Observation on Therapeutic Effects of Electroacupuncture on Polycystic Ovary Syndrome of Kidney Deficiency and Phlegm Dampness Type and Oxidative Stress Level

Objective:To observe the clinical effect of electroacupuncture on improving polycystic ovary syndrome(PCOS)of kidney deficiency and phlegm dampness type and serum oxidative stress level.Methods:There were 68 patients with polycystic ovary syndrome were randomly divided into observation group(34 cases)and the control group(34 cases),The observation group was treated by electroacupuncture,while the control group was treated by placebo electroacupuncture.Combined with the evaluation of menstrual cycle,menstrual color,quality,quantity and TCM symptom integral index,the difference of curative effect between the two groups was observed,and the levels of peripheral blood,sex hormones,insulin resistance and oxidative stress were detected before and after treatment for 3 months.Results:The total effective rate in the observation group was better than that in the control group(P<0.01);After intervention,serum LH,FSH,E_(2) and LH/FSH in the observation group were significantly different from those before intervention.The D values of serum LH,FSH,LH/FSH and E_(2) before and after intervention were significantly different between the two groups(P<0.01);Comparing the level of androgen,the serum A4 and T in the observation group were significantly different from those before intervention(P<0.01);After intervention,there was a significant difference in serum A4 and T between the two groups(P<0.01),and there was a significant difference in D value between the two groups before and after intervention;There was a difference in insulin resistance in the observation group before and after intervention(P<0.05),and there was a significant difference in D value between the two groups before and after intervention(P<0.01);After the intervention,the serum SOD,MDA,ROS in the observation group were significantly different from those before the intervention;After intervention,the results of serum SOD and ROS in the observation group were significantly different from those in the control group;There was no significant difference in serum MDA results.There were significant differences in SOD,MDA,ROS between the two groups before and after intervention.Conclusion:Electroacupuncture can improve oxidative stress injury,insulin resistance and hyperandrogenism in PCOS patients.

Theory discussion on airway remodeling of bronchial asthma

According to modern research,the pathogenesis of asthma mainly includes airway inflammation,airway hyperresponsiveness,airway remodeling,etc.Airway remodeling is the key factor that leads to the progress of asthma,and it is also the main factor that leads to airway hyperresponsiveness and irreversible airflow restriction.Traditional Chinese medicine believes that"phlegm and blood stasis"block the airway and narrow the lumen is the most important factor in the treatment of asthma.

陈博来基于“肾为生痰之本”辨治肾虚痰阻型腰痛

肾主水,为先天之本,对于体内津液的运行输布具有重要作用,且肾与水腑膀胱互为表里,通过冲脉与“水谷之海”的胃有经络上的联系,故肾在痰的生成中起着关键作用。陈博来教授认为,肾虚痰阻型腰痛为本虚标实之证,“痰阻”为其标,“肾虚”为其本,临床以腰骶钝痛、痛处固定、腰部僵硬、肢体麻木或偏枯为主要特点,兼见腰膝酸软、喜按喜揉等表现。肾虚痰阻型腰痛的治疗可基于“肾为生痰之本”,以补肾祛痰为法,拟定理痰汤(主要组成药物为芡实、半夏、黑芝麻、柏子仁、白芍、陈皮、茯苓等)为基础方,针对不同兼症辅以健脾、宣肺等药进行加减治疗。其辨治思路可为临床中医治疗腰痛提供参考。

防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的回顾性队列研究

目的:观察防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的疗效与安全性。方法:采用回顾性队列研究方法,选取上海市嘉定区中医医院代谢与肥胖专病门诊收治的单纯性肥胖患者,最终纳入统计分析共175例,其中治疗组95例,对照组80例。治疗组予以防己黄芪汤联合穴位埋线治疗,对照组予以二甲双胍缓释片治疗,疗程3个月,观察患者体质量、腰围、BMI、减重结局、中医证候疗效等主要指标;胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)和血脂等次要指标;肝肾功能等安全性指标。结果:与对照组比较,治疗组患者随时间的延长,体质量、BMI、腰围明显下降,达到临床减重结局的发生率明显更高,且治疗组HOMA-IR、HbA1c、甘油三酯等指标明显改善(P<0.05)。中医证候疗效方面,治疗组总有效率89.47%(85/95),优于对照组51.25%(41/80),差异具有统计学意义(P<0.05)。治疗过程中两组患者均未见肝肾功能异常。结论:防己黄芪汤联合穴位埋线可明显减轻患者体质量,改善血糖和胰岛素抵抗以及脂代谢,患者依从性良好,具有较好的安全性。

国医大师周仲瑛从痰瘀热结辨治系统性硬化症经验撷要

[目的]总结国医大师周仲瑛从痰瘀热结复合病机治疗系统性硬化症的临证经验,为临床提供参考。[方法]通过临床学习、收集整理周老治疗系统性硬化症的医案,从病因病机、辨机论治、用药特色等方面阐述周老治疗该病的临床经验,并举医案一则加以佐证。[结果]周老认为,系统性硬化症的病机关键为痰瘀热结,病理因素以“痰、瘀、热”为主导,三者转化相兼,复合为患,贯穿病程始终;根据病情进展及病理因素的演变,治疗多从痰瘀热结复合病机入手。痰瘀内生,胶结为患,治宜化痰祛瘀、逐邪蠲痹;痰热蕴结,热扰则发,治宜清化痰热、宣痹散结;瘀热相搏,血热鸱张,治宜凉血散瘀、寓透于清;伤阴耗气,虚热内生,治宜益气养阴、扶正祛邪。文中所附验案,周老辨为痰瘀热结、风湿痹阻、气阴两伤证,治以化痰祛瘀、透热蠲痹、益气养阴,方用白薇煎合秦艽鳖甲散加减。[结论]国医大师周仲瑛倡导辨证宜首重病机,从痰瘀热结复合病机辨治系统性硬化症,复法合治,灵活遣方,疗效显著,其经验值得传承推广。

探讨哮喘之宿根

哮喘是一种由气道挛急所致的气喘痰鸣疾患,中医认为哮喘难以治愈、反复发作的根本与其“宿根”未除密切相关。作者通过查阅古今文献,总结出哮喘宿根有“痰”“瘀血”“痰瘀”“肺脾肾虚”“肝风”“客邪”“湿邪”等,创新性地提出哮喘各宿根相互影响、相互作用、互为因果,从而形成恶性循环,为临床上多角度、多层次辨治哮喘提供了新思路。

从“痰涎本皆血气”认识痴呆补肾祛痰之治法

肾虚与痰浊是痴呆形成的关键因素,痴呆患者肾虚不能生髓,元气不充不能化水,遂致痰实为标,阻滞气血、脑窍,发为痴呆。张景岳谓痰涎与血气本属一源,在元气未充之时,水饮化失其正,血气即成痰涎,故在治疗上应补肾与祛痰并举,因为痰涎与血气本属一源,只有正本清源,恢复肾主水的生理功能,痰涎才会化得其正。临床有医家在治疗痴呆患者的过程中谓补肾会助生痰涎,倡导先祛痰实,再补肾虚,实是未得痰涎本皆血气之意。

Effect of reinforcing kidney-essence, removing phlegm, and promoting mental therapy on treating Alzheimer's disease

OBJECTIVE: To explore the mechanism of reinforcing kidney-essence, removing phlegm, and promoting mental therapy in treating Alzheimer's disease (AD). METHODS: Sixty patients with AD in Wuhan No.1 Hospital of Traditional Chinese Medicine for Geriatrics from May 2009 to April 2011 were randomly divided into two groups, with 30 in each group. Patients in Bushenhuatanyizhi group (BHY group) took BHY instant granules (6 g, twice per day). Patients in the control group took piracetam (0.8 g, 3 times per day). There were twelve weeks in a course. Changes in the mini-mental state examination (MMSE) score and Activity of Daily Living Scale (ADL) score were analyzed before and after treatment. RESULTS: MMSE scores in the two groups in-creased and ADL scores decreased after treatment, compared with those before treatment (both P< 0.05).The total effective rate was 86.67% in the BHY group (10 very effective, 13 effective, 7 non-responsive). The control group was 57.69% (5 very effective, 16 effective, 9 non-responsive) (P<0.05). Superoxide dismutase levels were increased, lipid peroxide and triglyceride levels decreased after treatment in the BHY group as compared with the control group. CONCLUSION: Reinforcing kidney-essence, removing phlegm, and promoting mental therapy can improve cognitive function and daily life of AD patients. The mechanism of the therapy might be related to improving blood fat, scavenging free radicals, and inhibiting lipid peroxides.

Mechanism of Erhuang capsule for treatment of multiple sclerosis

Erhuang capsule, a typical formula based on traditional Chinese medicine theory, is widely used to ameliorate multiple sclerosis, inflammation and side effects of glucocortJcoid treatment. Oligodendrocyte precursor cells are neural stem cells that are important for myelin repair and regeneration. In the present study, Erhuang capsule effectively improved clinical symptoms and neurological function scores, reduced mortality and promoted recovery of neurological functions of mice with experimental autoimmune encephalomyelitis. The mechanism of action involved significant increases in oligodendrocyte precursor cell proliferation in specific regions of the brain and spinal cord, increased oligodendrocyte lineage gene 2 expression and enhanced oligodendrocyte precursor cell differentiation.

Preventive online and offline health management intervention in polycystic ovary syndrome

BACKGROUND Polycystic ovary syndrome(PCOS) is characterized by hyperandrogenism, hyperinsulinemia, ovarian polycystic changes, and irregular ovulation, often occurring in women of childbearing age for whom it can be a cause of infertility. Hypothalamus-pituitary-ovarian axis dysregulation is important in the pathogenesis of PCOS and the associated chronic excess of sex hormones can lead to cardiovascular and cerebrovascular diseases, diabetes, and malignancies such as endometrial cancer, and breast cancer. At present, most scholars agree that lifestyle interventions in conjunction with drug treatment can help PCOS patients achieve their goals of successful pregnancy and childbirth.AIM To investigate the clinical effect of an online and offline(O2O) preventive health management model on PCOS with kidney deficiency and phlegm dampness.METHODS A total of 82 patients with PCOS of the kidney deficiency and phlegm dampness type who were admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from April 2019 to June 2020 were randomly divided into two groups. The treatment group was treated with oral Diane-35 for 3 mo and received preventive O2O medical health management for 6 mo(including eating and living, exercise, drug management). The control group was treated with oral Diane-35 for 3 mo and completed outpatient health education. The traditional Chinese medicine(TCM) syndrome score, acne score, hair score, sex hormone level and clinical effects were compared between the two groups before and after the intervention. RESULTS After treatment, the TCM syndrome score, acne score, and serum luteinizing hormone/follicle stimulating hormone level were significantly lower in the treatment group than in the control group(P < 0.05). After 3 mo of treatment, the TCM syndrome curative effect index in the treatment group was 97.30% compared to 54.05% in the control group(P < 0.05), whereas the total treatment effect in the treatment group was 91.89%, compared to 54.05% in the control group(P < 0.05).CONCLUSION An integrated therapeutic approach incorporating medication, TCM methods and social media is more effective than standard treatment for PCOS.

Resistance identification of bivalent fungi-resistant genes transformed soybean to Phytophthora sojae

Soybean is one of the most important sources of edible oil and proteins in the world. However, it suffers from many kinds of fungal diseases which is a major limiting factor in soybean production. The fungal disease can be effectively controlled by breeding plant cultivars with genetic transformation. In this study, the resistance to Phytophthora sojae of five bivalent transgenic soybean lines was identified using the hypocotyls inoculation technique. The lines were the T2 of the transgenic soybean which were transformed with kidney bean chitinase gene and barley ribosome inactivating protein gene, and were positive by Southern Blot analysis. The resistance difference was studied through comparing the death percentage of transgenic soybean with the control. The results showed that four lines were more resistant to P sojae, whereas other one had no significant difference in comparison with the control. These transgenic soybean lines with enhanced resistance to P sojae will be useful in soybean resistance breeding.

基于“填精补髓、清脑通络法”探讨血管性认知障碍中医证治规律

血管性认知障碍(VCI)是脑血管病变及其危险因素导致的血管性损伤,涉及至少1个认知域受损的临床综合征,涵盖从轻度认知障碍到痴呆、合并阿尔兹海默病等混合性病理所致的不同程度认知障碍。从中医“整体观念”出发,肝风内动是VCI的始动因素,肾虚髓减,痰瘀阻滞脑络是VCI的关键环节,根据“治病求本、杂合以治”的原则,治疗上应“间者并行,甚者独行”,须“标本兼顾,通补兼施”,临床运用填精补髓、清脑通络之法,以补肾填髓方药坚固脑之脉络,在痰瘀等病理产物尚未戕害清窍之时,阻断其阻滞脑脉或侵入脑内,基于以上理念探讨VCI中医证治规律,以飨同道。

散结生津方联合低温等离子消融治疗痰浊凝滞型舌根良性增生性肿物临床研究

【目的】探讨散结生津方联合低温等离子消融治疗痰浊凝滞型舌根部良性增生性肿物的临床疗效。【方法】将80例痰浊凝滞型舌根部良性增生性肿物患者随机分为治疗组和对照组,每组各40例。治疗组给予散结生津方联合低温等离子消融治疗,对照组单纯给予低温等离子消融治疗,疗程为2周并随访3个月。观察2组患者治疗前后的咽部异物感、吞咽阻挡感、焦虑情绪等主观症状视觉模拟量表(VAS)评分的变化情况,评价2组患者的近、远期疗效及安全性。【结果】(1)近期疗效方面:治疗2周后,治疗组的治愈率及总有效率分别为62.50%(25/40)、95.00%(38/40),对照组分别为30.00%(12/40)、72.50%(29/40);组间比较,治疗组的治愈率及总有效率均明显优于对照组(P<0.01)。(2)主观症状评分方面:治疗后,2组患者的咽部异物感、吞咽阻挡感和焦虑情绪等主观症状VAS评分均较治疗前明显降低,症状均明显改善(P<0.01),且治疗组对各项主观症状VAS评分的降低作用均明显优于对照组(P<0.05或P<0.01)。(3)远期疗效方面:治疗3个月后随访,治疗组的治愈率及总有效率分别为60.00%(24/40)、92.50%(37/40),对照组分别为27.50%(11/40)、70.00%(28/40);组间比较,治疗组的治愈率及总有效率均明显优于对照组(P<0.01)。(4)安全性方面:治疗过程中,2组患者均未出现出血等不良反应,患者的肝功能及肾功能等安全性指标也均未见异常。【结论】散结生津方联合低温等离子消融治疗痰浊凝滞型舌根部良性增生性肿物疗效确切,安全性高,可有效缓解咽部不适症状,缩短术后恢复时间,其疗效优于单纯低温等离子消融治疗。

苦杏仁与桔梗止咳、祛痰的配伍比例研究

目的研究苦杏仁、桔梗及两者配伍的止咳、祛痰作用,确定两者最佳配伍比例。方法分别采用浓氨水和枸橼酸刺激法制造小鼠和豚鼠咳嗽模型,记录咳嗽潜伏期和咳嗽次数;采用小鼠腹腔注射酚红、测定气管浸出液分光光度值法,研究小鼠气管排泌作用。结果苦杏仁、桔梗及两者不同配伍均有显著延长咳嗽潜伏期、减少咳嗽次数、促进气管排泌的作用;与单味苦杏仁或单味桔梗组比较,两者配伍组的上述作用有不同程度的增强。结论苦杏仁与桔梗配伍对止咳、祛痰有增效作用,两者配伍用于止咳、祛痰的最佳比例分别为1∶1和1∶2。

高脂血症从脾论治探幽

高脂血症是缺血性心脑血管疾病的主要且独立的危险因素,血脂水平与脾虚证有直接且密切的关系,脾气虚致使脾的运化和转输功能失司,痰浊内生,形成脂浊。目前中医药降脂的方法种类繁多,治疗角度各有差异,如疏肝除湿,泻肝活血、补肾降脂、利胆泄浊、涤痰化瘀,通腑降气等。不可否认,在实际应用中,这些方法都取得了一定的临床效果。但由于未抓住高脂血症发生及发展的关键——脾虚,仅针对某个病因或某个病机发展阶段论治,不能透过现象看本质,舍本求末,故临床疗效稍有不佳。笔者认为治疗高脂血症必须紧紧抓住脾失健运,痰浊内生这一病机关键,健运后天以治本,化痰祛浊以治标,脾健痰化,膏脂自消。因此理脾化痰为治疗高脂血症重要法则。以治脾为本,并不意味着排斥其他治法,而是根据患者伴随症状,在健脾的同时,伍以相应的治法,共奏降脂之效。

丁樱教授治疗小儿遗尿症经验

目的:总结丁樱教授治疗小儿遗尿症经验。方法:通过跟师学习,收集、整理、归纳丁樱教授对本病病因病机的认识及其治疗方法。结果:丁教授认为遗尿症主要病机特点为本虚标实,以下元亏虚为本,痰浊蒙窍为标,治疗重视固本开窍,谴方用药注重温阳补肾止遗、涤痰开窍醒神,临床擅用菟丝子。结论:丁樱教授治疗小儿遗尿经验丰富,很具借鉴意义。

孙升云教授治疗慢性肾病的经验

目的:总结孙升云教授治疗慢性肾病的经验。方法:通过跟师学习,总结孙升云教授治疗慢性肾病经验,并依据其典型病案,论述其对本病病因病机的认识及其治疗方法。结果:孙升云教授认为慢性肾病的基本病机为本虚标实,本虚以脾肾气虚、阳虚为主,标实主要指水湿、痰浊、瘀血等,正虚邪实贯穿疾病始终。孙升云教授以肾衰方为基础方治疗慢性肾病,并随症加减。结论:孙升云教授治疗慢性肾病疗效确切,很具借鉴意义。

高血压痰湿壅盛证常用方剂综述

中医降血压方剂在降血压的同时,能明显改善患者的临床证候,提高患者的生活质量,反映了中医治病以人为本的治疗理念。但是,中医方剂治疗高血压痰湿壅盛证的作用靶点尚不清楚,在该领域的研究亟待加强。另外,在观察方剂疗效时,多数医者所采用方法均为中西医药物联合治疗,这样虽然也体现了中医方剂对高血压痰湿壅盛证的治疗效果,但也说明了中医方剂对于该病的治疗尚处于辅助地位,对于其直接降血压的效果有待于进一步提高。

超重/肥胖、运动及其交互作用对痰湿体质的影响研究

目的探讨超重/肥胖、运动及其交互作用对痰湿体质的影响。方法在"正常人群中不同体质中医脉诊生理参数系统调查"数据库中,选取2015年3月—2016年5月在北京市获得的健康体检数据,排除相关变量缺失、体质量过低(BMI<18.5 kg/m^2)者,将符合条件的970例受试者的中医体质量表中痰湿体质亚量表得分由高到低排序,以得分的前262例(27.0%)为高分组、后262例(27.0%)为低分组。采用Logistic回归分析,将性别、年龄、文化程度、吸烟偏好、饮酒偏好作为混杂因素,探讨超重/肥胖、运动及其交互作用对痰湿体质的影响。结果多因素Logistic回归分析显示,超重、肥胖会增加高痰湿体质得分的风险[OR(95%CI)分别为1.981(1.275,3.079)、4.032(1.985,8.190),P<0.05];运动习惯对痰湿体质无影响(P>0.05)。按是否超重/肥胖、有无运动习惯分层后的Logistic回归分析显示,非超重/肥胖+无运动习惯者、超重/肥胖+无运动习惯者的高痰湿体质得分风险高于非超重/肥胖+有运动习惯者[OR(95%CI)分别为2.735(1.644,4.551)、2.154(1.168,3.976),P<0.05]。相乘和相加交互作用分析均显示,超重/肥胖、运动对痰湿体质的影响不存在交互作用。结论超重/肥胖、缺乏运动会增加痰湿体质的倾向,但二者间在统计学上无交互作用,进行运动和体质量管理将有助于调护痰湿体质。

眩晕辨治体会

目的:探讨中医辨证论治眩晕的临床体会。方法:总结中医对眩晕病因病机的认识和中医辨证论治的方法。结果:眩晕常见的病理因素为风、火、痰、虚、瘀,病位在脑,其病变脏腑与肝、脾、肾三脏相关。本病多属本虚标实,以肝肾阴虚、气血不足为本,风火痰瘀为标,但亦有实中带虚者,临床治疗应在辨病的基础上辨证施治,注重辨脏腑虚实,随证治之。结论:中医辨证论治眩晕的临床疗效显著。