真武汤辨治阳虚水泛型高血压病探讨

目前,高血压病中医辨证分型尚未论及阳虚水泛型,但临床中阳虚水泛型高血压病常见。高血压病其中一病机为阳虚水泛,指阳气亏虚则温煦推动无力,水液输布失常,水气上泛清窍,蒙蔽神明,临床表现头痛、眩晕,可予真武汤辨治。真武汤温脾肾助阳气、蒸化水气、促进人体气血津液各走其道,能有效治疗阳虚水泛型高血压病,临床应用取得良好效果。特此总结并附验案1则。     

基于《伤寒论》温阳法探讨眩晕的辨治思路

眩晕的病因病机较为复杂,其中有因阳虚所致者,人体阳虚可导致水饮、痰湿、瘀血等病理变化发生,进而影响气血津液运行、输布,其上可促使脑组织能量代谢发生障碍,脑失所养,故易发眩晕。而最早张仲景在其所著《伤寒论》中就明确提出了因阳虚所致眩晕的相关论述及具体方药,因此,文章主要就阳虚与眩晕的发病及《伤寒论》相关条文中运用温阳法治疗眩晕进行总结,进而对温阳法辨治眩晕进行探讨,以拓宽临床治疗眩晕的辨治思路和方法。     

心血管病临证辨治及预防

因心血管病症状繁多而隐匿型者亦不鲜见,余临证时深感对该病的治疗应从症入手,抓住疾病本质进行治疗。心血管病种多,临床不外眩晕、心悸、心痛、脉结代、喘息、水肿、痹阻几个方面,现就辨证施治分述如下：１眩晕可分为肝阳上亢、痰浊中阻、气血不足、阳虚、阴虚五种类...     

从瘀论治老年性眩晕120例

采用辨证将老年眩晕分为肝火血痪型、阴虚血瘀型、气虚血瘀型、血虚血瘀型、阳虚血瘀型、痰饮血瘀型6类,治疗120例,总有效率89.1％。提示从瘀论治是治疗老年性眩晕的较好方法。     

真武汤加减运用验案3则

"真武汤"为《伤寒论》名方,临床广泛运用于阳虚所致的眩晕、心悸、心衰等病症,特别是在心脑血管疾病中更具突出疗效,但仍需把握好该方的方义及药物的配伍,对于疗效的提高尤为重要。阳气亏虚,则或发冷,或眩晕,或心悸,或脑鸣,以温阳之法治之。真武汤专为阳虚水泛而设,可使清窍得以温通,水湿得以温散,筋脉得以温养。     

运用“近效术附汤”治疗阳虚眩晕的一点体会

<正> 眩晕一证,早在《内经》中就有“诸风掉眩,皆属于肝”的记载。后世医家又在《内经》论述的基础上进一步提出新的见解和认识,使之不断充实和丰富。如金·刘河间认为风火可以致眩;元·朱丹溪认为风痰可以致眩;明·张景岳则认为眩晕可以因虚而成。他们从各个不同的角度出发,阐明了眩晕证不同的病因病理,指导着临床实践。基于上述情况可知,眩晕的形成主要与风、火、痰、虚四个方面的因素密切相关。从临床实践观察来看,除因风、火、痰致眩不计外,还须进一步重视因虚致眩的问题。所谓“虚”,它既指出阴虚,也概括了阳虚(当然气血双虚也是致眩的因素之一)。如阴虚有热而致眩晕的,治宜滋阴清热;阳虚而致眩晕的,则非用补真阳、祛浊阴的办法不可。所以我们在临证时,既要在重视阴虚致眩的同时,务必还要把阳虚致眩的因素也重视起来。今就本人在临证常用近效术附汤治疗阳虚眩晕证的过程,并附医案介绍如下,仅供参考。患者吴××,女,43岁,家属。自述眩晕     

麻黄附子细辛汤新用

麻黄附子细辛汤出自《伤寒论》,为少阴阳虚兼太阳外感而设。临证用于治疗阳虚外感为人们所共识,然而用于其它疾病则鲜有报导,笔者自1988～1993年以此方治疗血管性头痛、内耳眩晕症,病态窦房结综合症疗效较好’现简介如下。1 血管性头痛     

阳虚淤血型高血压病26例疗效观察

高血压病,属于祖国医学“眩晕”,“头痛”,“肝风”,“中风”等病证的范畴。一九八一年以来笔者在中医辨证分型的基础上,对26例阳虚淤血型高血压病患者,采用温阳化淤法治疗、取得较好效果。现小结如下:     

郭维琴教授益气活血散结治疗大动脉炎经验总结

郭维琴教授将大动脉炎诊断为"无脉证",认为病因为外感寒邪。初期邪客于脉,日久阴阳不足,阳虚则寒凝血瘀,阴虚则脉络空虚,终末期阴阳亡脱而死。郭维琴教授在临床上将大动脉炎分为邪气入侵、阳虚寒凝、阴虚血阻、气虚血瘀4型进行辨证施治,4型之间可以互相兼夹,临床中可以灵活用药。     

全国名中医赵文海教授论治颈性眩晕的经验

<正>颈性眩晕为骨伤科常见病与多发病之一，临床常见头晕目眩，伴有颈或肩背部疼痛僵硬、肢体关节怕冷等症状^[1-3]。本病属于中医“项痹”“眩晕”范畴，赵文海教授认为其临床多以虚证引发，正如《景岳全书·眩晕》中说“头眩虽属上虚，然不能无涉于下。盖上虚者，阳中之阳虚也；阳中之阳虚者，宜治其阳气”^[4-6],说明阳气不振则髓海生化无源，气血津液推动及升发无力，日久痰湿内生，阻滞经络而致瘀痹，上扰清窍。     

《金匮要略》泽漆汤证治法探讨

文章主要发掘《金匮要略》泽漆汤证的治法机理,探讨了泽漆汤证的治疗法则,揭示了泽漆汤治疗的病位、病机和疾病。同时结合临床经验和引证实验结果说明泽漆汤治疗肺癌的可行性。泽漆汤逐水通阳、消痰散结、健脾扶正、清化郁热,是寒热并用、攻补兼施之治法,临床主要治疗肺癌、转移性肺肿瘤病等。其治法重视对病位的脏器气机调理,顺应脏腑特性,疏理肺脏气机。肿瘤病正气大虚,脾为后天之本,治当培本,是一大要义。泽漆先煎,去其毒性,为护正安胃之举,时时不忘顾护胃气之义。     

泽仁口服液对弱精症大鼠精子质量影响实验研究

目的:研究泽仁口服液对弱精症大鼠精子质量的影响。方法:共80只雄性SD大鼠,其中10只处死后检测其a级精子及精子活率(即a+b级),另70只用雷公藤多甙(GTW)灌胃造模。造模成功后10只立即处死并检测其a级精子及精子活率,60只随机分为3组各20只,泽仁组用泽仁口服液灌胃、五子组用五子衍宗片灌胃、对照组予正常饮食不用任何药物,1个月后均处死并检测其a级精子及精子活率。结果:造模组a级精子及精子活率与正常组比较明显降低(P0.01),泽仁组和五子组a级精子及精子活率与对照组比较明显升高(P0.01),泽仁组和五子组a级精子及精子活率比较无显著性差异(P0.05)。结论:泽仁口服液能改善弱精症大鼠的精子质量。     

In vitro hepatotoxicity of Petasites hybridus extract (Ze 339) depends on the concentration,the cytochrome activity of the cell system,and the species used

Ze 339, a CO₂ extract prepared from the leaves of Petasites hybridus, possesses antispasmodic and anti‐inflammatory effects and is proven to be effective in the treatment of allergic rhinitis. To study possible hepatotoxic effects of Ze 339, its main constituents and metabolites, a series of in vitro investigations were performed. Furthermore, different reconstituted fractions of extract (petasins and fatty acid fraction) were examined in three in vitro test systems using hepatocytes: Two human cell lines, with lower and higher activity of cytochrome P450 enzymes (HepG2, HepaRG) as well as a rodent cell line with high cytochrome P450 activity (H‐4‐II‐E), were used. Metabolic activity, assessed by the WST‐1 assay, was chosen as indicator of cytotoxicity. To assess potential bioactivation of Ze 339 compounds, metabolic experiments using S9 fractions from rats, dogs, and humans and isolated cytochromes (human/rat) were performed, and the formation of reactive metabolites was assessed by measuring cellular concentrations of glutathione and glutathione disulphide. Our data revealed that the cytotoxicity of Ze 339, its single constituents, and main metabolites depends on the concentration, the cytochrome activity of the cell system, and the species used.     

HPLC法研究贮藏期牡丹皮中三种药效成分的含量变化

目的通过测定安徽南陵牡丹皮中3种药效成分的含量变化,确定牡丹皮的最优贮藏方法及贮藏期,为牡丹皮GAP生产提供依据。方法采用HPLC法,以甲醇∶乙腈(1∶1)-0.5‰甲酸溶液为流动相;检测波长为265 nm,流速为1.0 m L/min,柱温为30℃。结果药效成分的含量随贮藏时间的增加而减少;密封包装对抗同贮优于单纯密封,散装贮藏效果最差。结论与泽泻对抗同贮有利于牡丹皮药材的保存;密封包装对牡丹皮成分影响较小,优于散装;该法简便,精密度、重现性好,可作为同时测定牡丹皮中多种化学成分的检测标准,为有效地控制丹皮的内在质量提供了科学依据。     

Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339

BACKGROUND: Intermittent allergic rhinitis (IAR) causes patients distress and impairs their work performance and quality of life. A variety of medicines are used by sufferers whose anguish frequently leads to trying new treatments, increasingly from herbal sources. METHODS: Prospective, randomized, double-blind, parallel group comparison study of Butterbur extract (Ze 339; 8 mg total petasine; one tablet thrice-daily), fexofenadine (Telfast 180, one tablet once-daily) and placebo in 330 patients. Protocol and analysis were according to the latest guidelines on new treatments for allergic rhinitis. The primary efficacy variable was a change in symptoms from baseline to endpoint during daytime. The secondary efficacy variables were: (a) as per primary variable (evening/night); (b) Physician's global assessment; (c) Responder rates. Safety was closely monitored. FINDINGS: Both active treatments were individually significantly superior to placebo (p<0.001) in improving symptoms of IAR, while there were no differences between the two active treatments (p=0.37). Superiority to placebo was similarly shown during the evening/night (p<0.001), by physicians' own assessment and by responder rates. Both treatments were well tolerated. INTERPRETATION: Butterbur Ze 339 and Fexofenadine are comparably efficacious relative to placebo. Despite being a herbal drug, Butterbur Ze 339 has now been subject to a series of well controlled trials and should be considered as an alternative treatment for IAR.     

A randomized, double blind, placebo-controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non-organic sleep disorder

Valerian and hops are traditionally used as sleep aids. Since the fixed extract combination (Ze 91019) as a whole is considered the active compound, the clinical efficacy must be demonstrated for this extract combination. The present clinical study aimed to demonstrate superiority of the fixed extract combination in comparison with placebo in patients suffering from non-organic insomnia (ICD 10, F 51.0-51.2). Objective sleep parameters were registered by means of a transportable home recorder system (QUISI). The primary outcome was the reduction in sleep latency (SL2) which had to be prolonged at baseline (>/=30 min) as an inclusion criteria. The treatment period lasted for 4 weeks with either placebo, single valerian extract (Ze 911) or the fixed valerian hops extract combination (Ze 91019). The amount of the single valerian extract was identical to that amount contained in the fixed extract combination, i.e. 500 mg valerian extract siccum. In the extract combination 120 mg hops extract siccum was added. Both the extracts were prepared with 45% methanol m/m with a drug-extract ratio of 5.3:1 (valerian) and 6.6:1 (hops), respectively. The fixed extract combination was significantly superior to the placebo in reducing the sleep latency whilst the single valerian extract failed to be superior to the placebo. The result underlined the plausibility for adding hops extract to the valerian extract.     

＂拉玛泽＂（Lamaze）呼吸减痛法的应用效果

目的：探讨＂拉玛泽＂（Lamaze）呼吸减痛法在分娩中对产妇的影响.方法：选择足月妊娠,可行阴道分娩的初产妇200例,随机分为干预组、对照组各100例,干预组从7个月开始接受＂拉玛泽＂呼吸减痛法训练,对照组只接受常规的宣教,观察两组产妇产程时间、剖宫产、产后出血情况.结果：两组比较,精神紧张、恐惧症状的发生,产程时间,剖宫产率、产后出血率等均有显著性差异（P〈0.05）.结论：＂拉玛泽＂呼吸减痛法能有效地减轻分娩疼痛,消除恐惧心理,加速产程,减少产后出血,降低剖宫产率,是一种简单有效、可行的非药物性减痛的方法.     

加味增液汤治疗吗啡类药物所致便秘38例

目的观察加味增液汤治疗吗啡类药物所致便秘的临床疗效。方法应用加味增液汤治疗吗啡类药物所致便秘患者38例,1剂/d,15d为1个疗程。1个疗程结束时评价疗效。结果治愈25例(占65.8%),显效8例(占21.1%),有效4例(占10.5%),无效1例(占2.6%),总有效率97.4%。结论加味增液汤治疗吗啡类药物所致的便秘具有较好的临床疗效,改善了患者的生活质量。     

眼针疗法对脑缺血再灌注大鼠脑源性神经营养因子表达的影响

目的观察眼针疗法对脑缺血再灌注损伤大鼠脑皮质脑源性神经营养因子（BDNF）表达的影响,探讨眼针在脑缺血再灌注损伤中的治疗作用。方法线栓法制备SD大鼠大脑中动脉梗死（MCAO）再灌注模型。将SD大鼠随机分为正常对照组、假手术组、模型组、眼针组。于再灌注24h后采用ZeaLonga评分法进行大鼠神经功能评分;采用实时定量PCR方法检测缺血脑皮质BDNF mRNA的表达;采用免疫组织化学法、蛋白免疫印迹法检测缺血脑皮质BDNF的表达。结果缺血再灌注24h后,眼针组大鼠神经行为评分显著低于模型组;眼针组大鼠脑皮质BDNF mRNA的表达和蛋白的表达较模型组均有明显减少。结论眼针疗法能诱导大鼠缺血再灌注后脑皮质BDNF表达水平,有利于缺血再灌注损伤后神经元损伤的保护。