浅谈《伤寒杂病论》与针灸

《伤寒杂病论》为东汉末年著名医家张仲景所撰,经后世医家校正、整理后分为《伤寒论》、《金匮要略》。张仲景在其著作中,倡导六经辨证,创造性的总结出中医学理、法、方、药的临床理论体系,在理论上和临床实践上都有较高的指导意义和实用价值。针灸学上,他继承了《内经》的学术思想,提出了用针灸治疗伤寒杂病的具体方法,对后世针灸学的发展起到了积极的推动作用,《伤寒杂病论》的针灸学术思想主要体现在以下几个方面。1针药结合张仲景是一位针灸药并重的医家,他认为针、灸、药各有所长,三者并用其效果肯定要比单用一种方法要好,《伤寒杂病论…     

浅谈《伤寒杂病论》与针灸

《伤寒杂病论》为东汉末年著名医家张仲景所撰，经后世医家校正、整理后分为《伤寒论》、《金匮要略》。张仲景在其著作中，倡导六经辨证，创造性的总结出中医学理、法、方、药的临床理论体系，在理论上和临床实践上都有较高的指导意义和实用价值。针灸学上，他继承了《内经》的学术思想，提出了用针灸治疗伤寒杂病的具体方法，对后世针灸学的发展起到了积极的推动作用，《伤寒杂病论》的针灸学术思想主要体现在以下几个方面。     

《金匮要略》急救法初探

《金匮》是汉代著名医家张仲景的著作,原与《伤寒论》合篇,是《伤寒杂病论》的内伤杂病部分,后因战乱散失,原著未得以流传于世。西晋王叔和搜集编次了伤寒部分,即今之《伤寒论》,但杂病部分未得其传。至北宋林亿等人根据《伤寒杂病论》的节略本——《金匮玉函要略方》,对杂病部分进行整理编次,《金匮要略》才得以流传于世。     

《伤寒杂病论》中草姜枣配伍应用规律研究

《伤寒杂病论》为东汉著名医家张仲景所著集理法方药于一体的医学经典著作,被后世誉为"方书之祖"。其伤寒部分经西晋王叔和搜集整理而形成后世流传的《伤寒论》,而杂病部分则直至北宋年间林亿等人删减校订了翰林学士王洙所发现的《金匮玉函要略方》,而形成后世流传的《金匮要略》。该文试从《伤寒论》与《金匮要略》中含有甘草生姜大枣的方剂中归纳总结仲景对草姜枣的配伍应用规律。     

《金匮要略方论》用药特点

《金匮要略方论》(以下简称《金匮》)是我国东汉时代著名医学家张仲景所著《伤寒杂病论》的杂病部分,也是我国现存最早的一部诊治杂病的专书。由于本书在理论上和临床实践上都具有较高的指导意义和实用价值,对于后世临床医学的发展有着重大贡献和深远的影响,所以古今医家都对此书推崇备至,赞誉其为方书之祖,医方之经,治疗杂病的典范。本文就该书用药特点,略书管见。     

《伤寒杂病论》柴胡药对规律研究

通过归纳张仲景《伤寒杂病论》中柴胡药对的运用规律,同时收集后世医家在临床应用此药对的理论和经验,总结柴胡药对在治疗疾病过程中和剂量运用的异同,分析张仲景辨证论治的用药思想,进一步揭示它们在临床中应用中的配伍规律。     

经方论治水肿病的规律总结及研究进展

早在《内经》时期对水肿就有了专篇论述,后世医家在此基础上对其病因病机、治则治法、遣方用药等进行了不同程度的探讨,尤以东汉·张仲景在《伤寒杂病论》中的论述对后世影响深远。文章旨在总结仲景治疗水肿病的学术思想,阅读了《伤寒论》和《金匮要略》中关于水肿病的相关篇章,并分类整理,同时收集后世运用经方治疗水肿病的相关报道和医案,在此基础上总结出仲景治疗水肿病的规律,以期为临床运用经方治疗水肿病提供有益的借鉴。     

《金匮、血痹虚劳病篇》虚劳病初析

虚劳,是“虚损劳伤”的简称,包括了人体脏腑阴阳气血虚损而产生的多种慢性疾病。病因为先天禀赋不足,或后天酒色、劳倦、七情、饮食所伤,或病后失于调理等等。仲景继承《内经》、《难经》的理论,在《金匮·血痹虚劳病篇》中首创了“虚劳”病名,论述了虚劳病的病因、病机、脉证和治法等各个方面,为后世论述虚劳病的辨证论治树立了典范。现对《金匮·虚劳病篇》的学术思想,主要成就及对后世医家的影响作初步探讨。     

《王孟英医案》载温补致误原因探析

温补法源于《内经》,经过后世医家的发展,日益完善。张仲景、李东垣、朱丹溪、张景岳等后世医家对温补法的发展作出了突出贡献。到了清代温补之风盛行,医者妄用温补,病家只喜温补,以致造成了大量的误诊误治。清代著名医学家王孟英在其著作《王孟英医案》中因误诊误治而导致的病症占有相当数量。今仅对《王孟英医案》中部分因温补所致的医案加以分析。     

《金匮要略》三步教学法探讨

《金匮要略》三步教学法探讨刘读文（河南中医学院，郑州４５０００３）主题词《金匮要略》；教学方法《金匮要略》（以下简称《金匮》）是医圣张仲景所著《伤寒杂病论》的杂病部分，它是我国现存最早治疗杂病的专著。本书理、法、方、药悉具，内容精要，价值珍贵，对后世...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.