Serum protein profiles suggest a possible link between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To identify potential serum protein candidates involved in linking the traditional Chinese medicine(TCM)-defined qi deficiency constitution(QDC)to Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Using participants with the TCM-defined balanced constitution as a control population,labelfree quantitative proteomics was adopted to identify differentially expressed proteins(DEPs)in serum samples from two case populations:case population 1(participants with QDC)and case population 2(patients with PQDS of CSG).The DEPs discovered in both case populations were analyzed to identify common DEPs as potential candidates for proteins involved in the link between QDC and PQDS.Based on Kyoto Encyclopedia of Genes and Genomes pathway(KEGG)and Gene Ontology(GO)enrichment analysis and analysis of proteineprotein interaction networks,we evaluated the possible functions of these potential serum candidates.Results:We discovered 24 and 28 proteins that were differentially expressed in case populations 1 and 2,respectively,compared with the control population.Hierarchical clustering analysis showed that the expression profile of DEPs of individuals from the same population clustered well,while those from different populations were segregated.Furthermore,GO analysis revealed the 10 DEPs that were common to both case populations to be mainly associated with negative regulation of cellular metabolic and immune system processes while KEGG analysis indicated these proteins to be associated with complement and coagulation cascades and peroxisome proliferator-activated receptor signaling.Notably,serum levels of C4b-binding protein beta chain,glycosylphosphatidylinositol-specific phospholipase D1 and MS-F1 light chain variable region proteins were notably higher in the two case populations compared with the control,particularly in the case of CSG with PQDS.Conclusion:The results presented here provide new insights into the molecular mechanisms underlying development of PQDS of CSG from QDC,and suggest candidate serum biomarkers for future application in integrative medicine.

Screening for blood leukocyte microRNA biomarkers responsible for association between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To screen for blood leukocyte microRNA(miRNA)biomarkers responsible for the association between the traditional Chinese medicine(TCM)qi deficiency constitution(QDC)and the Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Peripheral blood leukocytes were separated from people of two TCM constitutions(balance and qi deficiency)and from CSG patients with PQDS.Total RNA was isolated from the leukocytes and subjected to subsequent high-throughput miRNA sequencing to identify the miRNAs that are specifically and highly expressed in persons of QDC and CSG patients with PQDS.In addition,the target genes of the associated miRNAs were predicted.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway-based enrichment analyses of these target genes were performed to further evaluate the associated miRNA candidates as potential biomarkers responsible for the association between QDC and PQDS of CSG.Results:Compared with the control group with a balance constitution(P<.05,fold change>1.5 or<0.5),31 and 38 differentially expressed miRNAs were found in persons of QDC and CSG patients with PQDS,respectively.In particular,hsa-miR-145-5p and hsa-miR-146a-3p were highly expressed in both the persons of QDC and CSG patients with PQDS.GO analysis of the target genes of the two common miRNAs showed that they were mainly associated with functions related to synthesis and metabolism,such as cellular nitrogen compound metabolic processes,biosynthetic processes,cellular protein modification processes,and cellular component assembly.KEGG analysis identified the common pathways enriched among the target genes,including the Hippo signaling pathway and the transcriptional misregulation pathway.The common target genes of the two miRNAs seemed to be associated with the spliceosome pathway and the RNA degradation pathway.Conclusion:Hsa-miR-145-5p and hsa-miR-146a-3p may serve as candidate biomarkers responsible for the association between QDC and PQDS of CSG.

Clinical observation of Guipi Decoction Combined with non steroidal drugs on sleep in elderly patients with acute traumatic pain and Qi deficiency constitutionabortion

Objective:To explore the effect of Guipi Decoction Combined with non steroidal anti-inflammatory drugs on sleep time of elderly patients with traumatic pain and Qi deficiency constitution during hospitalization.Methods:A total of 52 elderly patients hospitalized in the orthopedic(trauma)ward of the Second Affiliated Hospital of Zhejiang Chinese Medical University from November 2020 to may 2021 were randomly divided into control group and treatment group.Patients in the control group were treated with loxoprofen sodium tablets immediately after admission,and placebo was added to loxoprofen sodium tablets from the second day of admission;The patients in the treatment group were treated with loxoprofen sodium tablets after admission.Guipi Decoction was added on the basis of loxoprofen sodium tablets from the second day of admission.Before and after admission,all patients used the TCM constitution classification judgment table to evaluate the score of qi deficiency and VAS;From the first day to the fourth day after admission,the bracelet was worn to monitor the sleep time(total sleep time,deep sleep time,light sleep time and awakening times)every night.The patients were scored by VAS after taking drugs every morning.Results:Finally 25 patients in the control group and 24 patients in the treatment group completed the experiment.There was no significant difference in gender,age,fracture location,chronic medical history VAS score and TCM Qi deficiency constitution score,between two groups at admission(P>0.05).At the time of discharge,the score of qi deficiency constitution in the treatment group was 33.724±12.634;The TCM Qi deficiency constitution score of the control group was 42.25±15.912,and there was significant difference between the two groups(P<0.05);and there was significant difference in VAS score between the two groups at discharge(P<0.05).There were significant differences in total sleep time,light sleep time,deep sleep time and night awakening times between the two groups on the second,third and fourth day of admission(P<0.05).Conclusion:1.Guipi Decoction can significantly improve the sleep time of patients with Qi deficiency acute traumatic pain.2.Guipi Decoction can not only improve the constitution of patients with Qi deficiency bias,but also improve the VAS score at discharge.

A Study on the Law of Birth and Formation of Yang-Deficiency Constitution Based on the Theory of Five Movement and Six Qi

Objective:To explore the law of birth and yang deficiency constitution based on the theory of five movements and six qi,as well as to provide a new way to better realize the prevention of yang deficiency constitution.Methods:The data of TCM quality table and luck data were collected via questionnaires.According to the data of from the TCM quality table,the respondents were divided into yang deficiency constitution group and non-yang deficiency group.According to the luck data,the distributions of gestational age were compared between the two groups.Results:A total of 175 questionnaires were collected,of which 89 were non-yang deficiency constitution and 86 were yang deficiency constitution.The proportion of Ding year(15.1%)in the yang deficiency group was significantly higher than that in non-yang deficiency group(5.6%),in which the difference was statistically significant(P<0.05).Conclusion:The possibility of yang deficiency constitution is higher.

Constitutional Mismatch Repair-Deficiency Syndrome Is a Rare Cause of Cancer Even in a Highly Consanguineous Population

Biallelic germline mutations in the mismatch repair genes, including MLH1, MSH2, MSH6 or PMS2, lead to a recessive constitutional mismatch repair-deficiency (CMMR-D) syndrome characterized by early onset malignancies in children and young adults. Because consanguinity unmasks autosomal recessive disorders, we hypothesized that the frequency of CMMR-D is inflated in the highly consanguineous population of Saudi Arabia. In this study, 371 pediatric and young adult?patient samples from Saudi Arabia that cover the tumor spectrum of CMMR-D syndrome were analyzed for biallelic germline mutations in the MLH1, MSH2, MSH6 and PMS2 with the use of direct genomic sequencing. However, none of the 371 patients involved in the study was found to have biallelic pathological mutations of MLH1, MSH2, MSH6 or PMS2. This result indicates that CMMR-D is exceptionally rare among pediatric cancer patients and adult early onset cancer patients, even in the highly consanguineous Saudi population. Our findings suggest that larger cohorts will be needed, particularly in outbred populations, to determine the frequency of CMMR-D and that routine screening for this syndrome among cancer patients is not warranted.

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。

“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。

影响阳虚体质因素的Logistic回归分析

目的:研究影响阳虚体质的主要因素。方法:采用横断面调查,收集上海中医药大学附属岳阳中西医结合医院治未病中心2020年9月至2021年11月中医体质调查数据。中医体质调查采用中医体质辨识软件V3.0实施,运用多因素Logistic回归模型分析筛选影响阳虚体质的主要因素。结果:共纳入811例研究对象,其中阳虚质211例(26.0%)。多因素Logistic回归分析结果显示,相对女性,男性阳虚质比例降低,差异具有统计学意义[OR=0.55,95%CI(0.37~0.81),P=0.002];相对年龄<50岁,年龄≥50岁者阳虚质比例较高,差异具有统计学意义[OR=1.83,95%CI(1.26~2.65),P=0.001];体质量超重、肥胖人群阳虚质比例高于体质量正常及偏低人群,差异具有统计学意义[OR=0.59,95%CI(0.38~0.91),P=0.018];高脂血症患者阳虚质比例高于血脂正常人群,差异具有统计学意义[OR=0.63,95%CI(0.44~0.90),P=0.011];脂肪性肝病患者阳虚质比例高于正常人群,差异具有统计学意义[OR=0.56,95%CI(0.37~0.87),P=0.010];功能性胃肠病阳虚质比例高于正常人群,差异具有统计学意义[OR=1.77,95%CI(1.05~2.99),P=0.032]。结论:年龄、性别、超重/肥胖、功能性胃肠病、脂肪性肝病、高脂血症是影响阳虚质的主要因素。

959例子宫内膜异位症患者中医体质分布特点

【目的】探讨959例子宫内膜异位症(EMs)患者的中医体质分布特点。【方法】选取2019年1月至2019年11月就诊于中国中医科学院广安门医院、首都医科大学附属北京妇产医院、北京医院、北京中医药大学东方医院、首都医科大学附属友谊医院、首都医科大学附属复兴医院的EMs患者959例,记录患者的一般情况,进行中医体质辨识,分析其中医体质分布情况、兼夹体质的关联关系以及与年龄、合并痛经的关系。【结果】(1)EMs患者的体质分布占比由多到少依次为阳虚质65.1%(624/959)、气郁质58.4%(560/959)、气虚质52.8%(506/959)、血瘀质44.2%(424/959)、痰湿质42.5%(408/959)、湿热质41.9%(402/959)、阴虚质39.6%(380/959)、平和质26.8%(257/959)、特禀质16.6%(159/959);患者中单一体质者较少,占比为20.2%(194/959),兼夹体质者居多,占比为79.8%(765/959)。(2)基于Apriori算法的关联规则挖掘结果发现相关规则33条,气虚质-阳虚质、血瘀质-阳虚质、血瘀质-气郁质是其中置信度较高的关联规则。(3)与35岁及以下患者相比,35岁以上患者中血瘀质所占比例较大(P<0.05);与无痛经患者相比,合并痛经患者各偏颇体质占比均增加、平和体质占比减少(P<0.05或P<0.01)。【结论】阳虚质、气郁质、气虚质、血瘀质是EMs患者的高发体质类型,EMs患者中医体质兼夹现象普遍存在,较单一偏颇体质更为常见;从温阳、解郁、益气、活血角度管理EMs,及时纠正偏颇体质,防止疾病进展,可有效发挥中医体质调理的“治未病”效果。

长蛇灸调节阳虚体质的体表温度特征

目的探讨长蛇灸调节阳虚体质施灸时体表温度特征。方法将80例阳虚体质受试者以1∶1比例随机分为督脉组和膀胱经组各40例。督脉组取背部督脉为施灸部位,膀胱经组取膀胱经〔据后正中线10 cm(3寸)处〕为施灸部位,进行长蛇灸治疗,1次/w,每次3壮(约45 min),共治疗12次。观察两组治疗前、后阳虚体质评分,评估临床疗效;运用温度测试探头采集施灸时体表温度,对比不同经脉施灸、不同疗效程度受试者的体表温度特征。结果治疗后督脉组总有效率明显高于膀胱经组(P<0.05)。治疗后,督脉组和膀胱经组阳虚体质转化分均明显低于治疗前;且督脉组阳虚体质转化分明显低于膀胱经组(P<0.05)。督脉组总平均体表温度明显高于膀胱经组(P<0.05);不同测量时间对经脉体表温度的影响差异有统计学意义(P<0.05);不同测量时间对体表温度的影响存在经脉之间的显著差异(P<0.05);第3、5、7、12次治疗的督脉组平均温度明显高于膀胱经组(P<0.05)。膀胱经组中治疗有效者的体表温度明显高于治疗无效者(P<0.05);所有受试者中治疗有效者的体表温度显著高于治疗无效者(P<0.05)。结论长蛇灸可有效调节阳虚体质,督脉是优选治疗部位;长蛇灸疗效与体表温度呈现出督脉温度高于膀胱经温度、灸效越好温度更高的特征。

基于STRAW+10分期的广州地区围绝经期代谢综合征患者中医体质调查

【目的】基于生殖衰老分期(STRAW)+10调查广州地区围绝经期代谢综合征患者的中医体质类型分布,为围绝经期代谢综合征患者提供中医体质调养理论依据。【方法】根据代谢综合征的诊断标准,纳入围绝经期代谢综合征患者共90例,根据STRAW+10分期标准分为绝经过渡早期(-2期)组49例、绝经过渡晚期(-1期)组24例、绝经后期早期(+la期)组17例。采用《中医体质分类与判定标准》对所有调查对象进行中医体质调查,同时采用焦虑自评量表(SAS)及抑郁自评量表(SDS)进行焦虑抑郁评分,分析不同STRAW+10分期患者的中医体质类型分布,比较不同STRAW+10分期患者的SAS、SDS评分情况。【结果】(1)绝经过渡早期(-2期)组的最主要中医体质类型中,出现频次最高的中医体质为阳虚质14例(29.79%),其次为平和质10例(21.28%),再次之为阴虚质和血瘀质各6例(12.76%);绝经过渡晚期(-1期)组的最主要中医体质类型中,出现频次最高的中医体质为阳虚质6例(25.00%),其次为平和质和血瘀质各4例(16.66%),再次之为气虚质和痰湿质各3例(12.50%);绝经后期早期(+la期)组的最主要中医体质类型中,出现频次最高的中医体质为阳虚质7例(46.67%),其次为平和质、痰湿质、血瘀质各2例(13.33%),再次之为气虚质、气郁质各1例(6.67%)。(2)绝经过渡早期(-2期)患者的SAS评分和SDS评分分别为(34.55±7.46)、(35.55±10.61)分,均高于绝经过渡晚期(-1期)患者的(33.83±7.73)、(35.46±11.35)分和绝经后期早期(+la期)患者的(35.65±8.67)、(36.59±12.07)分,且均高于总体平均水平。【结论】围绝经期代谢综合征患者的中医体质以阳虚质为主,平和质随着分期的进展逐渐减少,而偏颇体质从阴虚质、血瘀质逐渐转变为气虚质、痰湿质,再到痰湿质、血瘀质;随着分期进展,围绝经期代谢综合征患者本虚更虚而标实之邪也在加重。

高血压患者体质类型与认知障碍相关性研究

目的:探讨高血压伴认知障碍(CI)患者的体质分布情况及CI的影响因素。方法:纳入3799例高血压患者,分为CI组和无认知障碍(NCI)组,记录两组患者一般资料(年龄、性别、文化程度、婚姻状态、工作类型、烟酒史等)、实验室指标(空腹血糖、血脂、血肌酐等)水平、量表[简易智力状态检查量表(MMSE)、匹兹堡睡眠质量指数量表(PSQI)、中医体质类型量表]评分等信息。以体质类型为主要监测指标,分析高血压伴CI患者体质类型分布状况。结果:3799例高血压患者中有506例(13.32%)被纳入CI组。CI组患者年龄、年龄大于60岁人群比例、女性比例、文化程度在初中以下人群比例、工作类型以体力劳动为主人群比例、3级高血压人群比例、有睡眠障碍人群比例、高血压病程、血肌酐水平显著高于NCI组(P<0.05);汉族人群比例、吸烟人群比例、饮酒人群比例、体质量指数(BMI)及甘油三酯、胆固醇、低密度脂蛋白(LDL)水平低于NCI组(P<0.05)。CI组气虚质患者人数最多,NCI组平和质患者人数最多。偏颇质高血压患者的定向、记忆、计算、回忆、命名、阅读、执行、书写认知功能比平和质高血压患者更差(P<0.05)。Logistic回归分析显示,体质类型是CI发病的影响因素,气虚质、气郁质与CI发生相关。年龄大于60岁、文化程度低、汉族以外的其他民族、存在睡眠障碍、LDL水平低与CI发生有关。结论:不同中医体质的高血压患者CI发病倾向不同,气虚质、气郁质与CI发生相关,此类体质者应从“体病相关”理论出发,采取相应预防措施。

基于体质可调论治糖尿病大血管病变

糖尿病大血管病变为糖尿病后期的严重并发症,具有较高的致残致死率,早期干预可达既病防变目的,对于改善患者生活质量、节约医疗资源意义深远。中医体质学说认为人的体质不仅禀赋于先天,亦可通过外在手段干预而改变。糖尿病大血管病变的好发体质类型主要集中在阴虚质、气虚质、痰湿质与血瘀质。以中医治未病思想为指导,从体质可调出发,列举验案2则,为糖尿病大血管病变的高危体质类型制定出中医药、饮食、运动等具体体质调节方案,及早纠正体质偏颇,以期为临床防治糖尿病大血管病变提供参考。

中医体质与强直性脊柱炎患者发病因素的相关性研究

【目的】研究中医体质与强直性脊柱炎(ankylosing spondylitis,AS)患者发病因素的相关性。【方法】选取2019年8月至2020年9月就诊于西安市第五医院(即陕西省中西医结合医院)的100例强直性脊柱炎患者及其家系成员作为研究对象。采用中华中医药学会颁布的《中医体质分类与判定》中的准则对研究对象进行体质判定,通过问卷调查和临床调查的方式收集强直性脊柱炎患者及其家系成员的社会人口学、生活习惯、临床症状、中医体质等情况,调查强直性脊柱炎患者的疾病诱发因素;采用二进制逻辑回归模型,分析强直性脊柱炎患者中医体质类型与发病因素的相关性。【结果】(1)100例强直性脊柱炎患者中,以偏颇体质居多,其分布频率由高到低依次为阳虚质、气虚质、湿热质,分别占33.00%、14.00%、18.00%。(2)强直性脊柱炎患者的Ⅰ、Ⅱ、Ⅲ级亲属的患病率分别为56.25%、40.00%、25.00%;在人类白细胞抗原B27(HLA-B27)阳性率方面,强直性脊柱炎患者的HLA-B27均为阳性,而其Ⅰ、Ⅱ、Ⅲ级亲属的HLA-B27阳性率分别为44.31%、30.67%、15.63%。(3)回归分析结果显示,强直性脊柱炎患者的病程与气虚质、骶髂关节炎级别与气郁质、年龄与血瘀质呈显著相关性(P<0.05或P<0.01)。表明强直性脊柱炎患者的病程和年龄是影响体质的重要因素,其中病程与气虚关系密切,年龄与血瘀关系密切。【结论】强直性脊柱炎为高度遗传的自身免疫性疾病,其发病与HLA-B27相关;阳气亏欠是强直性脊柱炎最基本的体质特点,而湿热质是强直性脊柱炎疾病进展过程(尤其是疾病活动期)的主要体质类型,且随病程的延长会加剧病情和气虚表现。

超重/肥胖患者中医体质特征及与人体成分分析的相关性研究

【目的】研究上海地区超重/肥胖患者的中医体质特征及其与人体成分分析的相关性。【方法】对2020年8月至2022年12月至上海市第十人民医院内分泌科针灸埋线专病门诊就诊的有完整中医体质和人体成分检测的患者数据进行分析,根据体质量指数(body mass index,BMI)情况将患者分为正常体质量组(BMI<24 kg/m2)、超重组(24 kg/m2≤BMI<28 kg/m2)和肥胖症组(BMI≥28 kg/m2),分析3组患者的中医体质分布特征,并采用多元回归分析探讨中医体质与人体成分的关系。【结果】(1)共纳入315例患者,其中正常体质量43例,超重85例,肥胖症187例。(2)正常体质量人群体质分布比例从高到低依次为脾虚>肝郁>湿热>阳虚>阴虚,超重人群体质分布比例从高到低依次为脾虚>肝郁>湿热>阳虚>阴虚,肥胖症人群体质分布比例从高到低依次为脾虚>阳虚>湿热>肝郁>阴虚,超重/肥胖症组体质分布比例从高到低依次为脾虚>湿热>阳虚>肝郁>阴虚。正常体质量人群与超重/肥胖症人群的中医体质分布情况比较,差异无统计学意义(P>0.05);正常体质量和超重/肥胖症患者均以单一体质较多,兼夹体质少见,组间比较,差异无统计学意义(P>0.05)。(3)多元回归分析结果显示:所有患者基础代谢均与阳虚质呈正相关,与湿热质呈负相关,差异均有统计学意义(P<0.01),即阳虚质分数上升1分,基础代谢增加0.54 kcal;湿热质分数下降1分,基础代谢减少1.005 kcal。【结论】在上海地区,肥胖可能是体质改变的主要阶段;肥胖症患者体质除脾虚外,阳虚、湿热、肝郁的占比也较高。在中医体质与人体成分关系方面,基础代谢与阳虚质呈正相关,与湿热质呈负相关,故阳虚质和湿热质患者要注意自身基础代谢水平对疾病发展的影响。

基于Z评分系统运用通督健脾手法促脾虚质学龄前儿童生长发育研究

目的探讨小儿推拿“通督健脾手法”对脾虚质学龄前儿童生长发育的影响。方法将南昌市洪都中医院收治的60例符合标准的脾虚质学龄前儿童随机分为对照组与治疗组,每组30例。对照组给予饮食指导、健康宣教和密切观察病情等常规保健护理,治疗组在对照组基础上给予通督健脾手法治疗,比较两组治疗前后的脾虚质体质表现积分、生长发育指标及体格测量评分(Z评分)。结果治疗后,两组患儿的脾虚质体质表现积分均下降,且治疗组低于对照组(P<0.05);治疗组身高、体质量指标增值高于对照组(P<0.05),但两组胸围、腰围增值比较差异无统计学意义(P>0.05);两组Z评分(WAZ、WHZ、HAZ)均增加,且治疗组高于对照组(P<0.05)。结论通督健脾手法对改善脾虚质儿童的生长发育及体质转变情况有良好效果,能有效提高患儿免疫力,具有良好的社会效益,值得临床推广与应用。

腹泻型肠易激综合征与阳虚体质的相关性研究进展

腹泻型肠易激综合征是肠道疾病中常见的慢性疾病,临床以腹痛、腹胀或腹部不适为主要症状,与排便相关或伴随排便习惯如频率或粪便性状改变,具有病情复杂、易复发的特征。泄泻是以大便次数增多,粪质稀薄,甚至泻出如水样为临床特征的一种脾胃肠病证,所以腹泻型肠易激综合征在中医病证里属于“泄泻”的范畴。阳虚体质者常见大便溏薄、小便清长、精神不振等表现,发病易从寒化,易病泄泻、痰饮、肿胀。中医认为,脾的健运功能有赖于脾阳的温煦作用,脾阳有助脾运化水谷、运化水液以及温煦四肢等功能。脾阳不足可导致脾失健运,影响食物消化和精微物质吸收,从而出现食欲不振、腹胀、便溏以及倦怠乏力等症状。肾为先天之本,脾为后天之本,肾阳为脾阳之根本。肾阳虚衰,命门之火不足,不能助脾阳发挥作用,从而导致五更泄泻。治疗腹泻型肠易激综合征以改善焦虑、提高患者的生活质量为目的,而阳虚体质患者可以通过后天的调养平衡体内阴阳,进而改善或治愈腹泻型肠易激综合征。结合体病相关论,笔者认为阳虚体质者更易出现便溏、腹泻等病证。通过查阅近10余年的相关文献,笔者对阳虚质与腹泻型肠易激综合征的相关性进行归纳总结,分析目前存在的问题,以期能进一步完善体病相关论。

从体质偏颇论性早熟的中医辨治

性早熟对儿童身体、心理影响发生在患病之初,甚至持续终身,影响并非局限患儿自身,对家庭、社会均存在影响,具有较大的隐匿性危害。性早熟发病率逐年升高,目前已有向常见病方向发展的趋势。体质具有个体性、相对稳定性和可变性特征。体质辨识由来已久,可评估人体脏腑精气阴阳偏颇和功能活动差异。中医在儿童体质辨识上具有独特优势。历代医家经临证实践总结将性早熟儿童在体质上主要分为阴虚质、痰湿质、气郁质3种,但并不全面,在临床及相关临床研究的开展中发现平和质亦常发生该病。目前,对性早熟的中医体质研究已较为深入,但尚未体系化、统一化。

督灸联合微波治疗阳虚体质结核性胸膜炎的临床效果

目的观察督灸联合微波治疗阳虚体质结核性胸膜炎(TP)患者的临床效果及对腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)的影响。方法选取2023年1月至12月就诊于山东省公共卫生临床中心结核内科的80例患者作为研究对象,使用计算机随机数法分为西药组(40例)与中医组(40例)。西药组采用口服四联抗结核药物治疗,中医组在西药组基础上增加督灸和微波治疗,比较治疗前后患者的胸膜厚度、胸腔积液量、ADA、LDH含量及临床疗效。结果中医组治疗后的胸膜厚度低于西药组,胸腔积液量少于西药组,差异有统计学意义(P<0.05);中医组患者治疗后的ADA、LDH低于西药组,差异有统计学意义(P<0.05);中医组患者的治疗总有效率高于西药组,差异有统计学意义(P<0.05)。结论督灸联合微波治疗阳虚体质结核性胸膜炎临床疗效肯定,可作为中医绿色疗法推广。

督灸联合自血疗法治疗气虚质慢性荨麻疹的 临床效果

目的观察督灸联合自血疗法治疗气虚质慢性荨麻疹患者的临床效果及对IgE的影响。方法选取2022年1月至2023年1月山东省公共卫生临床中心皮肤科门诊收治的80例气虚质慢性荨麻疹患者作为研究对象,按照随机数字表法分为西药组(40例)与中医组(40例),中医组采用督灸联合自血疗法治疗,西药组采用口服盐酸依匹斯汀胶囊治疗,比较两组患者治疗前后的荨麻疹活动性评分(UAS)、IgE、临床疗效和复发率。结果治疗2个疗程后,中医组的总有效率高于西药组,差异有统计学意义(P<0.05);治疗后2、4、6个月,中医组的复发率低于西药组,差异有统计学意义(P<0.05)。两组患者治疗后的UAS评分、IgE水平低于治疗前,且中医组治疗后的UAS评分、IgE水平均低于西药组,差异有统计学意义(P<0.05)。结论督灸联合自血疗法治疗慢性荨麻疹临床疗效肯定,复发率低,可作为中医绿色疗法推广。