乳腺癌癌前病变中医发病机制及防治思路

在中医基础理论指导下,对乳腺癌癌前病变的中医发病机制予以分析,认为乳腺癌癌前病变以肝郁气滞,冲任失调,日久成瘀为本,临床治疗本病时要结合内外科治法,辨证施治,同时探讨乳腺癌癌前病变的防治方法与思路。     

略论自汗从湿阻论治

历代医家治疗自汗多从气虚、阳虚论治,而临床所见湿阻所致自汗亦不少见,湿阻而致的自汗病位多在中焦脾胃,湿阻自汗的基本病机是湿邪阻滞中焦,脾胃受邪,升降失常,运化障碍。通过对湿阻引起自汗机理的分析,湿阻自汗可用祛湿运脾止汗之法辨证用药治疗。     

从情志方面探讨乳腺增生病因病机

情志异常是乳腺增生病的重要病因之一,肝失疏泄在乳腺增生疾病发生发展过程中起着重要作用,从情志异常及肝失疏泄角度探讨情志与乳腺增生之间的内在联系;现代临床研究显示人情绪异常可引起内分泌紊乱、激素水平上变化,导致乳腺增生疾病.     

中医外治疗法与内治疗法治疗乳腺增生症疗效差异的meta分析

目的对外治疗法与内治疗法的疗效是否有差异性进行meta分析,明确中医外治疗法能否提高乳腺增生症患者疗效。方法网络检索相关数据库,采用RevMan Manager 5.1软件进行meta分析,计算合并RR值及95%的可信区间。结果检索相关数据库,1979年至2012年共有11篇文献纳入研究方案,可根据其有效率判定疗效,其中有8篇文献可根据治愈率判定疗效,11篇所纳入的研究文献异质性无统计学意义,采用固定效应模式进行meta分析,合并RR值1.08,95%的可信区间为(1.03,1.13),差异有统计学意义,其中8篇根据治愈率进行判定,异质性亦无统计学意义,亦可采用固定效应模式进行meta分析,合并RR值1.53,95%的可信区间为(1.30,1.79)。结论现有临床证据表明,与内治疗法相比,外治疗法不仅可以提高乳腺增生症患者的有效率,亦可提高乳腺增生症患者的治愈率,但由于纳入文献质量及数量原因,有待展开更高质量的系统评价。     

对无症状疾病的辨证论治浅解

从中医辨治思路定义无症状疾病、对无症状疾病进行辨证论治。可发挥中医望、闻、问、切优势,从体质学说、疾病病情发展过程、病因的形成,从微观辨证、参照中药药理理论及时截断逆转、调整阴阳,从而达到对无症状疾病的治疗目的。     

《伤寒论》中“阴”、“阳”含义探讨

张仲景在《伤寒论》中多次论及阴阳,阴阳在《伤寒论》不同的条文中有不同的具体含义。有时在一则条文内的前后语句间,涉及到的阴阳含义就有数种。本文结合经方大师胡希恕先生毕生研究《伤寒论》的成果,就《伤寒论》中"阴、阳"二字的具体含义作了初步分析、整理、归纳,以冀对读者有所启发并为临床、教学提供参考。     

肝郁型乳腺增生病发生与雌激素灭活的关系

乳腺增生病(HMG)是乳腺上皮的非肿瘤性、炎症性病变,属于中医"乳癖"的范畴,其发病率占育龄妇女的40％,占全部乳房疾病的75％[1].其病理形态复杂,表现为乳腺实质的良性增生,以乳腺小叶、小导管及末梢导管的高度扩张形成的囊肿为主要特征,同时伴有一些其他结构不良病变的疾病.中医上将HMG分为三型——肝郁气滞,痰瘀互结,冲任失调.现代研究认为,本病基本按照气滞→痰凝→血瘀的规律演进[2].因此对肝郁型乳腺病的研究及预防意义重大.     

中西医结合的探讨与思考

通过对中医与西医的思维方法分析,探讨中西医结合的思路与方法,在为中西医结合医学模式遇到瓶颈的时候得以参考,并为提高临床基本的治疗提供新模式。因此,思考中西医如何结合,是人类健康的需要,是社会的需要,也是学科的需要。     

妊娠恶阻案

Patient,female,26,public functionary,married,pregnant once but no birth.Date of first visit:May 4,2010.Main complaint:cessation of menstruation for 60 days accompanied with nausea and vomiting for half a month.Medical history:the patient was usually irritable and shorttempered,which was more obvious after pregnancy.Due to family argument about half a month ago,the patient had nausea,vomiting and poor appetite.She received some treatment at local hospital,but the symptoms were not obviously improved,then she was hospitalized at department of gynaecology in our hospital,and TCM herb drugs was prescribed.However,the herb drugs were spired out right after medicine intake,still no improvement was made.Present symptom:vomiting more than 10 times every day,which was acidwater,sometimes with blood;vomiting right after food intake;emaciation and weakness;dry mouth and lip;little urine,no defecation in 3 days;fever at 37.7 ℃,the tongue was red and its coating was little,the pulse was fast but weak.TCM diagnosis:pernicious vomiting.Western medicine diagnosis:hyperemesis gravidarum.Principle of treatment:to clear the liver and harmonize the stomach,to tonify qi and nourish yin.Selection of acupoints:main points included wèi (胃 CO4),nèifēnmì (内分泌 CO18),pízhìxià (皮质下 AT4),accompanying points were pí (脾 CO13),gān (肝 CO12),shénmén (神 门 TF4),dàcháng (大肠 CO7).Manipulation:after routine sterilization with 75％ ethanol cottonball on either side of ear,sensitive points were searched at selected acupoints by cotton swab with even and gentle strength.The seed of semen vaccariae was scalded in the boiling water and dried,then placed in the center of a piece of adhesive plaster,6 mm × 6 mm in size.