The effect of Supplementing Qi and Nourishing Yin combined with chemotherapy for lung cancer： a meta-analysis

目的：明确益气养阴法联合化疗是否较单纯使用化疗治疗肺癌在增效、减毒等方面更有优势.方法：从网络数据库中检索2013年1月至2017年1月期间以中医益气养阴为治法联合化疗方案对比单纯化疗治疗肺癌并且运用了随机对照试验研究的国内外文献,然后采用RevMan5.3.5软件对搜集的文献质量进行评价、筛选.结果：成功筛选符合系统评价的文献10篇,总病例691例,治疗组共369例（益气养阴中药＋化疗）,对照组322例（单纯化疗）.Meta分析结果显示治疗组在改善肺癌临床症状方面具有显著统计学差异（P〈0.001）,在实体瘤情况方面、在生活质量改善情况方面、在不良反应发生情况方面两组对比均有显著统计学差异（P〈0.001）.结论：益气养阴法联合化疗能显著改善中晚期肺癌患者的临床症状,减少因化疗引起的毒副反应,提高患者生活质量.

Effect of Chinese Herbal Medicine for Nourishing Yin,Supplementing Qi,and Activating Blood on the Th1/Th2 Immune Balance in Peripheral Blood in Patients with Primary Sjogren's Syndrome

Objective： To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ （IFN-γ,）/interleukin-4 （IL-4） in peripheral blood and disease activity in primary Sjogren＇s syndrome （pSS） patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods： A total of 66 pSS patients were randomized with tossing coins method into two groups： the integrative therapy group （34 cases） and the control group （32 cases）; and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results： Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients （P〈0.05）. Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment （P〈0.05）. The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group （P〈0.05）. For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion： Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Multi-central Clinical Research into Treating 80 Cases of Chronic Thrombocytopenia with Qi-supplementing and Yin-nourishing Therapy and Western Medicine

Objective: To probe the effects of qi-supplementing and yin-nourishing therapy (blood-increasing decoction and blood generating powder) on chronic thrombocytopenia. Methods: Two hundred patients with chronic thrombocytopenia were randomly divided into control (n=100) and test groups (n = 100) with Amino-polypeptide as a basic treatment for both. Test group patients consumed a blood-increasing decoction and blood-generating powder for 1-3 months. Improvements in platelet counts and TCM syndrome were observed. Results: One hundred and sixty-four (80 in the test group and 84 in the control group) of 189 total participants were treated for 3 months. The total effective rate in improving TCM syndrome was 95.00% in the test group and 79.76% in the control group (P<0.05). There was significant difference (P<0.05) in the accumulated score of TCM syndrome between the two groups treated at different time points. The total effective rate of platelet counts was 86.25% in the test group and 59.52% in the control group (P<0.05). There was a significant difference in platelet counts before and after treatment in the two groups (P<0.05). There was no significant differences in platelet count between the two groups treated for 1-2 months; however, a significant difference was found between the two groups after treatment for 3 months (P<0.05). Conclusions: After a 3-month treatment of chronic thrombocytopenia patients with qi-supplementing and yin-nourishing therapy, TCM syndrome was improved and platelet counts increased with no obvious side effects, and the quality of life of the participants was enhanced with noticeable long-term curative effects.

Effect of Chinese Drugs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Myocardial Perfusion in Patients with Acute Myocardial Infarction after Revascularization

Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...

Effect of Chinese Herbal Medicines for Nourishing Yin,Supplementing Qi,and Activating Blood on Reproductive Endocrine Activity and Immune Functions in Patients with Primary Sjogren's Syndrome

ABSTRACT Objective： To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren＇s syndrome （pSS）. Methods： Seventy pSS patients were randomly assigned to two groups using a randomized digital table： the integrative therapy group （36 cases） and the control group （34 cases）. Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, prolactin （PRL） by radioimmunoassay and immunoglobulin （IgG） by immunodiffusion, erythrocyte sedimentation rate （ESR） by Westergren, interferon-γ （IFN-γ） and interleukin-4 （IL-4） by enzyme linked immunosorbent assay were determined. Results： E2 and T levels in all patients were lower than those of normal subjects before treatment （P〈0.05） and were increased significantly after 6-month treatment （P〈0.05）. ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments （P〈0.05）, and were reduced significantly after the treatments （P〈0.05）. The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group （P〈0.05）. However, the PRL levels before and after treatment were not significantly changed in the two groups （P〉0.05）. The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment （P〈0.05）. Conclusions： The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Protective Effect of Chinese Herbs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Heart Function of Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

Objective： To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome （ACS） after successful percutaneous coronary intervention （PCI）. Methods： One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine （WM） treatment group （WMG） and a combined treatment group （CMG） treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association （NYHA） functional class, Chinese medicine （CM） symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events （MACE） were observed, serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and hyper-sensitivity C-reactive protein （Hs-CRP） were measured, an echocardiogram was conducted to examine left ventricular ejection fraction （LVEF）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, inter-ventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, and ventricular wall motion index （VWMI）. Results： Compared with the baseline, LVEF significantly increased （P〈0.01）, and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased （P〈0.01） in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI （P〉0.05）. VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG （P〈0.05 or P〈0.01） at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG （6% vs 22%, P〈0.05）. Conclusion： Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.

Randomized Double-blinded and Controlled Clinical Trial on Treatment of HIV/AIDS by Zhongyan-4 (中研-4号)

Objective： To assess the efficacy and safety of Zhongyan-4 （中研-4号, ZY-4, a Chinese herbal preparation worked out according to the therapeutic principle of supplementing qi, nourishing Yin, clearing heat and detoxication） in treating HIV/AIDS patients in the early or middle stage. Methods： Adopted was randomized double-blinded and placebo-parallel-controlled method, with 72 HIV/AIDS patients randomly divided into the ZY-4 group （36 patients） treated with ZY-4 and the control group （36 patients） treated with placebo. The treatment course was six months. The index of OD4^＋, OD8^＋ counts, body weight, clinical symptom scoring were estimated at 4 time points （0, 1, 3 and 6 month in the course）, and also the viral load before and after treatment. The whole course of observation was completed in 63 patients, 30 in the ZY-4 group and 33 in the control group. Results： OD4^＋ count in the ZY-4 group got elevated by 7.70 4±150.96/mm^3 on average, while that in the control group lowered by 27.33 4±85.28 /mm^3 . Fifteen out of the 30 patients in the ZY-4 group had their OD4^＋ count increased, which was evidently much higher than that in the control group （8/33, P〈0. 05）, suggesting that the efficacy of ZY-4 is superior to that of placebo in elevating OD4^＋ count. Moreover, ZY-4 showed actions in elevating OD45RA^＋ and OD8^＋ count, reducing HIV virus load, improving clinical symptom/sign and increasing body weight of patients. No obvious adverse reaction was found in the clinical trial. Conclusion： ZY-4 has an immunity-protective and/or rebuilding function in HIV/AIDS patients in the early and middle stage, and also shows effects in lowering viral load, increasing body weight and improving symptoms and signs to a certain degree.

甘温除热法治疗乳腺癌化疗后并发症

乳腺癌的发病以气郁、痰凝、血瘀为因,患之日久,积聚为核,囿于乳络,终耗气伤血,应用化疗药物后,毒邪进入体内最先伤及脾胃,脾胃受损则气血生化无本,输布无源,进而影响其他脏腑生理功能,致正气虚损、气血耗伤。甘温除热法可扶正祛邪、调畅气机、补益气血、安和诸脏,病及于心可用泻火升阳汤,病及于肝可用补中益气汤,病及于肺可用升阳益胃汤,病及于肾可用神圣复气汤。临证时需把握甘温除热法对应证的病机变化,选用方除李东垣著作中所载方外,亦可选黄芪建中汤、人参养荣汤、十全大补汤、七味白术散等符合甘温除热思想之方。

益气养阴活血法治疗2型糖尿病合并慢性心力衰竭患者的疗效观察

目的 探讨中医益气养阴活血法辨证治疗2型糖尿病(Type 2 diabetes, T2DM)合并慢性心力衰竭(Chronic heart failure, CHF)患者的临床疗效。方法 选取2021年1月—2022年1月期间唐山市中医医院内分泌一科收治的T2DM合并CHF患者102例作为研究对象,按随机数字表法分为对照组与治疗组,每组各51例。对照组给予常规西医治疗,治疗组在对照组基础上联合中医益气养阴活血法辨证治疗,均治疗12周。观察比较两组患者西医疗效、中医证候疗效、安全性及治疗前后血糖水平[空腹血糖(Fasting blood glucose, FPG)、餐后2 h血糖(Blood glucose 2 h after a meal, 2 h PG)、糖化血红蛋白(Glycosylated hemoglobin, HbAlc)]、心功能指标[6分钟步行试验距离(6 min walking test, 6MWT)、左室射血分数(Left ventricular ejection fraction, LVEF)、N末端B型脑钠肽前体(N-terminal B-type brain natriuretic peptide precursor, NT-pro BNP)]、生活质量评分[T2DM生活质量(Quality of life specific scale for diabetes patients, DSQL)、CHF生活质量(Minnesota Living with Heart Failure Questionnaire, MLHFQ)]变化。结果 临床疗效:治疗后治疗组西医疗效总有效率96.08%(49/51)高于对照组82.35%(42/51),差异有统计学意义(P<0.05);治疗组中医证候疗效总有效率92.16%(47/51)高于对照组68.63%(35/51),差异有统计学意义(P<0.05)。血糖水平:治疗后两组患者血糖FPG、2 h PG及HbAlc水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血糖FPG、2 h PG及HbAlc水平均明显低于对照组,差异有统计学意义(P<0.05)。心功能指标:治疗后两组患者心功能6MWT、LVEF水平较治疗前升高,NT-pro BNP水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组6MWT、LVEF水平高于对照组,NT-pro BNP水平低于对照组,差异有统计学意义(P<0.05)。生活质量:治疗后两组患者DSQL、MLHFQ评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组DSQL、MLHFQ评分均明显低于对照组,差异有统计学意义(P<0.05)。安全性:治疗期间,两组患者不良反应均为轻度或一过性,未影响治疗,且不良反应发生率组间比较,差异无统计学意义(P>0.05)。结论 中医益气养阴活血法辨证治疗T2DM合并CHF效果显著、安全性高,有利于控制患者血糖,改善心功能与生活质量。

益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清Vaspin和SCUBE2水平的影响

目的:观察益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)和骨形态发生蛋白1-表皮生长样结构域蛋白2(SCUBE2)水平的影响。方法:选择2021年1月至2022年12月于该院治疗的糖尿病视网膜病变患者102例,以随机数字表法分组。对照组50例患者给予常规西医治疗,观察组52例患者在对照组的基础上给予益气养阴化瘀方治疗。比较两组患者的临床疗效、治疗前后的中医证候评分,检测视野平均敏感度、视力、收缩期血流速度峰值、眼动脉阻力指数(RI)和舒张期血流速度峰值,检测患者Vaspin、低氧诱导因子-1(HIF-1)、可溶性细胞黏附分子(sICAM-1)、SCUBE2、外周血内皮细胞(CEC)和循环祖细胞(CPC)水平。结果:观察组患者总有效率为98.08%(51/52),高于对照组的84.00%(42/50),差异有统计学意义(P<0.05)。治疗后,观察组患者的中医证候评分较对照组降低,差异有统计学意义(P<0.05)。治疗后,观察组患者的RI低于对照组,收缩期血流速度峰值、舒张期血流速度峰值、视野平均敏感度和最佳矫正视力高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者的CPC水平较对照组升高,CEC水平较对照组降低,Vaspin、HIF-1、sICAM-1和SCUBE2水平较对照组降低,差异均有统计学意义(P<0.05)。结论:益气养阴化瘀法治疗糖尿病视网膜病变,可改善患者微血管功能、动脉血流、微视野和视力,提高临床疗效。

陈健教授从“伏火”论治儿童周期性发热综合征经验

[目的]总结陈健教授从“伏火”论治儿童周期性发热综合征的临床经验。[方法]通过门诊跟诊学习、病案收集整理及查阅相关文献,探讨儿童周期性发热综合征的病因病机,总结陈教授从“伏火”论治该病的治疗经验,并举验案一则加以验证。[结果]陈教授认为,儿童周期性发热综合征的核心病机为“伏火”,“伏火”为发病之本,痰、毒、瘀既是病理产物,也是贯穿病程始终的重要致病因素,郁为存在于发病全过程的病理状态。治疗上以益气除热或养阴清热与调气之法并行,并以自拟方药为治疗儿童周期性发热综合征的有效验方。所举验案以周期性发热为主要症状,辨为阴虚发热证,投以养阴清热、行气解郁之法,取得了较好的疗效。[结论]陈教授从“伏火”论治儿童周期性发热综合征,疗效显著,具有一定的指导意义,值得临床参考借鉴。

补气养阴通便汤配合多点柱状缝扎术治疗直肠前突临床观察

目的:观察补气养阴通便汤配合多点柱状缝扎术治疗直肠前突的临床疗效。方法:选取符合纳入标准的直肠前突住院患者50例作为研究对象,按随机数字表法分为对照组和观察组各25例。对照组采取多点柱状缝扎术治疗,观察组在对照组的基础上给予补气养阴通便汤治疗。比较两组术后疼痛评分、便秘患者症状自评量表评分、临床疗效、术后并发症发生情况。结果:对照组术后24、48、72 h疼痛评分高于观察组(P<0.05)。对照组治疗后便秘患者症状自评量表总分高于观察组(P<0.05)。总有效率观察组为96.00%(24/25),高于对照组的76.00%(19/25)(P<0.05)。术后并发症发生率对照组为16.00%(4/25)高于观察组的4.00%(1/25),但差异无统计学意义(P>0.05)。结论:补气养阴通便汤配合多点柱状缝扎术,可有效降低直肠前突患者术后痛感、减轻便秘程度,提高临床疗效。

益气养阴方治疗气阴两虚型慢性心力衰竭临床观察

目的:观察益气养阴方治疗气阴两虚型慢性心力衰竭(chronic heart failure,CHF)的临床疗效。方法:选取2022年8月至2023年8月郑州市第九人民医院诊治的CHF患者80例,按照随机数字表法分为对照组和治疗组,每组40例。对照组给予常规抗心力衰竭治疗,治疗组在对照组治疗的基础上给予益气养阴方治疗。观察两组患者临床症状(下肢水肿、呼吸困难、全身乏力)消退时间、心率(heart rate,HR)、6min行走试验(6-minute walking test,6MWT)、明尼苏达州心功能不全生存质量量表(Minnesota living with heart failure questionnaire,MLHFQ)评分、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)及左室射血分数(left ventricular ejection fraction,LVEF)变化情况。结果:治疗组有效率为92.5%,对照组有效率为75.0%,治疗组有效率高于对照组,差异具有统计学意义(P<0.05);治疗组呼吸困难、乏力、下肢水肿等临床症状消退时间短于对照组,差异具有统计学意义(P<0.05);治疗组治疗后6MWT长于对照组,MLHFQ评分、心率低于对照组,差异具有统计学意义(P<0.05);治疗组治疗后LVEDD、LVESD低于对照组,LVEF高于对照组,差异具有统计学意义(P<0.05)。结论:益气养阴方能改善气阴两虚型慢性心力衰竭患者心功能,提高左心室舒张能力、生活质量。

基于数据挖掘分析糖尿病肾病证候及用药规律

目的:应用数据挖掘技术分析总结相关文献中糖尿病肾病的证候及用药规律。方法:运用中国知网(CNKI)、维普资讯中文期刊服务平台,搜集2015年1月1日至2020年12月31日治疗糖尿病肾病的医案,提取用药信息,通过Microsoft Excel 2019建立数据库整理归纳数据,总结糖尿病肾病的证候分布情况、药物治疗分布情况以及药物组合关联规则等。结果:共检索相关文献923篇,根据证候分布情况,病位类证候要素主要为肾、脾、肝、肺、心等;病性类证候要素主要为瘀血、痰浊、阴虚、气虚、浊毒等。根据药物治疗分布情况,四气主要为平、温、寒、微温、微寒,五味多为甘、苦、辛、酸、淡、微苦,且归于肝、脾、肾、肺、心、胃、膀胱、大肠经。核心药物以黄芪、茯苓、山药、山茱萸、丹参等50味中药为主,可归纳为补虚药、活血化瘀药、清热药、利湿药、收涩药;药物组合关联规则显示,丹参、山药、山茱萸、茯苓均与黄芪联系密切。结论:益气养阴、活血通络法为糖尿病肾病主要治法,此为后续进一步开展临床研究提供了数据支撑。

益气养阴法治疗慢性萎缩性胃炎伴肠上皮化生的临床疗效研究

【目的】观察益气养阴法改善气阴两虚型慢性萎缩性胃炎(chronic atrophic gastritis,CAG)临床症状及胃黏膜萎缩伴肠上皮化生的疗效。【方法】将62例气阴两虚型CAG患者随机分为对照组和治疗组,每组各31例。对照组给予中成药摩罗丹口服治疗,治疗组给予中药白贝益胃汤(香砂六君子汤合乌贝汤的基础上加滋养胃阴及清热解毒药物组方而成)口服治疗,疗程均为12周。观察2组患者治疗前和治疗8周、12周后的中医证候积分、胃镜组织学积分及病理组织学积分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)脱落情况:研究过程中,对照组脱落1例,治疗组无脱落病例,最终共有61例患者完成全部疗程的治疗,其中治疗组31例,对照组30例。(2)疗效情况:治疗12周后,治疗组的总有效率为90.32%(28/31),对照组为63.33%(19/30),组间比较(χ^(2)检验),治疗组的疗效明显优于对照组(P<0.05)。(3)中医证候积分改善情况:治疗8周后,2组患者的胃脘胀满、胃脘灼痛、喜按、胃中嘈杂、口干口苦、乏力倦怠、大便异常(大便干燥)等中医证候积分均较治疗前有所下降,但差异均无统计学意义(P>0.05);治疗12周后,2组患者的各项中医证候积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗12周后对各项中医证候积分的下降幅度均明显优于对照组(P<0.05)。(4)胃镜组织学积分改善情况:治疗8周后,治疗组的胃镜组织学积分较治疗前明显下降(P<0.05),而对照组较治疗前有所下降,但差异无统计学意义(P>0.05);治疗12周后,2组患者的胃镜组织学积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗8周、12周后对胃镜组织学积分的下降幅度均明显优于对照组(P<0.05)。(5)病理组织学积分改善情况:治疗8周后,2组患者的腺体萎缩、肠上皮化生、慢性炎症、病变活动度等各项病理组织学积分均较治疗前有所下降,但差异均无统计学意义(P>0.05);治疗12周后,除对照组的慢性炎症外,2组患者的各项病理组织学积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗12周后对腺体萎缩、肠上皮化生、病变活动度等病理组织学积分的降低幅度均明显优于对照组(P<0.05)。(6)安全性评价:治疗过程中,2组患者均未发生明显不良反应,且2组患者的血常规、心电图、肝肾功能等安全性指标也均未出现异常,具有较高的安全性。【结论】基于益气养阴法的中药白贝益胃汤治疗气阴两虚型CAG患者疗效确切,可起到改善慢性炎症、缓解症状及逆转肠上皮化生的作用。

基于“湿火”理论探讨糖尿病合并冠心病的诊治

[目的]基于“湿火”理论探究糖尿病合并冠心病的临床治疗方法。[方法]以“湿火”理论内涵为着手点,基于古今文献,分析论证“湿火”与糖尿病合并冠心病病理过程的关系,总结出从“湿火”治疗糖尿病合并冠心病的原则,并附上一则医案予以佐证。[结果]糖尿病合并冠心病在中医学属于消渴合并胸痹的范畴,“湿火”是其重要病机,中医学以“火热”并谈,然“湿火”“湿热”两异,“湿火”为湿热伤阴,因此应益气养阴以清“湿火”,进而治疗糖尿病合并冠心病。目前临床上鲜有基于“湿火”理论指导糖尿病合并冠心病治疗的报道。所列举医案即为“湿火”所致,以益气养阴为治法,治疗后症状改善明显。[结论]从“湿火”论治糖尿病合并冠心病,并予以临证加减,疗效颇佳,可为医者提供新颖的治疗思路。

小建中汤治疗虚劳腹痛机制探析

张仲景在《金匮要略》中论述了虚劳的证治,综合篇中关于病机和症状的论述,以及《素问》中所言“阳气者,烦劳则张”“劳则喘息汗出,外内皆越”,可以将虚劳的病机概括为精血内虚、阳气外浮。“清谷、亡血、失精”皆会导致精血内虚,而“脉大为劳”“脉浮大”“手足烦热”等症状皆表明了精血内虚而兼有阳气外浮。虚劳腹痛是虚劳病损在脾的表现,中焦血不足不能濡养、气不足不能温煦,如此则易产生里急、腹痛的症状,张仲景用甘温的小建中汤温养中焦之气血,同时方中的芍药也有益阴敛阳的作用,将外散于四肢的阳热之气敛降于中焦,使中焦气血充足。

邹旭基于“年长则求之于府”治疗中老年冠心病经验

总结邹旭教授基于《黄帝内经》“年长则求之于府”的思想治疗中老年冠心病患者的临证经验。邹旭教授认为,中老年人因年龄增长而出现“脏虚”,“腑实”(“腑”包括六腑及气血之脉道)常伴随“脏虚”而出现,“腑实”的发生将导致气血津液代谢障碍,气血津液代谢障碍是冠心病的重要原因。对此,邹旭教授提出通过“通腑”方法,使机体上下通畅,气血津液的生成及输布正常运行,从而达到治疗中老年冠心病的目的。临证实践中,可在通法的基础上合用归一饮(主要由制附子、干姜、炙甘草组成)促进元气生发,使六腑及气血之脉道通畅,促进气机升降,并通过益气温阳养阴,重视调节心之阴阳平衡。

劳绍贤诊治便秘经验

介绍劳绍贤教授临床诊治便秘经验,并附验案3则以佐证。劳绍贤教授认为,便秘的病机为五脏功能失调,大肠传导失常。治疗上,以调理五脏、行气养阴为治则,并根据气虚、气滞、津伤的病机特点,病证结合,辨证施治。急性便秘者采用大承气汤或大黄牡丹汤治疗;慢性便秘者采用自拟润肠通便基础方(主要由槟榔、木香、台乌、郁李仁、生地黄、玄参、甘草等组成)治疗;其他胃肠疾病伴便秘者,治疗时可在胃病辨证用方基础上加用行气润肠药;大便多日未解者服用通便药前应先润化燥屎。同时嘱咐患者保持良好的饮食习惯,并进行腹部按摩、相关肌肉训练等以提高中药疗效,预防便秘复发。

益气养血活血法在偏枯治疗中的应用探讨

偏枯,又名偏风、半身不遂,是指一侧上下肢偏废不用,甚或兼疼痛,久则患肢肌肉枯瘦,而神志并无异常变化的一种疾病。偏枯,归于中医“痿证”范畴,其由于胸中大气虚损,不能充于全身,气虚则血无以生、无以行。益气养血活血法是以气血学说为基础而产生的一种中医学治疗方法,被广泛用于指导疾病的预防与治疗。“治痿独取阳明”理论:出自《内经》,是治疗痿病的一种方法。其含义有二:一则补益后天,即益胃养阴,健脾益气;二则清阳明之热邪,治疗重于益气养血活血,在临床上,对于痿证的治疗具有重要的指导意义。人之生者,赖于气血运行不歇;身之健,依气血充足且身体无未充实之处。偏枯与气血运行有着密切联系。在中医经典理论指导下,深入剖析该病的病因病机,基于“治痿独取阳明”理论,总结运用益气养血活血法治疗偏枯,探讨补偏汤加减治疗偏枯的合理性及优越性,为临床治疗偏枯提供更加充足的理论证据。