基于脾和内质网—线粒体相关性探析助脾运化法治疗糖尿病

糖尿病为临床常见病、多发病,其发病机制与能量代谢失衡密切相关。内质网(ER)和线粒体作为关键的细胞器,参与机体多种代谢过程的调节。ER功能失衡及线粒体功能障碍可能导致胰岛素抵抗,血液中糖脂积累,进而引发能量代谢失衡,最终导致胰岛β细胞损伤与凋亡,从而加速糖尿病的形成与进展。中医学中脾与内质网和线粒体均有其相关性,脾主运化与现代医学中促进物质能量代谢的功能相似。当脾主运化失职,分清泌浊失司时,会酿生痰浊水湿,壅滞中焦,干扰物质与能量的正常代谢。日久脾气亏损,动力不足,精微失于输布,故物质和能量代谢作用减弱。助脾运化法可扶脾气、助脾运、畅气机,恢复脾主运化功能,促进能量代谢平衡。因此,本文基于ER—线粒体互作,从“脾土壅滞—ER应激”与“脾气亏损—线粒体功能障碍”两方面探析助脾运化法可恢复机体能量代谢稳态从而治疗糖尿病。这可能成为从亚细胞水平层面科学理解传统中医学理论的新思路,可为助脾运化中药复方治疗代谢性疾病的分子机制研究提供研究方向。

脾气探微

"脾气"最早见于《内经》,厘清脾气功能及内涵才能更好发扬脾藏象理论。脾的藏象理论与气的功能特点相结合便是脾气,脾气包括气与脾气,分阴阳,在脾的藏象理论中起着核心作用,脾气中升发、活动、温煦的部分均归为脾阳,下沉、宁静、滋润的部分归为脾阴。脾阴与脾阳为脾气内在特点的两端性,包含于脾气的各个部分。脾主运化与统血为"后天之本",维持脾功能正常,是化生精微生成气血津液的基本物质,是保持脾生理活动的基础,脾气助运化(消水谷、散精微、输布水液),助统血(直接统血、间接统血),助升清(助升清阳、调节气机升降、保持内脏恒定),通过固摄、推动直接统血及化生气血而间接统血。脾气消水谷、散精微、疏布水液;通过固摄、推动作用直接统血及化生气血,间接统血。脾气虚则导致运化、统血失常,消化、水液代谢、血液运行失常等。

固本止泻汤治疗慢性结肠炎80例

目的 :探讨健脾益气 ,清热化湿类中药配伍治疗慢性结肠炎的疗效。方法 :采用自拟固本止泻汤 (炒山药、炒苡仁、白扁豆、茯苓、白术、白芍等 )治疗慢性结肠炎 80例。结果 :总有效率 92 .5 %。提示 :本方法具有健脾益气 ,助运化湿 。

补中益气汤临床应用浅析

目的:探讨补中益气汤的临床应用情况。方法:通过对柴胡在补中益气汤中的配伍及功效的分析,对补中益气汤的临床运用进行初步探讨。结果:补中益气汤主治中上二焦疾病,功用助脾运化、充盛谷气、开发上焦、通利营卫;下焦肝肾不足之人,若用补中益气汤,升发太过,则有耗损阴精之虞。临床上阴血不足的患者,应用补中益气汤时应当审慎。结论:补中益气汤系金元四大家之一李东垣创制,功能补中益气、升阳举陷,是临床常用的健脾益气方剂。但临证之际,应圆机活法,不可胶柱鼓瑟,执一而治。

Effects of three needling manipulations of the right-side Zusanli(ST 36) on brain using functional magnetic resonance imaging

OBJECTIVE: To investigate the effects on the brain using three needling manipulations(twirling, lifting-thrusting, and twirling plus lifting-thrusting)when the right-side Zusanli(ST 36) acupoint was stimulated with needles.METHODS: Seventeen healthy subjects accepted three needling manipulations stimulating the right Zusanli(ST 36) over separate days. Functional magnetic resonance imaging was used to detect changes in the brain during the manipulations, and then the needling sensations were recorded using the MGH acupuncture sensation scale(MASS) after each scan. f MRI data were processed using Statistical Parametric Mapping 8 to analyze the positiveand negative activation in the brain induced by different acupuncture manipulations.RESULTS: The individual needling sensations showed no statistically significant differences among the three manipulations. However, the MASS index showed that lifting-thrusting > twirling plus lifting-thrusting > twirling. Lifting-thrusting activated left premotor cortex, left postcentral,right middle frontal gyrus, left inferior frontal gyrus,right lingual gyrus, left insula, right putamen, bilateral cingulate gyrus and right cerebellum; and deactivated bilateral hippocampus and left caudate.Twirling activated bilateral orbital middle frontal gyrus, left opercular and triangular inferior frontal gyrus, and right middle occipital gyrus; and deactivated bilateral precuneus, right amygdala, left anterior cingulate gyrus, right inferior temporal gyrus,right middle frontal gyrus, right supplementary motor gyrus, and left postcentral. Twirling plus lifting-thrusting activated bilateral postcentral, left inferior occipital gyrus, left insula, left thalamus, left cingulate gyrus, and right putamen; and deactivated right superior frontal gyrus, right superior parietal gyrus, right temporal gyrus, right middle occipital gyrus, right insula, and left lingual gyrus. Pairwise comparisons of the three manipulations showed that signals induced by lifting-thrusting were the strongest, especially in the limbic system,followed by twirling plus lifting-thrusting; twirling alone was the weakest.CONCLUSION: Three methods of needling manipulations similarly activated areas associated with the somatosensory system, vision, cognition, and emotional regulation. This may have significant implications for acupuncture in clinical practice.