中医药分期防治新型冠状病毒肺炎的药性功效分析

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情严峻复杂,探讨中医药防治COVID-19处方的用药规律及特点具有重要意义。该研究收集2020年1月1日至2月18日国家卫生健康委员会,7个省市卫生健康委员会、国家中医管理局发布的和《新型冠状病毒肺炎中医诊疗手册》收录的中医药防治COVID-19诊疗方案以及3位国医大师、4位知名中医药专家所拟的方药,按照纳入、排除标准进行筛选,应用EpiData 3.0软件,建立"防治新型冠状病毒肺炎中医处方库""防治新型冠状病毒肺炎常用中药库",共收集有效中药处方93首,组成药物共计157味。应用SPSS 18.0软件进行数据分析,结果发现:①药性寒、温居多,其中性寒69味,占43.95%;性温57味,占36.31%;性热较少,仅占1.27%;②味苦、辛、甘药物较多,不同时期药味有异,初期以辛味居多,中期、重症期以苦味为主,恢复期多用甘味药;③归经以入肺、胃、心者多,入肺经最多,占24.55%;初、中期多入肺胃,重症期则入心肾;④口服药物多无毒,仅6味药物具有毒性,分别是苦杏仁、绵马贯众、重楼、细辛、半夏、炮附片;⑤以具有解表、化湿、清热、补虚、化痰止咳平喘5类功效的药物居多,初期解表与清热并重,各占18.81%;中期化痰止咳平喘药物使用多,占29.61%;重症期清热使用最多,占33.33%;恢复期补虚使用最多,占36.47%。中药防治COVID-19的药性特点和功效分布与中医对其病因、病位、病机的认识紧密相关,临证辨治尤需注重分期用药及因地制宜。     

从莪术 虎杖两味中药探讨寒热药性对大鼠大脑不同部位单胺类神经递质的影响

目的:从中枢单胺类神经递质的含量差异探讨中药寒热药性的科学内涵。方法:将莪术、虎杖两味药性相反的中药给大鼠灌胃给药1个月后,用HPLC-ECD(高效液相色谱-电化学)法检测大鼠大脑不同部位单胺类神经递质的含量。结果:温热药莪术明显促进大鼠大脑不同部位单胺类神经递质的分泌,与空白组相比有统计学差异(P0.05,P0.01);寒凉药虎杖明显抑制大鼠大脑不同部位单胺类神经递质的分泌,与空白组相比有统计学差异(P0.05,P0.01)。结论:中药的寒热药性与中枢单胺类神经递质存在一定的相关性。     

近视性屈光参差患者双眼角膜生物力学及眼压特点的研究

目的观察近视性屈光参差患者双眼角膜生物力学及眼压的特点。设计回顾性病例系列。研究对象116例(232眼)近视性屈光参差患者。方法按每人双眼等效球镜度(SE)高低分为低SE眼和高SE眼,比较双眼标志角膜生物力学参数的角膜阻力因子量(CRF)、角膜滞后量(CH)和眼压的特点;根据双眼间等效球镜度差值分为组1(SE差值2.5～3.0 D,37例)、组2(SE差值﹥3.0 D～6.0 D,44例)和组3(SE差值>6.0 D,35例),比较不同屈光参差程度组内低SE眼和高SE眼CRF、CH和眼压的特点。主要指标CRF、CH、角膜补偿眼压。结果总体低SE眼和高SE眼间的CRF分别为(10.40±1.74)mm Hg和(10.38±1.63)mmHg,差异无统计学意义(t=0.113,P=0.683),CH分别为(9.71±1.68)mm Hg和(9.66±1.90)mm Hg,差异亦无统计学意义(t=0.144,P=0.886)。在屈光参差程度不同的三组中,双眼间低SE眼与高SE眼CRF的差异均无统计学意义,组1:(10.58±1.74)mm Hg,(10.65±1.61)mm Hg(t=-0.175,P=0.862);组2:(10.31±1.88)mm Hg,(10.14±1.58)mm Hg(t=0.434,P=0.666);组3:(10.35±1.47)mm Hg,(10.31±1.65)mm Hg(t=-0.141,P=0.903)。各组双眼间CH差异亦均无统计学意义,组1:(9.66±1.59)mm Hg,(9.74±1.52)mm Hg(t=-0.210,P=0.834);组2:(9.89±1.90)mm Hg,(9.83±2.21)mm Hg(t=0.122,P=0.903);组3:(9.59±1.35)mm Hg,(9.35±1.71)mm Hg(t=0.336,P=0.512)。总体低SE眼和高SE眼间的角膜补偿眼压分别为(18.37±3.58)mm Hg和(18.67±3.48)mm Hg,也未发现差异有统计学意义(t=-0.607,P=0.545)。结论近视性屈光参差患者双眼间角膜生物力学参数及眼压无显著性差异。     

对电子处方在实际应用中所遇问题的探讨

目的优化处方流程,保证电子处方的合法应用。方法分析我院处方流程,解析电子处方在实际应用中的一些问题。结果提议优化相关流程,从技术和法律层面提出了相应的解决方法。结论健全和细化有关法律法规,以求处方无纸化和数字化。     

中医个体化诊疗疗效评价现状、方法与思路

中医个体化诊疗的信息载体是各种载体的病历记录。本研究简单回顾了中医药个体化诊疗临床疗效评价的现状,包括临床疗效评价指标体系的建立和患者报告的临床结局;引入了时间维度的动态评价;医院信息系统的发展和真实世界研究的开展。并且提出新的思路和方法：建立针对病案数据的中医药个体化诊疗疗效评价方法,单独计算和评价每一次或多次诊疗的疗效。     

长春花抗癌成分长春新碱研究的进展

长春新碱是从抗癌中药长春花叶中提出的二聚吲哚类生物碱 ,临床上用于治疗急性淋巴细胞白血病、何杰金及非何杰金淋巴瘤有确切疗效 ,但由于具有较大的神经系统毒性和局部刺激性 ,限制了其在临床上的应用。本文在简述其理化、药理、药动学特性基础上 ,综述了为解决长春新碱副作用 ,临床上主要采用联合用药方式的研究进展 ,及制剂学上 ,采用与抗体结合、脂质体包裹以及控释膜等制剂新技术、新方法的研究进展。     

基于气体传感器阵列技术的中医电子鼻研究

基于第3代薄膜型气体传感器阵列技术的中医电子鼻(WES-ENO11103-A)是福建中医药大学客座教授吴青海自主研发的新型嗅诊仪。本文对电子鼻的基本组成和工作原理、医用电子鼻技术的发展概况、薄膜型气体传感器阵列技术的特点、自主研发的中医电子鼻简况及前期实验结果进行了介绍,以期为中医临床诊断提供无创、科学、简便、快捷的嗅诊仪器,推动中医诊断技术的发展。     

Effects of traditional herbal medicine, Hwaotang, on atherosclerosis using the spontaneous familial hypercholesterolemia model, Kurosawa and Kusanagi-hypercholesterolemic rabbits and the venous thrombosis rats

Hwaotang (HOT), a traditional Korean medicinal formulation, is a dried decoctum of a mixture of seven herbal medicines, consisting of Angelica gigantis Radix, Rehmanniae Radix, Paeoniae Radix, Ciniamomi Cortex, Cnidii Rhizoma, Persicae Semen and Carthami Flos. In the present study, the inhibitory effects and anti thrombic properties of HOT on the progression of atherosclerotic lesions were studied using the spontaneous familial hypercholesterolemia (FH) model, Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits and rats. Changes in blood chemistry, pathology and low-density lipoprotein (LDL) oxidation were measured in a control and HOT group. In the control group, the area of atheromatous plaques of the aorta progressed between week 12 (36.65%) and week 14 (46.22%). This progression of atherosclerotic lesions did not occur in the HOT-treated group after 12 (24.24%) and 14 (23.34%) weeks. Antioxidative effects on LDL were seen in the HOT in weeks 12 and 14. HOT improved the hypercholesterolemia in the KHC rabbits. On the other hand, HOT and five of the seven herbs, except Cnidii Rhizoma and Carthami Flos, inhibited the endotoxin-induced hepatic venous thrombosis in high cholesterol diet-treated rats. However, Ciniamomi Cortex showed a very weak inhibitory effect on the endotoxin-induced hepatic venous thrombosis. The extract also inhibited the endotoxin-induced decrease in blood platelets and fibrinogen, and endotoxin-induced increase in fibrin degradation products (FDP) on disseminated intravascular coagulation in normal rats. In conclusion, these results suggest that HOT has inhibitory effects on the development of atheromatous plaque formation in spontaneous FH rabbits. It is also suggested that the antioxidative effects of HOT on LDL led to the beneficial effects observed in this study. The protection by HOT and its herbs on the artificially induced ischemic infarction might be related to their inhibitory effects on disseminated intravascular coagulation, platelet coagulation and thrombotic action.     

中药防风栽培品与野生品药材性状显微组织差异比较研究

目的:中药防风栽培品与野生品药材性状显微组织差异比较.方法:药材性状比对,根横切面、粉末显微特征测量和比对.结果:药材性状方面:防风野生品根呈长圆锥形或长圆柱形,少分枝;根头部有明显密集的环纹;断面有多数棕色油点;气味特异.防风栽培品根常有分枝;根头部横环纹较少,断面棕色油点较少;气微.显微组织方面:防风野生品根横切面韧皮部有多数类圆形油管,10～22环列;木质部导管呈放射状排列,但年轮状不明显.防风栽培品根横切面韧皮部油管10～11轮;木质部导管可见大小相间呈年轮状.结论:防风栽培品与野生品在药材性状和显微组织上存在一定差异,外观性状的差异和根横切面韧皮部油管环数的多少,可以作为两者的鉴别特征;1～4年的栽培防风可以根据木质部导管的年轮判别生长年限.     

Network Structure and Properties of Lithium Aluminosilicate Glass

Based on lithium aluminosilicate glass, the composition of glass was optimized by replacing SiO₂ with B₂O₃, and the influence of glass composition on structure and performance was studied. With the increase in B₂O₃ concentrations from 0 to 6.5 mol%, Al₂O₃ always existed in the form of four-coordinated [AlO₄] in the network structure, and B₂O₃ mainly entered the network in the form of four-coordinated [BO₄]. The content of Si-O-Si linkages (Q₄^(0Al)) was always dominant. The incorporation of boron oxide improved the overall degree of polymerization and connectivity of the lithium aluminosilicate glass network structure. An increase in the degree of network polymerization led to a decrease in the thermal expansion coefficient of the glass and an increase in Vickers hardness and density. The durability of the glass in hydrofluoric acid and NaOH and KOH solutions was enhanced overall.