邓铸涛教授甘温健脾法治疗疑难病

邓铁涛教授运用甘温健脾法治病一些临床常见的疑难病证，以补中益气汤加减治痿证，以补阳还五汤加减治中风偏瘫，以温胆汤加减治胸痹，自拟软肝煎治早期臌胀，以玉屏风散加味治汗症，均取得了较好的疗效。     

肝硬化中医治疗浅识

本文先分析了肝硬化的病因病机，认为病因主要是湿邪为患，病位以肝脾为主，由气分渐入血分，病情是本虚标实，所以在治疗上要先清利湿热，祛湿务尽，如湿聚成水，则化气行水，同时也要注意调和气血、调补脾肾，对于变证则随证治之。     

徐云生辨治2型糖尿病合并高脂血症经验

徐云生认为2型糖尿病合并高脂血症本虚标实为主要病机特点,虚指先天禀赋不足、五脏俱虚,以肾虚为主,实即痰浊、瘀血、气滞,治疗当以扶正祛邪为法,初期祛邪为主,后期补虚为主,补肾贯穿全程。具体辨证以肝肾阴虚、痰湿阻遏、血瘀脉络、肝郁气滞四型为主,分别方选杞菊地黄丸、导痰汤合半夏白术天麻汤、丹参饮与加味四物汤、柴胡疏肝散加减。     

化痰活血法改善2型糖尿病胰岛素抵抗的作用机制研究

目的:研究化痰活血法对2型糖尿病胰岛素抵抗大鼠的葡萄糖激酶(GK)和磷酸烯丙醇羧激酶(PEPCK)的影响与作用机制。方法:将健康的SD大鼠随机分为正常对照空白组和造模组,采用文献法建立2型糖尿病胰岛素抵抗大鼠模型;模型鼠又随机分成三组,即胰苏灵组、罗格列酮组、模型组,分别于给药后测定血糖、血脂、胰岛素、胰岛素受体数目与结合力,4周后禁食处死大鼠,留取血清并剪取肝组织以检测GK、PEPCK。结果:胰苏灵在改善胰岛素敏感指数,降糖、降脂、降低FFA等指标方面与罗格列酮无显著性差异(P>0.05),且胰苏灵可减轻大鼠体质量,胰苏灵组大鼠GK、PEPCK活性与罗格列酮组无显著性差异(P>0.05)。结论:胰苏灵可通过增加肝脏细胞葡萄糖激酶的mRNA及其蛋白质的表达达到改善胰岛素抵抗,发挥治疗糖尿病的作用。     

Long-Term Clinical Effect of Tangyiping Granules(糖异平颗粒)on Patients with Impaired Glucose Tolerance

Objective: To evaluate the long-term clinical effect of Tangyiping Granules(糖异平颗粒, TYP) on patients with impaired glucose tolerance(IGT) to achieve normal glucose tolerance(NGT) and hence preventing them from conversion to diabetes mellitus(DM). Methods: In total, 127 participants with IGT were randomly assigned to the control(63 cases, 3 lost to follow-up) and treatment groups(64 cases, 4 lost to follow-up) according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose(FPG), 2-h postprandial plasma glucose(2h PG), glycosylated hemoglobin(Hb A1c), fasting insulin(FINS), 2-h insulin(2hI NS), homeostatic model assessment of insulin resistance(HOMA-IR), blood lipid and patients' complains of Chinese medicine(CM) symptoms before and after treatment. Results: A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up(75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P0.05). The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up(16.67% vs. 31.67%, P0.05). Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride(TG), total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups(P0.05). After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group(P0.05). CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group(P0.05). No severe adverse events occurred. Conclusion: TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.     

人工全膝关节置换术的手术护理体会

随着我国人民生活水平的提高,人工全膝关节置换术（totalknee arthroplasty,TKA）为越来越多的膝关节疼痛患者减轻了疼痛、改善膝关节的功能并提高了患者的生活质量。全膝关节置换术手术护理是手术成败与否的关键步骤,本文介绍我院62     

健脾益气冲剂对提高机体抗病能力的临床观察

健脾益气冲剂由参苓白术散与玉屏风散合方加味配制而成 ,其功效是健脾益气 ,护卫固表 ,在长期的临床应用中证实其对提高体虚患者的抗病能力有较好作用。为拓宽应用前景 ,给临床进一步推广应用提供可靠依据 ,我们共设立了ＷＢＣ、Ｈｂ、ＲＢＣ以及ＩｇＡ、ＩｇＧ、ＩｇＭ等多项观察指标 ,对 10 0例中医临床辨证为脾肺气虚、卫外不固、体弱多病的患者进行了系统观察。现摘要报告如下 :1　一般资料病例来源 :病例均来源于江西中医学院附属医院 ,其中门诊 6 7例 ,住院 33例 ;男 73例 ,女 2 7例 ;平均年龄 40岁 ;慢性胃肠病 5 0例 ,慢性胆囊炎 2 …