中医学基础主干课程网络测评系统的构建

基于计算机网络技术,利用遗传算法制定编码方法和初始种群、设计适应度函数和停机条件实现组卷,构建具有中医药学科特色的中医学基础主干课程网络测评系统,并对测评结果进行分析.该系统较好地解决了中医药学科关键的需求——跨知识点组卷,将中医学基础主干课程知识点融合一起测评,生成的试卷科学、合理,符合中医药学科特色.     

脾虚证相关检测指标的研究进展与思考

本文通过综述脾虚证机体内D-木糖、蛋白质、脂肪、乳酸、微量元素、酶的特异性变化,表明了脾虚证与上述物质代谢有着非常密切的关系,同时也对脾虚证的诊断及治疗效果的判定具有重要的临床意义.     

脾虚证与物质代谢改变相关性的研究概况

脾虚,泛指因脾气虚损引起的一系列脾生理功能失常的病理现象及病证,包括脾气虚、脾阳虚、中气下陷、脾不统血等证型,多因饮食失调、劳逸失度,或久病体虚所引起。中医学认为“脾为后天之本,气血生化之源”,对于水谷精微的消化、吸收起着重要作用。脾虚则运化失常,并可出现营养障碍,水液失于布散而生湿酿痰,本文对脾虚证引起的机体物质代谢变化综述如下。     

针灸治疗慢性胃炎用穴规律探析

总结和分析针灸治疗慢性胃炎中的十四经腧穴用穴规律。主要搜集近五年针灸治疗慢性胃炎文献,筛选合格研究,对文献中使用的十四经腧穴进行提取应用。纳入合格文献38篇,腧穴55个,54个腧穴分布于十四经,其中足阳明胃经13个,任脉腧穴11个,膀胱经腧穴8个,脾经7个。纳入穴中特定穴37个,涉及特定穴10种。结果发现,针灸治疗慢性胃炎中使用的腧穴、归经主要以任脉、足阳明经为主,腧穴类型主要以特定穴为主。     

王小娟教授运用温补法治疗脾虚证的临床验案

脾胃为"后天之本",脾虚证是消化内科的常见病证。王小娟教授从事中医临床30余年,擅长诊治内科杂病,尤其在脾胃病的治疗方面颇有特色,她通过多年的临床探索,不断分析总结,在运用温补法治疗脾虚证方面取得了很好的疗效。通过典型病案举例,探讨了王小娟教授对脾虚证的临床经验,体现了中医药对于脾胃病的治疗特色,强调了辨证辨病相结合的治疗原则,在古方基础上灵活化裁也是取得良好疗效的关键所在。     

不同隔姜灸治时间对慢性浅表性胃炎脾胃虚寒证患者血清中SOD和MDA的影响

目的:探讨隔姜灸不同灸治时间对慢性浅表性胃炎脾胃虚寒证患者血清中超氧化物歧化酶(superoxide dismutase,SOD)与丙二醛(malondialdehyde,MDA)的影响。方法:将45例浅表性胃炎脾胃虚寒证患者随机分为隔姜灸20 min组(A组)15例、隔姜灸40 min组(B组)15例、雷尼替丁组(C组)15例。治疗组每天隔姜灸1次,10 d为1个疗程,疗程间休息1 d,共治疗2个疗程;对照组服用雷尼替丁每次0.15 g,1 d 2次,连续服药10 d为1个疗程,疗程间休息1 d,共服药2个疗程。于实验治疗前、治疗后分别抽血取血清检测SOD,MDA的含量,以此观察隔姜灸的疗效及对SOD和MDA的影响。结果:①3组的SOD含量:在各组治疗后与其治疗前比较均有显著性差异。B组治疗前后SOD含量的增加,与A,C两组比较均有显著性差异(P<0.05)。②3组的MDA含量:在各组治疗后与其治疗前比较均有显著性差异。但组间比较,各组治疗前后MDA含量没有显著性差异。结论:隔姜灸与雷尼替丁均能使血清中抗氧化酶SOD活性升高而自由基MDA水平降低,且隔姜灸40min提高SOD水平效果显著,明显高于隔姜灸20 min和雷尼替丁对SOD的作用。证明隔姜灸对浅表性胃炎脾胃虚寒证患者氧自由基产生与清除的酶系统具有良性调节作用,隔姜灸治疗浅表性胃炎脾胃虚寒证取效可能与此机制有关。     

Effect of herbal cake-partitioned moxibustion on MEK1/2 and ERK1/2 expressions of gastric tissues in rats with spleen deficiency syndrome

Objective

To observe the effect of herbal cake-partitioned moxibustion on the expressions of mitogen-activated protein kinase (MEK1/2) and extracellular regulatory protein kinase (ERK1/2) in gastric tissues of rats with spleen deficiency syndrome, and to explore the possible mechanisms of herbal cake-partitioned moxibustion in treating spleen deficiency syndrome.

Methods

Sixty Sprague-Dawley (SD) rats were randomly divided into a blank control group (group A), a model group (group B), a ranitidine group (group C), and a herbal cake-partitioned moxibustion group (group D) by random digit, 15 rats in each group. Rat models of spleen deficiency syndrome were made by intragastric administration of 4 °C 200% concentrated Da Huang (Radix et Rhizoma Rhei). After successful modeling, the rats in group C were treated with 25 mg/(kg·bw) ranitidine by intragastric adminstration and rats in group D were treated with herbal cake-partitioned moxibustion at Zusanli (ST 36) and Zhongwan (CV 12), for 8 d. Excepted for rats in group A, all the other rats were treated with indomethacin at 5 mg/(kg·bw) at 8:00 a.m. on the second day after finishing all the intervention and sacrificed 7 h later to isolate the stomach. Histopathological changes of the gastric tissues were observed under light microscope after hematoxylin-eosin (HE) staining. The protein expressions of MEK1/2 and ERK1/2 in the gastric tissues were detected by immunohistochemistry.

Results

After intervention, the gastric mucosal injury in group B was significantly severer than that in group A, with large breakage and ablating; the damage of gastric mucosa was decreased in group C compared with group B; the gastric mucosal surface remained relatively complete, and the status of breakage and ablating was significantly improved. After intervention, compared with group A, the protein expressions of MEK1/2 and ERK1/2 in gastric tissues of the other groups were significantly higher (P<0.01). Compared with group B, the protein expressions of MEK1/2 and ERK1/2 in group C and D were significantly higher (all P<0.01). Compared with group C, the protein expressions of MEK1/2 and ERK1/2 in group D were significantly higher (P<0.01).

Conclusion

Herbal cake-partitioned moxibustion promotes the repair of gastric mucosa in rats with spleen deficiency syndrome, via improving protein expressions of MEK1/2 and ERK1/2 in gastric tissues, as well as activating MEK/ERK signaling pathway.

     

背俞穴隔药饼灸干预肺癌癌因性疲劳患者的临床研究

目的探索背俞穴隔药饼灸对肺癌癌因性疲劳患者疲劳症状及生活质量的影响。方法 2015年1月至2016年12月共纳入符合标准的肺癌癌因性疲劳患者63例,分为对照组、治疗组。对照组29例,根据症状予以相应的对症支持治疗,同时接受肺癌健康教育,其中男18例,女11例,平均年龄(63.4±7.6)岁(51~70岁),病例分期:ⅢA期8例、ⅢB期12例、Ⅳ期9例;治疗组34例,在对照组基础上采用背俞穴隔药饼灸,其中男20例,女14例,平均年龄(62.7±7.0)岁(50~70岁),病例分期:ⅢA期8例、ⅢB期15例、Ⅳ期11例。观察患者治疗前及治疗后疲劳症状及生活质量。结果治疗后,治疗组Piper量表中感觉、情绪、认知、行为及总分均较治疗前有明显降低,且明显低于对照组的各项评分,差异具有统计学意义(P0.05);治疗组FACT-G中生理状态、社会/家庭状况、情感状况、功能状况及总分均较治疗前有升高,且明显高于对照组的各项评分,差异具有统计学意义(P0.05);对照组和治疗组血清IL-6、TNF-α含量均较治疗前有下降,但治疗组血清IL-6、TNF-α含量均明显低于对照组,差异具有统计学意义(P0.05)。结论背俞穴隔药饼灸可以减轻癌因性患者的炎症反应,起到缓解疲劳症状,提高生活质量的效果。     

不同灸量隔姜灸对脾虚证大鼠三叶因子1、粘蛋白5AC及表皮生长因子受体的影响（英文）

目的:观察不同灸量隔姜灸对脾虚证大鼠血清三叶因子1(TFF1)和粘蛋白5AC(MUC5AC)含量,以及胃黏膜表皮生长因子受体(EGFR)蛋白表达的影响,探讨隔姜灸治疗脾虚证的可能作用机制及量效特征。方法:将75只SPF级Sprague-Dawley(SD)大鼠按随机数字表法分为空白对照组(A组)、模型组(B组)、隔姜灸3壮组(C1组)、隔姜灸6壮组(C2组)和隔姜灸9壮组(C3组),每组15只。除A组外,其余各组大鼠采用200%的大黄浓缩液4℃灌胃制作脾虚证大鼠模型。造模成功后,B组大鼠不予治疗;C1、C2和C3组大鼠分别接受3壮、6壮和9壮隔姜灸足三里和中脘治疗,连续治疗8 d。观察大鼠一般症状评分,采用酶联免疫吸附法(ELISA)检测血清中TFF1和MUC5AC含量;免疫组化法检测胃黏膜EGFR蛋白表达。结果:干预结束后,与A组比较,B组大鼠脾虚症状积分增高,C1、C2和C3组大鼠血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达明显升高(均P0.01);与B组比较,C1、C2和C3组大鼠脾虚症状积分降低,血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达升高(均P0.01);与C1组比较,C2和C3组大鼠脾虚症状积分降低,血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达升高(均P0.01),但C2组与C3组差异无统计学意义(均P0.05)。结论:隔姜灸能改善大鼠脾虚症状,促进脾虚证大鼠胃黏膜的增殖修复,其作用机制可能与提高血清TFF1和MUC5AC含量,激活EGFR蛋白的表达相关,且灸9壮和6壮的疗效优于灸3壮,但灸9壮和灸6壮的效果相当。     

灸法量效关系的研究进展与思考

灸法疗效不仅与施灸所用的材料和穴位的特异性有关,而且与灸量密切相关。近年来,很多学者在灸量与疗效的关系上进行了广泛研究。分别从影响灸量的各个因素概述了灸量和疗效关系的研究进展。希望对以后能更好的研究最佳灸量并指导临床提供帮助。