Empirical Prescriptions Used in Treatment of Epigastralgia due to Blood Stasis of Deficiency Type

Epigastralgia,a commonly-seen symptom inchronic gastritis or gastric ulcer,and usually causesinjury of the vital-qi and thereby deficiency of thehuman body due to its chronicity.The deficiency isdivided into deficiency of yin,yang,qi,and blood.Asis said in A Guide to Clinical Practice with MedicalRecords(临证指南医案),illnesses at the early stageaffect channels which dominate qi while at the latestage collaterals which dominate blood,and

A CLINICAL TRIAL ON YU CONG TANG IN TREATMENT OF SENILE DEMENTIA

Yu Cong Tang ([symbol: see text]), a TCM decoction, was used to treat senile dementia. It has the action of invigorating the spleen, reinforcing the kidney, nourishing yin, strengthening yang, improving blood circulation, dredging the channels, removing phlegm and restoring consciousness. CT, EEG, REG, Hb, PaO2, Tch, TG and 17-OHCS were tested, showing significant differences (P

Dr.Zang Kuntang's Experience in Treating Diabetes

Dr. Zang Kuntang (臧堃堂), professor of the First PLA Military Medical University, has been engaged in the science of traditional Chinese medicine for more than 50 years, with a rich experience accumulated in the treatment of diabetes. It is a great honor for us to have the fortune to follow him in the clinic. The following is a summary of what we have learned from him.

A Mathematical Model for the Deficiency-Excess Mechanism of Yin-Yang in Five Viscera

To raise traditional medicine to a higher level of scientific research, a mathematical model has been proposed using symbolic notations and operators to describe several disease symptoms generally recognized in traditional medicine. Even though this model to a certain degree offers a mathematical approach to identify the relationships between yin-yang and the five viscera, it is not an efficient means of explaining the pathology in traditional medicine due to its use of superfluous notations and definitions. In this paper, we introduce two concise operators, a self-development operator and an action operator： the former describes the effect of a viscus in the unbalanced state on other viscera： the latter explains the engendering and restraining relationships between the two viscera. These tools are useful to elucidate the interactions among the states of the five viscera based on yin-yang and the five elements theory. Our mathematical model with these two operators facilitates description for the scheme of deficiency-excess of yin-yang in the five viscera. Accordingly, we have mathematically refined the existing results and shown clinical applications as well.

CLINICAL OBSERVATIONS ON FORTY CASES OF PARALYSIS AGITANS TREATED BY ACUPUNCTURE

Paralysis agitans is a kind of nervous diseases of common occurrence. It is clinically classified into the primary and the secondary, the former being called Parkinson’s disease and the latter the secondary Parkinson’s syndrome, but both being characterized by tremor, tetanic muscle tone and decrease in movement. It is generally considered as a syndrome with deficiency

Tonifying Shen-Yin and-Yang Principles in Treating Osteoporosis: All Roads Lead to Rome

Tonifying Shen strategy works as an important alternative and complementary method that is widely used to treat osteoporosis in Traditional Chinese Medicine(TCM) based on the proper identification of Zheng. Shen deficiency Zheng is one of the main types of osteoporosis while Shen-Yin and-Yang deficiencies represent two basic principles/types of Shen deficiency. Currently, Tonifying Shen strategy, in particular, the Tonifying Shen-Yin and-Yang principles, has been demonstrated to exert osteoprotective effects. However, the mechanisms by which Tonifying Shen strategy and/or Tonifying Shen-Yin and-Yang principles function in treating osteoporosis are still not clearly understood. Here we first briefly explore current understanding of Tonifying Shen strategy, such as Tonifying Shen prescriptions, herbs, and effective components, in treating osteoporosis. Furthermore, the mechanism of Tonifying Shen-Yang principle in treating osteoporosis is reviewed from the clinic experience, animal, and mechanistic investigation. Moreover, the mechanisms by which Tonifying Shen-Yin principle in treating osteoporosis are established. Finally, we compare the similarity and difference between Tonifying Shen-Yang and-Yin principles in treating osteoporosis.Our findings indicate that both principles exert bone-protective effects in treating osteoporosis by simultaneously stimulating the differentiation of mesenchymal stem cells(MSCs) into osteoblast and the differentiation of hematopoietic stem cells(HSCs) into osteoclast. However,Tonifying Shen-Yin principle is in favor of increasing bone mineral density(BMD) while Tonifying Shen-Yang principle is in favor of osteoporosis-related syndromes. Our findings indicate that Tonifying Shen-Yin and-Yang principles not only share some similarity but also obtain some difference in treating osteoporosis.

Analysis of Constitutional Factors in Patients with Gallstone Disease

Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution for gallstone disease, whereas the Balanced Constitution and Yin deficiency constitution have a lower tendency towards the development of the disease;gallstone disease is more prevalent among young men engaged in mental labor. Methods: A retrospective study was conducted on 180 patients with gallstone disease who were hospitalized in the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine (TCM), from July 2017 to July 2023. Additionally, 180 healthy individuals undergoing physical examinations at the Health Examination Center of the same hospital were selected as the normal control group. Both groups underwent general condition surveys, TCM constitution scales, Eysenck Personality Questionnaires, Brief Coping Styles Questionnaires, and Social Support Rating Scales to determine risk factors and common types. Results: Independent variables such as gender, Qi stagnation constitution, Balanced Constitution, negative coping scores, positive coping scores, and stressful life events were included in the model. The OR values for Balanced Constitution, gender, positive coping style, and overall social support were all less than 1, and the maximum value of the 95% confidence interval was also less than 1. After selecting the intercept into the model and analyzing the standardized regression coefficients, it was found that negative coping scores had a significant impact on the model, while stressful life events showed extremely high relevance to the study. Compared with the normal group, the frequency of Qi stagnation constitution in the study group significantly increased, with a significant difference (P χ2 = 11.109, P = 0.0009, indicating a significant difference (P χ2 = 4.0890, P = 0.0432, indicating a significant difference (P 0.05). However, when comparing mental workers with physical workers within the patient group, the frequency of Qi stagnation constitution in mental workers was significantly higher, with χ2 = 6.8467, P = 0.012, indicating a significant difference (P Conclusion: Qi stagnation constitution is a potential predisposing constitution for gallstone disease, whereas the tendency to develop the disease is relatively low for Balanced Constitution and Yin deficiency constitution. Gallstone disease is more commonly found in young male mental workers.

由“阳有余而阴不足”探讨自噬调节糖皮质激素介导的破骨分化

目前,糖皮质激素(glucocorticoids,GC)在临床上被广泛应用于抑制炎症反应与免疫系统,然而GC的长期大量应用会引起破骨细胞过度活跃,导致骨质疏松症以及相关骨折,被称为糖皮质激素性骨质疏松症(GIOP)。GIOP属于中医学“骨痿”“骨枯”的范畴,“骨痿”的发病病机与机体阴阳失衡密切相关。细胞自噬作为一种自我保护机制,对维持机体内环境平衡、调节“成骨-破骨”形成的骨稳态至关重要。成骨细胞与破骨细胞介导的骨稳态与中医理论中的阴阳自和理论不谋而合。本文基于GIOP发病的病机“阳有余而阴不足”探讨通过“调节自噬-平衡阴阳”来调控骨稳态,为防治GIOP提供新的思路。

宫颈高危型人乳头瘤病毒感染患者中医体质类型分布研究

目的:分析宫颈高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染患者中医体质类型分布特点,为中医药调理体质防治宫颈HR-HPV感染提供依据。方法:选择2019年1月至2020年12月就诊于河南中医药大学第一附属医院妇科门诊及体检中心的420例宫颈HR-HPV感染者作为观察组,选择420例同时段宫颈HR-HPV检测阴性者为对照组。分析两组中医体质类型分布情况、观察组不同年龄段中医体质类型分布情况、观察组不同HR-HPV基因型别中医体质类型。结果:观察组中医体质分布依次为:痰湿质(30.50%)>湿热质(19.00%)>平和质(15.50%)>阳虚质(14.80%)>气虚质(10.00%)>阴虚质(5.90%)>瘀血质(2.70%)>气郁质(1.70%);对照组中医体质分布依次为:平和质(73.30%)>湿热质(8.40%)>阴虚质(5.70%)>痰湿质(4.50%)>气虚质(4.30%)>阳虚质/瘀血质(1.80%)>气郁质(0.20%)。两组中医体质类型比较,差异具有统计学意义(P<0.05),其中,痰湿质、湿热质、阳虚质、气虚质,两组间比较,差异具有统计学意义(P<0.001)。观察组体质类型居前三位的是痰湿质、湿热质、阳虚质,占全部体质类型的64.30%。对照组平和质324例,占比73.50%,观察组平和质81例,占比15.50%,两组间比较,差异具有统计学意义(P<0.001)。观察组中,痰湿质、阳虚质、阴虚质主要见于46~55岁,湿热质、气虚质、气郁质主要见于36~45岁,组间比较差异具有统计学意义(P<0.05)。两组宫颈HR-HPV16、18型和非16、18型中医体质比较,差异无统计学意义(P>0.05)。结论:痰湿质、湿热质、阳虚质为宫颈HR-HPV感染人群的易感体质;痰湿质、湿热质、阳虚质与年龄具有相关性,痰湿质多见于36~45岁,湿热质、阳虚质多见于46~55岁,HR-HPV基因型别与中医体质类型之间无明显相关性。

中医滋阴潜阳法对多囊卵巢综合征伴胰岛素抵抗大鼠PI3K/Akt信号通路、性激素及胰岛素相关指标的影响

目的探讨中医滋阴潜阳法对多囊卵巢综合征(polycystic ovarian syndrome,PCOS)伴胰岛素抵抗(insulin resistance,IR)大鼠的磷脂酰肌醇3激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3K/Akt)信号通路、性激素及胰岛素相关指标的影响。方法以来曲唑加高脂饲料诱导建立多囊卵巢及胰岛素抵抗双重大鼠模型。采用滋阴潜阳法配合达英-35及二甲双胍干预,用免疫荧光法测定卵巢PI3K、Akt通路信号,实时荧光定量PCR检测卵巢PI3K、Akt途径信号分子mRNA表达及PI3K、Akt、胰岛素受体底物-1(insulin receptor substrate 1,IRS-1)、胰岛素受体(insulin receptor,INSR)蛋白表达,性激素、胰岛素生长因子-1(insulin-like growth factor 1,IGF-1),胰岛素敏感指数(insulin sensitivity index,ISI),观察卵巢组织形态变化。结果中医滋阴潜阳法能显著增加卵巢PI3K、Akt mRNA相对表达量(P<0.05),并能显著增加卵巢PI3K、Akt蛋白表达,上调IRS-1、INSR,降低血清睾酮(testos teron,T)、促黄体生成素(luteinizing hormone,LH)含量,调节ISI,增加卵巢颗粒细胞层数及黄体组织数量。结论中医滋阴潜阳法可提高PI3K/Akt通路信号表达水平,改善胰岛素抵抗及卵泡颗粒细胞功能,调节促黄体生成素/卵泡刺激素(LH/FSH)比值,控制LH异常增高,调节多囊卵巢综合征及胰岛素抵抗。

基于“阳有余而阴不足”理论治疗甲状腺功能亢进症

甲状腺功能亢进症是临床常见的高代谢性疾病,西医治疗复发率高、副作用大,而中医治疗甲状腺功能亢进症具有较好的临床疗效。基于朱丹溪提出的“阳有余而阴不足”理论,对甲状腺功能亢进症的中医病因病机及各阶段治疗展开论述。该理论揭示了甲状腺功能亢进症的致病核心,提出了甲状腺功能亢进症的病理基础为“阴不足”,病理表现为“阳有余”。临证时,应针对其不同时期的病理特点辨证论治:疾病初起时实邪当泻,注重解郁泻火;疾病进展时多见虚实夹杂,需补虚泻实,既固护真阴又化痰逐瘀;疾病日久则重在平秘阴阳。附临床验案一则,以期为临床辨证论治提供参考。

中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响评价

目的评价中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响。方法选取2022年1月至2023年1月江西省妇幼保健院收治的80例肾气亏虚型多囊卵巢综合征患者作为研究对象,按照随机数字法将其分为观察组(40例)与对照组(40例)。对照组采用枸橼酸氯米芬片治疗,观察组在对照组方法的基础上联合中药滋阴补阳方剂治疗。比较两组患者的治疗效果、卵泡发育情况、激素水平、子宫动脉血流灌注情况及子宫内膜厚度。结果观察组的有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的卵泡及优势卵泡数目多于对照组,差异有统计学意义(P<0.05);观察组治疗后的黄体生成素(LH)、促卵泡激素(FSH)、睾酮(T)均低于对照组,雌二醇(E2)高于对照组,差异有统计学意义(P<0.05);观察组治疗后的搏动指数(PI)、阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05);观察组治疗后的子宫内膜厚度高于对照组,差异有统计学意义(P<0.05)。结论将中药滋阴补阳方剂应用于肾气亏虚型多囊卵巢综合征不孕症患者治疗中,可积极改善患者的激素水平及子宫动脉血流灌注情况,同时能够促进卵泡发育,增加子宫内膜厚度,改善症状,值得推广。

从阴阳气化探讨糖尿病“郁热虚损”四期病机转化规律

糖尿病是一种慢性代谢性疾病,中医认为血糖属人体精微物质,阴阳气化高度概括了机体物质、能量的转化方式,具体运动方式是“阳化气,阴成形”,只有阴阳气化的运动相协调,血糖才能正常代谢,否则余而为害,逐渐发展为糖尿病。“郁、热、虚、损”是对糖尿病全过程中医病机的概括总结,笔者试从阴阳气化的角度探讨糖尿病全程的病机转化规律,以期为临床治疗提供新的思路。

“瘦人多火症”的因机证治探析

提出消瘦是临床常见的体质状态,常常会伴随“瘦人多火症”相关证候表现。阴气不足是形体消瘦的主要生理、病理基础,燥火偏旺是形体消瘦的继发表现,病位涉及五脏,核心在脾。治疗原则以滋养阴气为主,宣发郁热为辅。具体包括治本与治标两个方面,治本当滋养阴气以改善“消瘦”体质,治标在发散郁热以消除“多火”状态,二者孰轻孰重应依据火旺轻重缓急而定。临床根据病情之标本缓急、消瘦而能食不能食、火热之虚实微盛、病机兼夹以及季节等因素进行药味加减。

瑞格列奈片联合加味肾气丸治疗阴阳两虚型2型糖尿病临床观察

目的分析瑞格列奈片联合加味肾气丸对2型糖尿病阴阳两虚型患者的治疗效果。方法纳入2020年10月—2021年10月山东省枣庄市薛城区人民医院100例阴阳两虚型2型糖尿病患者进行探究,以单双号方式分两组,对照组使用常规治疗和瑞格列奈片治疗,观察组在此基础上联合加味肾气丸。通过症状积分观察两组疗效,并对比其血糖和临床指标。结果治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白数据低于对照组(P<0.05);观察组血清视黄醇结合蛋白4、白细胞介素-6、尿N-乙酰-β-D-葡萄糖苷酶数据均低于对照组(P<0.05)。观察组的主要症状、次要症状积分低于对照组(P<0.05)。结论瑞格列奈片联合加味肾气丸治疗阴阳两虚型2型糖尿病患者,可以减轻炎性反应,提升抗氧化、抗纤维化能力,并能够减轻患者症状,对于控制并发症、延缓病情进展有着积极作用,值得推广。

病证结合骨质疏松模型大鼠骨骼的生物力学性能分析

背景:肾虚是骨质疏松症的最主要病机,对肾阳虚、肾阴虚与骨质疏松的关系研究有利于病证结合临床诊疗模式的发展。目的:评价右归丸对肾阳虚、肾阴虚大鼠股骨生物力学性能的影响差异,从生物力学角度论证骨质疏松症病证结合、因证施药的科学性。方法:手术摘除60只雌性SD大鼠双侧卵巢建立骨质疏松模型,10周后将大鼠随机分为肾阴虚组(n=30)和肾阳虚组(n=30),肾阳虚组臀部肌肉注射氢化可的松注射液,肾阴虚组灌胃甲状腺片混悬药液,1次/d,连续14 d。造模结束后,每组取20只灌胃右归丸混悬液,1次/d,连续12周,剩余10只作为对照不灌胃。灌胃结束后使用Micro-CT扫描测量股骨微结构参数,在力学试验机上对股骨分别进行三点弯曲、有限元仿真、股骨头压缩及表面压痕分布实验。结果与结论:①Micro-CT扫描显示,与肾阴虚组比较,肾阴虚+右归丸组股骨骨密度、骨体积分数、骨表面密度、骨小梁数量、骨小梁分离度升高(P<0.05);与肾阳虚组比较,肾阳虚+右归丸组股骨骨体积分数、骨表面密度、骨小梁数量及骨小梁厚度升高(P<0.05);②三点弯曲实验显示,与肾阳虚组相比,肾阳虚+右归丸组股骨弹性模量、最大抗弯强度和弯曲断裂强度均降低(P<0.05),韧性提高(P<0.05);③有限元仿真显示,右归丸能显著提高肾阳虚组大鼠股骨抗骨折能力,对肾阴虚组大鼠不产生明显作用;股骨头压缩实验显示,右归丸可增强肾阳虚组大鼠股骨头抵抗形变的能力,但右归丸对肾阴虚组和肾阳虚组大鼠股骨头表面性能的影响无显著区别;④结果表明,右归丸可增强肾阳虚骨质疏松骨骼生物力学性能,但对肾阴虚骨质疏松骨骼无显著影响。

从《黄帝内经》“阳虚阴盛”理论探析重度哮喘病机及治疗

重度哮喘的发病率虽不高,约占哮喘患者的10%,但对患者的生活质量影响严重,治疗效果往往不理想。中医认为重度哮喘的发生与阳虚阴盛有关。中医治疗重度哮喘具有一定的优势,中医药能够通过调理人体阴阳平衡,提高机体免疫力,减少哮喘发作次数,减轻发作程度。从黄帝内经“阳虚阴盛”阐释重度哮喘的病因病机及治疗的方法,丰富了重度哮喘的中医理论。“阳虚阴盛”是重度哮喘的基本病机,“阳虚”影响了脏腑功能的正常运行,使水液代谢失常,内生痰饮,导致“阴盛”的夙根,进而引起重度哮喘反复发作,迁延不愈。治疗上,以平衡阴阳为总则,把握虚损之脏腑,从阴中求阳,兼顾平喘、化痰。从黄帝内经“阳虚阴盛”论治重度哮喘,疗效可观,为中医治疗重度哮喘提供了思路。

中药穴位贴敷联合耳穴压豆对阴虚阳亢型老年高血压合并衰弱的临床观察

目的探讨中药穴位贴敷联合耳穴压豆对阴虚阳亢型老年高血压合并衰弱的临床效果,为老年高血压合并衰弱患者的防治提供借鉴。方法选取2023年3—11月医院收治的60例阴虚阳亢型老年高血压合并衰弱患者作为研究对象,按照组间基线资料具有可比性的原则分为对照组和观察组,各30例。对照组给予常规降血压护理和健康教育,宣教2周,每周1次,共宣教2次;观察组在对照组基础上采用中药穴位贴敷联合耳穴压豆治疗,每天1次,1周为1疗程,共干预2周。2周结束后,比较两组患者干预后的临床效果。干预前、干预2周后采用电子血压计、中医证候积分量表、老年人衰弱评估量表评估两组患者的收缩压(SBP)、舒张压(DBP)、中医证候积分及老年衰弱评分的改善程度。结果干预前,两组患者血压、中医证候积分、老年衰弱评分比较,差异无统计学意义(P>0.05);干预后,观察组患者在血压、中医证候积分、老年衰弱评分均低于对照组,差异具有统计学意义(P<0.05)。干预后,观察组降压效果优于对照组,两组间比较差异有统计学意义(P<0.05)。结论对阴虚阳亢型老年高血压合并衰弱患者进行中药穴位贴敷和耳穴压豆,根据其证型选穴贴压肝、肾、交感、神门、降压沟、皮质下、胆、心八大穴位,其效果良好,操作简便,无不良反应发生,可有效改善患者血压、中医证候及衰弱症状,促进患者康复。

巢国俊应用“扶阳消阴,培本通络”法治疗视网膜色素变性经验

介绍巢国俊教授诊治视网膜色素变性临床验案。阳气为人之根本,视网膜色素变性患者本质为脾肾阳虚,阳虚气化不足导致阴邪内生,阴盛则寒,内生阴邪加之外寒之邪,寒性凝滞,进而影响阳气的通达及气血的运行,气血不能到达、濡养视网膜周边,故有夜盲之象。临床诊治视网膜色素变性应当以阴阳为纲,补虚扶本,兼顾气血,遵循“病在阳者,扶阳抑阴”,先温补脾肾之阳,固守先后天之本,扶阳消阴,散邪通络,阳气通达,阴实消散,气血畅通,则视物夜盲改善。

从脉象探讨《难经》“阴阳盛虚汗下法”及其临床应用

“阴阳盛虚汗下法”始见于《难经·五十八难》,“阳虚阴盛,汗出而愈,下之即死;阳盛阴虚,汗出而死,下之而愈”,后世医家对此理解执见不一。两者皆为外感疾病中的危重病证,文章提及从脉象把握“阴阳盛虚汗下法”更易于诊断和指导临床治疗。即阳虚阴盛脉见浮取小弱或难以触及,沉取应指明显或推筋至骨方得,此时阴寒凝盛而阳虚不能透达,人体气机入多出少,治当温阳发汗,使阳气得助,阴邪得散,如麻黄细辛附子汤之类;阳盛阴虚脉见浮取应指明显,沉取柔弱或难以动指,此时阳热炽盛而阴津竭乏,人体气机出多入少,治当滋阴攻下,折其阳热,急保阴津,如增液承气汤之类。