奇恒之府藏泻功能对防治椎间盘退变的意义

奇恒之府兼具有"藏"和"泻"两方面的功能,而椎间盘代谢的特点与奇恒之府藏泻机制相似。基于奇恒之府的部位大多是成体干细胞分布较密集之处,且髓核细胞具有类似干细胞多样分化的能力,因此认为成体干细胞符合奇恒之府所藏精微物质的特征,藏泻机制对防治椎间盘退变性疾病具有重要的指导意义和现实价值。     

设立“奇恒之腑辨证”刍议

中医辨证规范,应建立在中医理论体系的基础上,即应建立以脏腑归类为主体的辨证体系。但脏腑辨证中有些证名仍须落实具体病位,以解决中医辨证学中某些概念不清、病位混淆等问题。我认为,根据中医理论基础,很有必要设立“奇恒之腑辨证”(以下简称“奇腑辨证”)。就此略陈一孔之见。     

论奇恒之腑辨证

《中医诊断学》的辨证方法中,没有谈及奇恒之腑辨证,而奇恒之腑是属于臧象学说的内容.我作为30年前全国中医诊断学师资班的学员,首倡奇恒之腑辨证,值此朱文锋学术思想暨纪念全国中医诊断学师资班30周年学术研讨会之际,为了完善脏腑辨证的内容,便于临床应用,再论奇恒之腑辨证,以供同道参考.脑、髓、骨、脉、胆、女子胞(男子精室)为奇恒之腑,髓、骨在肾病辨证、脉在心病辨证、胆在六腑病辨证中已讨论,故奇恒之腑辨证重在讨论脑、胞宫、精室病辨证.     

《内经》论头脑

《内经》论头脑陈峰浙江省嘉兴市第一医院３１４０００关键词内经奇恒之府脑中图分类号Ｒ２２１头脑位于人体之巅，其内藏脑髓，外聚经脉，为周身气血津液会聚之处。《内经》对头脑的生理功能和病理变化有明确的认识，现归纳分析如下：１头脑的生理基础１．１先天之精气注...     

奇恒之腑中脑,髓之我见

作者对中医脑、髓所指内容认识不统一，以及它们与奇恒之腑总的形态学上存在的矛盾作了理论上的分析和探讨。提出脑、髓应分别指为脑膜腔和脊髓膜腔的见解。     

略论精室当为奇恒之腑

略论精室当为奇恒之腑王劲松查安生南京中医药大学１９９５年级研究生２１００２９关键词精室奇恒之腑中国图书资料分类法分类号Ｒ２２３．１３奇恒之腑，名出《内经》。《素问·五脏别论》说：“脑、髓、骨、脉、胆、女子胞，此六者，地气之所生也……名曰奇恒之腑。”奇...     

基于藏象学说探讨“卵巢为奇恒之娇脏”

卵巢为实性器官,形态具备“脏”的特性。其形质功能周期性变化,兼具“藏泄”,且“娇小”柔软而敏感易损。临证应依据不同年龄的生理病理特点分阶段论治;顺应藏泄规律遣方选药;忌峻补强攻。在养护方面,需避免医源性损伤卵巢组织;保持健康生活方式;卵巢功能不良宜早诊断早治疗。     

论脑为"元神之府"

脑,或称“脑髓”,又名髓海,深藏于头部,居颅腔之中,是精髓和神明汇集发出之处,又称为元神之府。《素问·五藏生成篇》云:“诸髓者,皆属于脑。”《灵枢·海论》云:“脑为髓之海,其输上在于其盖,下在风府。”《本草纲目》载:“脑为元神之府。”所谓“元”者,乃起始而混然未分之谓也,《尔雅·释诂》云:“元,始也”。人体初生之神则曰“元神”,即元始之神,是曰“先天之神”,先天主生不主用。1脑为“元神之府”的生理学基础     

新生大鼠缺氧缺血脑组织水肿及水通道蛋白-4的表达变化

目的 探讨新生SD大鼠缺氧缺血不同时间点脑组织水肿及水通道蛋白-4 (AQP-4) 表达的功能意义。 方法 健康3 d龄SD大鼠60只, 分为对照组 (12只) 和缺氧缺血脑损伤模型 (HIBD)组 （48只)。HIBD 组行右侧颈总动脉结扎后,分为吸入80 mL/L O2+920 mL/L N2 4 h、8 h、16 h、24 h 四个亚组,每组12只大鼠。对照组仅行假手术, 不予右颈总动脉结扎和缺氧缺血。HIBD各亚组分别于持续缺氧缺血4 h、8 h、16 h、24 h后处死动物,对照组于手术后12 h处死。取脑组织分别进行HE染色观察脑组织病理改变、脑含水量测定、实时荧光定量PCR检测大脑海马AQP-4 mRNA表达。 结果 HE染色示:随着缺氧缺血时间延长,右脑神经细胞与胶质细胞肿胀进行性加重,24 h组神经细胞溶解损伤明显,胶质细胞稀疏变性。HIBD 组右侧大脑持续缺氧缺血8 h、16 h和24 h脑组织含水量均较对照组增加, 差异有统计学意义 (P<0.05);实时荧光定量PCR显示右脑海马AQP-4 mRNA表达较对照组减少 (P<0. 05)。 结论 新生大鼠缺氧缺血后脑组织水肿,海马AQP-4表达下调,提示AQP-4与脑组织水肿有关。     

脑胶质瘤OUR-XGD伽玛刀和显微外科手术疗效临床探讨

目的探讨脑胶质瘤OUR-XGD伽玛刀治疗和显微外科手术治疗临床效果对比分析.方法对88例脑胶质瘤病例采用伽玛刀治疗和133例显微外科手术肿瘤切除治疗,结合文献进行回顾性探讨.结果伽玛刀治疗88例,其中正常工作21例(23.86%),生活自理20例(22.73%),生活不能自理7例(7.95%),肿瘤复发18例(20.45%),死亡22例(25.0%).显微外科手术治疗133例,其中正常工作19例(14.29%),生活自理21例(15.79%),生活不能自理23例(17.29%),肿瘤复发28例(21.05%),死亡42例(31.58%).结论应用OUR-XGD伽玛刀对脑胶质瘤,可采用分次、分隔治疗,达到提高生存率、减少复发率和死亡率的目的.     

Brain death revisited: it is not 'complete death' according to Islamic sources

Concepts, such as death, life and spirit cannot be known in their quintessential nature, but can be defined in accordance with their effects. In fact, those who think within the mode of pragmatism and Cartesian logic have ignored the metaphysical aspects of these terms. According to Islam, the entity that moves the body is named the soul. And the aliment of the soul is air. Cessation of breathing means leaving of the soul from the body. Those who agree on the diagnosis of brain death may not able to agree unanimously on the rules that lay down such diagnosis. That is to say, there are a heap of suspicions regarding the diagnosis of brain death, and these suspicions are on the increase. In fact, Islamic jurisprudence does not put provisions, decisions on suspicious grounds. By virtue of these facts, it can be asserted that brain death is not absolute death according to Islamic sources; for in the patients diagnosed with brain death the soul still has not abandoned the body. Therefore, these patients suffer in every operation performed on them.     

效应室浓度作为目标浓度靶控输注异丙酚的脑摄取研究

目的研究靶控输注(target-controlledinfusion,TCI)时效应室浓度(effectcompartmentconcentration,ECC)与异丙酚的脑摄取之间的关系。方法ASAⅠ~Ⅱ级择期腹部手术病人12例,以ECC4.00μg/ml为目标浓度进行异丙酚TCI静脉全身麻醉,给药后不同时间点同步抽取桡动脉、颈内静脉球部全血各1ml,以高效液相色谱荧光法测定异丙酚的血药浓度,并计算动脉-颈内静脉球部血药浓度-时间曲线下面积差(areaundercurveofarterial-jugularbulbconcentrationdifference,AUCa-jv)值。结果给药后,ECC达目标浓度前,各时间点ECC与AUCa-jv呈显著正相关(rECC-AUC =0.977,P<0.01),而动脉血药浓度(arterialconcentration,Ca)、颈内静脉球部血药浓度(jugularbulbvenousconcentration,Cjbv)与AUCa-jv不相关(rCa-AUC =0.054,P=0.92;rCjbv-AUC =0.335,P=0.516)。TCI维持ECC为4.0μg/ml至停药前,各时间点Ca与Cjbv间经统计分析无显著差异(P=0.512)。停止输注异丙酚至病人意识清醒时,各时间点ECC与AUCa-jv呈正相关(rECC-AUC =0.942,P<0.005),Ca、Cjbv也与AUCa-jv呈正相关(rCa-AUC =0.986,P<0.001;rCjbv-AUC =0.974,P<0.001)。结论以ECC为目标浓度的异丙酚TCI时,ECC与AUC相关性显著,可同步反映异丙酚的脑摄取变化。     

效应室浓度作为目标浓度靶控输注异丙酚的脑摄取研究

OBJECTIVE: To study the correlation between the effect compartment concentration (ECC) and the brain uptake of propofol during sedation by target-controlled infusion (TCI). METHOD: Twelve ASA physical status I to II patients with neither cardiac nor intracranial diseases were scheduled for elective abdominal operation. Computer-assisted target-controlled infusion of propofol was performed for general anesthesia in all patients with the target ECC set at 4.0 microgram/ml. The plasma propofol concentrations were measured simultaneously from the radial artery and the jugular bulb at different time points by high performance liquid chromatography (HPLC), and the area under time-concentration curve (AUC(a-jv)) was calculated. RESULT: Before reaching the target propofol concentration of 4.0 microgram/ml (4.7+/-0.16 min), EEC was positively correlated with AUC(a-jv) (r(ECC-AUC)=0.977, P<0.001), but neither the arterial (Ca) nor jugular bulb propofol concentrations (Cjbv) showed such relation to AUC(a-jv) (r(Ca-AUC)= 0.054, P=0.92; r(Cjbv-AUC)=0.335, P=0.516). When ECC was controlled at 4.00 microgram/ml by TCI, Ca was comparable with Cjbv (P=0.512). Positive correlation was noted between AUCa-jv and ECC (r(ECC-AUC)=0.942, P<0.005) after the termination of infusion till the consciousness recovery of the patients, and Ca and Cjbv showed similar correlation with AUC(a-jv) (r(Ca-AUC)=0.986, P<0.001; r(Cjbv-AUC)=0.974, P<0.001). CONCLUSION: During TCI of propofol with ECC as the target concentration, ECC is significantly correlated with AUC(a-jv) to reflect the dynamic changes in cerebral propofol uptake.     

抑郁症患者治疗中脑内神经递质的变化

目的：观察抑郁症患者治疗前后脑内神经递质的变化。方法：对入组的30例患者用脑电超慢涨落分析仪在治疗前后的不同阶段对神经递质含量进行检测。结果：抑郁症患者脑内神经递质（尤其是5-HT及NE）降低,治疗2周后NE值明显回升（P〈0．05）,治疗6周后5-HT及NE显著上升（P〈0．01）。结论：抑郁症患者脑内5-HT及NE含量降低,随着药物治疗和症状的改善,患者脑内5-HT及NE含量逐步升高。