半夏白术山楂汤治疗高脂血症86例临床观察

目的:探讨半夏白术山楂汤治疗高脂血症的临床疗效。方法:将86例患者随机分成治疗组43例与对照组43例,治疗组应用半夏白术山楂汤加减,对照组应用洛伐他汀治疗作比较观察。结果:治疗组与对照组总有效率为94.2%和56.2%(P0.05)。结论:半夏白术山楂汤具有健脾益气,燥湿化痰,活血散结作用。     

半夏泻心汤治疗寒热错杂型胃溃疡50例

目的:观察半夏泻心汤治疗寒热错杂型胃溃疡的临床疗效。方法:选择本院2009年12月—2013年12月治疗的有胃溃疡病史,治疗时处于活动期,服药依从性好的寒热错杂型胃溃疡患者100例,随机分为中药组与对照组各50例。对照组给予四联疗法治疗,中药组给予半夏泻心汤加减治疗。结果:中药组转阴率84.78%,对照组转阴率55.56%,中药组优于对照组(P0.05);中药组痊愈19例,显效20例,有效4例,无效7例,有效率86%,对照组痊愈10例,显效10例,有效9例,无效21例,有效率58%,中药组有效率明显优于对照组(P0.05)。结论:半夏泻心汤治疗寒热错杂型胃溃疡疗效显著,能提高幽门螺杆菌转阴率。     

Pinellia Total Alkaloids Modulate the GABAergic System in Hippocampal Formation on Pilocarpine-Induced Epileptic Rats

Objective: To investigate the neuromodulatory effect of pinellia total alkaloids(PTA) on the gamma-aminobutyric acidergic(GABAergic) system in epileptic rats, and preliminarily evaluate the anti-epileptic effect of PTA. Methods: Ninety-one male Sprague-Dawley rats were randomized to a control group(n=17) or an epileptic group(n=74) using computer-generated random numbers. Status epilepticus(SE) was induced with pilocarpine in the epileptic group. Epileptic rats that survived SE were randomly divided into 4 groups, namely an epilepsy group(n=13), a topiramate(TPM, 60 mg/kg) group(n=12), a high-dose PTA(800 mg/kg) group(n=12), and a low-dose PTA(400 mg/kg) group(n=10). Treatments were given intragastrically once daily for 14 days. The control group and epilepsy group received normal saline. Spontaneous recurrent seizures(SRSs) were monitored 8-h daily for 7 days after treatment. Then, the hippocampal formation tissues were collected. GABA level was measured using enzyme-linked immunosorbent assay. Protein and mRNA expression levels of glutamate decarboxylase 65(GAD65), GABA transporter-1(GAT-1), GABA transaminase(GABA-T), and GABAA receptor(GABAAR) α4, α5, γ2 and δ subunits were measured using Western-blotting analysis and quantitative polymerase chain reaction. Results: PTA lowered the incidence and frequency of SRS(both doses vs. the TPM group, P0.05). Compared with the epilepsy group, PTA increased the levels of GABA(both doses P0.01) and GAD65(mRNA, 800 mg/kg, P0.01), and suppressed the levels of GAT-1(mRNA, 800 mg/kg, P0.01; 400 mg/kg, P0.05), GABA-T(mRNA, both doses P0.01), and GABAAR δ subunit(protein, 800 mg/kg, P0.05) and γ2 subunit(protein, both doses P0.01). PTA upregulated the low-expressed mRNA levels of GABAAR α5 subunit(400 mg/kg, P0.01), δ subunit(800 mg/kg, P0.05), and γ2 subunit(400 mg/kg, P0.05). Conclusions: PTA regulated the GABAergic system through modulating GABA levels and the expression levels of GAD65, GAT-1, GABA-T, and GABAAR α4, α5, γ2 and δ subunits. PTA may exert antiepileptic effects on the pilocarpine-induced epilepsy model.     

张永华教授应用半夏类方治疗不寐的临证经验

[目的]总结浙江省名中医张永华教授应用半夏类方治疗不寐的临证经验,提高不寐的临床疗效。[方法]通过跟师学习,记录和整理张永华教授运用半夏类方治疗不寐的医案,结合相关古籍资料及现代文献研究,研究半夏类方所主不寐的病机、半夏体质的主要特征以及半夏类方的应用,最终分析总结张永华教授运用半夏类方辨证治疗不寐的临床经验,并通过验案佐证。[结果]张永华教授认为,不寐的病机与中焦不畅、阳不入阴有关,而半夏具有化痰降逆、通利中焦等功效。通过配伍,半夏秫米汤、半夏枯草煎、半夏厚朴汤、黄连温胆汤、半夏泻心汤等半夏类方可通过化痰降逆、通利中焦、调和阴阳,发挥治疗不寐的效果。所举医案,患者为胆胃不和、痰热中阻之不寐,治以理气化痰、清热安神之法,依次以半夏类方黄连温胆汤及黄连温胆汤合半夏厚朴汤加减治疗,效果明确。[结论]张永华教授运用半夏类方药辨治属半夏体质的不寐疗效显著,经验值得临床传承及推广学习。     

导痰汤治疗中风痰浊上扰证60例临床观察

目的观察中药导痰汤治疗中风痰浊上扰证的临床疗效。方法选择120例中风患者,随机分为治疗组60例,对照组60例。两组均予常规西药治疗,治疗组在此基础上加用导痰汤,治疗4周后统计疗效。结果治疗组临床疗效总显著进步率为55.0%,对照组为36.7%,两组比较差异有统计学意义(P<0.05);中医证候疗效治疗组总显效率为63.3%,对照组为30.0%,差异有统计学意义(P<0.05);治疗组中医证候积分减少明显优于对照组,差异有统计学意义(P<0.05)。结论中药导痰汤治疗中风痰浊上扰证有较好疗效。     

半夏泻心汤加减治疗寒热错杂型功能性消化不良疗效分析

目的探讨半夏泻心汤加减治疗寒热错杂型功能性消化不良的临床疗效。方法将98例患者随机分为治疗组和对照组,治疗组用半夏泻心汤加减治疗,对照组用西药多潘立酮治疗,观察比较两组临床疗效及中医证候积分变化情况。结果治疗组有效率为89．8％,对照组有效率为83．7％,两组比较有显著性差异（P〈0．05）;两组经过治疗后中医证候积分相比也有显著性差异（P〈0．05）。结论半夏泻心汤加减治疗功能性消化不良（寒热错杂型）疗效确切,值得临床推广。     

基于多指标的半夏产地加工去皮前加工工艺研究

目的研究半夏Pinelliae Rhizoma产地加工去皮前的处理方法及工艺参数,为保证半夏药材质量提供关键的技术参数。方法分别采用"自然发汗""拌石灰粉""拌石灰水"3种方法处理,在各法处理第2、4、6、8天取样、去皮。以样品外观性状、叶绿素含量、去皮率、得率、浸出物和琥珀酸含量为指标进行综合评价。结果以样品性状及叶绿素含量为指标评价时,半夏质量以拌石灰水法为最佳,其次为拌石灰粉;以样品去皮率、得率及浸出物和琥珀酸含量为评价指标时,以拌石灰粉处理4 d的样品较好。按总评归一法综合评分,确定拌石灰粉处理4 d为最佳处理方法。结论半夏产地加工去皮前以拌石灰粉(每100 kg鲜半夏用石灰为10 kg)处理4 d为最佳,该方法简便,药材质量好。     

《吴鞠通医案》石膏半夏配伍应用浅析

《吴鞠通医案》作为一本较为实用的临床参考书,对后世有重要指导意义。石膏、半夏二味的配伍使用尤为精当。本文拟从探本溯源、本草考究、配伍特点三方面对该配伍进行论述,以期有助于经典研读及临床应用。     

和法在糖尿病中的运用

糖尿病寒热错杂、虚实兼夹,可分为湿热蕴脾证、肝郁气滞证、肝胃郁热证、胃热阴虚证、肠道湿热证、血脉瘀滞证等证型,治疗当运用和法辛开苦降、疏肝理气、清泻热结、滋阴清热、清热利湿、活血化瘀,选用半夏泻心汤、四逆散、大黄黄连泻心汤、大柴胡汤、白虎加人参汤、葛根芩连汤、桃核承气汤以调整气机、平调寒热、补虚泻实,并在药物治疗的基础上注重饮食、运动,调和身心。使机体恢复"阴平阳秘"的状态,"阴阳自和者必自愈"。