中医治疗慢性萎缩性胃炎研究进展

中医认为,慢性萎缩性胃炎的病因为外邪犯胃、饮食失调、情志内伤、体质素虚,为本虚标实之证.发病之本为脾胃虚弱,发病之标为气滞、痰湿、血瘀.中医学从整体观念出发,注重辨证施治、因人施治,同时结合胃镜和病理检查的“望诊”,拓展其宏观辨证和微观辨证.整体调控、施治灵活和手段多样是中医药治疗慢性萎缩性胃炎的特色及优势,可以有改善胃黏膜组织,逆转、防治疾病的发展.     

中风病机探讨：665例中风患者临床资料分析

关于中风病机的认识，历来论点不一，本文通过对６６５例中风患者的主要症状、舌象、脉象以及证型的综合分析，认为中风的病机特点是以虚为本，以实为标，本虚标实。“虚”是贯穿始终的最基本病机，包括元气亏虚和肝肾阴虚；“实”则以瘀、痰、火为主。标实多因本虚引起，本虚、标实的最终结果都表现为“风”。     

从“正气内虚,痰瘀并存”论治肺间质纤维化

中医认为,肺间质纤维化的病因病机特点为本虚标实,本虚为肺、脾、肾三脏虚损,标实为痰、瘀、热、毒,痰、热、毒均在虚和瘀基础上形成.正虚和邪实可以相互影响,并互为因果,形成因虚致实、因实致虚、虚者更虚、实者更实的病理特点.中医药治疗该病有其独特优势,可外感与内伤并重,扶正与祛邪并调.从“正气内虚,痰瘀并存”的病机观点论治肺间质纤维化,可为该病的治疗提供理论依据.     

冠心病“本虚标虚”病机内涵探析

冠心病“本虚标虚”病机内涵探析黄惠勇导师：朱文锋（湖南中医学院诊断教研室４１００７１）关键词冠心病，本虚标实，心气虚，胸痹，病机冠心病理属中医病名“胸痹、心痛”之范畴。中医内科学各版教材及有关论著所论其病机都以“本虚标实”为规范，其本虚言阴阳气血的亏...     

浅议李东垣的脾虚阴火论

认为东垣阴火论中“阴火”是指里虚、脾胃中气不足而产生内热而言,喜怒过度、饮食失常、寒温不适、劳倦所伤、内伤脾胃、中气不足等均可导致阴虚生内热;对其机理、临床表现作斩阐述。阴火证是本虚标实证,故其治疗也应从本虚和标实两方面加以考虑。虚,常用甘温益气法;阴火实的一面,多取苦寒泻火法或升阳散火法,这样,乃成标同同治之剂。     

王会仍治疗肺系疾病经验

王会仍认为,肺系疾病的病位在肺脾肾,肺脾肾亏虚为本,滞、痰、瘀、热为标,外感六淫、饮食不节、情志不畅为诱因;强调从肺脾肾论治,主张以“急则标本兼治”“缓则治其本”为治疗原则,兼顾补气理气、清肺化痰、活血化瘀,重视调畅气机,擅长运用虫类药及膏方.     

杨勤教授治疗幽门螺杆菌相关性胃病经验

杨勤教授认为,幽门螺杆菌相关性胃病多因饮食、情志等损伤脾胃,正气不足,感受外邪所致,主要病机为湿热为标,土虚为本.临证常用清热燥湿,辛开苦降,益气温中、和里缓急,滋阴养胃、病久治瘀等法治之,并常用药对.本病常相兼为病,秉着“知犯何逆,随证治之”的原则,兼夹使用,灵活处理.     

溃疡性结肠炎中医药治疗进展

1病因病机 中医学认为溃疡性结肠炎发病的主要原因是患者先天禀赋不足,后天脾胃运化失调.多是在脾胃虚弱的基础上感受外邪、饮食不慎或忧思恼怒引起大肠传导失司、气机不畅、通降不利,损伤肠膜脉络而发病.本病的病机为本虚标实,本虚为脾肾虚弱,标实为湿、痰、热、瘀、毒.     

紧张型头痛病因病机分析

认为紧张型头痛的发病根本是素体虚弱、阴血亏虚,发病的诱因常为外邪侵犯,发病的特点是内外合邪,拘急而痛;常因情志内伤、饮食劳倦、局部劳损导致气血失常,不通、不荣则筋脉失养,拘急作痛;病机为本虚标实,本虚为营血亏虚,标实为气滞血瘀。     

紧张型头痛病因病机分析

认为紧张型头痛的发病根本是素体虚弱、阴血亏虚,发病的诱因常为外邪侵犯,发病的特点是内外合邪,拘急而痛;常因情志内伤、饮食劳倦、局部劳损导致气血失常,不通、不荣则筋脉失养,拘急作痛;病机为本虚标实,本虚为营血亏虚,标实为气滞血瘀。     

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.     

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.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.