孙丽平教授运用对药辨治小儿咳嗽临证荟萃

阐述了孙丽平教授治疗小儿咳嗽临床常用的8组对药,即前胡与白前、紫菀与款冬花、苦杏仁与桃仁、橘红与桔梗、瓜蒌与冬瓜子、地龙与僵蚕、川贝母与浙贝母、沙参与麦冬的配伍特点及临床应用心得,并列举其临证经典医案,结合中药学理论和现代药理学研究,总结分析孙教授运用对药治疗小儿咳嗽的学术经验及用药思路。孙教授认为小儿体属稚阳,其咳多起肺虚实之热,主以清热护肺,次以运脾滋阴,主次同疗,则阴阳平矣,强调小儿咳嗽用药,应以辨别个体体质差异为基础,提倡对药组方"肺脾同治、气血通调、阴阳平补"的用药理念。附案例1则,以资验证。     

孙远征教授运用循经远取动法治疗痛症举隅

痛症是临床上较为常见的症状之一,往往影响患者的工作与生活,近年来得到了人们的广泛重视。孙远征教授在明辨痛症病因、针灸镇痛机理的基础上,根据传统经络循行及疼痛部位的特点,结合"标本根结"理论,遵循"经脉所过,主治所及"和"上病下治,下病上治"的选穴原则,同时配合运动疗法,提出了循经远取动法治疗痛症。尤其在治疗软组织痛症方面,疗效显著,值得临床上加以总结应用。     

基于寒区发病特点的龙江医家血液病中医辨治思维与实践＊

中医临床思维在诊疗中扮演着重要角色，为立法之纲纪，治病之根本。今之血液系统疾病变化趋于复杂，临床辨治思维是中医血液病诊治的关键所在。本文基于寒区发病特点、龙江地域气候与人民生活特征，总结以前辈高仲山、华廷芳先生，国家级名中医孙伟正教授为代表的龙江名医血液病诊疗特色经验，通过“因实、因虚致病”病机，以“三因制宜”为基础，系统阐述了“实者以决、结者以散、虚者宜补、劳者宜温”的血液病中医辨治思维及其实践，为寒区血液疾病的中医诊治提供了治法方向。     

孙建芝治疗心系疾病的临床用药规律探讨

目的:探讨和总结孙建芝教授治疗心系疾病的临床用药规律。方法:以“孙建芝”等为检索词,系统检索中国期刊全文数据库(CNKI,1992年1月~2017年12月)、中文科技期刊全文数据库(VIP,1989年1月~2017年12月)、万方数据库(1990年1月~2017年12月)、中国生物医学文献数据库(CBM,1978年1月~2017年12月),搜集其治疗心系疾病医案文章,并采用SPSS19.0统计分析软件对其临床常用中药进行聚类分析。结果:筛选的138个处方中最常用药物依次为丹参、川芎、甘草、桂枝、红花、茯苓、赤芍、红参。结论:孙建芝教授临证治疗心系疾病重视血瘀理论,善用活血化瘀法且不拘一法,体现了治疗心系疾病的“瘀血学说”理论和擅长运用活血化瘀法于心系疾病领域的学术思想,聚类分析结果客观反映其临床用药规律。     

明代温补学派痈疽诊疗思路探微

[目的]探讨明代温补学派痈疽诊疗思路与特色。[方法]从中医文献整理、研究的角度,对明代温补学派代表医家汪机、薛己、孙一奎的著作《外科理例》《外科枢要》《赤水玄珠》中以温补治疗痈疽的论述、医案、具体药方、针刺手法进行系统分析,归纳和总结其痈疽论治思路和特色。[结果]三位医家以温补论治,可使痈疽消之,不至寒凉太过耗损人体正气;扶正固本以助恢复,不致病情反复。汪机在内外兼治的基础上,强调经络辨证结合刺灸外治;薛己善辨痈疽脉象,以清补兼施为用药特色;孙一奎把握病程发展及病情转归,注重温补脾肾,用香药行气血以治痈疽。[结论]明代温补学派从温补角度论治痈疽,不对痈疽单纯以“火毒”论治,不使寒凉之剂攻伐太过,以补益脾胃、扶正固本为祛邪外出之法。而今日医家多治以寒凉,故进一步挖掘温补学派治法,于临床启发良多。     

Better Adherence to the Mediterranean Diet Could Mitigate the Adverse Consequences of Obesity on Cardiovascular Disease: The SUN Prospective Cohort

Strong observational evidence supports the association between obesity and cardiovascular events. In elderly high-risk subjects, the Mediterranean diet (MedDiet) was reported to counteract the adverse cardiovascular effects of adiposity. Whether this same attenuation is also present in younger subjects is not known. We prospectively examined the association between obesity and cardiovascular clinical events (myocardial infarction, stroke or cardiovascular death) after 10.9 years follow-up in 19,065 middle-aged men and women (average age 38 year) according to their adherence to the MedDiet (<6 points or ≥6 points in the Trichopoulou’s Mediterranean Diet Score). We observed 152 incident cases of cardiovascular disease (CVD). An increased risk of CVD across categories of body mass index (BMI) was apparent if adherence to the MedDiet was low, with multivariable-adjusted hazard ratios (HRs): 1.44 (95% confidence interval: 0.93–2.25) for ≥25 – <30 kg/m² of BMI and 2.00 (1.04–3.83) for ≥30 kg/m² of BMI, compared to a BMI < 25 kg/m². In contrast, these estimates were 0.77 (0.35–1.67) and 1.15 (0.39–3.43) with good adherence to MedDiet. Better adherence to the MedDiet was associated with reduced CVD events (p for trend = 0.029). Our results suggest that the MedDiet could mitigate the harmful cardiovascular effect of overweight/obesity.     

孙伟护肾养阴法治疗慢性肾脏病

肾虚是慢性肾脏病发生发展的基础,由于先天不足、过食温燥、劳逸失度、情志内伤、久病迁延等因素,肾阴虚,乃至气阴两虚等证在临证中频频涉及。孙伟教授提出了护肾养阴法,在治疗上强调补益肾阴,兼顾五脏,弥补亏损之元阴。常用药有制黄精、山萸肉、旱莲草、女贞子、石斛、玉竹、黄芪、太子参等,慎用辛热之品以防劫阴太过,损耗肾阴。善用杜仲、川续断、菟丝子等平补肾阳之品,以期阳中求阴,并适当佐以活血化瘀药物,如当归、丹参、益母草、牛膝等,不致滋阴太过加重湿浊内蕴,使得补而不滞,养阴而不助邪。整体上更注重以养为护、养护并重,从而达到阴阳调和、延缓疾病进展的目的。     

A Mediterranean lifestyle reduces the risk of cardiovascular disease in the “Seguimiento Universidad de Navarra” (SUN) cohort

Background and aimsA healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD.Methods and resultsThe “Seguimiento Universidad de Navarra” (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterranean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardiovascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) = 0.50; (95% confidence interval, 0.31–0.81) for the highest MEDLIFE scores (14–23 points) compared to the lowest scores (0–9 points), p (trend) = 0.004.ConclusionA higher level of adherence to the Mediterranean lifestyle was significantly associated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health.