从脾胃论治汗证体会

汗证总属阴阳失其协调所致,治疗旨在使机体营卫和调。从脾胃立论,则脾胃健,卫气充,营卫和调,腠理致密,汗止。     

孙喜才教授用四逆散治疗汗证经验

介绍孙喜才教授治疗汗证的经验。认为气机不畅也可导致汗出。气机不畅 ,营卫二气的循环节度规律就会发生紊乱 ,营卫不和 ,腠理开合不利而引起汗液外泄。提出了从疏理气机不畅入手来治疗汗证的方法。选用四逆散加味治疗。     

妇科汗证治疗浅析

妇科疾病所致汗证与疾病本质息息相关,临证当见微知著,循因求本,分清寒热虚实,辨别轻重缓急,方能不治汗而汗自除.更年期汗证以和解枢机、调和营卫为主;产后发热汗出以补血养阴、益气清热为主;妇人腹痛感染邪毒所致汗证以清热解毒、凉血化瘀为主;带下病、阴痒病中肝经湿热型汗证以疏肝清热、利湿排浊为主.此外,应根据疾病所处的病理阶段...     

中医如何治疗汗证

汗证是指人体阴阳失调、营卫不和、腠理不固而引起汗液外泄的病证,是临床上较为常见的病证。汗证包括自汗与盗汗。白昼时时汗出,动则益甚者为自汗;睡中汗出,醒来即止者为盗汗。一、治疗原则治疗本病当辨证施治,分清虚实,虚则补之,实则泄之。自汗多因     

汗证的中医药治疗概况

汗证是指阴阳失调、营卫不和、奏理开闻不利而引起汗液外泄的病症。历代医家都对汗的辨证论治颇为重视。汗证多属于现代医学的植物神经功能紊乱、甲状腺功能亢进等范畴。由此可见汗证是一个既常见又不能忽略的病症，在临床治疗上有着极重大的意义。近年来对汗证的中医药治疗取得了很大的进展。现对汗证的中医药治疗方法论述如下： 1 辨证论治 1．1 肺气不足、肺卫不同 治法宜固表止汗，方用玉屏风散。酌加党参、麻黄、附子、龙骨、牡蛎、桂枝等药物。若……     

王哲教授运用神阙穴贴敷治疗产后汗出不止经验撷英

[目的]探讨王哲教授应用神阙穴贴敷治疗产后汗证的临证经验,以期为中医外治法治疗产后汗证提供相关经验。[方法]分析王哲教授对产后汗证的病因病机认识,阐明神阙穴贴敷作用机制、贴敷时间及注意事项等,并列举典型案例加以佐证。[结果]王哲教授认为产后汗证的病因病机主要为产时耗伤气血,亡血伤津,致气血虚弱,阴血暴脱,虚阳外越,熏蒸汗出。针对其病因病机,采用益气养血、收敛止汗的原则,运用神阙穴贴敷治疗,可较大程度发挥神阙穴固本培元、调整阴阳及药物五倍子、煅牡蛎收敛止汗的功效,有助于产妇整体恢复,临床应用疗效显著。所举验案辨为气血虚弱、营卫失和证,选取益气固表方联合神阙穴贴敷治疗,以固本培元、收敛止汗为治则,使营卫调和,汗出自止。[结论]王哲教授运用神阙穴贴敷外治法治疗产后汗证,方小精简,经济便捷,疗效突出,其经验值得借鉴。     

小儿汗证治疗八法

论述小儿汗证的治疗,勿拘泥于均为以“补”为治,应辨虚实,依据临床体会,总结出消积泄热,清热利湿,疏肝理脾,活血化瘀,益气固表,调和营卫,益气养阴,滋阴清热八种疗法。     

玉屏风散加味治疗难治性汗证患者1例报告

汗证是指汗出异常的证候,当汗出而无汗、不当汗出而多汗,或身体局部汗出异常者,均属于病理现象,可归属于中医学"汗证"范畴[1].汗证一般多见于甲状腺功能亢进、风湿热、植物神经功能紊乱、肺结核等疾病.中医学认为,汗证多由于阴阳失调、腠理不固而致汗液外泄失常导致,既可单独出现又可作为伴随症状出现在其他疾病中.难治性汗证主要是...     

自拟补虚敛汗方治疗肺痨汗证40例

目的:探讨补虚敛汗方对肺痨汗证的疗效.方法:80例肺痨汗证患者随机分成两组,两组病人均经中医辨证属气阴两虚型.对照组予常规抗痨治疗,治疗组除常规抗痨治疗外,予补虚敛汗方.两组疗程均为2月.结果:治疗组总有效率达90.00%.对照组总有效率达47.50%.两组有效率对比具有显著性差异(P＜0.01).结论:补虚敛汗方能较...     

扶阳法治疗汗证临床探析

中医的汗证主要包括自汗和盗汗两种。传统以益气固表,调和营卫,滋阴降火,清化湿热为主要治疗方法,但应用于临床,疗效并不理想。现代人生活方式加之抗生素、激素及苦寒药的滥用,极度损伤人体阳气。所以现代临床上由于阳虚导致的疾病很多见,汗证亦不例外。肾阳为人体阳气之本,立命之根,真阳虚衰,不能统摄肾阴,阴火沸腾,虚阳外越则汗出不止。应用扶阳法治疗,临床疗效颇佳。     

小儿汗证的中医药治疗

小儿汗证是指小儿在安静状态下、正常环境中全身或局部出汗过多,甚则大汗淋漓的一种病证。因患儿气阴不足、营卫不和、卫表不固或脾胃湿热而致,病机之关键在于阴阳失调、腠理开合失司和湿热郁蒸。中医药治疗主要以药物内服辨证施治,或以药粉外扑、洗浴、敷脐止汗,或施以针灸推拿,疗效均较肯定,且均未见明显不良反应。今后应结合多种方法,形成具有中医药特色的治疗体系,并积极进行中药剂型改革和中药外治法的拓展。     

下肢慢性皮肤溃疡辨证分型标准的临床研究

目的：建立下肢慢性皮肤溃疡临床辨证分型标准,为指导临床,进一步提高临床疗效以及建立综合的临床疗效评价体系奠定基础。方法：通过338例下肢慢性皮肤溃疡患者证候的临床病例观察,提取证候要素,在此基础上进行聚类分析及主成分分析,结合国内相关专家问卷调查修正,得出下肢慢性皮肤溃疡的临床辨证分型标准。结果：338例下肢慢性皮肤溃疡患者证候要素经聚类分析聚为4类,通过专家修正,第1、3类（气血两虚证、气虚血瘀证）合并为气虚血瘀证,第2类为脾虚湿盛证,第4类为湿热瘀阻证,并由主成分分析和专家平均排位情况确定每一类证型的主症和次症。这3种证型反映了下肢慢性皮肤溃疡患者的临床基本证候。结论：下肢慢性皮肤溃疡的临床基本证候可辨证为气虚血瘀证、脾虚湿盛证和湿热瘀阻证。局部辨证在下肢慢性皮肤溃疡的临床辨证中尤为首要．     

伤寒论评话

目的：探讨伤寒和中风、麻黄汤证和桂枝汤证的异同及其交叉证候的辨证治疗机理。方法：对《伤寒论》第23条、第25条和第27条进行分析。结果：发现伤寒和中风、麻黄汤证和桂枝汤证有异有同,并有二者的交叉证候需仔细辨证①第23条桂枝麻黄各半汤证是伤寒表实证的卫闭与中风表虚证的营泄两者混合而成。营阴外泄但不能出于皮表,卫气内闭但不能到肌里,卫闭和营泄僵持在肌外皮里,就出现了面红和身痒的典型症状。治疗时麻黄汤、桂枝汤同用,通过小汗出使外泄的营阴复归于脉内,闭阻的卫气敷布与体表,从而达到双管齐下,一举两得的治疗效果。②第25条＂服桂枝汤＂后出现＂脉洪大＂是因为用药的方法不当,风邪未祛,加之桂枝汤辛温药物激荡鼓动,且正气未衰,有足够能力抵御邪气,正气不衰、风邪荡漾、药力鼓动,三者合力导致脉象洪大。③第25条＂服桂枝汤＂后出现＂脉洪大＂,是因为用药的方法不当,风邪未去,加之桂枝汤辛温药物激荡鼓动,且正气未衰,有足够能力抵御邪气,正气不衰、风邪激荡、药力鼓动,三者合力导致脉象洪大。④太阳伤寒表实证和太阳中风表虚证两者,一个是卫气闭合太过,重点在卫气;一个是营阴疏泄太过,重点在营阴,一个无汗,一个汗出,看似截然不同,其实随着病情的迁延,两者有时会出现在同一患者身上,所以在治疗时就不能拘泥于＂有汗不得用麻黄,无汗不得用桂枝＂的常规。结论：伤寒和中风、麻黄汤证和桂枝汤证及二者的交叉证候需要＂平脉辨证＂,随证而施,辨证论治,不可拘泥。     

气虚发热证家兔皮肤、肺脏、脾脏的形态学变化

目的研究气虚发热证家兔的皮肤、肺脏、脾脏的形态学变化,探讨气虚发热对皮肤、肺脏、脾脏的影响。方法将家兔随机分成2组,即正常组与气虚发热组,采用禁食不禁水和腹腔注射脂多糖（LPS）建立气虚发热模型,取皮肤、脾脏、肺脏组织制备石蜡组织切片,显微镜下观察其形态学变化。结果显微镜下观察组织切片,与正常组相比,气虚发热组家兔肺脏局部有炎性细胞浸润,脾脏局部组织有灶状多核巨细胞浸润并见肉芽肿性病变,皮肤表皮呈不规则皱缩,毛囊变短,毛孔头数明显减少。结论气虚发热证家兔的皮肤、脾脏、肺脏与正常家兔比较存在组织形态学差异。     

运转大气三法初探

大气是聚集于人体胸中,由先天元气化生,为后天脾胃运化的水谷精微之气和肺吸入的清气一起充养的人体之气,具有重要的生理作用。大气之要,贵在运转,大气得运,则营卫和谐,阴阳调和;大气失转,则百病蜂起,诸症丛生。调补太阳、化痰通阳、宣通玄府为运转大气之法,可为临床借鉴。     

浅析湿热盗汗的病因病机与治疗思路

[目的]阐述湿热盗汗的病因病机,纠正一遇盗汗便敛阴止汗的惯性思维。通过理论与临床相结合的方式提出湿热盗汗的论治之法。[方法]对临床上证属湿热内蕴型的盗汗患者,使用葛根芩连、四妙散合三仁汤加减清热化湿治疗。在中药治疗的同时,改变患者可能会导致湿热证的不良生活习惯。最后观察疗效,并举隅验案一则。[结果]通过清热化湿的中药治疗以及健康宣教后,不仅患者的主症盗汗状况得到有效控制,湿热证的其余症状均有所改善。[结论]盗汗患者证有虚实,临床上存在湿热证象者不在少数,故应当予以重视。而导致湿热之病因繁多,中医治病必求于本,故在治疗上需从盗汗问题产生的源头入手,而不应局限于盗汗之表象。治疗此病,从改良患者生活习惯、药物辅助治疗两方面入手,改良生活习惯可令患者阴阳调和,正气充沛,不易产生湿热证；中药治疗攻补兼施,清化湿热与补益脾胃并举,可令药物与人体正气相辅相成,共同将邪气排出体外。最后达到阴平阳秘,精神乃治的状态,盗汗自然能愈。     

“阳和通腠”思想指导肉芽肿性乳腺炎治疗

肉芽肿性乳腺炎属本虚标实之证,病因病机为气血亏虚、气化不利、阴毒痰凝。阳和通腠法是通过温阳与辛散之品配伍,使阴邪随汗液排出的一种治疗方法,营卫气血得和、邪毒从表而散是该法的核心理论。临床上治疗肉芽肿性乳腺炎应遵循阳和通腠的原则,通气血而开腠理、化阴凝而布阳和,使寒痰阴毒得温化宣发而出。     

原发性胆汁性肝硬化与慢性乙型病毒性肝炎文献证素比较研究

目的:通过原发性胆汁性肝硬化(PBC)与慢性乙型病毒性肝炎(CHB)的文献证素比较研究,探析PBC的证素分布特征及病机特点。方法:基于万方及中国知网文献数据库,结合人工筛选,获取2000年1月至2014年6月公开发表的非重复PBC中医研究文献,参照CHB证素研究方法建立PBC证素数据库。通过与CHB的对比显示PBC证素分布规律与特点。结果:①文献特征:纳入56篇文献,病例1368例,研究快速增加,高质量研究主要集中于三级甲等中医院。②证型分布特征:析出证型56个,依次为肝肾阴虚等10个高频证型,按照证素聚合后形成6大核心证素群依次为:血瘀、脾虚、阴虚、肾虚、湿热及肝郁,与CHB中湿热、肝郁、血瘀、毒、阴虚有所不同。③证素分布特征:PBC病位证素依次为肝、脾、胆、肾;CHB为肝、脾、肾、胆、络。PBC中胆为高频病位,胆络、肝络为特有病位。PBC中病性证素依次为气虚、血瘀、气郁、湿、热;CHB为气郁、湿、热、阴虚、血瘀、阳虚;与CHB相比,PBC中气虚、血瘀为高频证素,气郁、热、阴虚、阳虚为低频证素。结论:PBC中瘀、气虚(脾虚)等6大核心证素群值得重点关注;胆、肝络及胆络是特有病位,应在实践中丰富关于胆系的中医治法;气虚、血瘀是PBC绝对优势证素,早期使用补气活血治法可能有助于改善预后。结合前期研究,提出PBC三阶段演变假说,气虚血瘀为核心证型,毒损胆络是关键推动机制。     

Transplantation of human bone marrow-derived mesenchymal stem cells transfected with ectodysplasin for regeneration of sweat glands

Background  Patients with severe full-thickness burn injury suffer from their inability to maintain body temperature through perspiration because the complete destructed sweat glands can not be regenerated. Bone marrow-derived mesenchymal stem cells (BM-MSCs) represent an ideal stem-cell source for cell therapy because of their easy purification and multipotency. In this study, we attempted to induce human BM-MSCs to differentiate into sweat gland cells for sweat gland regeneration through ectodysplasin (EDA) gene transfection.

Methods  The dynamic expression of EDA and EDA receptor (EDAR) were firstly observed in the sweat gland formation during embryological development. After transfection with EDA expression vector, human BM-MSCs were transplanted into the injured areas of burn animal models. The regeneration of sweat glands was identified by perspiration test and immunohistochemical analysis.

Results  Endogenous expression of EDA and EDAR correlated with sweat gland development in human fetal skin. After EDA transfection, BM-MSC acquired a sweat-gland-cell phenotype, evidenced by their expression of sweat gland markers by flow cytometry analysis. Immunohistochemical staining revealed a markedly contribution of EDA-transfected BM-MSCs to the regeneration of sweat glands in the scalded paws. Positive rate for perspiration test for the paws treated with EDA-transfected BM-MSCs was significantly higher than those treated with BM-MSCs or EDA expression vector (P <0.05).

Conclusions  Our results confirmed the important role of EDA in the development of sweat gland. BM-MSCs transfected with EDA significantly improved the sweat-gland regeneration. This study suggests the potential application of EDA-modified MSCs for the repair and regeneration of injured skin and its appendages.

     

Morphological and distribution characteristics of sweat glands in hypertrophic scar and their possible effects on sweat gland regeneration

Background In hypertrophic scar tissue, no sweet gland and hair follicle exist usually because of the dermal and epidermal damage in extensive thermal skin injury, thus imparing regulation of body temperature. This study was designed to reveal the morphological and distributional characteristics of the sweat glands in normal skin and hypertrophic sear obtained from children and adults, and to study the possible interfering effects of the sear on regeneration of the sweat gland after burn injury.Methods Biopsies of hypertrophic sear were taken from four children (4 - 10 years) and four adults (35 -51 years). Normal, uninjured full-thickness skin adjacent to the sear of each patient was used as control. Keratin 19 (K19) was used as the marker for epidermal stem cells and secretory portion of the sweat glands, and keratin 14 (K14) for the tube portion, respectively. Immunohistochemical and histological evaluations were performed.Results Histological and immunohistoehemical staining of skin tissue sections from both the children and adults showed K19 positive cells in the basement membrane of epidermis of normal skin. These cells were seen only single layer and arranged regularly. The secretory or duet portion of the eccrine sweat glands was situated inthe dermis and epidermal layer. However, in the sear tissue, K19 positive cells were scant in the basal layer,and the anatomic location of the secretory portion of sweat glands changed. They were located between the border of the sear and reticular layer of the dermis. These secretory portions of sweat glands were expanded and were organized irregularly. But a few K14 positive cells were scattered in the sear tissues in cyclic form.Conclusions There are some residual sweat glands in sear tissues, in which the regeneration process of active sweat glands is present. Possibly the sweat glands could regenerate from adult epidermal stem cells or residual sweat glands in the wound bed after burn injury.