脾虚和肾虚雌性大鼠生育能力的实验观察

为系统观察脾虚和肾虚雌性ＳＤ大鼠的生育能力，将大鼠随机分为：脾虚组、脾虚复健组、肾虚组、肾虚复健组、正常组。脾虚组和肾虚组分别按常规方法用利血平和羟基脲制成脾虚模型和肾虚模型。虚证动物模型出现与人类相似的症状：动情周期紊乱，甚至消失；生殖器官萎缩；血清卵泡刺激素（ＦＳＨ）、雌二醇（Ｅ２）水平下降；子宫腺体数目减少，卵巢次级和成熟卵泡数减少，生育能力下降。而肾虚大鼠上述变化更显著。用四群子喂饲脾虚模     

糖尿病视网膜病变患者的中医证候与图形视觉诱发电位的关系

[目的]探讨糖尿病视网膜病变（简称糖网症,DR）的中医辨证分型及其与图形视觉诱发电位（P-VEP）的关系。[方法]对临床资料完整的104例186眼,按中医辨证分组,分别以不同的空间频率（0.388Hz,1.55Hz)、不同颜色图象组合（黑/白、红/洋红、蓝/青）作刺激条件,检测在100ms检测点上的P-VEP（P100）的潜时（t)和波幅（V）并与正常组作对照。[结果]104例186眼中,气阴两虚型有103眼,以单纯性糖网症为主;而气滞血瘀型及阴阳两虚型各有47眼和36眼,均以增殖性糖网症为主,糖网症无论中医辨证分属哪种证候,其P100潜时均延长,波幅均下降,其中以气滞血瘀的潜时延长最为突出,阴阳两虚组的波幅下降最明显,而气阴两虚组的潜时和波幅改变最小。[结论]不同中医证候的糖尿病视网膜病变患者的P-VEP的差异有显著性意义。因此,可以认为不同刺激条件的图形视觉诱发电位的检测,有可能为糖尿病视网膜病变的中医辨证分型提供客观指标。     

冠心病心气虚与非心气虚证间左心形态及功能表现

[目的]比较胸痹(冠心病)心气虚与非心气虚患者左心形态及功能方面的差异。[方法]回顾分析1998~1999年就诊的184例冠心病患者的临床资料,由中医师按病例记载的临床证候分为心气虚组和非心气虚组,再比较两组患者超声测量的数据特点。[结果]心气虚组与非心气虚组的左室射血分数和心肌缺血程度仍在正常值范围,心气虚组的射血分数为(61.0±15.1)%,非心气虚组为(66.62±12.67)%,两组比较差异有显著性(t=2.754,P<0.01);心肌缺血程度两组间比较也有显著性差异(秩和检验Uc=53.99,P<0.0005)。超声测量左室腔和左心房大小、左室心肌厚度、左室每搏量、心输出量、心肌缺血范围,结果两组间差异无统计学意义。[结论]心气虚并非等同于临床上的心功能不全,超声测量虽在正常范围内,但射血分数表现为正常低值者,对胸痹(冠心病)的病程进展的判断可能有所帮助。     

不同证候的注意缺陷多动障碍患儿多巴胺D2受体基因携带情况检测

注意缺陷多动障碍（ａｔｔｅｎｔｉｏｎｄｅｆｉｃｉｔｈｙｐｅｒｃａｔｉｖｉｔｙｄｉｓｏｎｒｄｒ,ＡＤＨＤ）是常见的儿童行为障碍,目前病因尚未明确,国外近年由于分子生物学方法的介入,发现多巴胺Ｄ２受体ＴａｑＩＡ１等位基因与本病相关,通过对广州市城镇学龄儿童多巴胺Ｄ２受体基因ＴａｑＩＡ多态性的检测,支持Ａ１等位基因与本病的关系（Ｐ＝０．００６５２０）并发现病该基因与中医辨证的“肾虚肝亢”证候关系更为密切     

血清Ⅳ型胶原测定对慢性肝病中医证型的诊断作用及临床意义

采用放射免疫法测定160例慢性肝病患者血清肝纤维化标志物Ⅳ型胶原（Ⅳ-C）,以探讨在血清中Ⅳ-C的质量浓度ρⅣ-C与中医证型的关系及临床意义。结果显示,各中医证型组的ρⅣ-C均较对照组明显升高,其升高程度依次为肝郁脾虚＜瘀血阻络＜肝肾阴虚＜湿热中阻＜脾肾阳虚。统计分析表明,湿热中阻和脾肾阳虚组ρⅣ-C的升高与肝郁脾虚组比较存在显著性差异（P＜0．01）。提示：（1）测定ρⅣ-C对慢性肝病中医分型有一定指导意义;（2）肝纤维化在肝郁脾虚阶段已启动,但相对静止;（3）湿热中阻和脾肾阳虚是肝纤维化的活跃期,后者的病情尤其严重。     

脾虚小鼠脏器组织学变化及强肌健力口服液的修复作用

【目的】观察脾虚证模型小鼠肝、脾、肾、胸腺等脏器组织形态学的变化及强肌健力口服液对其修复作用。【方法】将健康雄性NIH小鼠40只随机分为正常对照组、脾虚模型组、强肌健力口服液组和四君子汤组;除正常组外,其他3组均采用腹腔注射利血平法复制脾虚模型,强肌健力口服液组与四君子汤组均按26 g.kg-1.d-1剂量灌胃给药,其他2组灌服等容积蒸馏水,连续21 d;最后1次给药后12 h,各组动物称体质量,取肝、肾、脾、胸腺进行组织病理学观察。【结果】模型组小鼠体质量下降,肝、肾、脾、胸腺均有不同程度的组织损伤;强肌健力口服液与四君子汤均能使模型小鼠体质量增加,使已遭损伤的各脏器组织得以修复。【结论】脾虚模型小鼠的肝、脾、肾、胸腺均呈现不同程度的损伤,而健脾方药对其具有修复作用,验证了《内经》有关“脾主身之肌肉,”“脾为孤脏,中央土以灌四傍”的理论。     

Weakness after gastric bypass

Two patients underwent gastric bypasses and had uneventful hospital courses. In the early postoperative periods, both developed severe, protracted vomiting, weakness, and hyporeflexia. After thorough laboratory and clinical evaluations by neurologists, the patients were diagnosed with Guillain-Barré syndrome, although there were many atypical features. The clinical presentations of these patients are very similar to case reports of nutritional polyneuropathy associated with gastric partitioning. This paper addresses the difficulties of differentiating these two diagnoses.     

Peripheral Polyneuropathy from Thiamine Deficiency following Laparoscopic Roux-en-Y Gastric Bypass

The neurologic form of beriberi has been described in multiple case reports following bariatric surgery for morbid obesity. Thiamine deficiency occurs due to marked emesis and/or altered absorption secondary to the reconfiguration of the gastrointestinal tract to achieve the malabsorption needed to achieve weight loss. This case report illustrates the typical presentation of a patient after gastric bypass, and highlights the symptoms that bariatric surgeons must detect and reviews the treatment.     

Fatigue,Weakness, and Sexual Dysfunction after Bariatic Surgery – Not an Unusual Case but an Unusual Cause

Background: Malabsorptive bariatic surgery for morbid obesity has been very effective in producing weight loss. However, patients may experience some degree of malnutrition, which may lead to various clinical symptoms, such as fatigue and weakness. Morbid obesity is often associated with impaired reproductive function, and weight loss generally improves sexual function in both sexes. However, women with extreme weight loss may experience secondary amenorrhea. In men, zinc deficiency may lead to impaired testosterone synthesis resulting in hypogonadism and impotency. Case Report: A 43-year-old male 5 years after jejunoileal bypass for morbid obesity performed in a foreign institution presented with a recent history of progressive fatigue, general weakness, and declining libido and potency. Unexpectedly, his symptoms were not related to the operation or to his weight loss but rather to a structural cause. Endocrine and radiologic evaluations revealed a cystic tumor in the sella turcica causing partial hypopituitarism and secondary hypogonadism. Conclusion: Long-term follow-up is mandatory in patients after bariatic surgery. Non-specific symptoms and findings should be further investigated. A loss of sexual activity and performance may have causes other than the previous bariatic operation.     

《理虚元鉴》中虚证治疗特色浅析

该书在虚证的病因认识、预防、治疗及预后方面都无不强调情志因素的重要性,同时提出了清金保肺原则。总结出虚证三大治疗总则,即清金保肺,无犯中州之土;培土调中,不损至高之气;金行清化,则水自流长,合金水于一致。