浅谈《伤寒论》之八纲

浅谈《伤寒论》之八纲青海省中医院妇科孔桂茹八纲：即指表里、虚实、寒热、阴阳。是中医辨证的基本方法和纲领。徐灵胎说：“阴阳者，夫天地之纲纪，万物之化生，人身之根本；六要者，表里寒热虚实也，此医中最大关键，明乎此，则万病皆如指掌。“用八纲可以归纳说明病变...     

试论八纲辨证在针灸临床中的应用

八纲，即阴、阳、表、里、寒、热、虚、实。它是中医临床辨证的基本方法之一，也是针灸临床辨证选穴，进行施术的重要依据。因此，八纲辨证对针灸治病有着一定的指导作用。1证分阴阳统领六要阴阳是表里、寒热、虚实六要的总纲，代表着事物的两种不同属性。一切疾病的性质、表现也都可以用阴阳来分为两大类，即表证、热证、实证为阳证，里证、寒证、虚证为阴证。因此，《素问·阴阳应象大论》说：“善诊者，察色按脉，先别阴阳”。《素问·至真要大论》也谈到治疗疾病应“谨察阴阳所在而调之，以平为期”。针灸治病的机理之一就是调和阴阳，…     

浅谈张景岳首倡八纲辨证

景岳治学 ,以喜施温补而享誉医林。但迄今为止 ,先哲后贤对景岳先生倡言“八纲辨证”方面的建构则尚未言及。而《景岳全书·传忠录》中对“阴阳”、“六变”(表里、虚实、寒热 )所作的论述 ,是把《内经》和张仲景的辨证理论 ,作了颇为深刻的分析、归纳和阐析 ,从而对八纲辨证的系统化和规范化作出了不可磨灭的贡献。本文拟对相关内容作一探讨 ,试陈于后。1 .诊病先审阴阳纲景岳说 :“凡诊病施治 ,必须先审阴阳 ,乃为医道之纲领。阴阳无谬 ,治焉有差 ,医道虽繁 ,而可以一言以蔽之者 ,曰阴阳而已。故证有阴阳 ,脉有阴阳 ,药有阴阳。以证而言 ,…     

论体质与八纲证候

疾病是体质对病因作用的反应,证候的产生、性质和类型不仅取决于病因的质和量,还取决于机体的体质特性。“易感”和“从化”反映了体质决定证候的主要过程。八纲证候的产生各有其特定的体质基础。根据机体阴阳矛盾运动的倾向特点,将体质分为亢奋型、迟冷型、虚弱型、强力型四类,并论述了体质与八纲证候的必然联系,以提高八纲辨证的准确性,弥补八纲之不足。     

论藏泻十纲辨证

藏泻是一切运动着的或有生命结构的最基本特征,在人体内一切运动的结果最终都以对物质能量信息的藏泻表现出来,藏以成形,泻以化气,藏以致泻,泻以致藏,藏泻双方相互矛盾制约,相互依存,相互为用,此消彼长,互为消长,在人体内完成一系列生命运动。藏泻辨证与阴阳辨证为中医辨证的两对纲目,为总纲,藏泻与阴阳、表里、寒热、虚实总称藏泻阴阳十纲辨证。藏泻十纲辨证是一种新的辨证方法,比以往阴阳八纲辨证更具体而实用,可更好地辨明疾病的本质。文章用《伤寒论》之太阳病条文举例分析以阐明藏泻十纲辨证之义,以更好地指导临床辨证论治。     

八纲辨证中的“一分为三”说

病分阴证阳证是八纲辨证方法的纲领。笔者在临床及教学中发现,八纲辨证中存在着“一分为三”的辨证方法,亦即辨阴证、辨阳证、辨阴阳错杂证。“一分为三”应该成为辨证方法的总纲。     

《备急千金要方》脏腑辨证与八纲辨证的关系

对《备急千金要方》脏腑辨证与八纲辨证的关系进行了详细考察,探讨了阴阳、表里、寒热、虚实在脏腑辨证中的作用,并分析了各纲领之间的关系。《备急千金要方》脏腑辨证中,阴阳与表里二纲的指导意义均弱化,而以虚实为辨证的基本纲领体现了以虚实寒热为核心的脏腑辨证特色,对现今脏腑辨证的规范性研究具有重要借鉴意义。     

中风病辨治阴阳为纲源流

中风病阴阳为纲简化辨证，源远流长。《内经》奠定辨病阴阳为纲大宗，张仲景《金匮要略》进行初步归纳，唐孙思邈强调先定其冷热，已具阴阳为纲雏形；明杨继洲、王肯堂明确提出中风要分阴阳辨治；明赵献可、清周学海、近现代任应秋就阴阳为纲的病理基础阴虚和阳虚及治法方药进行完善和发展。中风病阴阳为纲简化辨证，理论依据充分，提纲挈领，最为简洁实用，应加以继承发扬，制定统一的规范和量化标准，并推广应用。     

辨阴阳 治便秘

阴阳,既能概括整个病情,又能用于一个症状的分析。在《素问·阴阳应象大论篇》中提出：“察颜切脉,先辨阴阳”。明代医家张景岳强调,“凡诊脉施治,必先审阴阳,乃为医道之纲领”。这阴阳是八纲辨证的总纲,它能统领表里、寒热、虚实3对纲领,故有人称八纲为“二纲六要”。由此可见,阴阳辨证在疾病辨证中的重要地位。中医治病,首辨阴阳,对于临床较为棘手的慢性便秘的治疗同样遵循。     

试论十纲辨证体系在《临证指南医案》中的运用

所谓“十纲”辨证体系为“八纲”体系新增上与下二纲而成阴、阳、寒、热、虚、实、表、里、上、下十个辨证纲领。十纲辨证的内容在《内经》与《伤寒杂病论》中已有论述,而在清·叶天士的《临证指南医案》中,虽无十纲之名,但却有其实,而且论述颇多。以下以《临证指南医案》中有关论述与案例作为佐证,略述上、下二纲与阴、阳、表、里、寒、热、虚、实八纲的关系。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.