智慧与医道——《匡调元医论》二版导读

《人体新系猜想——匡调元医论》于2004年出版迄今已8年,此间,我在认识上又有了些进展,所以决定出第二版,并采纳了朋友们的建议,更名为《匡调元医论——人体新系猜想》二而一,一而二,唯重点略有倾斜而已。 2008年12月,有位素不相识的医生从西安来上海会我。他认为《匡调元医论》是一本医道层面的书,不是论医术的。一语中的。这正是我的本意。     

益心舒胶囊治疗冠心病心绞痛150例临床观察

目的为观察益心舒胶囊治疗冠心病心绞痛的临床疗效。方法随机设治疗组150例,服用益心舒胶囊治疗,对照组50例,服用复方丹参滴丸治疗,疗程均为4周。结果治疗组的临床总有效率为83%,对照组为80%(P>0.05);两组均有改善心电图、心绞痛以及心绞痛的程度等作用,组间比较,P>0.05;治疗组对降低收缩压、改善临床气短、乏力、头晕目眩,以及血液流变学检测指标等方面疗效明显好于对照组(P<0.05,或P<0.01)。结论益心舒胶囊治疗冠心病心绞痛有较好疗效。     

颐脑解郁方改善抑郁症肾虚肝郁型患者中医证候的临床观察

目的观察颐脑解郁方对抑郁症肾虚肝郁型患者中医证候的影响。方法将60例抑郁症肾虚肝郁型患者随机分为颐脑解郁组30例和氟西汀组30例。颐脑解郁组给予颐脑解郁方治疗,氟西汀组给予氟西汀治疗,用药疗程均为6周。在治疗2周、4周、6周时,观察两组患者主要中医证候的改善情况。结果颐脑解郁方对性欲减退、时有太息的疗效在2周、4周、6周时均优于氟西汀(P<0.05或0.01);对腰酸背痛的疗效在2周、4周时优于氟西汀(P<0.01),在6周时组间比较无明显差异(P>0.05);对胁肋胀痛的疗效在2周时优于氟西汀(P<0.01),在4周、6周时组间比较无明显差异(P>0.05);对神思不聚的疗效在2周、4周时组间比较无明显差异(P>0.05),在6周时优于氟西汀(P<0.01);对忧愁善感、兴趣索然、精神委靡的疗效与氟西汀相当(P>0.05)。结论颐脑解郁方能有效改善抑郁症肾虚肝郁型患者的主要中医证候。     

仝小林从络辨治阳痿验案1则

阳痿病从肾虚论治、补肾壮阳的治疗思路始终占有主导地位,而从络辨治、补气活血通络治疗鲜有论述。仝小林教授临证数十年,精于辨证,擅长从络辨治疑难杂病。现将其以补阳还五汤合抵当汤为主方治疗阳痿病的1则验案总结介绍如下,以供同道参考。 1 病案实录 牛某,男,46岁。初诊日期：2008年2月28日。     

分消走泄法治疗非霍奇金淋巴瘤并肺纤维化反复发热案1则

分消走泄法是叶天士《温热论》中提出的治疗湿热病的主要方法之一。叶氏指出:"邪留三焦,亦如伤寒中少阳病也。彼则和解表里之半,此则分消上下之势,随证变法,如近时杏、朴、苓等类,或如温胆汤之走泄。"笔者在临床上应用该方法治疗1例非霍奇金淋巴瘤合并肺纤维化导致的反复发热,取得了满意疗效,现介绍如下。1病案实录     

中药熏洗治疗膝关节骨关节病疗效观察

为观察中药舒筋汤熏洗治疗膝关节骨关节病的疗效,随机将114例病人分为两组.观察组(A组)61例采用中药舒筋汤熏洗患膝部;对照组(B组)53例采用骨友灵外搽患膝部加热水熏洗.治疗时间均为4周.结果显示两组治疗后的近期HSS均较治疗前有非常明显的提高(P＜0.01);远期HSS A组仍较治疗前有明显提高(P＜0.05),而B组与治疗前相比无改善(P＞0.05).两种治疗方法总疗效比较,近期疗效A组明显优于B组(P＜0.05);远期疗效A组非常明显优于B组(P＜0.01).另外,两组治疗后HSS评分差比较A组明显高于B组(P＜0.05).临床统计结果提示中药外用是治疗膝关节骨关节病一种较好的方法,但舒筋汤熏洗较传统药物疗效更好,症状复发率更低.     

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,     

Ursolic acid induces U937 cells differentiation by PI3K/Akt pathway activation简

AIM： Ursolic acid （UA）, a pentacyclic triterpenoid, is used as an anti-inflammatory and anti-cancer agent. There were few studies on the effects of UA on differentiation, and this is the first time to elucidate the potential effect and molecular mechanism of UA on inducing differentiation in the human leukemia cell line U937. METHODS： Wright-Giemsa staining, nitroblue tetrazolium reduction assay and flow cytometric analysis were utilized to demonstrate the differentiation of U937 cells induced by UA. Western blotting and immunofluorescence assay were used to investigate the possible mechanism. RESULTS： It was found that UA could induce the differentiation of U937cells and Akt-activity was significantly increased during differentiation. Additionally, LY294002, a PI3K-Akt inhibitor, could block the differentiation of U937 cells induced by UA. CONCLUSION： UA could induce the differentiation of U937 cells by activating the PI3K/Akt pathway, and it could be a potential candidate as a differentiation-inducing agent for the therapy of leukemia.     

半夏治疗睡眠障碍经验

睡眠障碍主要是指睡眠量的障碍,表现为睡眠过少、睡眠过多;也有睡眠质的改变,如睡眠倒错、睡眠呼吸暂停综合征、睡行症等。中医学对睡眠障碍没有明确的分类,在中医睡眠学说中单独成立的疾病只有不寐和嗜睡,其他症状散在于诸多疾病中。     

管窥骨关节炎“痹痿并存”

石印玉教授对于骨关节炎的病机,提出“本痿标痹、痹痿并存”的学术观点。我们通过跟师学习,渐感其含义深刻。 早期随师学习时,笔者如下理解“本痿标痹、痹痿并存”的学术观点,也有专文发表,摘录如下： 骨关节炎属痿,原因有四：其一,从本质上看,骨关节炎符合痿证病机,即骨关节炎多由肝’肾不足而发病。其二,骨关节炎发病符合痿证特点。本病多发中老年以后,女子六七,男子六八,肝气衰,筋不能动,     

Effects of Bushenyiqihexue formula on the endometrial gland apoptosis in mice with blastocyst implantation dysfunction

Objective: To observe the effects of Bushenyiqihexue Formula (补肾益气和血方 Formula for Tonifying the Kidney, Replenishing qi and Harmonizing Blood, FTKRQHB) on the endometrial gland apoptosis in the mice with blastocyst implantation dysfunction. Methods: The mice with the first-day pregnancy were divided into the control, model and treatment groups, with 30 in each group, and blastocyst implantation dysfunction was induced by subcutaneous injection of mifepristone in the mice of the model and treatment groups. The pregnancy rate and implantation number of blastocysts were measured and the expressions of proliferating cell nuclear antigen (PCNA), Bax, Bcl-2, and activated caspase-3 were detected in all the three groups. Results: The model group had significantly depressed pregnancy rate, implantation number of blastocysts and apoptosis index, and elevated proliferation index of endometrial gland as compared with the control group (P0.05 or P0.01). Administration of FTKRQHB (the treatment group) resulted in significant increases in pregnancy rate, implantation number of blastocysts and apoptosis index of the endometrial gland, and a significant decrease in the proliferation index of the endometrial gland as compared with the model group (P0.05 or P0.01). The differences in the four indexes between the treatment group and control group were not significant statistically. The Bax and activated caspase-3 expressions in endometrial gland in the model group became significantly lower than that of the control group (P0.01), whereas those in the treatment group were significant higher than that of the model group (P0.01). However, the Bax and activated caspase-3 expressions in endometrial gland were similar in both treatment and control groups. Conclusion: Promoting the increases in Bax and activated caspase-3 expressions in the endometrial gland and bringing into balance between apoptosis and proliferation of the glandular cells at the implantation window phase by FTKRQHB may contribute to the effects of promoting the establishment of endometrial receptivity and improving blastocyst implantation dysfunction.     

试论咸味药的软坚作用

四气五味是中药的药性,也是临床用药的依据之一。《素问·至真要大论》谓：“酸先入肝,苦先入心,甘先入脾,辛先入肺,成先入肾。”中药学理论认为,咸味之药,性浸润,柔软坚凝,使肿块顽痰消散;咸属水,     

煨脓生肌法在烧伤创面治疗中的应用

烧伤的创面处理是整个治疗过程中的重要环节,一般处理原则为保护创面、减少渗出、预防和控制创面感染。中医药治疗烧伤的历史悠久,疗效显著。近年来,笔者对于烧伤患者的创面采用煨脓生肌法治疗,取得了较好的效果,现将个人的有关体会小结如下,以供同道参考。     

刘喜明运用经典方辨治咳嗽验案4则

刘喜明老师系中国中医科学院广安门医院主任医师、教授、博士研究生导师。治学严谨,勤求古训,博采众长,对杂病及疑难病的诊治独具匠心,疗效显著。笔者有幸侍诊,得其教诲,受益匪浅。现择选刘师运用经典方辨治咳嗽验案4则介绍如下。     

郭裕诊治耳鼻喉疾病验案3则

郭裕（1961-）,教授,硕士生导师,主任医师,兼任中华中医药学会耳鼻喉科专业委员会常务委员,上海市中医药学会耳鼻喉科专业委员会主任委员,上海市中西医结合学会耳鼻喉科专业委员会委员。     

王文健辨治代谢综合征合并糖尿病肾病验案1则

王文健教授系上海市名中医,潜心钻研岐黄之术数十年,融中西医学之所长,尤其对糖尿病、脂肪肝、高血压等疾病诊治经验丰富,疗效显著。笔者有幸侍诊在侧,聆听教诲,收获颇丰,兹择其典型验案1则,以飨同道。     

黄煌经方内科医案(八)——肌肉痉挛治验2则

肌肉痉挛指肌肉突然、不自主的强直收缩,常引起肌肉僵硬及疼痛不适。根据发作持续时间,本病可分为阵挛性肌痉挛与强直性肌痉挛两类,前者如面肌痉挛、三叉神经痛性面肌痉挛,后者如手足搐搦症、破伤风、狂犬病、药物中毒、职业性肌痉挛、痛经、膈肌痉挛以及高热惊厥、自主神经性癫痫等。肌肉痉挛在临床     

孙桂芝运用“肾为五脏之本”理论治疗恶性肿瘤验案4则

孙桂芝教授是中国中医科学院广安门医院著名的中医及中西医结合肿瘤学家,博士、博士后导师,全国老中医药专家学术经验继承工作指导导师,享受国务院政府特殊津贴。孙师潜心研习并运用中医、中西医结合法治疗恶性肿瘤40余年,学术底蕴丰厚,经验宏富,疗效卓著,深受广大患者及行业同仁的信赖与推崇。     

赵和平从肝论治神经性疾病验案举隅

赵和平主任医师系湖北省名中医,湖北省十堰市中医医院副院长,从事中医临床工作30余年,在治疗疑难杂病方面积累了丰富的经验。笔者跟师学习多年,常见其从肝论治多种神经系统疾病,取效良好。现结合3则验案,小结其经验如下。     

针刺“三气穴”治疗妇科疾病验案4则

“三气穴”既气海、气穴、气门,分别属于任脉穴、肾经穴及经外奇穴,此三穴均位于脐下小腹部,具有调补冲任、壮元益肾、滋阴养血之功。笔者在临床中,将“三气穴”应用于妇科疾病的治疗,疗效颇佳。现举例如下。