四物汤与十全大补汤的抗突变作用研究

用姐妹染色单体互换技术检测中药方剂四物汤、十全大补汤，发现其能明显降低环磷酰胺所致的ＳＣＥ值升高，表明有抗突变作用。     

参乌冠心颗粒治疗冠心病心绞痛肾虚血瘀证60例临床观察

[目的]观察补肾益气活血方参鸟冠心颗粒治疗冠心病心绞痛中医辨证属肾虚血瘀证的临床疗效.[方法]将90例冠心病心绞痛患者,依据随机双盲双模拟的原则分为治疗组60例和对照组30例,两组均给予西医常规治疗,治疗组在此基础上加服参鸟冠心颗粒,对照组在此基础上加服地奥心血康.治疗4周后进行心绞痛疗效、心电图疗效和主要症状疗效评定,并对血脂各项指标进行治疗前后比较.[结果]治疗组患者心绞痛疗效总有效率、心电图疗效总有效率分别为91.7%、85.0%,优于对照组的73.3%、66.7%(P<0.01).两组治疗后血清总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白的水平均有改善(与治疗前比较,P<0.05或P<0.01),其中治疗组在改善总胆固醇、甘油三酯、高密度脂蛋白方面明显优于对照组(P<0.05或P<0.01或P<0.001).在缓解腰膝酸软、耳鸣健忘、少寐多梦等症状方面,治疗组优于对照组(P<0.01),并能改善胸痛、胸闷等症状.[结论]参鸟冠心颗粒治疗冠心病心绞痛肾虚血瘀证疗效确切,早期运用补肾益气活血方治疗冠心病心绞痛,可抑制病情发展.     

吴鞠通对《伤寒论》的继承与发展

通过对吴鞠通<温病条辨>的学习,认为"鞠通遥承仲景,并多有创新",并举例加以说明.除阐明其"羽翼伤寒"外,着重论述其对仲景学说的发扬,如阐明白虎之用、创制承气诸方、明确黄连阿胶汤之用、巧变复脉诸方.都足以说明吴氏对<伤寒论>理论和方药运用,多有创新.     

吴考槃教授精研经典解惑学术真谛

[目的]探讨吴考槃教授研究《素问》《灵枢》《难经》等名著的学术思想。[方法]通过对吴老研究素、灵等名著而发表的相关论文与出版著作的系统收集,采用文献研究的方法进行挖掘整理研究。[结果]吴老对经典名著的研究不仅运用校勘、训诂、注解、今译的方法,并通过归类、分析、阐发等挖掘与加工,将经文中的理论精髓和蕴涵的学术思想给予揭示剖析。[结论]对中医经典的研究不仅要有基本的中医基础理论功底,更重要的具有博而精的文献底蕴。     

武维屏运用柴胡治疗慢性阻塞性肺疾病经验探析

[目的]总结武维屏教授运用柴胡治疗慢性阻塞性肺疾病的经验。[方法]通过分析武维屏教授对慢性阻塞性肺疾病病机的认识,解析肝在本病病机演变中的作用,阐释武老从肝治疗本病及运用柴胡治疗本病的经验,并附医案验证。[结果]武老认为,肺虚是慢性阻塞性肺疾病之本,痰瘀是重要病理因素,虚痰瘀贯穿疾病始终。肝肺共司气血之调畅,痰浊瘀血的产生都与肝肺密切相关。故武老临床常以调肝之法治疗本病,包括疏肝理肺、清肝泻肺、解郁化痰活血之法,临证时善用柴胡。柴胡疏肝理气、推陈致新,伍黄芩能和解少阳、疏肝利胆,配芍药能理气活血通络,合二陈能解郁化痰,恰合慢性阻塞性肺疾病痰夹瘀血碍气之病机。所举验案辨为痰浊内阻、肺气壅滞、枢机不利之证,治以疏肝理肺、化痰降气,以小青龙汤合小柴胡汤加减,临床疗效良好。[结论]武老运用柴胡调肝理肺,治疗慢性阻塞性肺疾病,其经验具有较强的临床实用价值,值得继承和推广。     

武连仲教授治疗中风后肢体远端运动障碍经验

从辨证思想、临床取穴及针刺手法上介绍武连仲教授针刺治疗中风后肢体远端运动障碍的经验。武教授运用独创的中风病"十辨法",强调辨神施治与辨证施治,辨证注重三阳经及肾经,选取手臂五针、四渎、胫前三针、足背三针、足内翻三针、照海、复溜及太溪穴;针刺治疗时有明确的手法量学标准。     

Predictors and Outcomes of Renal Replacement Therapy After Left Ventricular Assist Device Implantation

ObjectiveTo examine the frequency and outcomes of patients requiring renal replacement therapy (RRT) early after left ventricular assist device (LVAD) implantation.Patients and MethodsWe examined use of in-hospital RRT and outcomes in consecutive adults who underwent continuous-flow LVAD implantation from February 15, 2007, through August 8, 2017. Logistic regression was used to examine predictors of RRT. The associations of RRT with outcomes were examined using Cox proportional hazards regression.ResultsOf 354 patients who underwent LVAD implantation, 54 (15%) required in-hospital RRT. Patients receiving RRT had higher preoperative Charlson Comorbidity Index values (median, 5 vs 4; P=.03), Model for End-Stage Liver Disease scores (mean, 19.0 vs 14.5; P<.001), right atrial pressure (mean, 19.1 vs 13.4 mm Hg; P<.001), and estimated 24-hour urine protein levels (median, 357 vs 174 mg; P<.001) and lower preoperative estimated glomerular filtration rate (eGFR) (median, 43 vs 57 mL/min; P<.001) and measured GFR using ¹²⁵I-iothalamate clearance (median, 33 vs 51 mL/min; P=.001) than those who did not require RRT. Approximately 40% of patients with eGFR less than 45 mL/min/1.73 m² and 24-hour urine protein level greater than 400 mg required RRT vs 6% with eGFR greater than45 mL/min/1.73 m² and without significant proteinuria. Lower preoperative eGFR, higher estimated 24-hour urine protein level, higher right atrial pressure, and longer cardiopulmonary bypass time were independent predictors of RRT after LVAD implantation. Of patients requiring in-hospital RRT, 18 (33%) had renal recovery, 18 (33%) required outpatient hemodialysis, and 18 (33%) died before hospital discharge. After median (Q1, Q3) follow-up of 24.3 (8.9, 49.6) months, RRT was associated with increased risk of death (adjusted hazard ratio [HR], 2.86; 95% CI, 1.90-4.33; P<.001) and gastrointestinal bleeding (adjusted HR, 4.47; 95% CI, 2.57-7.75; P<.001).ConclusionIn-hospital RRT is associated with poor prognosis after LVAD. A detailed preoperative assessment of renal function before LVAD may be helpful in risk stratification and patient selection.     

“治未病”构筑中西医结合防控战线——吴以岭院士访谈录

2021年7月29日,中国工程院重点咨询项目“中西医结合疾病防控人才学科体系建设”课题组对吴以岭院士进行了专访,访谈的核心内容是中医治未病与建立中西医结合疾病防控体系。吴院士表示：中医治未病和中西医结合防控体系的建立,对推进健康中国建设,提高人民健康水平发挥着至关重要的作用。其关键是找到学科的交叉点,即中西医结合。     

吴银根膏方治疗哮喘70例疗效观察

研究通过对导师吴银根教授运用膏方治疗哮喘70例患者的临床随访观察研究,表明导师膏方治疗哮喘疗效显著,痊愈率及总有效率分别为22.86%、82.86%,且随着患者服用膏方时间的延长,疗效明显提高,尤其痊愈率增加明显(P<0.05)。     

《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.