Asymptotic Analysis of a Stochastic Model of Mosquito-Borne Disease with the Use of Insecticides and Bet Nets

Ross’ epidemic model describing the transmission of malaria uses two classes of infection, one for humans and one for mosquitoes. This paper presents a stochastic extension of a deterministic vector-borne epidemic model based only on the class of human infectious. The consistency of the model is established by proving that the stochastic delay differential equation describing the model has a unique positive global solution. The extinction of the disease is studied through the analysis of the stability of the disease-free equilibrium state and the persistence of the model. Finally, we introduce some numerical simulations to illustrate the obtained results.

Regional characteristics and spatiotemporal differentiation of the prevalence of hand, foot, and mouth disease in Xinjiang, China

In recent years,the number of hand,foot,and mouth disease(HFMD)cases in China has continued to grow,and the disease has become a serious public health issue.Xinjiang Uygur Autonomous Region is located in the arid areas of Northwest China,where the epidemiological trend of HFMD is gradually increasing and characterized by geographical heterogeneity.In this study,based on the HFMD case data in all counties and cities in Xinjiang,we employed statistical and GIS spatial analyses,and geographic probe models to characterize the spatiotemporal differentiation of HFMD epidemics in Xinjiang during the period of 2009–2018,and quantitatively analyzed the factors influencing the spatial differentiation of HFMD epidemics.The results showed that HFMD incidence rate in Xinjiang had non-stationary temporal characteristics on the interannual and monthly scales,and the monthly variation characteristics of HFMD epidemic were quite different in southern and northern Xinjiang.The spatial distribution characteristics of HFMD epidemics showed a north–south spatial differentiation pattern with the Tianshan Mountains as the boundary;cold spot and hot spot of HFMD epidemics in Xinjiang have shifted from scattered to concentrated,and the spatial differentiation pattern had gradually stabilized.Moreover,the dominant factors influencing the spatial differentiation of HFMD epidemics in Xinjiang were socioeconomic factors,such as per capita GDP and urbanization rate,while the basic factors affecting its spatial differentiation were natural environmental factors.The spatial differentiation and evolution patterns of HFMD epidemics differed between northern and southern Xinjiang.Specifically,the leading role of socioeconomic factors is more obvious in southern Xinjiang than in northern Xinjiang,while natural environmental factors(e.g.,dryness and relative humidity)contribute to the prevalence of HFMD epidemics in northern Xinjiang,and the perturbing effect of these factors was more prominent than other factors.The results of this study can provide a scientific basis for the prevention of HFMD epidemics and early warning of HFMD epidemics in Xinjiang.

Differentiating and Treating Gynecological Diseases based on the Theory of Collateral Diseases

The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.

Epidemic Diseases and Chinese Medicine: Example of SARS and COVID-19: Part Two

Along with the legends about epidemic demons,China has developed over the centuries a medical approach to epidemic diseases based on the teachings of Hucng Di Nei Jing(《黄帝内经》Huangdi s Intermnal Classic),Nan Jing(《难经》Classic of Difficult Issues),and Shang Han Lun(《伤寒论》Treatise on Cold Damage).Other doctors and scientists participated in this evolution of knowledge,like Wang Shuhe(王叔和),Ge Hong(葛洪),Chao Yuanfang(巢元方),Sun Simiao(孙思邈),and Liu Wansu(刘完素).However,it was in the 17^th century,after the great break of the Song,Jin,and Yuan eras that an innovative spirit,Wu Youke(吴又可1582-1652)first foresaw the existence of microorganisms as we know them now.His Wen Yi Lun(《瘟疫论》Treatise on Pestilence)foreshadows an original approach to epidemic diseases,particularly emerging infectious diseases of the 21^st century.After them,traditional Chinese medicine developed a comprehensive method of diagnosing and treating of these diseases(Epidemic Diseases Theory瘟疫学说)within the School ofHeat Diseases(温病学派).In a third article,we will examine some applications in the treatment of the SARS 2003-2004 epidemic(非典型肺炎)and the current COVID-19(新型冠状病毒肺炎)pandemic.

Epidemic Diseases and Chinese Medicine:Example of SARS and COVID‑19:Part Two

Along with the legends about epidemic demons,China has developed over the centuries a medical approach to epidemic diseases based on the teachings of Huang Di Nei Jing(《黄帝内经》Huangdi’s Internal Classic),Nan Jing(《难经》Classic of Difficult Issues),and Shang Han Lun(《伤寒论》Treatise on Cold Damage).Other doctors and scientists participated in this evolution of knowledge,like Wang Shuhe(王叔和),Ge Hong(葛洪),Chao Yuanfang(巢元方),Sun Simiao(孙思邈),and Liu Wansu(刘完素).However,it was in the 17th century,after the great break of the Song,Jin,and Yuan eras that an innovative spirit,Wu Youke(吴又可1582–1652)first foresaw the existence of microorganisms as we know them now.His Wen Yi Lun(《瘟疫论》Treatise on Pestilence)foreshadows an original approach to epidemic diseases,particularly emerging infectious diseases of the 21st century.After them,traditional Chinese medicine developed a comprehensive method of diagnosing and treating of these diseases(Epidemic Diseases Theory瘟疫学说)within the School of Heat Diseases(温病学派).In a third article,we will examine some applications in the treatment of the SARS 2003–2004 epidemic(非典型肺炎)and the current COVID-19(新型冠状病毒肺炎)pandemic.

基于“玄府气液”理论治疗慢性难愈性溃疡

慢性难愈性溃疡是“虚”“瘀”两种致病因素相互交织、相互作用的结果,“虚”“瘀”贯穿疾病发展的始终。而“玄府开阖失司,气液代谢失调”是本病迁延难治的病机关键。刘丽芳教授综合运用煨脓生肌、阳和通玄、托里消毒诸法开玄府、调气液,令玄府开阖有司,气液代谢调和,临床疗效满意,附验案一则加以阐明。

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。

再谈“寒温统一论”

外感热病中的寒温之争由来已久,一定程度上造成了临床中的困扰。文章从六经辨证、中医体质学、免疫学、外感热病治疗学等角度论证了伤寒与温病的统一性:一是从六经辨证认识,伤寒、温病辨证规律的相同之处;二是从中医体质学认识,伤寒、温病的辨治体系均与体质相关;三是从现代医学免疫学的观点认识,伤寒、温病均属于病原体感染后的免疫反应;四是以新型冠状病毒感染重型为例,从免疫学观点认识“寒温统一论”;五是从《黄帝内经》中“各通其脏脉”治疗外感热病解读“寒温统一论”;六是从《黄帝内经》中“疏其血气”治疗外感热病解读“寒温统一论”;七是从扶正法治疗外感热病解读“寒温统一论”。基于外感热病属于感染诱发的免疫应答过程,文中指出温病病邪从口鼻而入,故病原体更早定植于呼吸道咽、气管、肺等部位;而伤寒中于皮毛,其发病与机体非特异性免疫的皮肤黏膜屏障作用相关,但两者免疫过程及转归大致是相同的。治疗上,二者均应早期疏通气机以祛邪;及早运用清热解毒及活血化瘀药物以扭转截断病情的进展;重视扶正,防止急性虚证的产生。最后结合耗散结构理论对其进行了相应的诠释:在引入熵的概念后,伤寒与温病可以从发病机制和治疗学上都得到相应的统一。由此证实两者在发生发展规律、病因病机认识、辨证体系及治疗方法上都可以融合统一。

清热解毒法在恶性肿瘤治疗中的临床应用

现代中医肿瘤学的癌毒病机理论提出,清热解毒法为治疗恶性肿瘤的抗癌解毒八法之一,可在恶性肿瘤治疗中广泛应用。清热解毒法治疗恶性肿瘤的临床应用需基于辨证、辨病、分期、辨体相结合的综合辨治模式。若肿瘤患者热毒证候明显,辨证应用清热解毒法无疑;若热毒不明显或无证可辨,结合现代肿瘤的病理本质特征,在不违背整体遣方用药原则下,可辨病应用清热解毒法以发挥抗癌祛毒之效。清热解毒法本质属于攻法,其辨证或辨病应用均应以患者正气强弱为考量因素,同时还需结合患者的肿瘤分期、体质因素等。辨证应用强调了清热解毒法运用于肿瘤热毒证的普遍性,辨病应用突破了清热解毒法仅用于宏观热毒证的局限性,分期应用体现了清热解毒法阶段性使用的精准性,辨体应用则体现了清热解毒法应用过程中的个体性。辨证、辨病、分期、辨体4种辨治模式当相互参照、综合运用,方可取得显效。治疗肿瘤常用的清热解毒药物有白花蛇舌草、半枝莲、重楼、天葵子、漏芦、山豆根等。

基于卫气营血辨治新型冠状病毒感染

新型冠状病毒感染(COVID-19)属中医“疫病”范畴,以发热、干咳、乏力、肌痛为主要症状,具有很强的传染性和流行性,人群普遍易感。该病的发生发展过程与叶天士《温病条辨》的卫气营血辨证较为契合:新型冠状病毒肺炎轻型、普通型、重型和危重型符合卫气营血四个阶段的发展规律。因此,参照《新型冠状病毒肺炎诊疗方案(试行第八版)》,以温病卫气营血辨证为依据,探讨COVID-19的传变规律,并结合卫气营血辨证,防治疾病的进一步传变,强化中医治未病思想,为临床中COVID-19的防治提供理论依据。

清代瘟疫学家辨治疫病理论与经验探析

清代瘟疫学家结合治疫经验,对疫病病因、传变和辨治理论进行了补充与发展。在病因方面,遵杂气致疫,对杂气属性有更全面的认识。在传变与辨治方面,戴天章提倡表里传变与辨治;一些医家创以中道为中心的传变与辨治理论,如余师愚的毒热入胃布散十二经的理论、李炳的浊邪壅闭肺胃理论、朱增籍的沴邪直干肺胃理论;一些医家重视三焦传变与辨治,如杨栗山的三焦怫热郁滞理论、朱增籍的沴邪郁结三焦理论;此外,刘奎、朱增籍遵六经传变与辨治。清代瘟疫学家辨治疫病理论与经验对当代防治疫病有指导与启发意义。在当今时代,诸家所展现的变通和创新思维在防治新发和突发传染病方面显得尤为重要。

基于“新八纲”辨治慢性肝病

对唐旭东教授“脾胃病辨证新八纲”(简称“新八纲”)在慢性肝病领域的应用进行总结,认为慢性肝病当从“脏腑-气血-虚实-寒热”4个维度次第辨证:脏腑之辨,调肝理脾为主,兼顾他脏他腑;气血之辨,知其有余不足,病位深浅轻重;虚实之辨,正虚血瘀为本,损益邪正偏盛;寒热之辨,肝胆湿热多见,勿忘厥阴肝寒。在此基础上以通降理论为治疗立法,执简驭繁,全阶段指导慢性肝病遣方用药,可取得较好疗效。

基于数据挖掘探究温病古籍大头瘟辨治规律

目的基于数据挖掘技术探究温病古籍大头瘟辨治规律。方法检索温病古籍知识库,以古代温病文献作为数据来源,运用数理统计、因子分析、聚类分析、关联规则分析大头瘟病因、病位、证候、治法、方药。结果纳入大头瘟温病文献191条,涉及古籍31部,包含《温毒病论》《治疫全书》等;大头瘟病因以热邪、毒邪、风邪、温邪、时气为主,病位多见阳明、少阳、太阳、里、心、肺、经络;根据症状可分为气血两燔证、邪留气分、邪热阻络、少阳经证、阳明经证、卫分证候六类,治法以清热、清解、外用、针刺为主;共纳入方剂38首、中药118味,以清热剂、解表剂、开窍剂和外用剂为主,甘草、黄芩、连翘、桔梗、玄参、黄连等出现频次较高。关联规则结果显示,支持度最高的药对为玄参-连翘,僵蚕、板蓝根、桔梗、牛蒡子、玄参、连翘等同时出现的频次较高,与普济消毒饮组成较吻合。结论大头瘟以风热时毒为主因,“疠气”为因需重视;病位在头,邪多留于肺胃;其证候取决于头部发病部位,伴见全身其他症状;治疗多采用内治与外治相结合的方法;用药配伍有清热解毒、疏风散邪之功,具有大头瘟治疗特色;普济消毒饮及其加减方是治疗大头瘟的要药。

吴鞠通从运气学说论治疫病思想探析

清代医家吴鞠通重视运用运气学说论治疫病。吴鞠通认为疫病病邪主要是厉气夹杂秽浊,疫病有温疫、寒疫之分,无论温疫、寒疫的发生均与运气条件有着密切的联系,处方用药更需根据疫病发生的运气学特点配伍化裁。吴鞠通以每年的五运六气条件结合更大时间范围的三元甲子类四时论,对于疫病理论进行了阐发,为丰富当代疫病诊疗理论提供了重要的借鉴。

儿童重症支原体肺炎毒热闭肺证微观辨证特点研究

目的借助纤维支气管镜技术,基于络病理论将儿童重症支原体肺炎(SMPP)毒热闭肺证镜下表现分为肺络痰结证和肺络痰瘀证,并结合现代实验室检测技术和手段,比较两组临床差异。方法收集北京儿童医院中医科住院部行纤维支气管镜检查SMPP患儿206例,根据中西医诊断标准,结合络病理论及纤维支气管镜镜下分为肺络痰结证和肺络痰瘀证。分别记录患儿一般资料、实验室指标,并分别比较两组差异,从中、西医角度探讨两组辨证分型的意义。结果肺络痰瘀证患儿C反应蛋白(CRP)、铁蛋白(SF)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、D-二聚体(D-D)、纤维蛋白原(FIB)较肺络痰结证患儿升高(P<0.05),血小板(PLT)、白蛋白(ALB)较肺络痰结证患儿降低(P<0.05),余差异均无统计学意义(P>0.05)。结论在SMPP毒热闭肺证微观辨证分型中,肺络痰瘀证毒热更甚,伤津耗气,瘀血阻络更为明显,更易传变。在治疗过程中,毒热闭肺证要在常规辨证治疗的基础上,结合支气管镜结果,加强化瘀通络、疏肝泄热、益气扶正等治疗,以期促进临床康复。

谈寒湿疫之寒湿入营

仝小林院士提出新型冠状病毒感染属寒湿疫,其病理因素为寒湿,应从散寒化湿而治。寒湿入营是寒湿疫特殊证型,见于危重阶段,其病因病机及辨治施治均不同于热入营分。从寒湿入营的特点及鉴别角度进一步梳理、更新、完善寒湿疫辨证理论体系,诠释寒湿入营理论的临床意义,以期为寒湿疫危重症防治提供新思路。

基于六维辨证探讨吴鞠通“通下法”在温病急危重症的应用

六维辨证是笔者团队基于中医理论与临床经验总结提出的辨证思路,旨在临床辨证中把握整体,抓住机要,从病期、病位、病势、病因、病性、病理六个维度分辨证态,有助于全面识清病机,指导临床治疗。吴鞠通善用“通下法”治疗温病急危重症,强调适时攻下、逐邪外出、截断病势、顾护阴津,对其相关方证的辨证和治疗仍需梳理清楚。文章结合六维辨证分析吴鞠通“通下法”在温病急危重症的临床应用。从病因病性角度,温热主以承气汤类方泄热攻下,湿热主以宣清导浊、化湿通腑;从病期角度,气营血期均可通下以给邪(邪热、瘀热)出路;从病势角度,辨邪正态势、传变态势、邪气趋势而采用纯攻下、攻补兼施等;同时结合病理、病位而兼证兼治,以期为急危重症的中医临床诊治提供一定的参考。

从温病血分清、散、养之法论治系统性红斑狼疮

系统性红斑狼疮是一种自身免疫性疾病,常累及到身体的多个器官组织,严重影响病人的日常工作和生活质量。在临床中一般采用免疫抑制剂、激素等来进行治疗。近年来,中医药在该病治疗上疗效显著,越来越受到临床医师所关注。根据系统性红斑狼疮临床特点,其属于中医“阴阳毒”“红蝴蝶疮”等范畴。文章以中医古籍及相关文献、临床研究为基础,认为温病血分清、散、养之法在分析系统性红斑狼疮的病机及治疗中具有重要意义,可为该病防治提供参考。

从《伤寒论》少阴篇讨论阳虚阴盛证辨治规律

[目的]讨论《伤寒论》中阳虚阴盛证的病势、层次、治法及用药规律,探究并扩充阳虚阴盛证的辨治规律及临床意义。[方法]结合后世医家的医论,明确阳虚阴盛证的病机及证候;从病理生理学角度,阐释阳虚阴盛证的机制;分析少阴篇中各版本条文的差异,论述病位、邪气性质、胃气、津液的不同,治法、主方、配伍的变化,归纳在少阴篇中隐含的辨治规律。[结果]阳虚阴盛证的辨治原则是“保胃气、存津液”,可将其细分为太阴湿土病、少阴君火病、厥阴风木病。细致的望闻问切,并结合现代医学的病理生理基础能精确辨阳虚阴盛证。少阴为三阴枢机,少阴篇结构完整,能动态反映少阴发病、两阴合病或并病、三阴合病的相互变化过程。由条文可发现,病位由表入里,治法有灸焫、温经、温阳、通阳之别;病情由轻而重、痰饮有无,治法有散寒、散饮、利水之别;津液损伤程度不同,治法有救逆、救阴之别。[结论]从病理生理角度,能阐释中医主症的变化机制。辨治阳虚阴盛证时,应根据病位、邪气性质、胃气、津液择取方药,阳虚阴盛证的辨治规律对于其他证候的辨治同样具有指导意义。

基于“扶阳”理论探讨冠心病合并焦虑抑郁辨治思路

《素问·生气通天论篇》云:“阳气者,若天与日,失其所则折寿而不彰”,维持和恢复阴阳相对平衡是中医诊疗疾病的根本法则。该文以《黄帝内经》“扶阳”理论为切入点,从整体出发进行辨治,认为冠心病合并焦虑抑郁以心阳不振、心神失养为本,浊气归心,脾土失温,酿生痰浊、瘀血为标,龙相火动,阴火妄动为扰。因此,该文试从温阳、通阳、潜阳角度论治此病,通过温阳益心、神清志平以固本,通阳化浊、豁痰除痹以止病进、潜阳纳摄,引火归元以防变等治法治则,使人体阳气发挥正常调气血、温心神、暖脾土、排浊毒、防僭越等生理功能,以使机体达到阴平阳秘的状态。以期进一步为临床诊疗冠心病合并焦虑抑郁提供理论参考,从而提高中医药辨治此类疾病的疗效。