著名中医学家林兰教授学术经验系列之五 辟秽降浊防传变养阴生津贵润燥——治疗糖尿病乳酸性酸中毒的经验

乳酸性酸中毒属于中医“秽浊”、“神昏”、“脱症”等范畴。主要病因病机可概括为脾失健运 ,湿浊中阻 ;心火肝郁 ,痰浊蕴结 ;误治失治 ,阴脱阳亡三端。治疗上中医可分痰浊中阻型、痰浊蒙蔽型和阴脱阳亡型灵活论治 ;宜抓住治疗时机 ,中西医结合以提高疗效 ,降低死亡率。

李振华脾胃病学术思想及临证经验探讨

国医大师李振华经多年实践提出了脾胃学术思想:脾本虚证,无实证,胃多实证;脾虚是气虚,甚则阳虚,脾无阴虚而胃有阴虚:脾病多湿,健脾要祛湿,利湿即所以健脾;治脾胃必须紧密联系肝;治脾兼治胃,治胃亦必兼治脾,脾胃病不可单治一方;重视湿热互结,湿热缠绵,病理是阴阳寒热矛盾交错;脾胃病胃阴虚证治,用药宜轻灵甘凉;通过长期脾胃病临床和调查统计,各种慢性胃病脾胃气虚者占90%以上,胃阴不足者不到10%,及脾统四脏等。同时阐述了李老脾胃病治疗用药经验并附有医案。

谷云飞治疗放射性直肠炎经验

放射性直肠炎是一种常见的腹盆腔肿瘤放疗后的并发症,不仅对生活质量造成了严重的影响,甚至可能危及生命。主要介绍谷云飞教授临床辨证运用中西医结合疗法治疗放射性肠炎的经验。谷云飞教授作为江苏省名老中医,对于放射性直肠炎的治疗,有自身独特见解,从自身经验出发,认为"邪之所凑,其气必虚",其基本病机是本虚标实,遵循"治外必先诸内"的原则,以扶正祛邪为大法,兼以急则治标、缓则治本的原则。据病症的缓急,然后选择内外结合的疗法,因人施治,因证施治,灵活运用清、温、补等疗法辨证论治。并坚持"中西医结合,内治与外治并用,局部与整体并重",除使用特色中药内服外,美沙拉嗪栓配合院内制剂黄芩油膏塞肛,抗炎、黏膜修复、调整肠道功能药物的联合使用,取得了较好的临床效果。

Study on the Drug Selection Law for Treatment of Chronic Gastritis with Spleen Deficiency and Stomach Dryness by Complex System Entropy Cluster

Objective:To study on Prof. GAO Zhong-ying’s drug selection law for treatment of chronic gastritis with data mining technique. Methods: The 407 medical records of chronic gastritis treated by Prof. GAO Zhong-ying were collected and the study on these drugs in the recipes was carried out with data mining method. Among them, the recipe composed of one drug was studied with frequency statistical method, correlativity between drug pairs with improved mutual information, correlativity among multi-drugs with complex system entropy cluster technique. Results: In treatment of chronic gastritis by Prof. GAO Zhong-ying there were 30 drugs with a higher use frequency of over 38 times, 94 commonly-used drug pairs with correlation coefficient of over 0.05, 11 commonly-used drug core combinations. Conclusion: The results attained with data mining technique for studying experience of famous and old TCM physicians conform to the clinical practice and the method is of an important significance for summarization of famous and old TCM physicians’ experiences.

定性访谈法在中医药领域中的应用及优势

访谈法是一种遵循一定规则并通过交谈来收集资料的定性研究方法,中医药领域内使用定性访谈法的研究逐年递增。目前使用定性访谈的中医药相关主题主要有医护临床实践经验及方法,患者观点、经验以及选择中医疗法的意愿,中医的应用、教学情况,以及中医量表制作相关的访谈。中医因其整体观念和辨证论治的特点,适合使用定性访谈法对相关研究进行补充发现,可在名老专家治疗经验探索、疾病证候演变及结局指标构建、辨证论治诊疗模型构建、中医疗效评价要素研究、解决中医科研中的障碍、中医科研进展中的质量检测、中医教育及管理模式这些方面使用定量研究结合访谈的混合方法进行全面探索。