其元素的原子序数成线性关系,并呈现周期性。