基于因子分析及二元Logistic回归分析探讨慢性咳嗽治法的用药规律

目的:探讨中医药治疗慢性咳嗽的用药规律。方法:选取2009年2月至2017年12月北京中医药大学东方医院呼吸热病科咳嗽专病门诊收治的慢性咳嗽患者641例作为研究对象,通过因子分析及二元Logistic回归总结常用药物组合与证型的关联性,从而获得慢性咳嗽的治法及用药规律。结果:慢性咳嗽治疗主以祛风宣肺为主,常用药物有炙麻黄、黄芩、前胡、厚朴、炙紫菀、炙款冬花、细辛、青风藤等;兼湿热郁肺者,佐以清热化湿,常用药有薏苡仁、佩兰、白豆蔻、广藿香等;兼有肺阳亏虚者,佐以温阳健脾,兼寒饮伏肺者,佐以温阳化饮,此2证常用药有白术、茯苓、桂枝、炙甘草、细辛等;兼有痰湿阻肺者,佐治以理气燥湿、化痰止咳,常用药有紫苏子、紫苏梗、炒白芥子、炒莱菔子等;兼肺阴亏虚者,佐治以养阴清热、润肺止咳,常用药有麦冬、芦根、白茅根等。结论:慢性咳嗽以祛风宣肺为基本治法;遣方用药须兼顾宣降共施,寒温并用,肺脾同治。

常克治疗小儿咳嗽治法规律研究

目的:运用数据挖掘技术,分析常克教授治疗小儿咳嗽的用药经验,总结其治法规律。方法:收集常克教授治疗小儿咳嗽的病案,将药物及剂量等相关信息录入到中医传承辅助系统平台(V2.5),采用软件集成的用药频次统计、关联规则分析及熵层次聚类等数据挖掘算法,分析其治疗小儿咳嗽的用药经验,总结治法规律。结果:筛选出病案127例,处方127首,包含药物共计174味。通过频次统计得出常用药物59味(使用频次≥10次),排名前3位的依次为杏仁、黄芩、射干;通过药物之间的关联规则分析得到使用频次较高的药对73个,排名前3位的依次为黄芩-杏仁、射干-杏仁、黄芩-射干;通过熵层次聚类分析算法发现11个关联系数较高的潜在药对及11个新处方。结论:常克教授治疗小儿咳嗽的常用方法为复宣降、消痰气、调寒热、利咽喉,变法为利小便、泄肠热、清肝热。

《傅青主女科》之妇人血崩七症用药初探

《傅青主女科》为妇人杂病之经典古籍,针对妇人血崩典型七证有独到见解,见血崩不急于止血,待临症象神,辨证准确,用药精简。崩漏为妇科常见病,出血量过多可为急重之症不容忽视。本文围绕书中所写,从起病原因,治法规律加以总结,将卷中方剂用药特色等加以深层分析。《傅青主女科》对后人在崩漏诊治中影响深远,特色的治疗理念值得世人反复研读应用于临床之中。

中医肾脏病临床研究的几个关键问题

中医肾脏病的临床研究长期以来争议较多,关键在于临床研究方向不甚明确。基于长期的中医肾脏病临床研究实践,我们主张将肾脏病分成复合证型,有利于研究的设计与统计分析,可提高临床研究的实际操作性;治法方面,温阳药的应用、祛风湿法与清热解毒利湿法的鉴别,扶正法的地位,治则的组合及其应用时点等值得进一步研究。相关中药的研究是较为常见的切入点,临床疗效评价体系尚有待进一步健全。总之,中医临床研究要从临床需求出发,以问题为导向设计方案,有体系、有步骤的实施,才能提高研究的水平。

Report of gossypiboma from the standpoint in medicine and law

We report on a case of gossypiboma. A 78-year-old man was admitted to our hospital with acute abdomen. He had undergone an operation for colon cancer 4 mo previously.Abdominal ultrasonography revealed an echogenic lesion with a hypoechoic rim and strong posterior acoustic shadowing in the lower abdomen. Diagnosis of gossypiboma can be made by ultrasonography to avoid loss-of-chance of survival. We reviewed the English literature briefly of gossypiboma from the medical and juridical view. According to the theory of loss-of-chance, the damage of plaintiff is the loss of the chance of survival or recovery, rather than the final harm. The victim would allow recovery for the loss of the chance from the defendant. But the plaintiff would show by a preponderance that he was deprived of a betterchance of a cure. Under the proposed rule, the compensable value of the victim would be the plaintiff's compensation for the loss of the victim's chance of survival.

The Research and Analysis to the Financing Dilemma and Countermeasures of China＇s Medium and Small Sized High-tech Enterprises

The Financing problem of Medium and small Sized High-tech Enterprises is the key point to enterprises＇ survival and development. Firstly it is pointed out that the difficulty in financing is due to without enough emphasis on Medium and Small Sized High-tech Enterprises, without sound targeted laws and regulations, the imperfect credit guarantee system, and corporate governance structure problem of the enterprise Then, according to the problems existing in the financing of China＇s Medium and Small Sized High-tech Enterprises, the assay put forward several countermeasures which have referential value.

Kingship in Nepal： Envisioning a Contemporary Perspective

The aim of this study is to observe the prospect of kingship in Nepal. It presents an analysis of the people＇s perspective on dismissed monarchy and challenges faced by Nepal. There was little voice on Nepali monarchy system, yet many individuals and researcher expressed the need for monarchy to build nation and keep its culture, tradition, and nation unity. To promote the democratic system, political parties should practice democratic norms and respect rules of law in real life rather than just in talk. For the express of people voice and envision prosperous Nepal, this paper attempts to contribute to the need of monarchy back in Nepal far its savereignty and unity. The paper gives a historical overview of kingship in Nepal and discusses incompetent political parties and the importance of monarchy in Nepal. It identifies that to unite the Nepal and Nepali and give the nation social cultural identity, and it needs any form of monarchy in Nepal. The past and present, despite of political systems, social movement, and practice seen from the political parties were failed several times to fulfill people＇s mandate, such as holding election, writing constitution. The fields discussed in the paper include apathetic attitude of the political parties toward establishing peace and stability in Nepal.

麻黄类方在小儿肺系疾病中运用探讨

目的《伤寒论》中以麻黄为主要(或君药或臣药)的一系列拥有相似方药的类方被后世医家称为麻黄类方,本类方在小儿肺系疾病如扁桃体炎、急性上呼吸道感染、急慢性支气管炎、喘息性支气管炎、支气管肺炎、新生儿肺炎、支气管哮喘等中运用广泛,至今仍广泛指导儿科临床,若合理的运用可明显增强临床疗效,本文旨在从麻黄类代表方证分析及治法特点、原则分析以探讨在小儿肺系疾病中运用的规律,以更好的指导儿童临床辩证及提高疗效。