基于态靶理论的子宫肌瘤治疗方略探析

子宫肌瘤发病机制尚不明确。态靶理论是仝小林院士基于多年临证经验提出的现代中医诊疗范式,适用于多种慢性疾病的诊疗。根据态靶理论,认为子宫肌瘤当以瘀态贯穿始终,于瘀态之下细述证治方药,其中,气滞血瘀证予四逆散合膈下逐瘀汤;寒凝血瘀证予少腹逐瘀汤加三棱、莪术;痰瘀互结证予苍附导痰丸合桂枝茯苓丸;气虚血瘀证予理冲汤。列举针对患者不同症状及指标的靶药,如经行小腹胀痛,可加厚朴、元胡、乌药;经行小腹冷痛,可加肉桂、炮姜;贫血者,可加生黄芪、党参、当归等。

“高知”群体更信赖中医吗?

背景越来越多的证据表明,年轻的、高学历的、来自经济发达地区的“高知”人群正成为中医药的主要使用群体。目的本研究拟依据技术接受整合(UTAUT)模型,采用变量中心与个体中心相结合的方法,更深入地探究国民中医接受度的影响因素。将人口学、慢性疾病、健康素养、传统文化认同、科学思维等变量纳入考量,聚焦家长是否愿意让孩子接受中医儿科治疗。方法2023年7—9月,使用自搭建的DiggMind在线心理测评平台发放问卷进行调查,通过方便取样的方式选取广东省的幼儿园、小学、中学各1所,对717名家长进行问卷调查。收集家长的人口学变量(性别、年龄、学历、职业、户籍、患慢性疾病),采用6级Likert量表(分数越高代表“越符合自身情况”)测量UTAUT模型的6个维度及3个影响因素变量(健康素养、传统文化认同和科学思维)。使用路径分析、潜在剖面分析和Logistic回归分析对数据进行统计。结果UTAUT模型对中医儿科使用意向与行为的解释率高达72%。通过对效果期望、社会影响、便利条件、风险认知、使用意向、使用行为UTAUT模型6个维度进行潜在剖面分析,结果显示将样本分成4个亚组的方案相对最优,将本研究样本划分出“抵制组”“持疑组”“认同组”“坚信组”4个中医接受程度逐步递增的亚型。家长的科学思维和传统文化认同对中医儿科接受态度有正向作用(P<0.05),而学历、户籍类型、职业声望等变量的影响无统计学意义(P>0.05)。结论本研究揭示出真正促进“高知”群体信赖中医药文化的是他们身上所具备的良好品质而非学历、职业、户籍等外在因素,为现代科学理论与传统医学实践之间的融合搭建了桥梁。

基于“络病理论”探讨卒中后认知障碍

卒中后认知障碍(PSCI)是脑卒中常见的临床后遗症之一,其主要症状包括患者在学习、记忆、语言、视觉空间以及执行等方面的能力均受到了损伤。基于“络病理论”,运用中医药治疗PSCI优势显著,为PSCI诊疗提供了新思路。中医学认为PSCI发病基础为髓海空虚,与肾精不足、血脉瘀阻、脾虚痰困等有关,基于络病理论视角探讨PSCI的病因病机与治疗,以期为临床提供参考。

基于成功智力理论的基层中医护理岗位胜任力评价指标体系构建

目的:构建基层中医护理岗位胜任力评价指标体系。方法:基于斯滕伯格的成功智力理论和文献分析法对基层中医护理人员、中医医师及专家进行半结构式访谈,拟订基层中医护理岗位胜任力评价指标体系初稿。运用德尔菲专家咨询对核心能力要素进行验证和细化,层次分析法确定各级指标权重。结果:两轮专家函询后,确定一级指标3个(分析性中医护理能力、实践性中医护理能力、创造性中医护理能力)、二级指标7个(中医护理基本理论、中医护理基本知识、中医护理基本技能、沟通协作能力、专业发展能力、评判性思维能力、个人特质)、三级指标37个。专家积极系数均为100%,专家权威系数分别为0.83、0.89,第二轮咨询的一级、二级、三级指标肯德尔和谐系数分别为0.527、0.432、0.403(P<0.05)。结论:以斯滕伯格成功智力理论为基础建立了一套科学、合理的基层中医护理岗位胜任力评价指标体系。

一种基于主动学习和TCM-EKNN的邮件过滤方法

目前结合机器学习、文本分类的过滤方法成为研究热点。而这些过滤方法在邮件过滤时存在使用训练集数据量和表征数据的特征向量维数过多,引发"维灾难"和较大的运算量等问题。结合证据理论K近邻方法(evi-dence theory based K-nearest neighbors,EKNN)和直推式信度机(transductive confidence machines,TCM)算法思想,提出一种TCM-EKNN的邮件过滤方法,并且采用主动学习样本选择方法选择较少高质量的训练样本构建邮件分类器从而高效地实现垃圾邮件过滤。对比实验结果表明:相对于传统的邮件过滤方法,TCM-EKNN获得了良好的过滤效果,从而论证了TCM-EKNN有效性;并且在保证传统的邮件过滤方法同等高准确率前提下,TCM-EKNN采用主动学习方法后,极大地减少了训练样本数量,提高了过滤器性能,在各项评价指标上具有优越性。

“天人合一”观下女性难治性慢性咳嗽证素、“七七”年龄及节气分布规律

目的:基于“天人合一”观探究女性难治性慢性咳嗽中医证素特点、“七七”年龄分布及发病节气规律。方法:收集2020年1月至2024年5月在北京中医药大学第三附属医院就诊的584例女性难治性慢性咳嗽患者的临床资料(基本资料、相关因素、中医四诊),采取证素评分矩阵确定中医证素,证素间采用Apriori算法进行关联规则分析,因子分析提取公因子,k-means聚类法分析公因子组合情况,归纳年龄、证候、节气分布规律。结果:共纳入584例女性患者,以“七七”患者居多。提取以阴虚、痰、气虚、气滞、肺及肝等为主的病性病位证素24个。10个因子组合共聚为4类证型:血虚风燥证、气阴两虚证、肝郁气滞证、风痰阻络证。发病节气“白露”“小寒”占重要比重。结论:女性难治性慢性咳嗽以气阴两虚证、风痰阻络证为主,不同“七七”年龄段证候分布比例存在差异,且受节气影响。

Mathematical Reasoning of Treatment Principle Based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine (II)

By using mathematical reasoning, this paper demonstrates the treatment principle: “Do not treat a disease after it has occurred. But treat the disease before it will occur” (不治已病治未病) based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine (TCM). We defined generalized relations and reasoning, introduced the concept of generalized steady multilateral systems, and discussed its energy properties. Later based on the treatment of TCM and treated the healthy body as a steady multilateral system, it has been proved that the treatment principle above is true. The kernel of this paper is the existence and reasoning of the non-compatibility relations in steady multilateral systems, and it accords with the oriental thinking model.

Acupuncture Treating Dystrophy Based on pH <br/>—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (III)

Theory of both Zangxiang (藏象) and Jingluo (经络) is useful in understanding disease. By using mathematical reasoning based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (TCM), this paper demonstrates the treatment principle: “Searching for a root cause of disease in cure, treatment of both the root-cause and symptoms at the same time” (治病求本, 标本兼治). It means that for a human body, there is the mathematical structure of both Zangxiang and Jingluo as her/his second physiological system. It can be used to determine both the root-cause and symptoms of the sick organ by using both Zangxiang and Jingluo. In general, for the human blood pH value, the normal range of theory is [7.34539, 7.45461] nearly to [7.35, 7.45], and the center is 7.4. The first or second transfer law of a human body’s energies changes according to the different blood pH values whether in the normal range or not. Human disease treatment should protect and maintain the balance of two incompatibility relations: the loving relationship and the killing relationship. As an application, acupuncture is used to treat limb-girdle muscular dystrophy.

The New Understanding of Yin and Yang of TCM Physiological Model

From the view of the physical model,structure and function characteristics,the material basis and clinical application of Yin-Yang theory,analysing and thinking combined with modern medical theory,this paper finds that as one of the most basic and important theory of traditional Chinese medicine(TCM),Yin-Yang theory reveals the understanding of human physiology in TCM,which has many consensuses with modern medicine,so it is worth studying further.

Acupuncture Treating Heart Disease Based on Eight Palaces or Eight Veins <br/>—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (IV)

Theory of eight palaces (八宫) or eight veins (八脉) is useful in understanding the basic sick subsystems that may be to fall ills as the root-cause. By using mathematical reasoning based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (TCM), this paper demonstrates the treatment principle: “Even if all changed, it is hard to change one’s nature” (江山易改, 本性难移). The eight palaces or eight veins can be used to diagnose basic sick subsystems that may be to fall ills as the root-cause. The first or second transfer law of human body energies of the eight palaces or eight veins according to the different blood pH values of a human body whether in the normal range or not, respectively, assuming that the range of blood pH value is divided into four parts from small to large. Both second and third are for a healthy human body. Both the root-cause and symptoms come from the first transfer law of human body energies. And both first and fourth are for an unhealthy human body. Both the root-cause and symptoms come from the second transfer law of human body energies. A disease treatment should protect and maintain the balance of two incompatibility relations: the loving relationship and the killing relationship. As an application, acupuncture is used to treat atrial premature beats as a congenital heart disease.

TCM-16APSK在通信理论新技术中的应用研究

随着北斗卫星导航系统的广泛应用,非线性卫星信道性能的研究成为通信理论新技术中研究的热点。16APSK是一种非恒定包络调制技术,它充分利用信号平面的幅度和相位具有较高的功率和带宽效率,同时又有对抗非线性失真的内在特点,而格型编码是一种将编码和调制相结合的带宽有效和功率有效编码调制技术。在Saleh非线性模型的基础上,推导出带限非线性信道下TCM-16APSK的误码率公式,分析了其在高斯及带限非线性信道下的性能特点,并提出了基于RLS的均衡算法。仿真结果表明:RLS均衡算法能有效地改善非线性失真,保证了TCM-16APSK在非线性条件下的编码增益。

从美国针灸流派的产生发展看中医针灸理论的国际传播——以TCM针灸流派和医学针灸流派为例

传统中医针灸流派和医学针灸流派分属美国针灸流派的两大阵营,且最具代表性。从二者的产生以及在美国的传播发展历程看,针灸作为一门传统医疗技术,在美国实现“本土化”,以及进一步走向国际化和现代化的进程中,其面临的理论国际传播问题最为突出。站在医学史的角度,并结合针灸医学的自身特点,从理论整合重构、科学研究深化以及针灸海外教育三个方面入手,冲破针灸医学在国际传播中的局限,向世界展现中医针灸理论的全貌,是目前针灸医学理论实现国际化和现代化的前进方向。

Research Progress of Traditional Chinese Medicine Constitution Theory in Patients with Cervical Spondylosis

This paper expounds the theory of traditional Chinese medicine(TCM)constitution applied to patients with cervical spondylosis,in order to clarify the distribution characteristics of TCM constitution of patients with cervical spondylosis.And to analyze the correlation between TCM constitution theory and cervical spondylosis is helpful to provide ideas for integrated nursing care of TCM and western medicine in patients with cervical spondylosis,and provide the basis for the construction of health management program and the evaluation of health promotion effect.

Discussion on pathogenesis of colorectal cancer based on the theory of rheumatic fever in traditional Chinese medicine

Rheumatic fever is a disease according to the theory of traditional Chinese medicine(TCM),and its main clinical manifestations include coma and confusion of eyes and head,severe limb drowsiness,fever without consciousness,sticky and greasy stool,short and blood urine,red tongue with yellow and greasy coating,and slippery rapid pulse.Colorectal cancer is a common malignant tumor in the digestive tract.According to the theory of TCM,rheumatic fever is the main etiology and pathogenesis of colorectal cancer,which is the common syndrome of colorectal cancer.The method of antipyretic and removing dampness has been widely used in TCM treatment for colorectal cancer which is effective.From the perspective of rheumatic fever,the article summarizes the material basis of colorectal cancer from the perspectives of gene,protein,metabolism,and microorganism,discussing the potential mechanism of rheumatic fever in the occurrence and development of colorectal cancer combined with the theory of TCM,summarizing the defects of the research direction at this stage,in order to better guide the prevention and treatment of colorectal cancer.

A Skopos Theory-based Study of Translation Principles of Traditional Chinese Medicine Decoctions

English translations of Traditional Chinese medicine(TCM)terms and prescriptions need standardizing to minimize ambiguity as the popularity of TCM spreads globally.Herein an evaluation guide for translation of TCM decoctions in English into diverse social,cultural and medical systems,is proffered which integrates Skopos theory and Li Zhaoguo’s principles of English translation(conciseness of lexical composition,information accuracy,and similarity in lexical composition).Based on a case study of the traditional herbal medicine Mahuang Xingren Gancao Shigao Tang,direct translation methods with concise lexical composition are determined to most clearly convey the sophisticated and verbose original TCM prescription.

基于“筋骨平衡”理论针刺推拿疗法治疗椎动脉型颈椎病的临床观察

目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)评分、颈椎曲度及脑血流参数的影响。方法选择该院2019年12月—2021年12月就诊的CSA患者86例实施研究,随机数字表法分作观察组与对照组,各43例;其中对照组脱落2例,剔除1例,共完成40例;观察组脱落1例,剔除1例,共完成41例;对照组予以常规牵引疗法,观察组予以基于“筋骨平衡”理论针刺推拿疗法;比较两组治疗前与治疗后中医症状积分、ESCV评分、颈椎曲度及脑血流参数的变化,并对比两组疗效。结果治疗后,观察组中医症状积分皆显著低于对照组(P<0.05)。治疗后,观察组ESCV评分和颈椎曲度皆明显高于对照组(P<0.05)。治疗后,观察组椎底动脉及左、右椎动脉的Vs与Vd水平均显著高于对照组(P<0.05)。观察组总有效率显著高于对照组[95.12%(39/41)vs 80.00%(32/40),P<0.05]。结论基于“筋骨平衡”理论针刺推拿疗法对CSA患者疗效显著,有效改善中医症状积分、ESCV评分以及颈椎曲度,增强脑血流参数。

Analysis of the features of TCM and western medicine in the diagnosis and treatment of subclinical hypothyroidism characteristics

The diagnosis and treatment of subclinical hypothyroidism are summarized by reviewing the related English and Chinese literature, the comparative analysis of traditional Chinese medicine （TCM） and western medicine in the understanding of subclinical hypothyroidism, the epidemiology, etiology, pathogenesis, the patterns addition to the therapeutic hypothyroidism, with a pr and the clinical manifestation in principle and drugs of subclinical ospect of providing insight in the clinical treatment of the disease.

Acupuncture Treating Heart Diseases Based on Sixty JiaZi and Eight Palaces <br/>—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (V)

Theory of Sixty JiaZi (60 甲子) is useful in understanding a human body disease. By using mathematical reasoning based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (TCM), this paper demonstrates the treatment principle: “seize the momentum of development, hasten lucky avoids disaster” (顺势而为, 趋吉避凶). Sixty JiaZi is hidden behind eight palaces. The first or second transfer law of human body energies of Sixty JiaZi changes according to the different blood pH values of a human body whether in the normal range or not, respectively, assuming that the range of blood pH values of a human body is divided into four parts from small to large. Both second and third are for a healthy human body. Both the root-cause and symptoms come from the first transfer law of human body energies. And both first and fourth are for an unhealthy human body. Both the root-cause and symptoms come from the second transfer law of human body energies. The treating disease of a human body should protect and maintain the balance of two incompatibility relations: the loving relationship and the killing relationship. As an application, acupuncture is used to treat atrial premature beats as congenital heart disease.

基于治未病理论灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用

目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组常规接受化疗,观察组化疗前连续3 d给予灸药同治(艾灸+加味八珍汤)。比较治疗前、化疗后7 d 2组患者中医证候积分、血常规[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、生命质量[卡诺夫斯凯计分(KPS)、中国癌症患者生命质量(QOL_(2))调查问卷],比较化疗后7 d 2组患者骨髓抑制情况[发生率、严重程度、重组人粒细胞集落刺激因子(rhG-CSF)使用情况]。结果:化疗后7 d,2组患者中医证候积分升高,但观察组低于对照组(P<0.05);Hb、WBC、PLT、NEUT、KPS评分及QOL_(2)评分降低,但观察组高于对照组(均P<0.05);观察组骨髓抑制发生率、rhG-CSF使用率低于对照组,0、Ⅰ度比例高于对照组(均P<0.05)。结论:基于治未病理论,灸药同治能够改善实体恶性肿瘤化疗患者临床症状及血常规,提高患者生命质量,减少骨髓抑制的发生。

Research and Development of Skincare Products Based on the Theory of Traditional Chinese Medicine

The application of traditional Chinese medicine in skincare formula development was expounded from the views of“symptom,theory,method,prescription,medicine and effect”.Traditional Chinese medicine prescriptions were improved according to the laws and regulations for China’s cosmetic industry and by the modern scientific and technological means,which had important guiding significance for the research and development of plant-based functional skincare products.The problems in concept claim and quality control standard,and the problems of market confusion,which were ascribed to the lack of basic research in the application of Chinese herbal cosmetics,were pointed out.The future development direction of plant-based functional cosmetics guided by TCM theory was prospected.