Upholding fundamental principles and breaking new ground: ensuring positive efficacy and reaching new consensus

<正>The work of Traditional Chinese Medicine(TCM) should “follow the development laws of TCM, carry forward the essence, uphold fundamental principles and break new ground”. How to correctly understand “upholding fundamental principles” and “breaking new ground” and how their relationship is are the key to the future development of TCM.     

The Effect of Peony and Licorice Decoction on the Voltage-Gated Sodium Channel Subtype 1.4 Based on Standard Decoction

Objective: The objective of this study is to investigate the inhibitory effect of peony and licorice decoction and its compatibility components on the Nav1.4 voltage?gated sodium channels (VGSCs). Materials and Methods: Writhing test was carried out with ICR mice. Paeonia lactiflora and Glycyrrhiza uralensis group were administrated 0.2 ml of solution of freeze?dried powder dissolved in normal saline with the concentration of 2.94 mg/ml, 1.47 mg/ml, and 0.74 mg/ml using intragastric administration, respectively. Peony and licorice decoction groups were administrated 0.2 ml of solution of freeze?dried powder dissolved in normal saline with the concentration of 5.89 mg/ml, 2.94 mg/ml, and 1.47 mg/ml using intragastric administration, respectively. For electrophysiology studies, each freeze?dried powder was dissolved in DMSO to make 10 mg/ml and 50 mg/ml stock solutions. The electrophysiological recordings were obtained under visual control of a microscope. For UPLC analysis, the freeze?dried powder was dissolved in methanol and then determines the contents of the nine marker compounds. Results: The effect of G. uralensis on incubation period and writhing frequency was significantly better than that of peony and licorice decoction group and P. lactiflora group. The inhibition rate of 50 mg/ml water extracts of the three samples was significantly higher than that of the 10 mg/ml group. Moreover, the water extract of G. uralensis at 50 mg/ml had the strongest inhibitory effect on INav1.4 of the three. Conclusion: The possible mechanism of peony and licorice decoction in relieving spasm and pain is most likely by inhibiting Voltage?Gated Sodium Channel Subtype 1.4.     

艾灸温补作用的理论探源

从温补学说的形成;温补乃治虚之本;温补之法,莫过于灸法;温补中阳、脾胃之要;温、通、疏三法的灵活应用等5个方面,对艾灸温补作用的理论进行了论述和探源。希望对今后能更好的研究和探讨艾灸温补理论的临床应用提供帮助。     

骨质疏松症中西医结合诊疗专家共识

骨质疏松症；中西医结合；辨证诊疗；专家共识     

Perspective on the Development of Traditional Chinese Medicine and World Medicine

Following the spirit of Central Committee about the Opinions on Promoting the Inheritance, Innovation, and Development of Traditional Chinese Medicine, Academician Chen Kai-Xian, from Shanghai University of Traditional Chinese Medicine, made a wonderful report on the development of traditional Chinese medicine (TCM) and global medicine. The report deeply elaborated on five aspects: the characteristics and advantages of TCM, the challenges faced by contemporary medicine, the status and role of TCM in the contemporary era, the inheritance and innovation of TCM, and the cooperation and development of “Belt and Road.”     

骨质疏松性骨折中西医结合诊疗专家共识

骨质疏松性骨折;中西医结合诊疗;规范;专家共识     

颈椎病中西医结合诊疗专家共识

国家自然科学基金项目（81930116,81730107,81873321）;国家中医药“传承创新团队”计划项目（ZYYCXTD-C-202202）;上海市重中之重研究中心建设项目（2022ZZ01009）;国家科技部重点领域“创新团队”计划项目（2015RA4002）;国家教育部“创新团队”计划项目（IRT1270）;上海高水平地方高校创新团队计划项目（沪教委人[2022]3号）;上海市促进市级医院临床技能与临床创新三年行动计划重大临床研究项目（SHDC2020CR1010A）;上海市长宁区卫生与计划生育委员会光华卓越PI工程(2016-01,2016-06)     

类风湿关节炎中西医结合诊疗专家共识

类风湿关节炎；中西医结合；辨证诊疗；专家共识     

Mongolian medicine: History, development and existing problems

Mongolian medicine (MM) is an important part of Mongolian culture. Exploration of MM can play a crucial role in the prevention and treatment of various diseases and can help provide better health care globally. In this article, we gave a brief introduction to the origin and development of MM, the theoretical system of MM, the principles of Mongolian materia medica formula, the modern research on Mongolian materia medica and the quality control of Mongolian materia medica. The present situation and outlook of MM were also discussed.     

膝骨关节炎中西医结合诊疗专家共识

膝骨关节炎;中西医结合;辨证诊疗;专家共识     

补散法在深层单疱性角膜炎中的应用

目的：探讨中西医结合治疗深层单疱性角膜炎及预防复发的效果。方法：将68例（69眼）复发性、深层型单疱性角膜炎随机分为中西医结合组36眼和对照组33眼,治疗组除用西药外,还服用中药外,还服用中药,随访14－32个月。结果：治疗组治愈率为83．33％,对照组为57．58％（P＜0．05）;治疗组与对照组复发率分别为3／30,8／19,P＜0．05。结论：补散方能提高复发性、深层型单疱性角膜炎的治愈率,并能防止复发。     

温肾暖胞助孕丸治疗脾肾阳虚型不孕症60例

目的:观察温肾暖胞助孕丸治疗脾肾阳虚型不孕症的临床疗效。方法:将120例脾肾阳虚型不孕症的患者,随机分为对照组和观察组,每组各60例。对照组给予调经促孕丸,观察组给予温肾暖胞助孕丸。观察两组患者的临床疗效,检测两组患者治疗前后激素[黄体生成素(luteinizing hormone,LH)、孕酮(progesterone,P)、促卵泡生成素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E2)、睾酮(testosterone,T)]水平。观察两组患者的排卵率、妊娠率及治疗前后中医症状积分变化情况。结果:两组患者经治疗后FSH较治疗前升高,LH、E2、T水平较治疗前下降,差异具有统计学意义(P0.01)。治疗后观察组LH、T水平明显低于对照组,FSH高于对照组,差异具有统计学意义(P0.05)。两组患者治疗后中医症状积分均明显低于同组治疗前,且观察组低于对照组,差异具有统计学意义(P0.01)。对照组排卵率为33.33%,妊娠率为8.33%,观察组排卵率为63.33%,妊娠率为26.67%,两组患者排卵率及妊娠率比较,差异具有统计学意义(P0.05)。对照组有效率为61.66%,观察组有效率为81.66%,两组患者临床疗效比较,差异具有统计学意义(P0.01)。结论:温肾暖胞助孕丸治疗脾肾阳虚型不孕症患者,能有效改善中医症状,促进排卵,增加妊娠率,临床疗效确切。     

益气温阳汤治疗心率失常38例

目的:观察益气温阳汤治疗心率失常的临床疗效。方法:本院2012年1月1日—2014年6月30日共收治58例心率失常患者,随机分为治疗组和对照组,对照组20例给予美托洛尔治疗,治疗组38例采用益气温阳汤治疗,观察两组患者临床疗效及不良反应情况。结果:治疗组有效率为92.1%,显著高于对照组的有效率80.0%(P0.05);治疗组复发率为8.7%,显著低于对照组复发率36.4%,两组比较具有统计学意义(P0.05);两组患者治疗期间血、尿常规及ALT、CRE、BUN检査无显著变化,出现轻度头晕等症状的患者,继续用药一段时间后,症状自行消失。结论:益气温阳汤治疗心律失常疗效显著。     

中医辨证治疗强直性脊柱炎

强直性脊柱炎(ankylosing spondylitis,AS)的病机为肾虚督亏、寒湿热痹阻、脉络瘀阻,为本虚标实之证。其病因以肾阳虚衰,外邪入侵和病理产物蓄积为主,内因为肾督阳虚,外因为寒、湿、热、风邪,病理产物主要包括痰浊、瘀血,外因中寒邪入侵尤为关键。故笔者临床治疗AS多从肾督辨治,从脾胃辨治,从痰浊、瘀血辨治,强调从肾督、脏腑、脾胃、血瘀等方面论治,临证中把本病分为肾虚督寒证、寒湿阻滞证、瘀血痹阻证、湿瘀互结证四型,根据不同的症状体征标本兼顾,应用固肾通督、温经散寒、祛风健脾除湿、化瘀通络等治疗方法,灵活用药。常用的药物有补虚药、祛风湿药、活血化瘀药、清热药及平肝熄风药。     

针灸与药物治疗枕神经痛70例疗效对照观察

观察针灸与药物治疗枕神经痛的疗效及副作用的差异.方法:治疗组针灸患侧天柱穴和双侧风池穴35例,并与对照组口服卡马西平和强的松片35例治疗1疗程后进行比较.结果:治疗组总有效率88.5%,对照组总有效率85.7%,经统计分析无显著性差异(P＜0.05),但远期疗效及副作用治疗组明显优于对照组.结论:针灸疗法治疗本病优于对照组.     

知柏地黄汤联合舒康凝胶剂治疗肾虚湿热型老年性阴道炎58例

目的:观察知柏地黄汤口服联合舒康凝胶剂阴道塞药治疗肾虚湿热型老年性阴道炎的临床疗效。方法:将116例老年性阴道炎患者随机分为治疗组和对照组,每组各58例。观察两组患者治疗前后中医证候积分和局部症状积分变化情况,比较两组患者的临床疗效和治疗结束后1个月的复发率。结果:治疗组有效率为96.55%,对照组有效率为89.65%,两组患者临床疗效比较,差异具有统计学意义(P0.05)。两组患者治疗后中医证候积分和局部症状积分均低于治疗前,且治疗组低于对照组,差异具有统计学意义(P0.05)。治疗组复发率为10.0%,对照组复发率为16.7%,两组患者复发率比较,差异具有统计学意义(P0.05)。结论:知柏地黄汤口服加舒康凝胶剂外用治疗老年性阴道炎,临床疗效确切,可改善患者的临床症状,降低复发率。     

加味补阳还五汤联合康复训练治疗脑卒中后肩手综合征60例

目的:观察加味补阳还五汤联合康复训练治疗脑卒中后肩手综合征的临床疗效。方法:选取脑卒中后急性期肩手综合征患者120例,按随机数字表法分为治疗组和对照组,每组60例。治疗组给予加味补阳还五汤联合康复训练治疗,对照组给予康复训练治疗。结果:治疗组治疗后上肢Fugl-Meyer评分、NDS评分优于对照组(P0.05);治疗组有效率75.0%,对照组有效率38.3%,治疗组优于对照组(P0.05)。结论:加味补阳还五汤联合康复训练治疗脑卒中后肩手综合征疗效显著。     

健胃化瘀汤治疗反复发作消化性溃疡脾虚血瘀证41例

目的:观察健胃化瘀汤治疗反复发作消化性溃疡脾虚血瘀证的临床疗效及对血清中碱性成纤维细胞生长因子(basic fibroblast growth factor,BFGF)和血管内皮细胞生长因子(vascular endothelial cell growth factor,VEGF)水平的影响。方法:将82例反复发作消化性溃疡患者随机分为治疗组和对照组各41例,对照组采用质子泵抑制剂(PPI)三联疗法,治疗组在对照组治疗的基础上采用健胃化瘀汤治疗,日1剂,常规水煮2次内服,两组疗程均为4周。比较两组患者治疗前后中医症状、胃和十二指肠黏膜损伤评分及临床疗效。检测两组患者血清BFGF和VEGF水平。结果:治疗后,治疗组中医症状评分、胃和十二指肠黏膜损伤评分明显低于对照组(P0.01);治疗组有效率为95.12%,优于对照组的75.61%(P0.05)。治疗组治疗后血清中BFGF和VEGF水平明显高于对照组(P0.01)。结论:健胃化瘀汤治疗反复发作消化性溃疡脾虚血瘀证疗效显著,其作用可能与提高血清中BFGF和VEGF水平有关。     

清热化瘀法治疗多囊肾发热浅析

认为多囊肾在合并感染或出血情况下的高热不退,其病机特点是邪热与瘀血相结合,可采用温病清热化瘀法进行治疗.运用该法的关键是以准确辨证为前提,并根据病程之久暂、血瘀之轻重灵活变化,施治得法,则可收明显疗效.     

中药内服联合外洗治疗掌跖脓疱病26例

目的:观察中药内服联合外洗治疗掌跖脓疱病的临床疗效。方法:将48例掌跖脓疱病患者按照随机数字表法分为对照组22例和治疗组26例。对照组给予以清热解毒利湿为治疗大法的经验方口服,治疗组在对照组的基础上联合除湿止痒方外洗治疗。比较两组患者临床疗效、瘙痒证候疗效及治疗前后皮损积分变化情况。结果:两组患者治疗后4周及治疗后8周,皮损积分均低于本组治疗前,且治疗组皮损积分低于对照组同期治疗后,差异具有统计学意义(P<0.05)。对照组有效率为86.36%,治疗组有效率为96.15%,两组患者有效率比较,差异有统计学意义(P<0.05)。对照组瘙痒证候优良率为45.45%,治疗组优良率为84.61%,两组患者优良率比较,差异具有统计学意义(P<0.05)。治疗组复发率为9.09%,对照组复发率为66.67%,两组患者复发率比较,差异有统计学意义(P<0.05)。结论:中药内服联合外洗治疗掌跖脓疱病,可显著改善患者的临床症状,且复发率低。