加减小青龙汤和从龙汤治疗老年慢性阻塞性肺疾病急性加重期外寒内饮证的临床研究

目的观察加减小青龙汤和从龙汤治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)外寒内饮证的临床疗效。方法采用随机对照研究,将62例AECOPD患者按随机数字表法分为治疗组和对照组,每组31例。两组均给予西医基础治疗,治疗组在此基础上给予加减小青龙汤和加减从龙汤治疗。观察并比较两组治疗前后咳嗽、喘息等临床症状评分、改良呼吸困难指数(mMRC)评分、慢性阻塞性肺疾病评估测试(CAT)评分、日常生活活动能力评分(Barthel指数),并比较两组住院天数和住院费用。结果治疗后两组临床症状评分、mMRC评分、CAT评分均较本组治疗前降低(P<0.05),日常生活活动能力评分较本组治疗前升高,且治疗组改善情况优于对照组(P<0.05)。治疗组住院天数明显短于对照组(P<0.05),且住院费用明显低于对照组(P<0.05)。结论加减小青龙汤和从龙汤可有效改善老年AECOPD患者的临床症状,减少住院天数,降低住院费用。

齐聪辨治卵巢子宫内膜异位囊肿经验

齐聪教授认为卵巢子宫内膜异位囊肿发病机理在于肾虚血瘀痰凝,宜用补肾活血化痰法治疗本病,临证运用自拟补肾消瘤方取得了较好疗效。并附验案1则佐证。

运用“从龙法”辨治支饮临证感悟

张锡纯创制"从龙汤"治疗服用小青龙汤后出现的变证,后世医家将治疗体虚支饮者误下小青龙汤所生变证之法称为"从龙法"。后经发展,从龙法一定程度扩大了适用范围,也可直接用于辨治体虚支饮患者。以归属于"支饮"范畴的心源性哮喘为例,发病基础为多种心系疾病发展至心力衰竭阶段所为,其本为虚,若因其咳嗽咯痰、喘息不得卧之主症,以小青龙汤等辈论治,必耗伤阴阳,变证丛生。此外,重症心衰病引起的心源性哮喘正气损耗严重,亦可出现变证,符合从龙法所治范围。本文浅析4位医学大家对从龙法的论述与治验,另附典型医案2则。

Fuxin decoction attenuates doxorubicin-induced heart failure in rats via oxidizing suppression and regulating immune responses

OBJECTIVE:To observe the effects of Fuxin decoction in rats with heart failure induced by doxorubicin injections.METHODS:We employed a doxorubicin-induced heart failure model to investigate the effect of Fuxin decoction.Rats were orally administered with Fuxin decoction from 10 to 40 mg/kg.Organization structure changes were assessed by histology,circulating levels of oxidative stress-related biomarkers and inflammatory cytokines were detected via enzyme-linked immunosorbent assay.RESULTS:Administration of Fuxin decoction improved the growth retardation in doxorubicin hydrochloride injection rats.Cardiac involvement was alleviated by Fuxin decoction,as well as changes of congestion systemic circulation in this rat models.Furthermore,Fuxin decoction regulates immune responses and suppresses oxidation reaction in doxorubicin hydrochloride-induced rats.CONCLUSION:Fuxin decoction might be an interesting candidate for congestive heart failure.

何迎春教授辨治耳鸣经验浅析

[目的]介绍导师何迎春教授治疗耳鸣的临床经验和学术观点。[方法]通过跟随何迎春教授临诊,记录相关医案、分析典型病例,从病因病机、治法方药,并从三种证型探析何迎春教授治疗耳鸣的临床经验和学术观点。[结果]何迎春老师认为耳鸣病机主要是浊邪害清、清气不升和阳气内郁,根据病因病机,治疗从"化浊邪""升清气""升阳散火"出发,常用宣畅气机、清利湿热,益气健脾、升举清阳和升阳散火、化瘀开窍等治疗方法,方药多用三仁汤加减、益气聪明汤加减及升阳散火汤加减,屡获良效。[结论]何迎春老师对耳鸣的治疗从化浊邪""升清气""升阳散火"出发,灵活配伍,在临床上效果显著,值得医家借鉴,具有推广应用价值。