从脾胃论治抑郁症

本文从脾胃生理与抑郁症、脾胃气机升降与肝肺气机运行、脾胃与精神情志的关系等方面分析脾胃与抑郁症发生的关系,阐明脾胃对抑郁症的发病上具有非常重要的作用。同时,结合《金匮要略》,列举了健脾清胆法、健脾行气法、通阳宣痹、疏肝解郁法、健脾利湿,养血调肝法、清热祛湿健脾法等调理脾胃功能出发治疗抑郁症的方药,为临床中从脾胃论治抑郁症提供了较好的思路与方法。     

中医药防治胃癌思路与方法探讨

结合文献及临床研究,分析胃癌的中医病名、病因病机,认为胃癌的主要病机是胃腑气阴两伤,邪毒稽留,血络瘀滞;治疗方面要紧扣本虚标实病性,谨遵扶正祛邪纲领分期施治;同时要结合胃腑通降之性,运用润降益胃解毒通络之法。     

奈维在胸腔镜肺大泡切除术后防止漏气的临床疗效

Objective To explore the clinical efficacy of NEOVEIL in postoperative pulmonary air leakage of pulmonary bullae resection by video-assisted thoracic surgery. Methods We retrospectively analyzed clinical data of 37 cases received NEOVEIL combined with ATB45 in video-assisted thoracic surgery (the NEOVEIL group), and clinical data of 40 cases by ATB45 alone(the control group) . We compared postoperative hospitalization time, keeping time of pleural cavity tubes, the pulmonary leakage time and the incidence of pulmonary infection in the two groups. Results There was no postoperative mechanical ventilation,hemothorax and death. In the NEOVEIL group, the postoperative hospitalization time was 5 to 9 days, the postoperative keeping time of pleural cavity tubes 2 to 4 days, the postoperative pulmonary leakage time 0 to 2 days with 4 patients un-leakage, and 1 patients with pulmonary infection; whereas the postoperative hospitalization time was 6 to 10 days,the postoperative keeping time of pleural cavity tubes 3 to 6 days,the postoperative pulmonary leakage time 2 to 5 days and 8 patients with pulmonary infection in the control group. There was statistical significance in the postoperative hospitalization time, keeping time of pleural cavity tubes, the pulmonary leakage time and the incidence of pulmonary inflammation in two groups(P ＜ 0. 05). The incidence of pulmonary inflammation of the NEOVEIL group (2. 7%) was significantly lower than that of the control group(20. 0%)(x2 = 4. 02, P ＜ 0. 05). Conclusion The operative effectiveness of the NEOVEIL group is better than that of the control group. The NEOVEIL can prevent the postoperative pulmonary leakage.     

复方蜥蜴散不同微粒组合剂对PLGC模型大鼠的影响研究

目的观察复方蜥蜴散不同微粒组合剂对胃癌前病变(PLGC)模型大鼠血管内皮生长因子(VEGF)和缺氧诱导因子(HIF-1α)表达的影响,探讨该方干预PLGC的机制。方法 SPF级、4-6w龄雄性SD大鼠120只,随机分为维酶素对照组A、PLGC模型对照组B、复方蜥蜴散不同微粒组合剂高剂量组C、中剂量组D、低剂量组E、空白对照组F,20只/组。除F组外,其余各组均以MNNG,综合饥饱失常、乙醇等灌服24w后病检以证实PLGC大鼠模型制备成功。各治疗组用药12w后观察大鼠胃黏膜病理改变情况;免疫组化测胃体HIF-1α和VEGF水平。结果 VEGF和HIF-1α水平在各模型组与F组比较,P0.05,AOD值降低;各治疗组与B组比较,P0.05,AOD值降低明显;C、D、E组与B组比较,P0.05,以C组AOD值最小。结论复方蜥蜴散可改善PLGC模型大鼠胃黏膜病理,阻断大鼠癌变趋势,其机制可能与该方影响HIF-1α和VEGF表达有关。     

复方蜥蜴散对慢性萎缩性胃炎模型大鼠肿瘤坏死因子-α及胃黏膜病理组织学的影响

目的 观察复方蜥蜴散对慢性萎缩性胃炎(Chronic Atrophic Gastritis,CAG)模型大鼠肿瘤坏死因子-α(TNF-α)及胃黏膜病理形态学的影响,探讨其治疗CAG的作用机制.方法 将90只SD雄性大鼠随机分为正常组,模型组,复方蜥蜴散大、中、小剂量组及维酶素组,除正常组以外,均采取55℃热盐水、2%水杨酸、20 mmol/L脱氧胆酸钠3个致萎缩因素配合饥饱失常造成CAG模型大鼠,分别运用复方蜥蜴散大、中、小剂量及维酶素治疗,观察各组大鼠血清TNF-α的含量及胃黏膜的病理学形态.结果 蜥蜴散大、中、小剂量组血清中TNF-α含量显著低于模型组(P<0.01),蜥蜴散大、中剂量组血清中TNF-α含量显著低于维酶素组(P<0.05).各组胃黏膜组织形态学观察,复方蜥蜴散组较模型组及维酶素组有明显改善.结论 复方蜥蜴散可以使CAG模型大鼠血清中TNF-α含量降低,能够明显改善CAG模型大鼠胃黏膜的炎症、萎缩性病变,对CAG模型大鼠有明显的治疗作用.     

奈维在胸腔镜肺大泡切除术后防止漏气的临床疗效

目的 探讨奈维(可吸收聚乙醇酸材料,NEOVEIL)在胸腔镜肺大泡切除术后防止漏气的临床疗效.方法 回顾分析37例使用强生ATB45(直线型切割缝合器)加奈维补片胸腔镜下肺大泡切除术患者(奈维组)和40例单纯使用强生ATB45胸腔镜下肺大泡切除术患者(对照组)的临床资料,比较2组术后的住院时间、术后留置胸引管时间、术后漏气时间及肺部感染发生率.结果 2组患者术后均未行机械通气,无血胸,无手术死亡,奈维组中术后住院时间为5～9 d,术后拔除胸引管时间为2～4 d,术后漏气0～2 d,有4例患者术后无漏气,有1例患者出现肺部感染;而对照组(未使用奈维组)中术后住院时间为6～10 d,术后拔除胸引管时间为3～6 d,术后漏气2～5 d,有8例患者出现肺部感染.2组患者术后住院时间、术后留置胸引管时间、术后漏气时间经秩和检验差异均有统计学意义(P均＜0.05).2组患者肺部感染发生率(奈维组为2.7%,对照组为20.0%)比较差异有统计学意义(x2=4.02,P＜0.05).结论 奈维补片能够有效地防止术后肺组织切缘的漏气.

Abstract：

Objective To explore the clinical efficacy of NEOVEIL in postoperative pulmonary air leakage of pulmonary bullae resection by video-assisted thoracic surgery. Methods We retrospectively analyzed clinical data of 37 cases received NEOVEIL combined with ATB45 in video-assisted thoracic surgery (the NEOVEIL group), and clinical data of 40 cases by ATB45 alone(the control group) . We compared postoperative hospitalization time, keeping time of pleural cavity tubes, the pulmonary leakage time and the incidence of pulmonary infection in the two groups. Results There was no postoperative mechanical ventilation,hemothorax and death. In the NEOVEIL group, the postoperative hospitalization time was 5 to 9 days, the postoperative keeping time of pleural cavity tubes 2 to 4 days, the postoperative pulmonary leakage time 0 to 2 days with 4 patients un-leakage, and 1 patients with pulmonary infection; whereas the postoperative hospitalization time was 6 to 10 days,the postoperative keeping time of pleural cavity tubes 3 to 6 days,the postoperative pulmonary leakage time 2 to 5 days and 8 patients with pulmonary infection in the control group. There was statistical significance in the postoperative hospitalization time, keeping time of pleural cavity tubes, the pulmonary leakage time and the incidence of pulmonary inflammation in two groups(P ＜ 0. 05). The incidence of pulmonary inflammation of the NEOVEIL group (2. 7%) was significantly lower than that of the control group(20. 0%)(x2 = 4. 02, P ＜ 0. 05). Conclusion The operative effectiveness of the NEOVEIL group is better than that of the control group. The NEOVEIL can prevent the postoperative pulmonary leakage.     

胸腔镜手术在37例胸外伤患者中的应用分析

目的 探讨电视胸腔镜(video-assisted thoracic surgery,VATS)在胸外伤救治中的价值。方法 2008年1月—2015年11月37例胸外伤患者在我科行VATS,包括胸腔内止血、肺修补术、凝固性血胸清除术、脓胸清除术、异物取出术等。结果 33例患者顺利完成VATS,术中发现1例心包积血、2例右肝叶破裂均中转剖胸,1例左膈损伤、胃肠损伤而中转剖腹。平均手术时间81 min,平均出血量88 ml,平均术后胸腔引流量506 ml。术后均痊愈出院,随访1~12个月,无明显并发症。结论 VATS具有微创、并发症少等优势,是胸外伤的有效诊治手段。     

中医辨证论治行走于黑白虚实之间

本文通过对太极图的研究,认为太极图的本义即黑白虚实,经查阅大量文献后发现,虚实辨证广泛存在于古今文献和临床实践中,因此结合导致疾病发生的基本原理,分析探讨了虚实二纲可以统领阴阳、表里、寒热,并试探性地提出以虚实辨证作为辨证论治的总纲,进一步指出虚实辨证在临证治疗中针对性强,可起到执简驭繁的作用。这不仅是对辨证论治在理论上的补充,同时也丰富了临床辨治思维,可以更好地指导中医辨证和论治。     

朱西杰教授应用蜥蜴散治疗胃癌合并上消化道出血验案

<正>胃癌是常见的消化道恶性肿瘤,发病率呈逐年上升趋势。胃癌合并消化道出血往往发病急,病情重,如得不到及时的控制,可危及生命。朱西杰教授为宁夏医科大学中医学院教授、主任中医师,硕士研究生导师,从事临床及教学工作30余年,学验具