慢性肾小球疾病辨证分型标准化的研究

慢性肾小球疾病（简称慢性肾炎）为多种病因引起的一组原发性肾小球疾病，可发生于不同年龄，以中青年为多，男性多于女性，病程较长，病情复杂，临床表现多样。属中医学之“水肿”、“虚劳”、“腰痛”、“尿血”等范畴。慢性肾炎是一现代医学病名，按中医进行辨证分型，历来极不一致，至于临床报导及临床应用中的辨证分型更是多种多样，慢性肾炎如何辨证？辨证分析标准如何制定？     

中医药治疗慢性肾炎的临床研究进展

慢性肾小球肾炎(chronic glomerulonephritis)简称慢性肾炎，系指蛋白尿、血尿、高血压、水肿为基本临床表现，起病方式各有不同，病情迁延，病变缓慢进展，可有不同程度的肾功能减退，最终将发展为慢性肾衰的一组肾小球病。有人分析，国内引起终末期性肾功能衰竭的多种病因中，慢性肾炎占居首位，达64．1％。因此，对慢性肾炎的治疗研究是当今医学界的一大课题。目前，在慢性肾炎的治疗方面，西医尚无特效药，而蓬勃发展的中医药对慢性肾炎的治疗取得了可喜的成绩。在此，仅将近几年来中医药治疗慢性肾炎的临床研究进展作一综述。     

刘仕昌教授治疗慢性肾炎的经验

刘仕昌教授治疗慢性肾炎的经验史志云，刘亚敏主题词慢性肾炎／中医药疗法，刘仕昌慢性肾炎是临床上常见病，以水肿、血尿、蛋白尿、高血压以及不同程度的肾功能减退等为主要临床表现。属中医“水肿”、“虚劳”范畴，刘老对慢性肾炎机理的认识以及辨治具有独到之处，现总...     

国医大师张琪教授治疗慢性肾炎验案赏析

慢性肾小球肾炎简称慢性肾炎，系由多种原发性肾小球疾病所致的以蛋白尿、水肿、高血压为临床表现的疾病，病程长（一至数年），最终多发展成渐进性肾功能衰竭。少数慢性肾炎是由急性肾炎发展而来（病情不愈直接迁延或临床痊愈若干时间后重出现），而绝大多数慢性肾炎是由病理类型决定其病情必定迁延发展，起病即属慢性肾炎，与急性肾炎无关。     

慢性肾小球肾炎饮食调理

慢性肾小球肾炎简称为慢性肾炎 ,是一种多病因引起的肾小球免疫性炎症 ,可发生在不同年龄 ,以青中年多见。临床典型症状为 :血尿、蛋白尿、管型尿、浮肿、高血压等。病情轻者可自行痊愈 ,慢性肾炎可持续 2 0～ 30 a,呈相对稳定和缓慢发展状态 ,发展恶化迅速的可于数日内进入尿毒症期。肾炎多属于中医“水肿”“虚劳”“腰痛”等证的范畴。如在采用中药治疗的同时 ,给予患者科学合理饮食 ,并结合食用一些食疗方 ,可以很好地控制高血压 ,纠正体内异常代谢 ,减轻水肿及肾脏的负担 ,从而延长进入肾功能衰竭的时间 ,提高患者生活质量。1　饮食原…     

运用经方治疗慢性肾炎的思路

慢性肾小球肾炎简称慢性肾炎,系指各种病因引起的不同病理类型的双侧肾小球弥漫性或局灶性炎症改变,临床起病隐匿,病程冗长,病情多发展缓慢的一组原发性肾小球疾病的总称。临床可表现为蛋白尿、血尿、水肿、高血压等。据统计有15％～20％从急性肾小球肾炎转变而来,此病仍属中医“水肿”“虚劳”等范畴。中医对慢性肾炎及慢性肾衰的治则多为温补脾肾、活血化瘀及利湿泄浊。运用经方辨治,具备坚实的理论基础和广泛的应用前景。     

慢性肾炎证治心得

慢性肾炎证治心得山东省梁山县机关门诊部（２７２６００）唐先平山东省梁山县中医院张远东慢性肾炎是由多种原因引起，具有进行性倾向的慢性肾小球炎症。主要临床表现为蛋白尿、高血压、水肿及肾功能损害。本病属于中医学“水肿”、“腰痛”、“虚劳”之范畴。仅就笔者在...     

加味玉屏风散预防慢性肾炎复发的体会

慢性肾炎是临床常见病、多发病，青壮年及儿童发病率较高，临床主要表现为蛋白尿、镜下血尿、水肿、高血压等，其病程长，在稳定期病程发展非常缓慢，但是患者一旦被链球菌感染或病毒感染，或劳累，或受冻等诱因影响，病情就可迅速恶化，而进入尿毒症期，出现肾功能衰竭，危及患者的生命，医学领域至今尚未找到根治慢性肾炎的有效方法。而相对地使其病情稳定，不使其发展，则是临床少疗本病比较重要的环节。西医一般用皮质激素维持治疗以延缓慢性肾炎的发展，但此类药物副作用较多，如加重高血压、氮质血症、锈发感染等。我们在总结前人经验…     

中医治疗慢性肾炎经验浅谈

慢性肾炎系由多种原发性肾小球疾病所导致的一组长病程的,以蛋白尿、血尿、水肿、高血压为临床表现的疾病。本病属于中医“水肿”、“腰痛”等范畴。笔者在内科临床工作多年,对慢性肾炎的辨证论治积累了一定的经验,现浅谈如下。     

李德修推拿治疗小儿水肿的经验

小儿水肿可在现代医学的急、慢性肾炎、肾病综合征中出现，临床症状表现轻重不一。急性肾炎属于祖国医学“阳水”“血尿”范畴，与肺、脾、肾、膀胱等脏腑功能失调有关；慢性肾炎及肾病综合征属于祖国医学“阴水”“虚损”范畴．其病变部位以脾肾两脏为主，即脾虚不能制水，肾虚不能行水，水液内停，外溢肌肤而成水肿。由于小儿口服中药难以下咽．更难坚     

杨洪涛运用健脾和中降浊法治疗腹膜透析消化系统并发症经验

腹膜透析(peritoneal dialysis,PD)主要用于治疗.肾衰竭,其利用人体自身腹膜作为透析膜,通过PD管向腹腔灌注透析液,保留一段时间,利用弥散、对流、渗透及超滤原理清除体内代谢废物和过多的水分,纠正水、电解质和酸碱平衡紊乱;同时通过透析液补充机体某些所需物质,如电解质、碱基和葡萄糖等.     

DT-13, a saponin of dwarf lilyturf tuber,exhibits anti-cancer activity by down-regulating C-C chemokine receptor type 5 and vascular endothelial growth factor in MDA-MB-435 cells简

AIM： To investigate the anticancer activity of DT-13 under normoxia and determine the underlying mechanisms of action. METHODS： MDA-MB-435 cell proliferation, migration, and adhesion were performed to assess the anticancer activity of DT-13, a saponin from Ophiopogonjaponicus, in vitro. In addition, the effects of DT-13 on tumor growth and metastasis in vivo were evaluated by orthotopic implantation of MDA-MB-435 cells into nude mice; mRNA levels of vascular endothelial growth factor （VEGF）, C-C chemokine receptor type 5 （CCR5） and hypoxia-inducible factor 1a （HIF-1a） were evaluated by real-time quantitative PCR; and CCR5 protein levels were detected by Western blot assay. RESULTS： At 0.01 to 1 umol·L -1, DT-13 inhibited MDA-MB-435 cell proliferation, migration, and adhesion significantly in vitro. DT-13 reduced VEGF and CCR5 mRNAs, and decreased CCR5 protein expression by down-regulating HIF-1 a. In addition, DT-13 inhibited MDA-MB-435 cell lung metastasis, and restricted tumor growth slightly in vivo. CONCLUSION： DT-13 inhibited MDA-MB-435 cell proliferation, adhesion, and migration in vitro, and lung metastasis in vivo by reducing VEGF, CCR5, and HIF-la expression.     

沈敏鹤从三焦辨治肿瘤临床经验

沈敏鹤主任医师系国家级名老中医吴良村教授的学术继承人,从事中西医结合肿瘤内科临床工作二十余载,擅长中西医结合治疗各种常见恶性肿瘤,尤其对从三焦辨治肿瘤见解独到。笔者有幸随师侍诊,获益匪浅,现将沈师从三焦辨治肿瘤的临床经验总结介绍如下。     

徐振晔“以通为用”治疗晚期恶性肿瘤经验

徐振哗教授从事肿瘤临床工作三十余年,经验丰富;认为晚期恶性肿瘤患者正气明显衰退,治疗当“以通为用”。笔者跟师临诊,获益良多,现将其“以通为用”治疗晚期恶性肿瘤的临床经验总结介绍如下。     

Qingkailing injection for the treatment of acute stroke： a systematic review and Meta-analysis

OBJECTIVE: To evaluate systematically the clinical efficacy and safety of Qingkailing(QKL) injection in the treatment of acute stroke.METHODS: Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database,Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software.RESULTS: A total of 13 studies with 1110participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk(RR) in the acute cerebral hemorrhage(ACH) sub-group was 1.17 [95%confidence interval(CI)(1.08, 1.26), P=0.0001]. In the acute cerebral infarction(ACI) sub-group, RR was 1.27 [95% CI(1.14, 1.42), P0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI(1.20,1.50),P0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference(MD)=﹣3.73, 95%CI(﹣4.48, ﹣2.98), P0.000 01],decreased neurological damage in ACI [MD=﹣5.60, 95% CI(﹣8.50, ﹣2.70), P=0.0002] and ACH[MD= ﹣ 4.08, 95% CI( ﹣ 8.00, ﹣ 0.16), P=0.04],promoted the recovery of awareness [RR=1.56, 95%CI(1.09, 2.21), P=0.01] and reduced the whole blood viscosity coefficient [MD=﹣ 0.75, 95% CI( ﹣1.47, ﹣0.03), P=0.04]. There were no adverse drug reactions reported in the included studies.CONCLUSION: Based on this systematic review,QKL combined with conventional therapy was effective compared with control treatment.However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.     

黄建平辨治胆石症、胆囊炎经验

黄建平教授系上海中医药大学附属曙光医院普外科主任医师,上海市中西医结合外科学会委员,主要从事中西医结合肝胆疾病的临床与研究工作,擅长治疗各类肝胆胰疾病。笔者有幸师从黄建平教授,获益匪浅，兹将老师辨治胆石症、胆囊炎的经验整理如下。     

Effects of feeding tyrosine and phenylalanine on the accumulation of phenylethanoid glycosides to Cistanche deserticola cell suspension culture

AIM： To investigate the effects of feeding phenylalanine （Phe） and tyrosine （Tyr） on the accumulation of total phenolic compounds and four phenylethanoid glycosides （PeGs） to a cell suspension culture of the parasitic plant Cistanche deserticola.METHOD： A cell suspension culture of C. deserticola was established and precursors of different concentrations were fed. In each group, the cell was sampled at the 24^th day after inoculation. The content of total phenolic compounds and four PeGs compounds were determined using the Folin-Ciocalteu method and an HPLC method, respectively.RESULTS： In the Phe fed cells, the maximum PeGs yield was achieved when Phe was fed at 1.5 mmol·L^-1 and the yield reached 1.13 times the control cell concentration. In the Tyr fed cells, the maximum yield of PeGs was 1.60 times of control when 0.75 mmol·L^-1 Tyr was fed to the cells. Furthermore, it was found that the salidroside yield was 4.01 times of control group when 5 mmol·L^-1 Tyr was fed.CONCLUSION： Tyr is a better precursor for PeGs accumulation compared with Phe, and the rate limiting enzymes might be involved in the Tyr branch.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE; To observe capillary blood flow at acu- points during acupuncture treatment of primary dysmenorrhea and gain new insights into its anal- gesic mechanism. METHODS： Patients with primary dysmenorrhea were enrolled and randomly assigned to a treat- ment or control group. Subjects＇ symptoms were differentiated into various Traditional Chinese Medi- cine （TCM） syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu （LI 4）, adding other acupoints based on syndrome. Laser speckle was used tocompare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu （LI 4） be- fore and during the treatment. Each subject was re- quired to finish the period pain symptoms observa- tion form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxi- ety scale, and numerical rating scale before and af- ter treatments. RESULTS： After 10 sessions, the symptom scores, pain index （PI）, and visual analog scale （VAS） de- creased significantly in treatment group. The vol- ume of blood flow in Hegu （LI 4） declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vaso- motor amplitude at Hegu （LI 4） increased remark- ably. CONCLUSION： Acupuncture can increase the capil- lary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

连建伟外科病治验举隅

连建伟教授现任浙江中医药大学副校长、博士生导师、中华中医药学会方剂分会主任委员、第三批和第四批全国老中医药专家学术经验继承工作指导老师,其治学严谨,学验俱丰,医术精湛,临床上擅长以调和中焦方法治疗内科疑难病。连教授认为中医治病当以辨证为要,外科疾患虽见症于体表,然四诊合参,细审其因,