中医学“正气”论

正气是中医学的重要概念。其含义为何？古今医家观点不一,见仁见智。本文就正气的概念内涵做一研究。1正气的现代认识《中医大辞典》认为即是真气,也指四季正常气候;五版《中医基础理论》：＂正气,是指人体的机能活动（包括脏腑、经络、气血等功能）和抗病、康复能力,

中医学“邪”与“邪气”概念解析

"邪"是与正相对的概念,可泛指一切致病因素,是一切致病因素的总称。"邪气"有广义、狭义之分,广义的"邪气"指各种病邪,包括外感六淫、精神、饮食及体内阴阳的变化等。狭义的"邪气"是指四时不正之气,如六淫以及疫疠之气等,表明了"邪"与"邪气"是从属关系。

石菖蒲挥发油β-环糊精包合工艺优选及气相色谱-质谱联用分析

目的：用正交设计法优选石菖蒲挥发油β-环糊精包合工艺的最佳条件。方法：用饱和水溶液-超声法。结果：最佳工艺条件是油与β-环糊精之比为1：8（ml／g），其次是乙醇浓度为95％，超声时间20min，超声时水温为30℃-35℃。结论：β-环糊精不同用量是影响石菖蒲挥发油包合效果的主要因素，该工艺方法简单，流程短，适合工业化生产。

《黄帝内经》中“正”字涵义辨析

目的:对《内经》中"正"字的涵义进行辨析。方法:采用文献学研究方法。结果:提出《内经》所论之"正"有不同层次的多种涵义:或指正常;或指正气;或指采用正常的治疗方法;或指旺盛;或指正常生长、生化;或有正当,合适的含义;另外正还通"之"、"定"或"政"。结论:通过对"正"字多种含义的理解,有助于对《内经》概念完整准确地把握。

Study on the compatibility principle of Wutou Decoction based on network pharmacology

Objective To investigate the underlying drug enhancement mechanisms of the Chuanwu(Aconiti Radix)and Huangqi(Astragali Radix)combination and toxicity reduction of Chuan-wu combined with Gancao(Glycyrrhizae Radix et Rhizoma)in Wutou Decoction(乌头汤,WTD),and to elucidate the compatibility principle.Methods The active compounds and potential effective targets of the selected combinations were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and Traditional Chinese Medicines Integrated Database(TCMID).The toxicity of Chuanwu(Aconiti Radix)was investigated by selecting all five toxic compounds from the literature and the TCMSP database,and obtaining their targets through SwissTargetPrediction.Targets related to rheumatoid arthritis(RA)were searched using Dis-GeNET,GenCards,and Online Mendelian Inheritance in Man(OMIM).Mutual targets between the drug pairs and RA were selected as potential RA therapy targets.The medicinally active compound-target network was constructed using Cytoscape 3.9.0.Gene ontology(GO)term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrich-ment were performed using the Database for Annotation,Visualization,and Integrated Dis-covery(DAVID)platform.Results We obtained 191 active compound targets for Gancao(Glycyrrhizae Radix et Rhizoma),171 for Huangqi(Astragali Radix),and 103 for Chuanwu(Radix Aconiti)(hypo-aconitine’s target was obtained through literature and SwissTargetPrediction).A total of 5872 genes were obtained for RA.A drug-active compound-target network involving 13 effect-en-hancing and nine toxicity reduction targets was constructed.PGR was the main effect en-hancement target,and KCNH2 was the main toxicity reduction target.The effect-enhancing targets were related to 23 GO terms(such as positive regulation of transcription from RNA polymerase II promoter,steroid hormone-mediated signaling pathway,plasma membrane,and protein binding)(P<0.01),and 13 KEGG pathways related to synergism[such as estro-gen signaling pathway,cholinergic synapse,and phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway].The toxicity reduction targets were related to 28 GO terms(mainly involes G-protein coupled receptor signaling pathway,plasma membrane,and drug binding)(P<0.01),and five KEGG pathways related to toxicity reduction(cholinergic syn-apse,calcium signaling pathway,regulation of actin cytoskeleton,neuroactive ligand-recept-or interaction,and serotonergic synapse).Conclusion The combination of Chuanwu(Aconiti Radix)and Huangqi(Astragali Radix)plays an important effect-enhancing role in WTD and involves the estrogen and PI3K/Akt sig-naling pathways,with PGR as the core.The Chuanwu(Aconiti Radix)and Gancao(Gly-cyrrhizae Radix et Rhizoma)combination decreases toxicity in WTD and is associated with the cholinergic synapse and calcium signaling pathways,with KCNH2 as the core.

Analysis on the outcomes in randomized controlled trials of perimenopausal syndrome treated with acupuncture and moxibustion

Objective:To search systematically the application situation of the outcomes in the randomized controlled trials(RCTs) of perimenopausal syndrome treated with acupuncture and moxibustion so as to provide the foundation for the core outcome sets in treatment of periomenopausal syndrome with acupuncture and moxibustion.Methods:The articles of RTCs on perimenopausal syndrome treated with acupuncture and moxibustion were searched in China National knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),VIP Chinese Journal Service Platform(VIP),Pubmed,Excerpt medica database(Embase)and Cochrane central register of controlled trials(CENTRAL) databases from January 1,2010 to December31,2020.Two reviewers screened the articles,extracted data and analyzed the application of outcomes in the eligible trials independently.Results:A total of 9391 articles were retrieved initially and 79 articles of them were eligible,including 43 articles in English and 36 articles in Chinese.115 outcomes were involved totally and collected according to 7 outcome domains,of which,the effective rate was the outcome with the highest use frequency.35 articles reported adverse events and 17 articles reported the effect in followup.Conclusion:At present,the outcomes of RCTs on perimenopausal syndrome in treatment with acupuncture and moxibustion are big in divergence,absent in normalization and lack of indicators for long-term prognosis and economics outcomes,as well as have the issues on the incomplete reports on the differentiation between the primary and the secondary outcomes,safety indicators and followup outcomes.It needs to construct the core outcome sets in line with the characteristics of acupuncture-moxibustion discipline so as to improve the quality of clinical trials of acupuncture and moxibustion.

Scraping therapy for treating the perimenopausal syndrome

Objective:To evaluate the clinical effect of scraping therapy in the treatment of perimenopausal syndrome(PMS).Methods:Thirty recruited PMS subjects were treated with scraping therapy in the Outpatient Department,Acupuncture-Moxibustion Hospital,China Academy of Chinese Medical Sciences,at the areas including Shéntíng(神庭GV24)-Běihuì(百会GV20),Qìhǎi(气海CV6)-Guānyuán(关元CV4),Zǐgōng(子宫EXCA1),Zúsānlǐ(足三里ST36)-Xiàjùxū(下巨虚ST39),Dìjī(地机SP8)-Sányīnjiāo(三阴交SP6),Tàichōng(太冲LR3)-Xíngjiān(行间LR2),Gānshū(肝俞BL18)-Dǎnshū(胆俞BL19),Píshū(脾俞BL20)-Wèishū(胃俞BL21),and Sānjiāoshū(三焦俞BL 22)-Shènshū(肾俞BL 23),with an even reinforcing-reducing method.Before and after treatment,the serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E_(2)) were tested.And before treatment and at the 4 th week,8 th week,and 12 th week of treatment,the Kupperman index(KI) and menopause-specific quality of life questionnaire(MENQOL) symptom scores were recorded for evaluating the clinical efficacy.Results:Comparing with before treatment,the modified Kupperman symptom scores were all decreased after treatment,the difference was statistically significant(P<0.05);all symptoms were relieved significantly after treatment,the difference was statistically significant(all P<0.05).There was no significant difference in serum E_(2),FSH,and LH levels after treatment(all P>0.05);the total effective rate was 85.71%after the 4 weeks’ treatment,96.42% after the 8 weeks’ treatment,and 96.42% after the 12 weeks’ treatment.Conclusion:Scraping therapy can relieve the PMS symptoms to some extent.It can improve the life quality of PMS subjects.Its influence on the estrogen levels of PMS subjects was not obvious.

Knee joint pain treated with scraping combined with collateral bloodletting therapy

Objective： To observe the clinical efficacy of knee joint pain treated with scraping combined with collateral bloodletting therapy in comparison with the routine acupuncture techniques.Methods： From March 2017 through to September 2017, 60 outpatients of knee joint pain were collected from the Acupuncture-Moxibustion Department. They were randomly divided into the group A（treated with scraping combined with collateral bloodletting therapy） and the group B（treated with the simple needling therapy of acupuncture）, 30 cases in each one. Once treatment was given every day and10 times consist of one course, two courses of treatment were required. At the end of treatment, the visual analogue scale（VAS） was adopted to evaluate the pain index, tenderness index and the overall effect of the patients in the two groups. Based on the Lysholm knee scale, the scores were compared in the patients of the two groups before and after treatment.Results： The total effective rate was 96.7% in the group A and was 86.7% in the group B, indicating the significant difference（P〈0.05）. VAS value was 3.03 ± 0.62 in the group A and was 3.67 ± 0.74 in the group B after treatment, indicating that difference is statistically significant（P〈0.05）. The Lysholm knee score was 89.2 ± 4.8 in the group A and was 82.4 ± 2.6 in the group B after treatment, indicating that difference is statistically significant（P〈0.05）.Conclusion： The scraping combined with collateral bloodletting therapy is significant in the efficacy on knee joint pain and feasible in the clinical guidance.