基于数据挖掘《临证指南医案》遗精病用药规律探讨

目的探讨叶天士治疗遗精病用药规律,为当代医家中医临证用药提供参考和借鉴。方法统计《叶天士医学全书·临证指南医案·卷三》中遗精病使用药物,并分别查出其药性、药味、功效及归经,运用Excel、Spss 22.0、Weka 3.8、Cytoscape 3.6.1对数据进行统计分析。结果叶天士治疗遗精病的高频药物为地黄、芡实、茯神、五味子、党参、茯苓、龙骨、远志、湖莲、山药等,多属补虚药和收涩药,药性多温平,药味多甘涩,归经多属肾经、脾经。根据高频药物的关联规则分析,得到药对配伍规则如地黄—芡实、芡实—湖莲、芡实—五味子、五味子—湖莲、茯神—地黄、地黄-芡实-湖莲、五味子-湖莲-地黄等。结论数据挖掘结果发现叶氏治疗遗精病以益肾填精、收敛固涩为主,兼以健脾益气,宁心安神、养阴生津、清热利湿等,对于当代医家在临床上辨证施治用药有着一定的指导意义。

孟河医家治疗遗精病初探

孟河医家在治疗内科、外科、妇科、儿科等各科疾病方面均积累了丰富的经验,在治疗遗精病方面也有所建树。本文主要介绍孟河医家对遗精病病因病机的认识及对此病进行辨证施治、组方用药的规律。

通因通用法治遗精病一得

遗精病每多由肾虚不周，肾不藏精，或肝肾阴虚，虚火上扰精室，迫精外泄为患。临床常以补，涩、固法为治。实践证明，单纯的虚证实属少见，临床往往同时兼有下焦湿热，肝郁气滞，心肝火旺等实证因素，并且在疾病的某一阶段，这些实证却是疾病的主要矛盾。因此，笔者若见到以实证为主因的病例，常常以通因通用法治之，

贾金铭从肝论治遗精验案二则

本文选取贾金铭运用自拟疏肝固精方治疗遗精验案两则。案一中患者因长期工作压力大导致精神紧张,情绪异常,常叹气不舒,而导致此病发生,多方求治无功,经用疏肝解郁、滋阴固肾之法而建功,此案抓住患者病情因社会因素导致情绪变化的特点而获效。案二中患者所处年龄段比较特殊,因病讳疾忌医,久至肾精亏乏,焦虑紧张,贾教授果断处以解郁安神、填精补肾大法,并嘱托其养成正确的生活习惯,病人不日而愈,竟收奇功。上述两则医案充分体现贾教授在治疗男科疾病时,因时、因人辨证施方的特点。

The Effect of Music Therapy for Patients With Huntington＇s Disease： A Systematic Literature Review

Huntington＇s disease is a progressive, neurodegenerative, and autosomal dominant disease characterized by motor- and psychiatric disturbances, and cognitive decline. Since there is no cure, all treatment is aimed at improving quality of life. One form of non-drug therapy which is barely recognized, is music therapy. The literature on its use and effect in patients with Huntington＇s disease is limited. We therefore performed a detailed literature survey in order to delineate the different types of music therapy interventions and their aims. Music therapy studies were included when targeting： （1） motor disturbances; （2） cognitive disturbances; （3） psychiatric disturbances; and （4） emotional/social disturbances. A total of eight studies that met these criteria were analyzed. We found that music therapy interventions vary throughout the different stages of the disease and are not yet applied optimally. Not the stage of the disease but the individual treatment goals seem to be more determinative for the music therapy indications. In conclusion, precise aims and methods in relation to the stage of the disease are not well determined. There is a need for systematic study of this treatment option.

EXPERIENCE IN THE POINT-SELECTION FOR ELECTRO-ACUPUNCTURE

Point selection along the course of meridians is the basic principle for acupuncture prescription and selection of points. In application, there are three categories of point selection: selection of local and adjacent points; selection of distant points, and selection of symptomatic points. Based on the

Schizophrenia:a classic battle ground of nature versus nurture debate

Much has been learned about the etiology and pathogenesis of schizophrenia since the term was first used by Eugene Bleuler over a century ago to describe one of the most important forms of major mental illness to affect mankind.Both nature and nurture feature prominently in our understanding of the genesis of the overall risk of developing schizophrenia.We now have a firm grasp of the broad structure of the genetic architecture and several key environmental risk factors have been identified and delineated.However,much of the heritability of schizophrenia remains unexplained and the reported environmental risk factors do not explain all the variances not attributable to genetic risk factors.The biggest problem at present is that our understanding of the causal mechanisms involved is still in its infancy.In this review,we describe the extent and limits of our knowledge of the specific genetic/constitutional and non-genetic/environmental factors that contribute to the overall risk of schizophrenia.We suggest novel methods may be required to understand the almost certainly immensely complex multi-level causal mechanisms that contribute to the generation of the schizophrenia phenotype.

Clinical study on Jin's three-needle therapy for post-stroke cognitive impairment

Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.

Autism genetics: Methodological issues and experimental design

Autism is a complex neuropsychiatric disorder of developmental origin, where multiple genetic and environmental factors likely interact resulting in a clinical continuum between "affected" and "unaffected" individuals in the general population. During the last two decades, relevant progress has been made in identifying chromosomal regions and genes in linkage or association with autism, but no single gene has emerged as a major cause of disease in a large number of patients. The purpose of this paper is to discuss specific methodological issues and experimental strategies in autism genetic research, based on fourteen years of experience in patient recruitment and association studies of autism spectrum disorder in Italy.

DNA methylation in schizophrenia: progress and challenges

Schizophrenia is a heterogeneous psychiatric disorder broadly accepted being caused by genetic and environmental factors. Although conventional genetic studies have identified some candidate genes for schizophrenia, low odds ratios and penetrance, and a lack of reproducibility have limited their explanatory power. Despite the major efforts made toward identifying environmental factors in schizophrenia, methodological limitations and inconsistent findings of epidemiological reports have obstructed attempts to identify exogenous causal factors. Epigenetic mechanisms, mediating between environment and genes, have recently been proposed to play an important role in the pathogenesis of schizophrenia. DNA methylation is the most stable and well-characterized epigenetic modification. In this paper, we briefly introduce DNA methylation mechanisms, genome-wide DNA methylation studies, and identify specific genomic methylation sites in individuals diagnosed with schizophrenia. The outline candidate genes such as Reelin and COMT, are also outlined before paying attention to the conundrum of recent researches.