叶天士学术思想探析

叶天士是清代温病学派的主要代表医家之一，他的主要学术贡献有：创卫气营血辨证体系，发挥三焦分证之理，临证诊断尤重辨舌验齿之法。叶天士论治内伤杂病亦有颇多建树，如倡导脾胃分治，善于甘润养胃；发展前人中风学术，立“阳化内风”之说；阐明络脉病理论，开创络治法之先河。叶天士学术思想是构建温病理论体系的基石，叶氏医术是华夏医学史上不朽的丰碑。     

《临证指南医案》从体质辨治外感病医案分析

通过分析《临证指南医案》中的7则医案,探讨叶天士从体质辨治外感病的特色。认为叶天士重视体质因素对于外感病发病的影响,在治疗时权衡外邪的强弱和体质本身的性质立法处方。     

《临证指南医案》胃脘痛治法特点探讨

目的：探讨叶天士著《临证指南医案》胃脘痛治法特点。方法：列举三个方面,一是首分胃阴虚/胃阳虚而治,达胃气和顺之效;二是治肝安胃,以肝郁犯胃,肝气犯胃,肝浊犯胃所致疼痛;三是久病入络,根据病因不同,分别治之。对久瘀病深者,用虫类搜剔。结果：叶氏治胃脘痛,机圆法活,辨证准确,用药精巧,效若桴鼓,为后人所推崇。结论：叶氏治疗胃脘痛的学术思想多有独创,辨证论治,立法处方条理井然,实补东垣脾胃学说之未及,为后世树立了典范。     

寒温相承宗一脉 叶吴本是经方家——叶天士、吴鞠通活用经方的思路与启示

通过对《临证指南医案》《未刻本叶氏医案》与《温病条辨》《吴鞠通医案》的阅读,可知叶天士、吴鞠通不仅是卓著的温病学家,还是真正的经方应用大师。他们首先具有扎实的《伤寒论》功底,是在对《伤寒论》的理法方药有了彻悟之后,才有了后来的理论与实践上的飞跃。叶天士、吴鞠通运用仲景方的特点可概括为尊经绍承用原方、加减化裁用变方、蝶变经方化新形三个方面,这在二者著作中的多则医案均有体现。     

探讨叶天士、吴鞠通对附子粳米汤方证的发挥

附子粳米汤所治病证的病机特点为阳虚寒盛,胃失通降导致的腹中雷鸣切痛,胸胁逆满呕吐.叶天士根据附子粳米汤的特点,去甘壅守补的甘草、大枣,加辛散温降的生姜汁,或干姜、生姜同用以理胃阳,弥补了大半夏汤通补阳明时偏于补气的不足,此外叶天士还将附子粳米汤化裁合四逆汤法重剂温通阳气,于治中防变.吴鞠通《温病条辨》对叶天士运用附子粳...     

Characterization of synthetic medium antigens of Micropolyspora faeni and Thermoactinomyces candidus

A synthetic (Syn) medium was developed for growth of Micropolyspora faeni and Thermoactinomyces candidus, and optimum conditions for culture filtrate antigen production were found to be 3 days for T. candidus and 9 to 12 days for M. faeni. Appearance of proteolytic activity in the culture fluid supernatant coincided with a decrease in precipitating antigen content, protein content, and number of proteins on polyacrylamide gel electrophoresis (PAGE), probably as a result of proteolysis. The results suggest that protein content, number of protein bands on PAGE, and proteolytic activity are predictive of precipitating antigen content. Antigens prepared in Syn medium were compared to those produced by the double-dialysis procedure and found to contain adequate amounts of antigenic material of sufficient quality to warrant clinical studies of their usefulness in the diagnosis of hypersensitivity pneumonitis.     

Endoscopic endonasal management of prolapsed silicone tubes after dacryocystorhinostomy

BACKGROUND: Loss or prolapse of silicone tubes at the medial canthus may occur after dacryocystorhinostomy (DCR) surgery. Repositioning of the prolapsed tubes is often difficult and can necessitate early removal of tubes. The goal of this study was to determine the incidence of tube prolapse after DCR, review the methods used to reposition them, and identify the optimum management. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: A total of 205 adults patients who had DCR with intubation by a specialist lacrimal service in West London over a 3-year period. METHODS: Patients with spontaneous tube loss or prolapse were identified from clinic attendance and case note review. MAIN OUTCOME MEASURES: Incidence and timing of prolapse, techniques used for repositioning and success, whether prolapse recurred, and further intervention necessary. RESULTS: Five (2.5%) had tube loss or prolapse or both, all within the first month after surgery. The tubes were repositioned initially in four patients, but prolapse recurred in two patients necessitating further intervention. Only nasal endoscopy enabled precise tube visualization and endonasal manipulation with eventual tube stability. CONCLUSIONS: Tube prolapse is rare after DCR surgery. The tubes can be pushed back in, but prolapse may recur unless the endonasal aspect is addressed. The position of the tie or knots should be inspected endonasally and the tubes further secured if indicated. Repositioning is best managed with endoscopic assistance, which is a simple office procedure.     

叶天士诊治妇人温病特点

因妇人具有经、胎、产的特殊生理过程,温病学家叶天士在其著作《温热论》中特别指出了妇人温病的证治特点及规律。在治疗胎前温病时,一定要时时注意保护胎儿,防止正气受到损伤,邪热内陷威胁胎元。诚如叶氏云:"然须步步固护胎元,恐损正邪陷也"。产后温病的治疗,应本着勿拘于产后,亦勿忘于产后的原则,使邪气得去,正气得安。热入血室的治疗要兼顾经期的特殊生理,配以活血行气,祛邪通络。     

Di(2-ethylhexyl) phthalate Disorders Lipid Metabolism via TYK2/STAT1 and Autophagy in Rats

Objective Previous studies have indicated that the plasticizer di(2-ethylhexyl) phthalate(DEHP) affects lipid accumulation;however, its underlying mechanism remains unclear. We aim to clarify the effect of DEHP on lipid metabolism and the role of TYK2/STAT1 and autophagy. Methods In total, 160 Wistar rats were exposed to DEHP [0, 5, 50, 500 mg/(kg·d)] for 8 weeks. Lipid levels, as well as mRNA and protein levels of TYK2, STAT1, PPARγ, AOX, FAS, LPL, and LC3 were detected. Results The results indicate that DEHP exposure may lead to increased weight gain and altered serum lipids. We observed that DEHP exposure affected liver parenchyma and increased the volume or number of fat cells. In adipose tissue, decreased TYK2 and STAT1 promoted the expression of PPARγ and FAS. The mRNA and protein expression of LC3 in 50 and 500 mg/(kg·d) groups was increased significantly. In the liver, TYK2 and STAT1 increased compensatorily;however, the expression of FAS and AOX increased, while LPL expression decreased. Joint exposure to both a high-fat diet and DEHP led to complete disorder of lipid metabolism. Conclusion It is suggested that DEHP induces lipid metabolism disorder by regulating TYK2/STAT1. Autophagy may play a potential role in this process as well. High-fat diet, in combination with DEHP exposure, may jointly have an effect on lipid metabolism disorder.     

叶天士辨治阳痿特色

以医案为切入点,从荆公妙香安心气、血肉有情填奇经、通阳消阴复其用、交通心肾举阳器、疏肝解郁调气血、清热祛湿愈痿疾等6个方面,总结叶天士辨治阳痿的临证特色。