基于“医教协同”背景下中医临床人才培养的思索

用"早临床、多临床、反复临床"的教育理念从宏观与微观角度对临床人才培养体系进行分析,诠释中医特色临床人才培养。

逆灸神阙、关元对痛经大鼠脊髓背角和下丘脑BDNF-TrkB通路的影响

目的:观察逆灸神阙、关元对寒湿凝滞型痛经大鼠的镇痛效果,以及对P物质(SP)、前列腺素(PG)F_(2α)及PGE_(2)的影响,探讨其镇痛机制。方法:将64只雌性Wistar未孕大鼠随机分为空白组、模型组、西药物及逆灸组,每组16只。大鼠动情间期每组筛选出合格大鼠8只。除空白组外,其他三组使用冰水浴结合苯甲酸雌二醇复合缩宫素的方法建立寒湿凝滞型痛经模型。第8 d造模后,逆灸组温和灸神阙、关元穴治疗,西药组布洛芬溶液灌胃,连续4 d。至第11 d,干预组(即西药组和逆灸组)注射缩宫素后再治疗1次。计算大鼠扭体评分,测定痛阈;检测血清脑源性神经生长因子(BDNF)、SP、PGF_(2α)及PGE_(2)含量,检测脊髓背角及下丘脑中BDNF及其受体原肌球蛋白受体激酶B(TrkB)mRNA及蛋白表达。结果:与空白组比较,模型组扭体评分升高(P<0.01),痛阈降低(P<0.01);血清BDNF、SP及PGF_(2α)含量升高(P<0.01),PGE_(2)降低(P<0.01);脊髓背角及下丘脑中BDNF、TrkB蛋白及mRNA表达升高(P<0.01)。与模型组比较,逆灸组和西药组的扭体评分明显降低,痛阈升高,血清BDNF、SP、PGF_(2α)含量降低,PGE_(2)含量升高,脊髓背角及下丘脑中BDNF、TrkB蛋白及mRNA表达降低,组间差异均有统计学意义(P<0.01)。与西药组比较,逆灸组扭体评分降低,痛阈升高,血清BDNF、SP及PGF_(2α)含量降低,PGE_(2)含量升高,脊髓背角、下丘脑中BDNF、TrkB蛋白及mRNA表达显著降低,组间差异均有统计学意义(P<0.05或P<0.01)。结论:逆灸神阙、关元可改善寒湿凝滞型痛经大鼠痛觉敏化状态,下调脊髓背角和下丘脑BDNF、TrkB mRNA和蛋白表达;调节血清SP、PGF_(2α)和PGE_(2)含量可能是其部分作用机制。

Effects of ginger-partitioned moxibustion on the expression levels of PGF2α, E2, P, and mRNAs of PGF2αR and E2R in rats with primary dysmenorrhea due to cold-dampness stagnation

Objective To observe the effects of ginger-partitioned moxibustion at Shenque(CV8)and Guanyuan(CV4)on the expression levels of endocrine-related molecules and their receptors in rats with primary dysmenorrhea(PD)due to cold-dampness stagnation,thus to explore their analgesic mechanisms.Methods Thirty-two female Wistar rats were divided into a normal group,a model group,a ginger-partitioned moxibustion group,and a Western medicine group according to the random number table method,with 8 rats in each group.Except for rats in the normal group,all other rats were treated with oxytocin combined with ice-water bath to establish the rat models of PD due to cold-dampness stagnation.After successful modeling,rats in the normal group and the model group did not receive treatment;rats in the ginger-partitioned moxibustion group received treatments with ginger-partitioned moxibustion at Shenque(CV8)and Guanyuan(CV4);rats in the Western medicine group received ibuprofen by intragastric administration.The writhing response of rats was compared among groups,and the serum levels of prostaglandin F2α(PGF2α),estrogen(estradiol,E2),progesterone(P),and the mRNA expression of PGF2αand E2 receptors in the uterine tissues were detected.Results No writhing behavior was observed in the normal group;compared with the normal group,the serum PGF2αand E2 levels in the model group were increased(P<0.01),while the P level was decreased(P<0.01),and the mRNA expression levels of the uterine PGF2αand E2 receptors were increased(P<0.01,P<0.05).Compared with the model group,the writhing behavior latency was prolonged,and the writhing response score was decreased in the ginger-partitioned moxibustion group and the Western medicine group(P<0.01);the serum PGF2αand E2 levels in the ginger-partitioned moxibustion group and the Western medicine group were decreased,while the P level was increased(P<0.05 or P<0.01);the mRNA expression levels of the uterine PGF2αand E2 receptors in the ginger-partitioned moxibustion group and the Western medicine group were decreased(P<0.05).Compared with the Western medicine group,the ginger-partitioned moxibustion group showed a prolonged writhing behavior latency,reduced writhing response score(P<0.05),and decreased serum E2 level(P<0.05),while no statistical differences in the serum PGF2αand P levels,or the mRNA expression levels of uterine PGF2αand E2 receptors(P>0.05).Conclusion The analgesic effect of ginger-partitioned moxibustion on PD due to cold-dampness stagnation may be related to regulating the mRNA expression levels of PGF2αand E2 receptors in the uterine tissues.

具有燕赵医学文化特色的中医药人才培养体系构建与实践

探讨了具有燕赵医学文化特色的中医药人才培养新体系的构建与实践,包括扁鹊医学社中医教育第二课堂、扁鹊中医班“1234”人才培养模式、“扁鹊计划”4段式师承教育模式、“一院一馆一讲坛”传承创新体系等。未来将继续弘扬燕赵医学文化,推进燕赵医学研究,创新燕赵医学理论,叫响燕赵医学品牌,推动燕赵医学走向世界。

“新医科”视阈下中医药人才培养创新体系的构建与思考

“新医科”教育强调成熟知识的融合创新,培养能够适应智能技术革命,运用交叉学科知识解决医学领域前沿问题的创新人才。“新医科”中医药人才培养的创新体系包括以生命健康为中心的理念创新、以学科融合为特质的结构创新、以多方协同为主体的模式创新、以优质教育为核心的质量创新、以自主学习为导向的范式创新、以人文教育为特点的特色创新等。“新医科”视阈下,构建中医药人才培养的创新体系对于“传承精华,守正创新”与培养卓越中医药人才具有重要意义。