《伤寒杂病论》麻黄煎法研究

《伤寒杂病论》之用麻黄,其先煎与否,非常灵活机动,要视病情、体质和用量大小及其配伍情况而定。一般而言：欲大汗猛汗者,则不必先煎去沫;欲缓发慢散,务去邪以尽者,必当先煎去沫;体质弱或用量小者,必须先煎去沫;而体质壮实,用量较大者,则勿须先煎去沫;配伍单纯,不相互牵制者,应予先煎去沫;而配伍复杂,有相畏、相杀、相恶者,则不必先煎去沫。     

宋本《伤寒论》北京—上海—美国—台湾转移释秘

今存之宋本《伤寒论》非北宋校正医书局原刻之本。原刻本分大字本与小字本两种。小字本亡于明万历二十七年（1599）后,大字本《伤寒论》据清末藏书家伯兮题记所述,他藏有北宋治平二年（1065）大字官刻本,今不知何在。今称之宋本《伤寒论》,指明代万历二十七年江苏常熟赵开美请当地优秀刻工赵应期刊刻之《伤寒论》,以北宋元祐三年（1088）小字原刻本为底本翻刻,尊称＂宋本伤寒论＂,实明刻也。宋本《伤寒论》确知共存五部,除台湾今存一部外,其余四部藏于中国大陆：沈阳中国医科大学图书馆一部,中国中医科学院图书馆一部,上海中医药大学图书馆一部,上海图书馆一部。     

《伊尹汤液经》学术思想初探

探讨杨绍伊《伊尹汤液经》学术思想,认为仲景论广《汤液经法》而成《伤寒论》,其书由《汤液经法》《伤寒论》、“遗论”三部分组成,论及王叔和对内容、文字进行多次编排;《胎胪药录》《平脉辨证》补充《伤寒论》内容;仲景既论“伤寒”又论“卒病”;《汤液经法》内容可概括为“一表二里之法”;对《伤寒论》重新编排,揭示了中医古籍形成及流传、发展的脉络,是研究《伤寒论》的重要著作。     

Studien zum Lingshu als Beitrag zur Bewertung klinischer Akupunkturstudien: – Punktlokalisation,Stichtiefe, De Qi

Background

Clinical trials on acupuncture use a variety of control methods, such as sham acupuncture, minimal acupuncture, and placebo. Frequently, needle insertion on non-classical acupuncture points (“minimal acupuncture”) is employed for this purpose. The aim of such clinical trials is to evaluate specific effects of acupuncture. There is a controversial discussion regarding the appropriateness of comparing “true” acupuncture to “minimal acupuncture”.Minimal and verum acupuncture are distinguished by various criteria, such as “localisation”, “depth of needle insertion”, and “induction of de qi”.

Aim

This study is dedicated to the question of what information the Huang Di Neijing, specifically the Lingshu-compilation which extensively focuses on needling techniques, has to offer regarding the above mentioned criteria, and their importance for successful acupuncture. In relation to this, it will be discussed if the definition of “minimal acupuncture” as used in the German Acupuncture Trials, is feasible.

Methods

The entire original text of the Huang Di Neijing Lingshu was searched for information regarding “point localisation”, “insertion depth”, and “induction of “de qi”. The paragraphs in question were compiled and probed on statements regarding the efficacy of treatment. These subsequently were compared to the technique of “minimal acupuncture” as in the German Acupuncture Trials (ART, GERAC).

Results

The analysis of the Lingshu shows that neither a specific point localisation, nor a certain insertion depth or the induction of de qi are clearly and in all cases relevant for a successful therapy. Rather, the Lingshu offers specific indications for superficial needling. Sites of acupoint localisation aren't clearly defined and the induction of de qi is not understood as mandatory for a successful therapy.

Conclusion

The criteria distinguishing „verum acupuncture” from „minimal acupuncture” as practiced in many clinical trials don't correspond to the early practice of acupuncture as documented in the Lingshu. This can be a possible explanation for the good clinical results of minimal acupuncture in a number of clinical trials.However, for further discussions of this problem the developments and the clinical evolution present-day acupuncture has undergone since the ancient times have to be held in account.     

针药并用治疗类风湿性关节炎79例

目的:观察针药并用治疗类风湿性关节炎的临床疗效。方法:采用毫针刺法配合中药经验方治疗类风湿性关节炎79例。结果:治愈18例,显效21例,好转34例,无效6例,总有效率92.41%。结论:针药并用治疗类风湿性关节炎具有良好的疗效。     

柴地合方对慢性应激大鼠大脑前额皮质和海马单胺类神经递质的影响

目的：研究柴地合方对脑组织单胺递质含量的影响,探讨其抗抑郁作用可能的机制。方法：复制大鼠慢性应激抑郁模型,慢性给予柴地合方,采用高效液相色谱系统(HPLC)加电化学检测器(ECD)检测前额皮质和海马组织中单胺类神经递质及相关代谢产物的含量。结果：慢性应激大鼠前额皮质中去甲肾上腺素(NE)、5羟色胺(5—HT)和3,4—二羟基苯乙酸(DOPAC)含量显著降低,柴地合方可以翻转这种降低;慢性应激大鼠海马中NE、5—HT含量显著降低,柴地合方可以部分逆转降低水平。结论：柴地合方可升高慢性应激模型大鼠前额皮质和海马中NE和5—HT水平,这可能是其抗抑郁的机制之一。     

张重华治疗变应性鼻炎经验

张重华教授认为,变应性鼻炎与肺、脾、肾三脏关系密切,肾阳不足为疾病之本,肺气虚寒为疾病之标,脾气虚弱为关键枢机.张教授治疗变应性鼻炎,强调病证结合,中西互参,标本同治,自拟验方扶正止鼽汤,以温肾健脾、益气固表、疏风宣肺、收敛固涩,临证加减,可获良效.     

张简斋妇科病证辨治特点探析

介绍了张简斋妇科病证辨治特点:调气血,辨虚实,消补兼施;益肝肾,固冲任,调补奇经;安五脏,分寒热,兼顾表里。张简斋特别重视气血辨证,并兼顾寒热、表里、虚实、脏腑等方面。治疗擅长调补奇经,刚柔相济,以轻去实。      

经方在儿科临床中的运用

张士卿教授乃甘肃省名中医,其临证辨治悉遵仲景之大法,疏方投药尤善以经方化裁,将张士卿教授临床活用经方治疗儿科病案略举数例,以飨读者.     

小柴胡汤联合鼠神经生长因子治疗职业性噪声聋40例

目的:观察小柴胡汤联合鼠神经生长因子治疗职业性噪声聋(occupational noise deaf,ONID)的临床疗效。方法:选取ONID患者80例作为研究对象,按照随机平行分组法随机分为治疗组与对照组各40例,对照组给予鼠神经生长因子治疗,治疗组加用小柴胡汤治疗,疗程均为28 d。结果:治疗后治疗组左耳、右耳及双耳语频平均听阈均较治疗前、同期对照组明显降低(P0.05);治疗组口苦口干、心烦、耳鸣、头晕等中医证候评分均较治疗前、同期对照组明显改善(P0.05),具有统计学意义。结论:小柴胡汤联合鼠神经生长因子可明显改善ONID患者听力水平、缓解伴随症状,临床疗效显著。