谈高职医学相关专业《中医学基础》的教学做法

为提高高职医学相关专业学生对《中医学基础》课程的学习效果,作者注重利用多种教学方法,创新性的引领学生走进中医学的特色情境,探索便于学生认识和理解中医学的途径,收到较好的效果.     

历代医事制度对中医学发展的影响

千年辉煌,百年变迁。一面是灿烂的历史和诱人的前景,另一面则是严峻而残酷的现实。中医药学在现代西方科技文明的强烈冲击下,在人类社会面临难以言喻的空前境遇。医生的职责是救死扶伤,其能力取决于医疗技术水平的提高,最终反映医学学术水平的提高。我们同样不能忽视医生作为自然人的属性,医事制度和其社会外环境也着实间接影响中医学的发展。本文着重在此方面探讨中医学发展的积极和消极因素。     

小议大黄临床用药宜忌

目的:对大黄的临床用药宜忌进行研究,结合现代药理实验结果,为其进一步开发利用提供参考。方法:利用中医文献学的方法对古代本草关于大黄使用宜忌的内容进行整理和分析。结果:大黄在使用时应分清生熟;须辨清病位用药;用之多寡,酌人虚实;脾胃虚寒、血虚气弱,妇女妊娠期、月经期、哺乳期均慎用大黄;须与谷气相远;忌冷水,恶干漆。结论:使用大黄时,应在辨证论治和"治病求本"原则的指导下,辨清病因病位用药,不可滥用误用。     

Observation on therapeutic effect of aligned acupuncture for lumbar intervertebral disc herniation

Objective

To observe the clinical effects of aligned needling therapy for lumbar intervertebral disc herniation (LIDH).

Methods

A total of 80 cases with LIDH in conformity with the inclusion criteria were randomly divided into a treatment group or a control group by their visit order, 40 cases in each group. The points from the Governor Vessel, L1-L5 Jiaji (EX-B 2) points, from the first lateral line of the Bladder Meridian, Huantiao (GB 30), Weizhong (BL 40) and Yanglingquan (GB 34) were selected for acupuncture in the treatment group. Shenshu (BL 23), Dachangshu (BL 25), Ashi (Extra) points and Weizhong (BL 40) were used for routine acupuncture in the control group. The clinical effects of the two groups after 2-course treatments and recurrence rates three months later were observed. The pain severity before and after treatments was assessed by visual analog scale (VAS). The improvement of the patient’s pathological situation was evaluated by the performance assessment of lumbar disease treatment from Japanese Orthopedic Association (JOA).

Results

After the treatment for two courses, there was no dropped-out case in the two groups. The curative rates and total effective rates were respectively 32.5% and 92.5% in the treatment group versus respectively 12.5% and 82.5% in the control group. The differences in the curative rates and total effective rates between the two groups were statistically significant (both P<0.01). After the treatment, VAS and JOA scores remarkably declined in the patients of the two groups, with statistical differences in comparison with those of the same group before treatment (both P<0.05). In follow-up check of three months, the recurrence rate was 10.7% in the cured and remarkably effective cases in the treatment group and was 29.4% in the control group. The recurrence rates of the two groups were statistically different (P<0.05).

Conclusion

The aligned needling technique is remarkable in the clinical effects, obvious in the analgesic effects and low in the recurrence rate in the treatment of LIDH.

     

针灸治疗腰椎间盘突出症随机对照临床研究文献的Meta分析

目的评价针灸疗法治疗腰椎间盘突出症的疗效和安全性。方法对2001年3月-2011年3月中国期刊全文数据库（CNKI）、中文科技期刊数据库（VIP）、万方数据库、MEDLINE数据库中相关文献进行电子检索以及手工检索,纳入针灸治疗腰椎间盘突出症与其他疗法比较的随机对照试验（RCT）和临床对照试验（CCT）,根据Jadad评分标准评价纳入研究项目的质量。采用RevMan4.2统计软件进行Meta分析。结果 13项研究符合纳入标准,共计1 558例患者。Meta分析显示,针灸治疗腰椎间盘突出症与其他方法（药物、牵引、推拿）治疗总有效率比较,差异有统计学意义[合并RR（固定效应模型）=3.86,95%可信区间（2.80,5.31）,经Z检验,Z=8.28,P〈0.0001]。结论针灸治疗腰椎间盘突出症疗效明显优于其他疗法,但仍需更多的大样本RCT进行验证。     

甘草治疗痢疾作用浅析

甘草可以治疗赤痢、白痢和赤白痢,以赤痢最多,其次为赤白痢,白痢最少。主要取其调和脏腑寒热、生肌止痛、调和诸药、缓和药性的作用。治疗热邪为主的赤痢或赤白痢时应使用生甘草,治疗以寒邪为主的白痢时应使用炙甘草。     

基于五行学说探讨大补脾土的中医临床应用

中医藏象的五行归属及生克制化关系是中医认识脏腑自身功能特点及与他脏交互关系的基本观点。在此基础上,中医又构建了以五脏为中心的藏象学说。该文基于五行生克制化,探讨中医大补脾土的理论基础、医经传承、临床应用等。