翟晓翔教授运用肺主皮毛理论治疗皮肤病验案

肺主皮毛"理论是对"肺"与"皮毛"关系的高度概括,两者在组织结构、生理病理方面具有诸多关联,该理论对于临床皮肤病的治疗具有指导意义。清燥润肤饮是翟晓翔教授基于肺主皮毛理论创制的经验方,功在清燥润肺、滋阴养血。翟教授结合多年临证经验,研究皮病的经肺论治,运用此方治疗皮肤科疾病,收效颇佳。     

“肺主皮毛”的科学内涵和临床意义

“肺主皮毛”的科学内涵和临床意义欧阳兵（山东中医学院济南２５００１４）关键词：肺；皮毛“肺主皮毛”是《素问·痿论》“肺主身之皮毛”的简称，它高度概括了肺与皮毛的多种关联，具有丰富的科学内涵和重要的临床指导意义。１肺主皮毛的科学内涵１．１肺皮同源，共同...     

"肺主皮毛"思想在针灸临床实践中的运用初探

通过文献分析并结合临床实践及病案,本文主要论述了"肺主皮"思想的内涵和外延以及在该思想的指导下针灸疗法在"皮病治肺"和"肺病治皮"两大病症中的运用.     

曲生老师治咳十法

曲生老师对咳嗽病有丰富的治疗经验,立论精确,用药 恰当。随师临证三载,有所收益,总结整理出老师治咳之 法,现报道如下。 1解表法 肺合皮毛,肺卫之气不固,而六淫之邪从皮毛或口鼻而 入,伤于肺络,而发生咳嗽。如《素问·咳论》所说:“皮毛 者肺之合也。皮毛先受邪气,邪气以从其合也”。此时以表     

从黏膜免疫防治慢性肾炎经验

慢性肾炎多因呼吸道感染而加重或复发,由于呼吸道、消化道与泌尿道都有黏膜覆盖,根据"肺主皮毛"的中医理论,宣肺祛邪和调节胃肠功能可以稳定泌尿系统黏膜的炎症和免疫活动。慢性肾炎的治疗既要重视治肾,更要重视治肺治胃,在补肾活血的基础上,积极宣肺祛邪及调理胃肠,可减轻肾脏异常的免疫和炎症活动,有效的提高慢性肾炎的防治效果。     

戴恩来教授运用麻杏石甘汤加减治疗痤疮经验

介绍戴恩来教授运用麻杏石甘汤加减治疗痤疮的经验。痤疮的发病与脏腑功能失调有关,戴恩来教授根据"肺主皮毛"理论,从肺论治痤疮,认为痤疮病位在肺、胃,病性多属郁热,治宜透散、化瘀、通腑,临床运用麻杏石甘汤加减治疗,疗效显著。附典型病案以验证。     

略论肺主皮毛的实质

肺主皮毛语出《内经》。不少学者仅从字面上理解肺主皮毛的含义，也有学者是从生物进化、胚胎发生、生理、病理等方面找到了肺与皮肤之间千丝万缕的联系〔１～２〕。然而笔者认为目前对肺主皮毛的认识仍不甚准确，肺主皮毛的实质应是肺的护卫肌表、抗御外邪侵袭功能。以下...     

小议“耳聋治肺”

根据肺与耳在生理病理上的相关性,结合现代医学认识,在"耳聋治肺"理论的基础上,阐释从肺论治耳病的理论依据、基础证型及治疗原则。     

从"肺主皮毛"论间质性肺疾病合并多发性肌炎/皮肌炎

"肺主皮毛"理论源于 《内经》,体现了"整体观念"有诸内必形于外"的思想.间质性肺疾病合并多发性肌炎/皮肌炎体现了肺与皮毛在生理上相互影响,病理上相互传变的特点.临床治疗该疾病在"肺主皮毛"的理论体系之下,分清标本虚实,从整体辨证论治,活血化瘀、益气养阴,可改善患者临床症状及肺功能指标,提高患者的生存质量.     

基于“肺与大肠相表里”理论探讨痤疮与肠道菌群的相关性及其中医治疗

痤疮的病位在皮，肠腑损伤，腑病及肺，肺主皮毛，故肠道菌群失调会参与或加重痤疮的发病。皮生痤疮，内合于肺，肺病及肠，又会引起肠道菌群失调。二者紧密联系，存在相关。本文基于 “肺主皮毛”、“肺与大肠相表里”理论，探讨痤疮与肠道菌群的相关性以及肠道菌群在中医中药干预痤疮治疗中的作用，为痤疮的中医临床治疗提供新的思路。     

从“二证二法”探析中医治疗急性肺血栓栓塞症的辨证思路

急性肺血栓栓塞症,以中医辨证治疗。从中医学对急性肺血栓栓塞症本质进行探讨,从"二证二法"的理论基础及与急性肺血栓栓塞症治疗进行论述,对中医治疗急性肺血栓栓塞症有重要意义。     

Association between Skin Reactions and Efficacy of Summer Acupoint Application Treatment on Chronic Pulmonary Disease: A Prospective Study

Objective: To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment(SAAT) on chronic pulmonary disease(CPD). Methods: A total of 2,038 patients with CPD were enrolled at 3 independent hospitals(defined as Groups A, B and C, respectively) in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen(BL 12) and Feishu(BL 13) on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data(no reaction, itching, stinging, blistering, and infection) were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients’ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results: A large number of patients(85.3%) displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B(99.3%) and Group C(76.5%) displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SAAT was as high as 90.4% for patients of Group B, which was followed by Group A(70.9%) and Group C(42.2%). Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching: odds ratio(OR)=2.17, 95% confidence interval(CI): 1.49 to 3.14; blistering: OR=0.43, 95% CI: 0.25 to 0.73; and no reaction: OR=0.56, 95% CI: 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions: SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.     

浅析“善治者治皮毛”

皮部位居人体最表,通过十二经脉与脏腑相沟通,具有"审内"与"御外"的作用。治皮之理、浅刺之法,其意皆在激发体表皮肤的卫阳之气,进而通过皮部—经络—脏腑这一信息传输通道,达到疏通经络、调节脏腑及平衡阴阳之目的。因此,无论是未病先防,还是既病防变,都可从"皮"论治,使病邪由"皮"而解。时至今日,从"皮"论治已衍生出多种针法,如梅花针、浮针、皮内针等。     

从"久卧伤气"探讨慢性阻塞性肺疾病合并坠积性肺炎发病机制

长期卧床的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者,痰液等分泌物易阻塞于呼吸道,甚则肺部形成瘀血,极易引发坠积性肺炎.中医认为"久卧伤气",气伤则虚、气伤痰阻、气伤血瘀,终致痰瘀互结.COPD患者肺、脾、肾虚,痰瘀交阻,久卧于床则加重三脏之虚,痰瘀益甚而合并坠积性肺炎.故从COPD并发坠积性肺炎的中医病机出发,深入剖析"久卧伤气"与COPD并发坠积性肺炎的关系,以期为临床诊疗提供理论基础.     

肺肠同治理论辨治慢性阻塞性肺疾病临床研究

目的:观察肺肠同治理论用于治疗慢性阻塞性肺疾病的临床疗效。方法:将180例慢性阻塞性肺疾病患者随机分成观察组90例和对照组90例。对照组采用常规西药治疗。观察组在对照组治疗基础上加用中医学肺肠同治理论辨证论治:痰热阻肺证采用宣白承气汤加减治疗,方药组成:厚朴10 g,生石膏20 g,茯苓10 g,陈皮10 g,甘草6 g,莱菔子10g,瓜蒌皮20 g,大黄9 g,清半夏10 g,炙麻黄10 g,苦杏仁15 g,水煎服,每日1剂,分两次服用;肺肾阴虚证采用增液承气汤加减治疗,方药组成:大黄9 g,生地黄20 g,熟地黄10 g,玉竹10 g,天花粉10 g,芒硝10 g,玄参20 g,麦冬15 g,生甘草6 g,百合10 g,水煎服,每日1剂,分两次服用。治疗后比较两组患者Pa O2、Pa CO2、p H值、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/FVC比值及两组患者的临床疗效。结果:治疗后观察组Pa O2(70.2±8.5)mm Hg(1 mm Hg=0.133 k Pa)、Pa CO2(44.3±3.9)mm Hg、p H值(7.36±0.20),两组比较,差异均有统计学意义(P0.05);观察组FVC(2.8±0.5)L、FEV1(1.8±0.4)L、FEV1/FVC(64.3±9.0)%,两组比较,差异均有统计学意义(P0.05);观察组有效率为94.4%,对照组有效率为76.7%,两组比较,差异有统计学意义(P0.05)。结论:采用肺肠同治理论辨证论治慢性阻塞性肺疾病疗效确切,可改善患者的临床症状及预后,不良反应少。     

基于病证症特色探讨针灸处方配穴运用规律

针灸处方思路的形成是基于中医基础理论和针灸学理论,强调整体与局部共治,强调病、证、症的整体把握。该文试从＂病、证、症结合＂和＂经筋病、脏腑病、皮部病、络病辨位治疗＂两个方面,初步探讨临床疾病针灸治疗处方的形成过程和理论依据,以期为临床工作提供一些针灸临证处方的思路。     

Versapulse激光治疗外源性皮肤色素性病变的临床应用

目的：观察Versapulse激光治疗外源性皮肤色素性病变的临床效果,方法：用Versapulse激光的三种不同Q开关激光激光分别治疗不同的外源性皮肤色素性病变。结果;此方法可明显去除或淡化外源色素性病变,无疤痕产生,结论：Versapulse激光对外源性皮肤色素性病变效果好,但个别病例如色素颗粒较大,色素较深,需多次治疗,才能达到效果,本方法明显优于传统的治疗方法,值得推广。     

肾病综合征应用免疫抑制剂治疗并发肺及皮肤隐球菌感染一例报道并文献复习

侵袭性真菌感染常见于免疫功能受损的免疫宿主,确诊困难,病死率高,肾病综合征患者应用免疫抑制剂治疗可导致其成为侵袭性真菌感染的免疫宿主。隐球菌感染是由隐球菌引起的一种全球性的真菌病,发病率呈上升趋势,但肾病综合征隐球菌感染相对少见,特别是经血液播散至皮肤更少见,误诊率高。本文报道1例肾病综合征患者应用免疫抑制剂治疗并发肺及皮肤隐球菌感染的病例,并结合国内外相关文献进行分析。     

Infection with Nocardia species in Queensland. A review of 102 clinical isolates.

OBJECTIVE: To review the species distribution, pathologic significance and disease associations of clinical isolates of Nocardia and related bacteria in Queensland, and to examine the characteristics, treatment and outcome of patients infected with these organisms. DESIGN AND SETTING: A retrospective review of Queensland State Health Laboratory records provided microbiological data for Nocardia isolates referred from other laboratories during the period January 1983 to December 1988. Clinical information was extracted from hospital case notes, or obtained from detailed questionnaires completed by attending physicians. Nocardia isolates were classified as "significant" if specific treatment for nocardiosis was given, or on the basis of autopsy findings. PATIENTS: One hundred and two patients had a Nocardia species or a related organism isolated from clinical specimens during the study period. RESULTS: The 102 isolates included Nocardia asteroides (45), N, brasiliensis (35), N. caviae (5) and N. transvalensis (5). Clinical results were available for 93 patients, of whom 74 (80%) had a significant isolate recovered. Primary pulmonary or disseminated disease occurred in 35 patients, and was caused mainly by N. asteroides. Significant infections of skin and soft tissues, primarily due to N. brasiliensis, were found in 39 patients. Preexisting lung disease and treatment with steroids and immunosuppression were risk factors for pulmonary and disseminated nocardiosis. A history of inoculation in an outdoor setting was frequent in patients with cutaneous disease. Antibiotic regimens that included trimethoprim-sulfamethoxazole or another sulfonamide agent were used to treat the majority of patients with significant infection. Deaths were confined to those with pulmonary and disseminated disease, with a case fatality rate of 40% in that group. CONCLUSION: Infection with Nocardia species appears to be more common than is generally appreciated. The local species distribution and disease spectrum are similar to those described elsewhere. A high index of suspicion for nocardiosis should be maintained in susceptible hosts with pulmonary infiltrates, particularly when there is evidence for metastatic infection, and in patients with superficial infections and a history of outdoor injury.     

TREATMENT OF HYALINEMEMBRANE DISEASE BYHUMAN AMNIOTIC FLUIDSURFACTANT

A case of hyaline membrane disease was treated successfully with pulmonary surfactant (PS) isolated from human amniotic fluid. Dosage was 150 mg phospholipid/kg. The exogenous surfactant was instilled into the airway via a tracheal cannula. Clinical symptoms, PO2 and FiO2 improved evidently 24 hours after administration. L/S ratio and phosphatidylglycerol recovered gradually in aspirates. Lung X-ray film manifested "white lung" before instillation of surfactant and showed a striking improvement 3 days after treatment. The duration of mechanical ventilation was 6 days. During the period of recovery complications of patent ductus arteriosus and bacterial pneumonia developed. However, the patient recovered completely and was discharged 32 days after admission.