弦虚弦弱脉刍议

对弦虚脉、弦弱脉作为相兼脉的属性，从文献研究、弦脉的脉图、弦脉的特征进行论证。认为：弦脉的脉象与虚脉或弱脉在脉势上是完全相反的脉，凡属性质完全相反的脉不能相兼出现。     

慢性肾功能不全患者脉象客观化研究

目的探讨慢性肾功能不全患者5种证型(脾肾气虚、脾肾阳虚、肝肾阴虚、气阴两虚、阴阳两虚型)脉图参数的变化,建立各证型判别模式,辅助临床诊断。方法采用上海道生公司生产的DS01-C型脉象仪分别对健康对照组与慢性肾功能不全患者组进行检测分析。结果健康对照组脉象以平脉为主,慢性肾功能不全患者以弦脉及其兼脉为主。随着病情发展,脉象也相应发生变化,脾肾气虚,脾肾阳虚以弦脉为主,肝肾阴虚与气阴两虚患者比较,两组以弦脉兼数脉多见外,肝肾阴虚还兼沉脉。阴阳两虚患者脉象以脉缓弦或弦兼数。结论慢性肾功能不全患者脉象改变以弦脉及相兼脉为主,各证型脉象变化复杂。     

慢性肾衰的中医辨证分型与治疗

1　病变初期病变初期 ,正虚为多 ,邪浊不很严重[1] 。孔薇等[2 ]对 4 44例患者常见症状进行观察统计 ,正虚症状中 ,神疲乏力、腰膝酸痛、纳食欠佳、面色少华、头晕目眩出现率最高 ,并认为该 5项症状主要反映了脾肾气虚的本质现象 ,而脾肾气虚通常是其他证的基本证或合并证。故此期治疗当以治本为主。1 1　脾肾气阳虚 　主证 :先有全身疲乏 ,气短懒言 ,容易感冒 ,纳呆腹胀 ,腰酸膝软 ,大便溏薄 ,小便清长 ,继则畏寒肢冷 ,面色白或晦滞 ,口淡不渴 ,舌淡体胖 ,有齿印 ,苔白或白腻 ,脉沉弱或沉弦。治法 :补气健脾温肾。方药 :周迎晨[3] 等以…     

消化性溃疡的辨证论治

１脾胃虚寒型 虚寒胃痛在溃疡病分型中占绝大多数。临床又有偏虚偏寒之别。偏于脾胃虚弱者除胃脘隐痛外，尚有体质虚弱、乏力、纳少、便溏４大证，体征多见舌淡苦薄白，脉弱。治当益气健脾，方选益气健脾的祖方四君子汤加味。方中重用党参，常用量为１５～３０ｇ，用量过少，往往导致虚滞，即痞满，乃因药力不足，斡旋无力所致。偏于脾胃虚寒者，胃脘痛者，遇寒加重，喜热饮食，有畏寒现象，大便多源或便软而不成形。舌淡嫩苔薄白而滑，脉多见迟弱。治疗当温中健脾，方选附子理中汤合良附丸。附子用量可根据病情而定，一般用量为１５ｇ，多…     

眩晕证治初析

眩晕临床上各科都较常见。本病的发生,以风、火、痰、虚四者为主因,多属本虚标实之证。笔者根据文献记载及临床所见,对本症的治疗归纳为八个证型,现分述于下,希同道指正。１眩晕的证治１１肝火上炎型:证见眩晕头痛,面赤目红,口苦咽干,烦躁易怒,舌红苔黄,脉象弦数或弦滑有?..     

肾气丸证治规律探讨

通过对古代医家临床应用肾气丸医案的分析 ,认为医家通过辨证论治合理地扩大了本方的主治范围 ;其使用的舌苔脉象为舌淡白 ,质胖 ,苔薄白 ,脉沉弱无力 ;桂枝易为肉桂或生地黄易为熟地黄 ,并且加重附子和桂枝的用量增强了本方温补之效 ,使肾气丸由温补肾气之剂衍变为温补肾阳之方 ;其加减变化包括药量、药味与剂型三个方面     

中晚期宫颈癌维吾尔族患者舌脉像初探

目的：观察新疆喀什地区中晚期宫颈癌维吾尔族患者舌脉像及证型。方法对50例中晚期宫颈癌患者运用中医数字化四诊仪进行舌脉像象及问诊数据的采集录入,并通过计算机分析辨证得到每位患者证型及体质结论。结果50例患者中舌质以暗红为最多,所占比例70%;舌苔见厚苔、腻苔或两者兼而有之者占70%,其中厚腻苔占56%;脉象见弦脉者占74%（37例）,见数脉者占38%（19例）,见虚脉者占28%;患者症状频数构成比超过50%的有7项,分别是腰痛、善怒、善忧思、易疲劳、干性皮肤、腰酸、善太息;患者证型中主证或兼证见气虚者占92%,其中主证为气虚者占76%。结论中晚期子宫颈癌维吾尔族患者亦以气虚为主要矛盾,同时可能存在痰湿内蕴、肝郁气滞等虚实错杂之病机。     

关于脾胃虚证病人虚脉脉象的研究

为了发掘祖国医学丰富的脉学理论,近年来国内已研制出多种类型的电子脉象仪,从而有了取得各种脉象客观依据的手段。自59年以来国内发表的脉象研究已有五十多篇报导,但由于使用传感器的材料不同,目前研制的脉象信还不统一,大多是对常见的弦、滑脉的脉图特征的研究,对虚脉的研究尚未见报导,而虚脉在中医临床中十分常见,对确定病证的性质和立法用药至关重要,为此,我们从脾胃虚证的脉象入手,企图寻找虚脉的脉象特征,为今后研究其它虚脉打下基础。     

咳嗽脉诊心得

咳嗽分为五脏之咳及六腑之咳,咳状各异。肺主气司呼吸,朝百脉,调节全身气血周行。寸口为手太阴肺经原穴太渊所在、手太阴经脉搏动之处,故为脉之大会,可以反映全身脏腑气血的情况,所以独取寸口亦能掌握疾病病机。若为土不生金之咳,脉象为右关脉弱或濡弱,右寸脉浮大或弦大甚或上溢鱼际,脾气不升,肺气不降;若为木火刑金之火咳,临床上会切到患者左关脉弦直硬具有不柔和之象,左寸脉浮甚或上溢鱼际,右寸脉虚浮无敛象;若为肺胃不降之咳,脉象除了右寸浮弦,右关可切到弦滑实邪之象;若为金不生水之咳,脉象表现左尺沉弱无力,右寸脉浮滑,右关软无力或兼见濡脉;若为阴虚燥热之咳,脉象多表现为右寸脉浮数或大或细,右关脉濡细;若为风邪犯肺之咳,脉象多为浮脉,脉紧为寒,脉数为热。     

从月经周期的脉象变化探讨月经生理的气血变化

近年来,笔者结合中医理论,通过多年临床观察,将育龄女性月经周期的生理机制概括为“气血转化”,并将其运用于月经病的辨证施治,取得满意疗效。现就月经周期脉象的变化规律与月经生理气血转化机制及其关系作一论述。1育龄女性脉象随月经周期发生规律性变化育龄女性脉象随月经周期发生规律性变化,已为临床研究所证实[1]。这种变化规律主要表现是:月经周期第1、2周的主要脉象为弦脉或弦滑脉,第1周以弦脉为主,第2周以弦滑脉为主,其中以左弦右滑脉最为多见;第3、4周脉象主要为滑脉;月经期的脉象随着时间后移由滑脉转为弦脉、弦滑脉。按照各脉象分…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.