女性肾中精气的外在指征与增龄的相关性研究

目的:研究随着成长壮老,女性健康人群肾中精气的外在指征与增龄的相关性,以确定可较好反映女性健康人群肾中精气盛衰的外在指征。方法:使用"生长壮老取决于肾"流行病学调查信息采集表(成人用表),收集482例健康女性的生殖、牙齿、头发、生长、发育、骨骼、形体、智力、耳、二阴等信息,采用主成分分析和因子分析对调查表中的96个常见症状进行分析。结果:F2(白发)、J13(性欲减退)、P4(皮肤松弛)、F3(头发干枯)具有综合相关性,主要解释了主成分1; J4(经质)、J3(经色)具有综合相关性,主要解释了主成分2;而J5(月经初潮年龄)主要解释了主成分3。这其中,J5(月经初期年龄)、J4(经质)、J3(经色)、F2(白发)、J13(性欲减退)表现最为突出。结论:月经初潮年龄、经色、白发、性欲减退、皮肤松弛和头发干枯等外在指征,可较好反映生长壮老过程中女性肾中精气的盛衰。     

中医证候研究的思考：从现状到展望

Syndrome differentiation is a key feature of Chinese medicine （CM） system. With CM receiving more and more attention from the mainstream medical systems, researchers from both traditional medical systems and the Western medical system are putting more effort into studying why and how the CM system works, particularly about CM syndromes. This paper reviews the current status of syndrome study and its future development. The major aspects include： （1） Usage of syndrome differentiation in clinical practice; （2） Formalization of syndrome diagnostic criteria; （3） Evidence-based determination of the common syndrome（s） of a disease; （4） Systems biology study of syndromes; and （5） Usage of syndrome in randomized controlled trials. It is expected to integrate the syndrome concept into the main stream medical system, in terms of diagnosis, treatment and prevention.     

从主观症状因子分析的结果看中医辨证的数学逻辑--附469例RA多中心临床病例分析

目的 :探讨中医辨证的数学逻辑 ,寻找中医证候量化的方法。方法 :对 469例类风湿性关节炎 (RA)多中心临床患者的主观症状进行因子分析 ,并对各中医证型的因子得分进行方差分析。结果 :因子分析得到四个有代表性的公因子 ,它们分别代表四组症状 ,即因子 1 (F1 )主要反映关节疼痛、关节肿胀、关节压痛、屈伸不利等 4项症状 ,F2反映腰膝酸软、精神疲乏、烦闷不安、肢体困重、眩晕、肢体麻木、夜尿多 7项症状 ,F3反映关节怕冷、畏寒、手足不温 3项症状 ,F4反映关节发热、口渴、发热、小便黄浊 4项症状。后 3个因子分别与中医的肝肾亏虚、寒、热的证候表现有关 ,故称这 3个因子分别为虚因子、寒因子和热因子。方差分析结果表明 :3个证候因子能很好地区分寒湿阻络、湿热阻络、寒热错杂与肝肾亏虚四证。结论 :中医的辨证理论蕴藏着数学的逻辑思维 ,是非常科学的 ;采用因子分析可对中医的证候进行量化处理 ,为进一步的证候研究提供借鉴。     

The Extraarticular Symptoms Influence ACR Response in the Treatment of Rheumatoid Arthritis with Biomedicine: A Single-blind,Randomized,Controlled,Multicenter Trial in 194 patients

Objective: The extraarticular symptoms are important in the pattern differentiation of traditional Chinese medicine (TCM), and the present study is designed in an attempt to find the associations between the extraarticular symptoms and American College of Rheumatology (ACR) Response in 194 cases of rheumatoid arthritis (RA) treated with biomedicine. Methods: The data were obtained from a randomized clinical trial. One hundred ninety-four RA patients were treated with the biomedical therapy (diclofenec, methotrexate and sulfasalazine). ACR20 response in 24 weeks was used for the efficacy evaluation. Eighteen symptoms (including 13 extraarticular symptoms) that TCM practitioners focus on were collected for exploration on the association between the symptoms and the efficacy of the biomedical therapy with association rules method. Results: After 24 weeks, a total of 135 patients receiving biomedicine had achieved an ACR20 response. The association rules analysis on each symptom showed that soreness in the waist was more associated with ACR20 response, but with lower support (selected sample size based, 20.10% and 14.95% respectively); cold intolerance and cold joint were found to be associated with ACR20 response with higher support (48.97% and 53.61% respectively), and the confidences (predicted effective rate) were 73.08% and 71.23% respectively. The associations between combination of symptoms (among them, there was at least one extraarticular symptom) and ACR20 response indicated that cold intolerance or cold joint with higher confidence and support were the most important extraarticular symptoms. Conclusion: The RA patients with "cold intolerance" and "cold joints", which are the extraarticular symptoms that TCM practitioners focus on, may show higher ACR20 response when treated with the biomedical approach.     

EXPERIMENTAL STUDY ON EFFECT OF TRADITIONAL BONE-KNITTING DRUGS ON TRAUMATIC GU BI (BONE-RHEUMATOID LESIONS)

Traditional bone--knitting drugs (TBKD) are used frequently in the treatment of bone frac-tures. An animal model of Gu Bi (bone--related rheumatoid lesions) with defects of articularcartilage as the main lesion was developed by surgical trauma under the stereomicroscope inWistar rats and treated with TBKD. The results showed that TBKD could promoteproliferation of cartilage cells around the traumatic site and improve the osteogenetic func-tion in the traumatic state, suggesting that TBKD can be used in combination with otherChinese drugs to treat Gu Bi, including bony lesions of the late--stage rheumatoid arthritisand bony arthritis. But the experimental results also suggested that TBKD might have an ef-fect of promoting development of inflammation, and therefore, should be used with care inthe acute phase of inflammation.     

中西医结合基础研究中的几个问题

1 经验和教训:评价系统 长期以来,中西医结合研究工作者对许多中医术语、证候进行了释义性研究,例如肾虚的理论研究、活血化瘀的研究,并以此在指导临床工作中起了一定的作用。同时,也由此引发了长期以来开展的对中西医结合思路方法论的讨论,甚至对中西医结合定义和中医现代化定义的争论,并似乎达成了一个共识:中西医结合研究应该突出中医特色。经过近年来的探索,人们发现:在什么是中医特色、通过什么途径突出中医特色等问题上仍有很多疑惑。从字面上可以认为:有别于其它医学的中医内容就是中医特色,而现代方法对有别于其它医学的中医特…     

中医临床基础学科本科教学方法优化设计研究

教学设计是教学改革的核心内容,其中的教学方法设计最能体现教育现代化,它是教学设计最基本的要素之一。传统的大学本科中医临床基础学科教学方法以讲解灌输式教学为主,在结构形式上缺乏多样性和优化系统性,已不能适应现代教育重质量、高效率的时代潮流,不能满足培养创造型人才的要求。因此,笔者根据自己的教学实践,结合现代教育理论,对中医临床基础学科本科教学方法优化设计方案进行了研究。     

脾虚证大鼠肝组织端粒长度的变化及其与氧化应激关系的探讨

目的:探讨脾虚证大鼠肝组织的端粒长度变化及其与氧化应激反应的相关性,进一步揭示脾虚衰老的病理机制。方法:采用饮食不节和劳倦过度结合法建立脾气虚证模型,然后分别采用苦寒法和辛热法建立脾阳虚和脾阴虚证模型。分别用硫代巴比妥酸(TBA)法、比色法和Southern blotting杂交法检测大鼠肝组织的丙二醛(MDA)含量、谷胱甘肽过氧化物酶(GSH-Px)活性和端粒(Telomere)长度。结果:与正常对照组相比,脾阴虚模型组肝组织MDA含量升高明显,P<0.05;脾阳虚模型组肝组织GSH-Px活性明显降低,P<0.01;脾阳虚和脾阴虚模型组端粒长度明显缩短,P<0.05。结论:脾虚状态下,在机体过氧化反应异常增强,自由基积累攻击DNA、损伤端粒而导致端粒长度缩短。     

高尿酸血症和非酒精性脂肪肝异病同治规律及分子机制预测

目的:探索高尿酸血症和非酒精性脂肪肝异病同治的规律及分子机制。方法:采用文本挖掘技术分析高尿酸血症和非酒精性脂肪肝中医证候分类及用药规律并进行可视化,提取两病共同的证候分类及其相应的中药配伍组合。检索中药配伍组合活性成分对应的人类靶蛋白和两病的相关基因;在分子网络分析平台分别构建靶蛋白和基因分子网络,通过网络映射分析,找到中药配伍组合治疗两病相关的通路和高连接分子。结果:痰瘀互结证是两病最常见的共同证型,方证对应,中药配伍组合(丹参、大黄、茯苓、泽泻、当归、白术)是治疗两病共用使用最多的药物;这些药物可能通过调控5个分子(26 S蛋白酶体,细胞外信号调节激酶1/2,核转录因子-κB,泛素C和蛋白激酶B)和1个生物学通路(肝X受体/维甲酸X受体激活通路)对两病发挥协同治疗效应。结论:高尿酸血症和非酒精性脂肪肝具有异病同治的生物学基础;文本挖掘和生物信息分子网络分析是探索疾病异病同治基础的有效方法。