银翘散方证分析与小儿温病

银翘散是清代温病大家吴鞠通创制的名方,具有辛凉解表、清热解毒的功效,被称为"温病第一方",在小儿温热病临床实践中发挥重要作用。本文采用文献梳理方式,对历代小儿温病、银翘散古籍进行整理,阐释银翘散方义及其在小儿温热病证治疗领域的应用。《温病条辨》以银翘散治疗太阴风温、温热、温疫、太阴伏暑、心疟、阳明温病、暑痉、暑风等小儿温热证候。后世医家谨遵银翘散辨治纲领,灵活加减,化裁新方,通过加减药物性味不同归纳总结,进一步拓宽了银翘散的应用范围,在小儿温热病、小儿呼吸系统疾病及病毒感染性疾病的现代临床实践中发挥重要作用。     

王素梅教授运用温热药物治疗小儿神志类疾病经验

中医儿科历来就有"纯阳"与"稚阴稚阳"的学派之争,治疗也有"偏凉"和"偏温"之别.王素梅教授认为小儿在生长发育过程往往表现出易寒易热,易虚易实的两面性,因此,"纯阳"与"稚阴稚阳"两种观点仅为出发点不同,两者是对立统一的辨证关系,均对辨证施治有指导意义,不可强调某个侧面而持割裂之议.故临床用药不避温药,或温敛肾阳,健脾...     

郑建民教授应用僵蚕、蝉蜕治疗小儿外感疾病经验

郑建民教授临床用药灵活,配伍巧妙,应用僵蚕、蝉蜕治疗儿科外感疾病经验丰富。临床上结合小儿的生理病理特点和病机演变,从两药归经及功效相结合辨证用药,收效甚佳。体现了中医"未病先防""既病防变"的治疗原则。     

基于温病"卫气营血"理论探讨小儿传染性单核细胞增多症的病机和证治

小儿传染性单核细胞增多症是儿童常见的发热性疾病之一,目前临床治疗中无统一的辨证论治原则,作者从温病卫气营血理论与小儿传染性单核细胞增多症的关系,探讨应用卫气营血理论辨证治疗小儿传染性单核细胞增多症的理论依据,丰富中医学治疗小儿传染性单核细胞增多症的理法方药研究.     

林季文老中医运用“清透汤”治疗小儿发热经验

林季文老中医根据《内经》“其未满三日者，可汗而已；其满三日者，可泄而已”，以及温病学派“邪未伤津，犹可清热透表”的原则，总结出治疗小儿反复发热，可用“清透法”治之，结合多年临床体会，加减运用“清透汤”治疗小儿发热，疗效显著。     

刁本恕多元疗法治疗小儿斑秃经验

小儿斑秃近年来发病率有增高的趋势,刁本恕主任中医师以调治脾胃为关键点,治疗用药结合儿科特点,采用多元疗法,综合各种疗法的治疗优势,形成系统完整的治疗理论与经验。本文试加以总结,为小儿斑秃辨证和临床治疗提供思路指导。     

任献青博士应用石菖蒲、远志治疗小儿遗尿经验

任献青博士临床用药灵活、配伍巧妙，在药物的配伍技巧方面具有丰富的经验。应用石菖蒲、远志治疗小儿遗尿症经验丰富，结合病机及小儿的生理病理特点，从两药归经及功效相结合辨证用药，收效甚佳。     

浅谈经方在小儿胃脘痛治疗中的应用

《伤寒论》经方立法组方精良,用药配伍慎密,临床辨证方证对应运用效果显著。本研究总结运用经方柴胡桂枝汤、四逆散、小建中汤和半夏泻心汤治疗小儿胃脘痛的经验,通过疏解表邪、理气和胃,疏肝理气、和胃止痛,温中补虚、缓急止痛和辛开苦降、散结消痞法治疗小儿胃脘痛,为儿科临床对应方证运用经方提供思路。     

赵坤教授从湿温论治小儿暑季发热经验

小儿暑季发热是儿科临床中常见的一种疾病,病因多与小儿时期体温调节中枢发育不健全有关,该病具有发病季节明显、病势缠绵及抗生素治疗效果欠佳等特点;赵坤教授认为此病属中医"湿温病"范畴,指出病因有多为外因、内因及内外因相合;其中脾胃为病变之中心,气遏湿阻为病机之关键;治疗上:调理脾胃气机贯穿疾病治疗的始终,结合病位之浅深、湿热之轻重、正邪之强弱而选方用药,临证多能应手获效。     

小儿病毒性心肌炎的辨证施护体会简

目的 探讨小儿病毒性心肌炎的辨证施护.方法对80例病毒性心肌炎患儿在中西医结合治疗及常规护理的基础上辨证施护.结果 通过对80例小儿病毒性心肌炎患者的辨证施护,全部病例均已达到痊愈的目的,经随访3个月无一例后遗症发生.结论 经过两年的临床观察及针对性的辨证施护认清疾病向重症转化的标志,认清＆quot;病在心,病人为风热、湿热＆quot;的特点,认清＆quot;症证在心,主意识思维＆quot;的护理方向,结合中西医治疗而实施有效的辨证施护,而达到尽早、尽快痊愈目的.     

小儿上病下取用验五则

文章介绍笔者在临床诊治过程中,运用上病下取法治疗小儿唇炎、汗证、针眼、痄腮、脓耳的经验体会。针对患儿的体质特点、疾病的证候特点的不同进行治疗。以辨证论治为首要原则,实则泻之,热者寒之,攻补兼施,并注重患者的服药方法、饮食禁忌。对患儿实施个性化的服药、饮食调理,充分运用传统中医中药,提高疗效,效果显著。     

Psychopharmaka in der Frauenheilkunde

Gynecologists often have patients receiving psychotropic medication to treat a mental disorder too. A knowledge of the modes of action and possible side effects makes it easier to deal with medication that the patient is already taking. In addition, there are a number of areas of use for tranquilizers, hypnotic drugs, antidepressants and antipsychotic (or neuroleptic) drugs in gynecology, ranging from severe premenstrual syndrome, hot flushes during perimenopause, exertional incontinence and complaints in the genital area to treatment-resistant hyperemesis gravidarum and anxiety and pain therapy. This article presents the various groups of substances and their use in different gynecological contexts.     

Frauenärztliche Aspekte des metabolischen Syndroms

In addition to susceptibility genes, environmental factors such as over nutrition and physical inertia are responsible for the dramatic worldwide increase of metabolic syndrome, the traits of which include visceral obesity, hyperglycemia, dyslipidemia, and hypertension. These in turn are predictors for type 2 diabetes as well as for coronary heart disease. In females with polycystic ovary syndrome, insulin resistance with hyperinsulinemia and diseases associated with metabolic syndrome are very common. Metabolic syndrome and its complications require an integrated treatment approach. Insulin resistance, visceral obesity and low grade inflammation are major components of the common bases for metabolic syndrome and atherosclerotic vascular disease. Therefore, life-style intervention with weight reduction, a low fat diet rich in complex carbohydrates and physical exercise are the primary options which form a basic treatment for all diseases included in metabolic syndrome. Medication should take into consideration coexisting disorders to use pleiotropic effects. The following medication should be preferred: oral antidiabetics such as acarbose, metformin and thiazolidinediones, antihypertensives such as ACE inhibitors, and ARBs and lipid-lowering drugs such as atorvastatin, rosuvastatin and the modern nicotinic acid derivate niaspan. Rimonabant is a new option for weight reduction. On the other hand, side effects such as the worsening of blood glucose levels caused by beta-blockers and diuretics should be avoided. The strategy using synergies in drug treatment can reduce polypharmacy and costs, and improve the compliance of the patients.     

Growing teratoma syndrome vs chemotherapeutic retroconversion: case report and review of the literature

BACKGROUND: Immature ovarian teratoma is the third most common germ cell tumor (GCT) following dysgerminoma and endodermal sinus tumor. The treatment of choice during childbearing age for immature teratoma composes of unilateral oophorectomy and in case of metastatic disease postoperative chemotherapy (BEP). Finding a solid mass in the peritoneal or chest cavity during routine follow up raises the suspicion of distance recurrence. DiSaia was the first to describe the appearance of benign distant metastasis during routine follow up. He termed this phenomenon "chemotherapeutic retroconversion". Latter, Logothetis described what seems to be a similar phenomenon in testicular non-seminomatous germ cell tumor (NSGCT) that he called the "growing teratoma syndrome". CASE: We present a case of a 12-year-old girl treated for growing teratoma syndrome after primary ovarian GCT. CONCLUSION: Review of the literature shows that this syndrome and the "chemotherapeutic retroconversion" are probably the same phenomenon.     

The use of oral antidiabetic drugs in the treatment of polycystic ovary syndrome

The polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is a complex metabolic-endocrine disorder with severe long-term health consequences like type 2 diabetes. The increased risk for cardiovascular diseases in women with PCOS is due to diabetes, adipositas and dyslipidemia. Insulin resistance plays a key role in the pathophysiology of this syndrome. This makes the use of oral antidiabetic drugs most compelling. The majority of studies have shown amelioration of the typical symptoms like hyperandrogenism and cycle irregularities. Ovulation and pregnancy rates increased. Furthermore these drugs might be cardioprotective by improving insulin sensitivity and reduce the risk for type 2 diabetes. This article reviews the use of different oral antidiabetic drugs in the treatment of PCOS and their influence on fertility, the risk for type 2 diabetes and cardiovascular diseases.     

Drug use during pregnancy: survey in 250 women consulting at a university hospital center

A prospective study of drug use in pregnancy was performed in the maternity outpatient department of a university hospital in Southwestern France. Two hundred and fifty pregnant women were selected at random and interviewed. Eighty-four percent of the women reported drug consumption, with an average of two medications per week. Some factors were significantly associated with an increase in drug use: European origin, high level of education, medical history, alcohol consumption. The most commonly used drugs were iron (43% of the women), medications for venous disorders (22%) and gynecology (21%) and analgesics (19%). Chronic use (beginning before pregnancy) occurred in 9% of the women. Self medication accounted for around 20% of the women. Adverse effects were described by the women 25 times out of 544 exposures: they concerned 10 drugs and were not "serious". After delivery, 14 cases of malformations of the new-born, three stillbirths, 25 neonatal pathologies and 10 resuscitations were observed. Except one neonatal withdrawal syndrome after "in utero" exposure to benzodiazepines, no relationship between drug exposure and pregnancy outcome could be established.     

A negative second trimester triple test and absence of specific ultrasonographic markers may decrease the need for genetic amniocentesis in advanced maternal age by 60%.

OBJECTIVE: A study was conducted to evaluate the sensitivity of combining a second trimester triple test and targeted ultrasound in order to detect Down syndrome in women undergoing amniocentesis over 35 years of age. METHODS: Women over 35 years of age underwent a triple test and an ultrasound examination for chromosomal markers immediately prior to genetic amniocentesis. RESULTS: One thousand and six women were examined. Four hundred and thirty seven were triple test-positive and in 195 cases ultrasonographic abnormalities were observed. Thirteen had Down syndrome and eight had other chromosomal abnormalities. All women with Down syndrome babies were triple test-positive and seven also had ultrasonographic markers. Three of eight women who had babies with chromosomal aberrations other then Down syndrome were also triple test-positive. CONCLUSIONS: The use of the triple test as a screening tool in our population would reduce the number of amniocenteses by 60%, while no cases of Down syndrome would be missed. Ultrasonographic markers have added little to this population. Three non-Down syndrome chromosomal abnormalities and two Down syndrome mosaic cases would be missed by this approach.     

Medications in pregnancy and breastfeeding

Advances in therapeutics, including a wider use of biologics and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) have substantially improved the management of rheumatic diseases, resulting in more women with severe disease considering pregnancy. Every clinical rheumatologist has encountered a woman who wishes to have a pregnancy – or who presents already pregnant – and who values the importance of reliable information on rheumatic diseases and safety of medications in pregnancy. This chapter summarises current evidence and knowledge on the use of ‘Medications in pregnancy and breastfeeding in women with rheumatic diseases’ and considers paternal medication use at the time of conception.     

Drug-prescribing challenges during pregnancy

Most women take either prescribed or over-the-counter medication during pregnancy. Pregnant women often make independent decisions about their treatment and require careful counselling that allows them to balance the risk of taking a drug against the risk of not taking a drug and leaving a medical condition untreated. Advice needs to be tailored to the individual and is hampered by the lack of safety data on drugs in pregnancy and the puerperium. Prescribing is further complicated by both the mother’s and the foetus’ changing physiologies as risk–benefit assessments alter throughout pregnancy. Treatment decisions may require the input of multi-disciplinary teams that consider the severity of the mother’s condition, maternal physiology, a drug’s pharmacokinetic, pharmacodynamic and safety profile and the developmental stage of the foetus.