电针足三里穴和尺泽穴对脓毒症患者急性肺损伤的影响

目的 评价电针足三里穴和尺泽穴对脓毒症患者急性肺损伤的影响.方法 脓毒症并发急性肺损伤/急性呼吸窘迫综合征患者60例,性别不限,年龄43 ～ 78岁,体重49 ～ 89 kg,急性病生理学和慢性健康评价-Ⅱ评分(APACHE-Ⅱ评分)16 ～ 23分,氧合指数125～256 mm Hg.采用随机数字表法,将患者分为3组(n=20):常规治疗组(S组)、常规治疗+电针非穴位组(SNE组)和常规治疗+电针穴位组(SE组).S组给予常规治疗,SE组在常规治疗基础上,电针刺激足三里和尺泽穴,参数:疏密波(2/50 Hz)波宽300 μs,刺激电流由0开始,以0.1 mA的梯度逐渐增大,逐渐达到患者能耐受的最大水平,然后维持刺激强度在此水平,持续刺激30 min,1次/d,连续5d.SNE组常规治疗基础上,电针刺激非穴位,电针刺激参数同SE组.于电针刺激前(T1)、电针刺激结束后3 d(T2)及5 d(T3)时取动脉血样,行血气分析,计算氧合指数,行APACHE-Ⅱ评分.T1、T3时取静脉血样和行肺泡灌洗,取支气管肺泡灌洗液(BALF),采用ELISA法测定血清及BALF中TNF-α和IL-10的浓度.记录电针刺激结束后5d内器官功能障碍综合征的发生情况和生死情况.结果 与T1时比较,T2、T3时3组氧合指数均升高,APACHE-Ⅱ评分降低,L时3组血清和BALF TNF-α浓度降低,IL-10浓度升高(P＜0.05或0.01);与T2时比较,T3时3组氧合指数均升高,APACHE-Ⅱ评分降低(P＜0.05);与S组比较,SE组T2、T3时氧合指数升高,T3时APACHE-Ⅱ评分降低,血清和BALF中TNF-α浓度降低,IL-10浓度升高(P ＜0.05或0.01),SNE组上述指标差异无统计学意义(P＞0.05).3组器官功能障碍综合征发生率和生存率差异无统计学意义(P＞0.05).结论 电针刺足三里和尺泽穴有助于减轻脓毒症患者急性肺损伤,其机制可能与调节促炎因子/抗炎因子平衡,抑制炎症反应有关.     

基于数据挖掘探讨鲁科达治疗肾性蛋白尿的用药规律

[目的] 探讨鲁科达教授治疗肾性蛋白尿的用药规律,归纳总结其组方经验,以供临床参考。[方法] 收集2018年1月至2020年12月鲁教授中医门诊的肾性蛋白尿医案,以Microsoft Excel 2019软件将处方信息转化为可分析的结构化数据,并建立相关数据库,利用频次统计分析、关联规则分析、聚类分析对高频药物、四气五味归经、高频药对、核心组方进行数据挖掘。[结果] 共纳入肾性蛋白尿病例691则,处方3 750首,共涉及中药261味,将使用频次前34味的药物作为高频药物,如黄芪、党参、白术、山药、茯苓、山茱萸、甘草、薏苡仁、地黄、川牛膝、青风藤、地龙等。利用关联规则分析得到高频药对20组,通过聚类分析演化得到4个核心组方。[结论] 鲁教授治疗肾性蛋白尿以补肾健脾、清热利湿、消瘀泄浊为主。     

路志正治疗慢性萎缩性胃炎经验

介绍路志正教授治疗慢性萎缩性胃炎的经验，即祛邪治标清利湿邪，通补兼施理气健脾，扶正固本益养胃阴。     

Linear tomography and the injured wrist

Linear tomography was used in the investigation of recent wrist injuries. By providing greater bony detail than conventional radiographs it proved a useful aid in the study of the suspected wrist fracture, and in the differentiation of the old from the recent fracture of the scaphoid. Such additional information may affect the clinical management of the injury, for instance when an injury is shown to be longstanding.     

电针不同经穴对心肌缺血大鼠下丘脑内单胺类递质NE含量的影响

目的探讨电针不同经穴治疗心肌缺血的作用机制。方法从80只健康SD大鼠中随机选取10只作为正常对照组,其余大鼠结扎冠状动脉旋前降支复制心肌缺血模型。选取模型复制成功的大鼠随机分为模型组、"神门"组、"内关"组和"太渊"组,每组10只。除模型组外,各治疗组分别电针大鼠左侧"神门"穴、"内关"穴和"太渊"穴,每次刺激10 min,每日1次,连续3 d。采用酶联免疫吸附试验(ELISA)测定下丘脑室旁核区去甲肾上腺素(NE)的含量。结果与正常对照组比较,模型组NE含量显著降低(P0.01);与模型组比较,各电针组NE含量显著升高(P0.01或P0.05);各电针组之间比较,"神门"组NE含量显著高于"内关"组和"太渊"组(P0.05或P0.01),"内关"组NE含量显著高于"太渊"组(P0.05)。结论电针"神门""内关""太渊"穴治疗心肌缺血的机制与其促进下丘脑室旁核区单胺类递质NE的释放有关。     

电针对心肌缺血大鼠下丘脑内单胺类递质含量的影响

目的：探讨电针治疗心肌缺血的作用机制。方法：从80只健康SD大鼠中随机选择10只作为正常对照组,其余大鼠结扎冠状动脉旋前降支复制心肌缺血动物模型。选取模型复制成功的大鼠随机分为模型组、“神门”穴组、“内关”穴组和“太渊”穴组,每组10只。分别电针大鼠左侧“神门”穴、“内关”穴和“太渊”穴,每次刺激10min,每目1次,连续3d。采用酶联免疫吸附试验测定下丘脑室旁核区去甲肾上腺素（norepinephrine,NE）、多巴胺（dopamine,DA）、5-羟色胺（5-hydroxytryptamine,5-HT）含量。结果：模型组大鼠下丘脑室旁核区NE、DA和5-HT含量均显著下降（P〈0．01）。与模型组比较,“内关”组和“神门”组NE、DA、5-HT含量均显著升高（P〈0．01）;“太渊”组仅NE含量显著升高（P〈0．05）。结论：电针“神门”、“内关”穴治疗心肌缺血的机制与其促进下丘脑室旁核区单胺类递质的释放有关。     

Current applications of molecular imaging and luminescence-based techniques in traditional Chinese medicine

Ethnopharmacological relevance

Traditional Chinese medicine (TCM), which is fundamentally different from Western medicine, has been widely investigated using various approaches. Cellular- or molecular-based imaging has been used to investigate and illuminate the various challenges identified and progress made using therapeutic methods in TCM. Insight into the processes of TCM at the cellular and molecular changes and the ability to image these processes will enhance our understanding of various diseases of TCM and will provide new tools to diagnose and treat patients.

Materials and methods

Various TCM therapies including herbs and formulations, acupuncture and moxibustion, massage, Gua Sha, and diet therapy have been analyzed using positron emission tomography, single photon emission computed tomography, functional magnetic resonance imaging and ultrasound and optical imaging. These imaging tools have kept pace with developments in molecular biology, nuclear medicine, and computer technology.

Results

We provide an overview of recent developments in demystifying ancient knowledge - like the power of energy flow and blood flow meridians, and serial naturopathies - which are essential to visually and vividly recognize the body using modern technology.

Conclusions

In TCM, treatment can be individualized in a holistic or systematic view that is consistent with molecular imaging technologies. Future studies might include using molecular imaging in conjunction with TCM to easily diagnose or monitor patients naturally and noninvasively.     

太渊穴自发红外辐射光谱研究

为研究穴位自发红外辐射特性，采用自制高灵敏度PHE201体裹红外光谱仪检测47名健康成年人和50名冠心病患者太渊穴1．5-16μm波段自发红外辐射光谱。结果：冠心病患者与正常人太渊穴自发红外辐射光谱形态基本相似，其峰值相位不存在统计学差异；在某些波段，冠心病患者的红外辐射强度与正常人的相比有显着差异。结论：冠心病患者心脏病理信息在太渊穴红外辐射特性上的反映主要是某些特定波段红外辐射强度的变化。     

陆鸿滨教授治疗肾炎重清利而慎温补的经验介绍

陆鸿滨教授认为，急性肾小球肾炎以湿热为主，慢性肾炎也与湿热密切相关，若滥用温补之品可致病情加重甚至恶化，对此特别提出“治肾炎重清利慎温补”的独到见解，强调芳化清利是肾炎的主要治法，常用经验方芳化清利汤治之，获得较好的疗效。