Treatment of Arthralgia Syndrome from Zang and Fu

More than 30 medical history works and classical medical literatures about the theory and prescription of arthralgia syndrome from Zang and Fu were collected,summarized and analyzed,and the theory of treating arthralgia syndrome from Zang and Fu in the lung,spleen,liver and kidney basically reflected the academic thought of treating Bi syndrome from the viscera in traditional Chinese medicine books.

Inter-Organ Relationships among Gut, Lung and Skin beyond the Pathogenesis of Allergies: Relevance to the Zang-Fu Theory in Chinese Medicine

Research on allergy has recently uncovered an apparent co-occurrence of allergies in skin and the lungs, a phenomenon that has been coined “atopic march”. A positive correlation has been found between gut microbiota at birth and the development of asthma and skin eczema later in life. Chinese medicine has long described a functional relationship between the large intestine and the lungs, and between the lungs and skin. In this short article, we examined the evidence in support of these inter-organ physiological/pathological relationships. In addition to the clinical observation of the relationship between the composition of gut microbiota at birth and the development of asthma later in childhood, gut microorganisms have also been shown to exert a protective effect on bacteria-induced pneumonia in experimental animals. Genetic predisposition was also found to play an important role in the co-existence of certain diseases of lung and skin. Despite the fact that the mechanism(s) underlying the connection of immune systems between two organs (such as the large intestine and the lungs) is still not clearly understood, it is the first time to correlate the relationship among gut, lung and skin based on recent clinical studies in relation to the Zang-Fu Theory in Chinese medicine. Future investigation of the gut-lung and lung-skin axes in terms of physiological/pathological relationships may help to provide a greater understanding of the pathogenesis of allergies, possibly establishing relevance to the Zang-Fu Theory in Chinese medicine.

Efficacy of 5-Fluorouracil and High-Concentration Cisplatin Suspended in Lipiodol by Short-Term Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.

Cosmological Origins of the Obverse-Reverse Zang Fu Pairing in Chinese Medicine

Most of the rich philosophical and scientific concepts which nurtured the Chinese thought we know today, were developed during the troubled final end of the era before ours, from V to II centuries. After reading reputed sinologists’ work on the cosmological origin and subsequent evolution of the Chinese concept of parallelism-pairing in poetry, literature, mathematic and other disciplines and since it is a tradition that all branches of knowledge in China are based on the development of those initiatory thoughts, the author asked herself if such knowing on the cosmological genesis of the parallelism concept could also be applied to Chinese medicine, science that describes its coupled structures and functions in pairs, simply based on yinyang, matrix of all pairings. Therefore, this paper proposes to apply those foundations, to explain the pairing of dynamisms in medicine. This work starts out from the oracular inscriptions in ancient times, cosmological basis of these ideas and their applications to Chinese literature and from there translates this approach to the study of the pairings described by Chinese medicine, and thanks to which (qi xue) blood-energy circulation occurs in human beings. Organic and functional pairs described by Chinese medicine are the basic element to understand the concept of health and disease, and this paper is about the cosmological roots of those pairings, the cosmic resonance influence and the numerology influence in them, and the whole is illustrated both through the description of the (obverse-reverse) biao li pair, different from (inside-outside) nei wai, and the functional relationship between these two couples.

周剂量多西他赛联合顺铂、5-FU治疗晚期胃癌临床研究

背景与目的:大多数胃癌患者确诊时已处于晚期,并伴有相临脏器、淋巴结的广泛侵袭或远处转移。近年来,多西他赛作为一种新的紫杉类药物已通过大量的临床研究证实其可观的疗效,因此我们旨在对比观察多西他赛联合顺铂、5-FU每周方案与三周方案治疗晚期胃癌临床疗效及毒副反应。方法:80例晚期胃癌被分为两组,每周方案组(A组40例):多西他赛25mg/m2静滴,第1,8,15天,顺铂25mg/m2静滴,第1～3天,5-FU500mg/m2静滴,第1～5天,每4周重复。三周方案组(B组40例):多西他赛75mg/m2静滴,第1天,顺铂25mg/m2静滴,第1～3天,5-FU500mg/m2静滴,第1～5天,每3周重复。治疗2个周期评价疗效,每周期评价毒性。结果:两组共80例,均无化疗相关性死亡,A组总有效率42.4%,B组总有效率45.0%,两组中性粒细胞Ⅲ/Ⅳ度减少分别为32.5%和77.5%;非血液学毒性主要是Ⅲ/Ⅳ度疲劳乏力,两组分别为22.5%和42.5%。结论:多西他赛联合顺铂、5-FU治疗晚期胃癌每周与三周治疗相比,疗效相似,但每周治疗血液学毒性反应与疲劳乏力感明显下降,耐受性好。

CTX、ADM联合CF+5-Fu持续滴注方案与CAF方案治疗晚期乳腺癌的疗效比较

目的比较CTX、ADM联合CF+5-Fu持续滴注方案与CAF方案治疗晚期乳腺癌的近期疗效与毒性反应。方法将64例晚期乳腺癌患者采用信封抽签法随机分组,CTX、ADM联合CF+5-Fu持续滴注方案为观察组,CAF方案为对照组,平均化疗2.5个周期。结果观察组有效率为71.88%(23/32),对照组为43.75%(14/32),两组有效率比较有显著性差异,P<0.05;观察组KPS改善率为75.00%(24/32),对照组46.88%(15/32),两组比较有显著性差异,P<0.05;观察组白细胞下降及血小板减少分别为71.88%(23/32)、62.50%(20/32),对照组分别为43.75%(14/32)、28.13%(9/32),两组比较均有显著性差异,P<0.05;观察组恶心呕吐、口腔粘膜炎、腹泻发生率分别为75.00%(24/32)、50.00%(16/32)、46.88%(15/32),对照组分别为50.00%(16/32)、18.75%(6/32)、21.88%(7/32),两组比较均有显著性差异,P<0.05。结论CTX、ADM联合CF+5-Fu持续滴注治疗晚期乳腺癌有效率高,毒性反应较明显,但病人可以耐受。

紫杉醇联合CF／5-FU治疗晚期胃癌22例临床观察

目的 观察紫杉醇为主联合亚叶酸钙／5-氟尿嘧啶（5-FU）治疗晚期胃癌的疗效及不良反应。方法 化疗方案：紫杉醇（Taxol）＋亚叶酸钙（CF）／5-FU，28d为一个周期，连用2周期后评价疗效。Taxol每周疗法，60mg／m^2加入0．9％生理盐水500mL静滴，不少于3h，d1、d8、d15；CF200mg，d1-d5，5-FU 600mg／m^2，d1-5。结果 全组共完成化疗70周期，22例均可评价疗效，全组1例CR（4．6％），8例PR（36．4％），总有效率40．9％。8例SD（36．4％）；5例PD（22．7％）。毒副作用，主要为骨髓抑制，白细胞减少占81．8％，其中Ⅰ、Ⅱ级占77．3％；脱发占81．8％，均为Ⅰ、Ⅱ级；肌肉节痛占54．5％；其它还包括过敏（4．6％）、腹泻（9．1％）、肝功异常（22．8％）、心电图异常（4．6％）等。但无严重超敏反应，无治疗相关性死亡。结论 晚期胃癌病人使用以紫杉醇为主联合化疗方案具有一定的疗效，毒副反应可以耐受，在晚期胃癌缺乏有效治疗措施的情况下可作为一种较好选择。

小剂量肝素联合5-FU治疗重症急性胰腺炎的研究

目的探讨小剂量肝素联合5-FU对重症急性胰腺炎的临床治疗价值。方法将21例重症急性胰腺炎(SAP)患者随机分为2组:A组用小剂量肝素联合5-FU治疗,B组用生长抑素治疗,观察各组临床治愈时间、并发症发生率和病死率,及临化全项、CT等作动态检查。结果A、B组的临床治愈时间分别是48d、44d,并发症发生率分别是70%、73%,病死率分别是10%、9%。A、B二组差异无统计学意义(P>0.05)。结论小剂量肝素联合5-FU治疗SAP疗效肯定。

5-FU对人结肠癌HCT116细胞摄取18F-FDG的影响

目的 探讨结肠癌HCT-116细胞对18F-FDG摄取率的影响因素,从而利用18F-FDG细胞摄取率的变化早期评价化疗的疗效.方法 依据实验结果依次改变实验条件中细胞浓度、反应时间、18F-FDG放射性活度、葡萄糖的浓度,测定结肠癌HCT-116细胞的18F-FDG细胞摄取率.在加入不同浓度5-FU前后,分别采用四甲基偶氮唑盐法（MTT）和细胞18F-FDG 摄取率测定细胞的增殖抑制率.结果 当细胞浓度1×106/瓶、加入18F-FDG放射性活度为3.7KBq,葡萄糖浓度为5.5mmol/ L,反应时间为100min,细胞摄取率为（43.93±3.54）%,加入终浓度10、20、30和50μg/mL 5-FU 100μL作用24h后,细胞摄取率分别为（32.47±5.43）%、（26.44±3.62）%、（22.26±3.63）%、（16.10±6.40）%;细胞摄取抑制率分别为 （25.81±5.64）%、（39.58±3.74）%、（49.31±5.16）%、（62.27±7.50）%,各组之间差异均有统计学意义,且随5-FU 剂量增加而下降,两者呈负相关（r=-0.879,P＜0.01）.给药24h后MTT实验细胞生长抑制率与细胞摄取抑制率呈正相关 （r=0.831,P＜0.01）.结论 5-FU作用24h后结肠癌HCT-116细胞18F-FDG摄取率下降,18F-FDG摄取抑制率升高,可以通过18F-FDG细胞摄取抑制率早期评价5-FU对结肠癌的杀伤作用.

浅议“五脏六腑皆令人不寐,非独心也”

不寐是临床上常见的一种睡眠障碍,长期不寐对人们的工作、生活和学习造成很大的影响,给患者、家庭和社会带来不同程度的隐患和危害。作者查阅古代医家文献及现代诸多学者论文基础上,结合多年临床治疗不寐经验,提出“五脏六腑皆令人不寐,非独心也”观点。文章分别从生理状态、病理变化、中医药治疗等方面就不寐与五脏六腑的管理进行论述,认为生理情况下人体各脏腑各司其职,互相协调,方可正常寤寐。病理情况下,各种因素引起五脏六腑功能失常,直接或间接导致心神不宁、心神失养,阴阳失交,从而产生不寐。因不寐的发病与五脏六腑均有密切联系,故概括为“五脏六腑皆令人不寐,非独心也”。通过探讨不寐与脏腑的关系,旨在拓宽临床不寐中医论治思路,为不寐的中医辨证论治开辟新思路和方案。

以脉调气理论指导下的脏腑推拿治疗小儿功能性消化不良疗效研究

目的探究以脉调气理论指导下的脏腑推拿治疗小儿功能性消化不良的疗效研究。方法采用随机数字表法将黑龙江中医药大学附属第一医院治未病中心2020年2月—2022年2月收治的106例功能性消化不良患儿分为观察组(53例)与对照组(53例)。对照组采用一般推拿治疗,观察组在此基础上采用“以脉调气”理论指导下的脏腑推拿治疗方法。观察两组患儿治疗前以及治疗20 d后的中医症状积分、血锌浓度水平、胃动素、胃泌素、食欲调节因子水平、尼平消化不良指数。观察两组患儿临床疗效与复发率。结果两组患儿治疗前食后腹胀、纳呆食少、大便异常和面色萎黄的证候积分对比差异无统计学意义(P>0.05)。治疗20 d后观察组食后腹胀、食少纳呆、面色萎黄和大便异常证候积分显著低于对照组(P<0.05)。两组患儿治疗前胃动素、血锌含量、胃泌素水差异无统计学意义(P>0.05)。治疗20 d后观察组胃动素、血锌含量、胃泌素水平显著高于对照组(P<0.05)。两组患儿治疗前Ghrelin、NPY和Leptin水平差异无统计学意义(P>0.05)。治疗20 d后观察组NPY、Ghrelin浓度水平明显较对照组高,而Leptin水平明显较对照组低(P<0.05)。两组患儿治疗前NDI评分差异无统计学意义(P>0.05)。治疗20 d后观察组NDI评分显著低于对照组(P<0.05)。观察组总有效率为90.57%(48/53),显著高于对照组[75.47%(40/53)](χ^(2)=4.283,P=0.039)。观察组复发率为3.77%(2/53)(40/53)略低于对照组9.43%(5/53),但两组复发率差异无统计学意义(χ^(2)=1.377,P=0.241)。结论“以脉调气”理论指导下的脏腑推拿能有效提高临床疗效、提升食欲、调节因子水平、提高生活质量、改善胃动素、血锌含量、胃泌素水平,值得临床推广。

宋代官修方书中脏腑病证研究进展

宋代官修方书是宋代医学成就的集中体现,也是在医学门户未大量分化之前最系统、最全面的中医学术总结。脏腑学说是中医理论体系的核心,而脏腑病证是中医认识疾病的核心,宋代官修方书中记载有大量脏腑病证相关内容,近年来学者们对其中各个脏腑的病证大都有所讨论,但仍不够系统与精深,宋代官修方书的系统性、权威性、实用性及承上启下作用为脏腑病证提供了一个良好的研究样本,值得系统挖掘与研究。

Treatment of 90 patients with scapulohumeral periarthritis in different phases by combining therapy centering on Fu's subcutaneous needling

Objective To observe the efficacy of combining therapy in treatment of 90 patients with scapulohumeral periarthritis in different phases. Method Ninety patients with scapulohumeral periarthritis were treated with Fu＇s subcutaneous needling（FSN） combined with physiotherapy in painful phase, acupotomology and massage in adhesion phase, and appropriate functional exercise in rehabilitation phase. Seven days were considered as one course of treatment, and efficacy evaluation was performed after three courses. Function evaluation of shoulder joint was made. Result The total effective rate was 100%（38/38） in acute phase, 93.5%（29/31） in adhesion phase, and 100%（21/21） in rehabilitation phase. After treatment, the range of motion（ROM） of shoulder joint, pain, muscle force, activities of daily living（ADL） and joint local morphology of the patient have been improved obviously. Conclusion Better clinical efficacy is achieved in treatment of scapulohumeral periarthritis in different phases by combining therapy centering on FSN.

基于“脾为之卫”探讨溃疡性结肠炎的辨治思路

[目的]探讨溃疡性结肠炎的病因病机及治疗方法,以期为拓展溃疡性结肠炎的辨治思路提供理论依据。[方法]基于对“脾为之卫”理论内涵的梳理,同时结合现代医学对溃疡性结肠炎发病机制的认识,探讨脾脏功能失常与溃疡性结肠炎病因病机的相关性,并根据溃疡性结肠炎病程演变过程中病机的变化,具体论述分期辨治原则及方药。[结果]“脾失于卫”作为溃疡性结肠炎的病机关键,贯穿其各期而为病,故以“助脾复卫”为中心治则,对溃疡性结肠炎进行分期论治,活动期以消积化滞、理脾和卫为法,缓解期以调气疏郁、健脾行卫为法,恢复期以清养生肌、补脾固卫为法。[结论]运用“脾为之卫”理论有助于认识溃疡性结肠炎发病机制与脾脏的密切关系,完善从脾论治溃疡性结肠炎的分期证治法则及具体方药。

刘铁军教授运用通腑除秽法治疗溃疡性结肠炎经验

溃疡性结肠炎是一种慢性非特异性肠道炎症性疾病,属于中医学“痢疾”“肠澼”“泄泻”等范畴。该病发病率呈逐年上升趋势,具有易复发和病程长的特点,严重影响患者的生活质量和身心健康。刘铁军教授认为溃疡性结肠炎的病机关键是“腑毒”,肝郁脾虚、食积脾胃、湿热蕴肠、血瘀肠络、脾肾两虚是形成腑毒的重要前提。治疗采用“通腑除秽法”,具体应用以疏肝实脾畅腑毒、消食导滞下腑毒、清热燥湿祛腑毒、化瘀通络消腑毒、健脾益肾通腑毒来治疗溃疡性结肠炎,临床常用经典名方加减化裁治疗,取得了良好疗效。

不同辨证体系中类风湿关节炎中医病机研究进展

类风湿关节炎属于一种以周围关节骨质损害为主要特征的自身免疫性疾病。中医学对其曾多以病因角度辨证,且多从风、寒、湿、热论治,其他辨证体系涉及较少。近年来,类风湿关节炎病机的相关研究得到广泛重视,其辨证体系和角度的探索也得到进一步拓展。该文对近年发表的有关中医治疗类风湿关节炎的文献进行梳理总结,从脏腑理论、气血津液理论及络病理论共三种辨证体系论述其论治研究进展。期望通过该文的归纳、分类与总结,为今后类风湿关节炎的病机研究和证型分类提供参考和思路。

《医林改错》脏腑理论模型的构建与运用

王清任一生的医学贡献凝聚于一册薄薄的《医林改错》,其构建的脏腑理论模型具有生理学与病理学的双重含义,具体可分为“气血运行模型”和“水谷运化模型”。前者侧重于病理探讨,生理描述亦多,可细分为“气运模块”与“血运模块”;后者常见于生理阐释,病理描述甚少,可细分为“水运模块”与“谷运模块”。“气运模块”的生理功能以存储和运行元气、津液为主,其病理变化以津液失常和气虚为主;“血运模块”的生理功能以存储和运行血液为主,其病理变化以血瘀为主;“水运模块”的生理功能主以运行水液,“谷运模块”的生理功能主以运化谷物,二者的病理变化均较少涉及。

基于“脾肾”脏腑理论探讨缺血性脑白质病变的病机及中医药治疗

近年缺血性脑白质病变的发病率逐年上升,该病早期症状隐匿且不典型,严重影响老年人群的生命及生活质量。目前西医的治疗手段主要是针对缺血性脑白质病变的基础病进行对症治疗,治疗较为局限且疗效欠佳,而中医在预防和改善缺血性脑白质病变临床症状方面有着独特的优势。基于脏腑理论,遵循“未病先防,既病防变”原则,结合临床经验,从脾肾两脏论治缺血性脑白质病变。通过调理脾肾,调和阴阳,达到治疗缺血性脑白质病变的目的。

补肾通腑方治疗脊髓损伤后神经源性膀胱患者临床疗效

目的探讨补肾通腑方对脊髓损伤后神经源性膀胱(NB)患者临床疗效。方法选择浙江省丽水市人民医院2021年8月至2023年8月脊髓损伤后NB患者94例,按治疗方法分为治疗组(47例)与对照组(47例)。对照组采用膀胱功能训练与间歇性无菌导尿治疗,治疗组在对照组基础上结合补肾通腑方治疗。2组治疗疗程4周。比较2组治疗疗效、治疗前后中医证候积分、膀胱容量和残余尿量、日平均单次尿量和日平均排尿次数及生活质量变化。结果治疗组总有效率高于对照组(P<0.05)。2组治疗后气短自汗、面色白、倦怠无力和小便频多积分低于治疗前(P<0.05);治疗组治疗后气短自汗、面色白、倦怠无力和小便频多积分低于对照组(P<0.05)。2组治疗后膀胱容量高于治疗前,而残余尿量低于治疗前(P<0.05);治疗组治疗后膀胱容量高于对照组,而残余尿量低于对照组(P<0.05)。2组治疗后日平均单次尿量高于治疗前,而日平均排尿次数低于治疗前(P<0.05);治疗组治疗后日平均单次尿量高于对照组,而日平均排尿次数低于对照组(P<0.05)。2组治疗后泌尿症状困扰评分(USDS)低于治疗前(P<0.05);治疗组治疗后USDS评分低于对照组(P<0.05)。结论补肾通腑方对脊髓损伤后NB患者疗效显著,且可改善患者尿动力学,提高患者生活质量。

基于“脏腑别通”理论运用加味小柴胡汤结合捏脊法治疗心肌炎的实验研究

本研究旨在探明加味小柴胡汤结合捏脊法治疗心肌炎(MC)的作用机制。方法:将30只小鼠随机分成空白组、模型组、西药组、柴治组、捏治组、合治组共6组,每组5只。空白组不造模,其余各组均制成自身免疫性MC模型。各组施以相应处理7 d,结束后取心肌组织和血清分别检测肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、Toll样受体4(TLR4)、核因子-κB p65(NF-κB p65)、B淋巴细胞瘤-2基因(Bcl-2)、Bcl-2相关X蛋白(Bax)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)的含量及心肌切片观察。结果:中医各治疗组对阻断心肌TLR4/NF-κB p65炎症通路及抑制心肌细胞凋亡的作用均优于西药组(P<0.05),且合治组在降低NF-κB p65、TNF-ɑ、Bax、Caspase-3和升高Bcl-2中的作用较其余治疗组为优(P<0.05);同时,与西药组比较,各中医治疗组心肌切片显示心肌细胞排列紊乱均有不同程度改善,心肌间隙炎细胞浸润较少,以合治组表现最佳。结论:加味小柴胡汤结合捏脊法可能通过抑制心肌TLR4/核因子-κB(NF-κB)信号通路阻止心肌炎症反应,同时抑制凋亡因子减少心肌凋亡来发挥对MC的治疗作用;二者结合运用能发挥良好的协同作用。