丹参——治冠心病之良药

朱老伯,73岁,一年前常觉心前区隐隐不适,偶而有刺痛感,经心电图检查发现有心肌缺血,医生诊断为“冠状动脉粥样硬化性心脏病”因服用硝酸酯类药物头疼剧烈无法忍受,改用丹参片口服,适时其舌质紫暗、脉细带涩,考虑为“血瘀证”,用药2周后症状明显减轻。     

“一九”开始，“九九”而止 膏方调理为什么要讲究时节

膏方可调补人之精、气、神,增强体力,提高工作效率,改善或治愈某些疾病,达到治病强身的目的,是祖国医学的一大特色。     

加强中医临床思维能力训练的初步探索

加强中医学生临床思维能力的训练，一直是中医学教育工作者思考的一个问题。学生在初期基础知识理论学习阶段，主要是大量信息输入和知识的扩展，包括的内容有中医基础、中药学、方剂学、经典著作等，进入专业理论课阶段后，接触的是一个个具体的病名和证型，而一进入临床，面对的则是复杂的病情和不等同于书本的证候。如能在较短的实习阶段，将基础知识与临床实际有机结合，对培养学生形成一定的中医临床思维能力，乃至今后的从业能力将大有裨益。     

活脉方对下肢动脉硬化症股动脉内-中膜厚度及中医临床症状的影响

目的：观察活脉方对下肢动脉硬化患者股动脉内-中膜厚度和中医临床症状的影响。方法：将78例患者随机分为对照组39例,予降脂药辛伐他汀40 mg,治疗组39例在对照组治疗基础上加用中药活脉方,12周为1疗程。结果：两组均可有效降低血清Tch、LDL浓度,活脉中药可有效治疗下肢动脉硬化患者的中医临床症状,且对降脂无促进或阻碍作用;治疗组治疗后股动脉IMT均值较治疗前明显降低,P〈0.05,对照组治疗后股动脉IMT均值较治疗前有降低趋势,P〉0.05。结论：活脉方可能有消减动脉粥样硬化作用。     

Effect of direct moxibustion on blood pressure and clinical symptoms in elderly patients with essential hypertension

Objective

To assess the effects of direct moxibustion on 24-hour ambulatory blood pressure (ABP) and clinical symptoms of traditional Chinese medicine (TCM) in elderly patients with essential hypertension, and to explore the antihypertensive effect and influencing factors of moxibustion.

Methods

A total of 101 elderly hypertension patients who met the inclusion criteria were randomly assigned to a direct moxibustion I group (n=33), a direct moxibustion II group (n=34), and a control group (n=34). The treatment of calcium antagonist (CCB) or angiotensin II receptor antagonist (ARB) was adopted in the control group. The treatment of direct moxibustion I plus the same medicine as the control group were adopted in the direct moxibustion I group, five cones per acupoint and three times per week, for 5 weeks in total. The treatment of direct moxibustion II plus the same medicine as the control group were adopted in the direct moxibustion II group, five cones per acupoint and three times per week, for 5 weeks in total. The changes of 24-hour ABP and clinical symptoms of TCM after treatment were compared in the three groups.

Results

The mean 24-hour ambulatory systolic blood pressure (mean 24 h ASBP), night ASBP, percentage of mean 24-hour ambulatory diastolic blood pressure (mean 24 h ADBP)>90 mmHg, and percentage of day ADBP>90 mmHg in the control group were elevated after treatment (P<0.05). The percentage of night ADBP>80 mmHg in the direct moxibustion I group was reduced by treatment (P<0.01). There were no significant differences in the other outcome measures of 24 h ABP, such as day ASBP, percentage of mean 24 h ASBP>140 mmHg, percentage of day ASBP>140 mmHg, percentage of night ASBP>120 mmHg, mean 24 h ADBP, day ADBP, night ADBP, 24 h ambulatory pulse pressure (APP), after treatment in all groups (P>0.05). The degree of improvement of the clinical symptoms of TCM showed significant differences among the three groups of patients (P<0.01). The total effective rate in the direct moxibustion I group was 73.3%, which was superior to those in the direct moxibustion II group and control group (13.3% and 10.0%, respectively).

Conclusion

The direct moxibustion has benign regulative effect on blood pressure of elderly patients with essential hypertension, and improves their clinical symptoms. The direct moxibustion method I (burning the next moxa cone after the previous one had totally burnt out) was superior to method II (burning the next moxa cone when the previous one had not totally burnt out ) in lowering blood pressure and improving symptoms of elderly patients with essential hypertension.

     

降脂饮治疗高脂血症30例临床观察

本文用降脂饮治疗高脂血症30例(男18例，女12例，年龄44～73岁)进行自身对照，结果显示：临床症状减轻，血胆固醇、甘油三酯下降(总有效率为80%)，载脂蛋白A／B比值升高，提示降脂饮豫可降低血脂外，还具有调节脂质代谢的功能。     

活血潜阳方治疗血瘀、阳亢证高血压病患者左心室肥厚的临床研究

为观察以活血化瘀、平肝潜阳为组方原则的方药治疗高血压病左心室肥厚的临床疗效,将60例高血压左心室肥厚患者随机分为活血潜阳治疗组(30例)和西拉普利对照组(30例),治疗半年。观测其临床症状、血压、心率及心脏超声下左心室肥厚相关指标。结果：活血潜阳方降压疗效低于西拉普利,但对临床症状的改善和左心室肥厚的逆转作用显著优于西拉普利,对患者的心率无影响。     

养血活血药抑制低密度脂蛋白氧化的研究

运用电子顺磁共振 (EPR)技术 ,研究养血活血药 (当归、桑椹、黄精、首乌 )对抑制脂质自由基的猝灭能力。建立低密度脂蛋白氧化的模型 ,采用EPR技术捕获在低密度脂蛋白氧化过程中所产生的脂质自由基 ,分别观察当归、桑椹、黄精、首乌这 4种药物对脂质自由基的抑制作用。结果 ,在 1 5g/ml浓度下对脂质自由基的猝灭能力单味当归为 73 4%、单味桑椹为 71 5 %、单味黄精为 40 9%、单味首乌无抑制能力。中药当归、桑椹具有抑制低密度脂蛋白氧化的能力 ,为良好的抗氧化剂。