失眠治验一得

笔者曾治疗家母失眠之证,然久治不愈,不料应用桂枝茯苓丸治疗其下肢静脉曲张的同时,失眠之证也得意外好转,一案之中,启发颇多,故录于此.     

浅析桂枝茯苓丸治疗寒湿瘀阻型下肢静脉曲张

桂枝茯苓丸临床常用于治疗妇人经产腹痛或腹有癥块者,用于治疗下肢静脉曲张的报道较为少见。本文从辨证论治中疾病阶段证与方剂适应证相契合的原则,阐述了桂枝茯苓丸治疗下肢静脉曲张的可行性,并选取张光荣运用桂枝茯苓丸加味治疗寒湿瘀阻型下肢静脉曲张验案1则加以佐证,以供同道临证参考。     

加味桂枝茯苓丸治疗精索静脉曲张型不育症269例

目的 :观察加味桂枝茯苓丸治疗精索静脉曲张型不育症的疗效。方法 :采用加味桂枝茯苓丸 (桂枝、茯苓、牡丹皮、芍药、桃仁、当归、黄芪、何首乌、枸杞子、川牛膝、甘草等 )治疗精索静脉曲张型不育症 2 69例。结果 :治愈 97例 ,总有效率86.2 5%。提示 :本方有祛瘀生新 ,补肾强精之功效     

曾庆琪运用桂枝茯苓丸治疗男科病验案3则

桂枝茯苓丸首载于《金匮要略》,有活血、化瘀、消癥之功效。曾庆琪教授擅用桂枝茯苓丸加减治疗男科病证属瘀血阻滞者,本文列举曾老师运用桂枝茯苓丸加减治疗前列腺增生症、不射精症、精索静脉曲张验案3则,以飨同道。     

桂枝茯苓丸的临床新用

笔者从医从教 30余年 ,用桂枝茯苓丸加味治疗妇科“血瘀”诸病 ,每获良效。临床应用中 ,此方通过加味 ,可治因“血瘀”所致妇科诸病。1先兆流产 :上方加炒丹参、炒蒲黄各 1 2 g,炒杜仲、桑寄生各 1 5 g;2子宫肌瘤 :上方加穿山甲、川牛膝、三棱、莪术各 1 2 g;3卵巢囊肿 :上方加     

桂枝茯苓丸加味治疗深静脉血栓形成综合征50例

深静脉血栓形成综合征多由久卧、久坐、外伤、产后或手术后长期卧床形成,多见于下肢,西医多以药物或手术方法治疗,存在一定局限性.笔者自1995年以来用桂枝茯苓丸加味治疗该病50例,取得一定效果,总结如下:     

桂枝茯苓丸加味治疗瘀血型失眠经验体会

目前临床因瘀所致失眠论述仍少,笔者从瘀入手,采用桂枝茯苓丸加味活血化瘀、调畅气血,临床治疗瘀血型失眠取得良好疗效。     

桂枝茯苓丸治疗顽固性失眠验案2则

桂枝茯苓丸具有化瘀生新、调和气血之功,为化瘀消癥之缓剂,临床多用之治疗妇科疾病,用其治疗失眠鲜有报道。笔者近年来根据《内经》阴阳出入之旨及叶天士的"久病入络"理论,应用桂枝茯苓丸加减治疗瘀血阻络型顽固性失眠疗效佳。     

桂枝茯苓丸临证举隅

正桂枝茯苓丸方出自《金匮要略》,书中记述:"妇人宿有癥病,经断未及三月,而得漏下不止,胎动在脐上者,为癥痼害……所以血不止者,其癥不去故也,当下其癥,桂枝茯苓丸主之。"该方由桂枝15g,茯苓30g,牡丹皮30g,桃仁15g,芍药15g组成,为活血化瘀轻剂。笔者将其用于治疗有瘀血征象的阑尾周围脓肿、卵巢囊肿、前列腺增生、乳腺增生等病证,取得较好疗效,兹举     

朱砂安神丸验案2则

朱砂安神丸出自李杲《内外伤辨惑论》,方由当归、黄连、甘草、地黄、朱砂组成,功能重镇安神、泻火养阴,主治心火亢盛,阴血不足所致失眠、心悸怔忡等症。笔者临床试将朱砂安神丸用作汤剂,治疗郁证、心悸取得了较好的疗效。方中黄连清心泻火;当归、生地既养血滋阴,又滋肾水以济心火;炙甘草调药和中;朱砂重镇安神,因朱砂含汞,有毒不宜久服,故一般选用生龙齿、珍珠母等。由于郁证和心悸伴有不同程度的心神不宁和心神失养,临症可根据患者病情的不同,随症选用重镇宁心或(和)养心安神药,以增强疗效。现举验案2则如下,敬请同道指正。     

外感发热辨治1则

发热为外感病常见主症，医家多以为温能助热，畏麻黄、桂枝之辛温而废用。然中医治病重在辨证，温热外感多用银翘散、桑菊饮之列，风寒外感则非麻黄汤、桂枝汤之类不可。兹举案例1则以说明之。     

王霞芳运用桂枝龙牡汤治疗小儿疾病经验

桂枝龙牡汤出自张仲景《金匮要略·血痹虚劳》,主治因阴阳两虚,阳失阴之涵养则火浮不敛,阴无阳之固摄则精不内守,出现虚劳、失精、梦交等症。以桂枝汤调和营卫、气血、脏腑、阴阳,加龙骨、牡蛎潜镇摄纳,使阳能固密,阴能内守,则阴平阳秘,精不外泄。王师临床经验丰富,对纷繁复杂的证候,求得病本,再辨阴阳表里、寒热虚实。王师探究桂枝龙牡汤组方之理,临床应用治疗多种小儿疾病,辨证精准,每获佳效,此即所谓“异病同治”也。     

Effect of Zhuyeshigao granule on tumor necrosis factor-a and inter- leukins serum protein levels in rats with radiation esophagitis

OBJECTIVE： To investigate the effects of Zhuyesh- igao granule （ZSG） on tumor necrosis factor-a （TNF-a）, interleukin-1 （IL-1）, IL-2, IL-6, and IL-8 in rats with radiation esophagitis. METHODS： Fifty Wistar rats were randomly divid- ed into five groups （10 rats in each group）： con- trol （without radiation）, saline-treated, and low, medium, and high-dose ISG-treated groups. Rats were given normal saline （10 mL/kg） or 1.15, 2.3, or 4.6 g/kg ZSG by intragastric administration once a day for 7 days. A rat model of radiation esophagi- tis was established by local irradiation of Co60 （490.25 cGy/min, totaling 30 Gy）. The administra- tion of ZSG was continued for another 7 days and on the 7th day post-irradiation, inferior vena cavablood was collected. The serum was separated, and TNF-a, IL-1, IL-2, 11_-6, and IL-8 protein levels were determined. RESULTS： Inflammatory response factors were found in the serum of each group. However, levels in ZSG-treated groups were significantly lower than in the saline-treated group （P〈0.05）. CONCLUSION： ZSG may prevent the development of radiation esophagitis, perhaps by inhibiting the generation and release of the inflammatory re- sponse factors TNF-a, IL-1, IL-2, IL-6, and IL-8.     

Clinical curative effect of fuzi-cake-separated moxibustion for pre- venting dysuria after operation for lower limb fracture

OBJECTIVE： To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji（CV 3）and Guanyuan（CV 4） for preventing dysuria after internal fixation of lower limb fractures.METHODS： Sixty patients conforming to the inclusion standards were randomly divided into a treatment group（n=30） and a control group（n=30）.Fuzi-cake-separated moxibustion was performed at Guanyuan（CV 4） and Zhongji（CV 3）, 20 min at a time, twice a day, for 3 days before operation in the treatment group. No fuzi-cake-separated moxibustion was performed in the control group. After treatment, the score for symptoms of first urination, urinary time, urinary volume, 24 h remaining urinary volume, incidence of uroschesis, and rate of controlling dysuria were compared to evaluate the curative effect of preventing post-operative dysuria.RESULTS： The score for symptoms of first urination,24 h remaining urinary volume（maximum 120 m L vs 250 m L, and less than 10 m L in 24 cases vs 15 cases）, and the rate of controlling dysuria（83.34% vs30%） were significantly better（P〈0.05, P〈0.05, and P〈0.001, respectively） in the treatment compared with the control group. There was no statistical difference（P〉0.05） between the two groups in first post-operative urinary time, urinary volume, or incidence of 24 h uroschesis.CONCLUSION： Fuzi-cake-separated moxibustion at Zhongji（CV 3） and Guanyuan（CV 4） can better prevent post-operative dysuria, effectively promote the functional restoration of the urinary bladder,and control the incidence of post-operative dysuria.     

Antidepressant-like effect of essential oil of Perilla frutescens in a chronic,unpredictable, mild stress-induced depression model mice

Perilla frutescens（Perilla leaf）, a garnishing vegetable in East Asian countries, as well as a plant-based medicine, has been used for centuries to treat various conditions, including depression. Several studies have demonstrated that the essential oil of P. frutescens（EOPF） attenuated the depressive-like behavior in mice. The present study was designed to test the anti-depressant effects of EOPF and the possible mechanisms in an chronic, unpredictable, mild stress（CUMS）-induced mouse model. With the exposure to stressor once daily for five consecutive weeks, EOPF（3, 6, and 9 mg·kg-1） and a positive control drug fluoxetine（20 mg·kg-1） were administered through gastric intubation to mice once daily for three consecutive weeks from the 3rd week. Open-field test, sucrose consumption test, tail suspension test（TST）, and forced swimming test（FST） were used to evaluate the behavioral activity. The contents of 5-hydroxytryptamine（5-HT） and its metabolite, 5-hydroxyindoleacetic acid（5-HIAA）, in mouse hippocampus were determined by HPLC–ECD. Serum interleukin（IL）-1, IL-6, and tumor necrosis factor（TNF）-α levels were evaluated by enzyme-linked immunosorbent assay（ELISA）. The results showed that CUMS significantly decreased the levels of 5-HT and 5-HIAA in the hippocampus, with an increase in plasma IL-6, IL-1β, and TNF-α levels. CUMS also reduced open-field activity, sucrose consumption, as well as increased immobility duration in FST and TST. EOPF administration could effectively reverse the alterations in the concentrations of 5-HT and 5-HIAA; reduce the IL-6, IL-1β, and TNF-α levels. Moreover, EOPF could effectively reverse alterations in immobility duration, sucrose consumption, and open-field activity. However, the effect was not dose-dependent. In conclusion, EOPF administration exhibited significant antidepressant-like effects in mice with CUMS-induced depression. The antidepressant activity of EOPF might be related to the relation between alteration of seroto     

Oral JS-38,a metabolite from Xenorhabdus sp.,has both anti-tumor activity and the ability to elevate peripheral neutrophils

AIM： JS-38（mitothiolore）, a synthetic version of a metabolite isolated from Xenorhabdus sp., was evaluated for its anti-tumor and white blood cell（WBC） elevating activities. METHOD： These anti-proliferative activities were assessed in vitro using a panel of ten cell lines. The anti-tumor activities were tested in vivo using B16 allograft mouse models and xenograft models of A549 human lung carcinoma and QGY human hepatoma in nude mice. The anti-tumor interactions of JS-38 and cyclophosphamide（CTX） or 5-fluorouracil（5-Fu） were studied in a S180 sarcoma model in ICR mice. Specific stimulatory effects were determined on peripheral neutrophils in normal and CTX- and 5-Fu-induced neutropenic mice. RESULTS： The IC50 values ranged from 0.1 to 2.0 μmol·L-1. JS-38（1 μmol·L-1） caused an increase in A549 tumor cell apoptosis. Multi-daily gavage of JS-38（15, 30, and 60 mg？kg-1？d-1） inhibited in vivo tumor progression without a significant effect on body weight. JS-38 additively enhanced the in vivo anti-tumor effects of CTX or 5-Fu. JS-38 increased peripheral neutrophil counts and neutrophil rates in normal BALB/c mice almost as effectively as granulocyte colony-stimulating factor（G-CSF）. In mice with neutropenia induced by CTX or 5-Fu, JS-38 rapidly restored neutrophil counts. CONCLUSION： These results suggest that JS-38 has anti-tumor activity, and also has the ability to increase peripheral blood neutrophils.     

Roles of Chinese medicine bioactive ingredients in the regulation of cellular function of endothelial progenitor cells

To improve the function of endothelial progenitor cells （EPCs） is one of the goals in Chinese traditional therapy to treat various cardio-celebrovascular diseases. In the past decades, scholars in the field of traditional Chinese medicine （TCM） have found fifteen active compounds to regulate the function of EPC. These metabolites are extracted from thirteen, plant-based Chinese medicine, with majority of them as potent reductive or oxidative hydrophilic molecules containing phenyl groups. These active compounds either enhance the mobilization of EPC, or inhibit their apoptosis through different signaling pathways. In this review, the molecular structure, biophysical properties, and the plant sources of these active ingredients and their regulatory effects on the function of EPC are summarized, aiming to reveal the modem basis of Chinese medicine for promoting blood circulation and removing blood stasis at the progenitor cell level.     

李振华辨治单纯性肥胖症验案1则

李振华教授出生于中医世家,其父为豫西名医,幼承庭训,后从事中医临床、教学及科研工作凡60载,其临床经验丰富,学术造诣精湛,为全国首批名老中医,擅长治疗急性热病、脾胃病及疑难杂病。笔者侍诊李老身侧,撷其治疗肥胖症验案介绍如下,以飨同道。1病案实录张某,男,45岁。初诊日期:2005年8月12日。患者患肥胖症3年,慢性胃炎病史7年余。3年前无明显诱因出现肥胖,以致行走困难,不能工作。3年来,经多方检查,仅发现三酰甘油轻度升高,余无异常,按内分泌紊乱治疗亦未取效。现症见:身体肥胖,头昏沉,倦怠乏力,动则易汗,多梦健忘;食后腹胀,大便溏薄,每日2~3次;舌质淡,舌体胖大,边有齿痕,苔白腻,脉濡缓。查体:面色白,身体呈对称性肥胖,体质量92.5kg,身高175cm,血压150/100mmHg;甲状腺无肿大,心肺无异常,皮肤无紫纹;腹壁脂肪厚,下肢轻度凹陷性浮肿。肝肾功能检查无异常。西医诊断:肥胖症,特发性水肿;中医诊断:肥胖,水肿;中医辨证:脾胃气虚,痰湿阻滞。治法:健脾益气,祛湿化痰;方以健脾豁痰汤加味(经验方)。处方:白术10g,茯苓20g,泽泻18g,玉米须30g,桂枝6g,半夏10g,厚朴10g,砂仁8g,广木...     

Clinical Application of Yongquan （KI 1）Acupointd

Yongquan （KI 1） is the Jing-Well point of Kidney Meridian of Foot Shaoyin. It can be used to treat many kinds of diseases, such as parietal headache, vertigo and blurred vision, hypopharynx swelling and pain, dry tongue, voice loss, epistaxis, apoplexy and apoplectic sequela, dysufia, ungratifying defecation, epilepsy, syncope, planter fever, palpitations, lower limbs spasm, hypertension, vomiting, infantile convulsion. The author applied Yongquan （KI 1） in clinical practice and obtained satisfactory therapeutic effects. Now five cases were introduced as follows.