Classification Analysis Based on Literature about TCM Syndrome Types of Depressive Disorder

在遵循循证医学原则的前提下,系统检索近10年来抑郁症中医及中西医结合临床研究类文献。并将检索的文献按照证候研究、方药治疗、辨证论治、综述进行分类,根据各类文献的研究特点采用不同的统计方法,对抑郁症证候分类进行分析研究,以期总结归纳出抑郁症临床常见证候,为抑郁症中医证候规范化、客观化提供参考依据。统计分析结果显示抑郁症临床常见证候依次为:肝气郁结、肝郁脾虚、心脾两虚、痰气郁结、肝郁肾虚、气郁化火。On the premise of following evidence-based medicine,we searched the clinical research literature of traditional Chinese medicine( TCM) and combined traditional Chinese and western medicine on depressive disorder in nearly a decade comprehensively.We classified these literature according to the syndrome types research,clinical therapy,syndrome differentiation and treatment and literature review.On the basis of the characteristics of literature and different statistical methods,we analyzed the syndrome classification of depressive disorder to summarize the common syndrome types of clinical depressive disorder,providing some references for the standardization and objectification of syndromes for depressive disorder.Statistical analysis results show that the depressive disorder common clinical syndromes in the order:stagnation of liver qi,stagnation of liver qi and spleen deficiency,heart-spleen deficiency,phlegm-qi stagnation,liver depression and kidney deficiency,qi depression transforming into fire.福建省自然科学基金项目(2014J01374);; 厦门市科技计划项目(3502Z20133007

Syndrome Index System Screening Based on Expert Questionnaire of Correspondence Between Traditional Chinese Medicine Syndrome and Symptom of Sub-health

目的:筛选亚健康中医证候指标,建立亚健康证-症对应关系。方法:采用专家问卷调查,考核专家权威系数、协调系数,运用均值,等级和,满分比等方法对亚健康脾气虚证、心气虚证、肺气虚证、肝气郁结证、火证和湿证6个中医证候对应的63个症状进行筛选。共有40位专家参与此次问卷调查。结果:问卷回收率为87.5%,34份有效问卷参与统计分析。问卷单个领域和总体的权威系数均≥0.8,问卷单个领域和总体的专家协调系数检验均具有统计学意义(P<0.01),问卷总体的专家协调系数为0.479。经过筛选,最后筛选出6个亚健康证候所对应的43项症状指标。结论:在保证专家群体具有较高权威性、协调性的情况下,运用专家问卷调查法,结合相关数理评价指标对亚健康中医证候指标体系进行筛选是有效的可行的。Objective: To screen the sub-health traditional Chinese medicine( TCM) syndrome indexes,and establish the corresponding relationship between sub-health syndromes-symptoms. Method: Expert questionnaire survey was used to test the authority coefficient and the coordination coefficient of experts,with use of means,sum of ranks,ratio of full marks to screen 63 symptoms included in the 6 TCM syndromes of spleen-Qi deficiency,heart-Qi deficiency,lung-Qi deficiency,liver stagnation,fire syndrome and dampness syndrome. A total of 40 experts were involved in the questionnaire survey. Result: The questionnaire recovery rate was 87. 5%,and 34 valid questionnaires were involved in statistical analysis. The overall and individual questionnaire authority coefficient was 0. 8 or higher,with statistical significance in overall and individual questionnaire coordination coefficient( P < 0. 01). The overall experts coordination coefficient was 0. 479. After screening,finally 43 symptoms in 6 sub-health syndromes were selected. Conclusion: Under the condition of a high degree of authority and coordination for the experts group,it is effective and feasible to screen the sub-health TCM syndrome indexes by using expert questionnaire survey combined with the relevant mathematical evaluation indexes.国家自然科学基金项目(81403324);; 广东省中医药管理局科研课题(20141211

疏肝法对肝郁型多囊卵巢综合征疗效系统性分析

目的:运用Meta分析总结中医疏肝法对肝郁型多囊卵巢综合征(Polycysticovarysyndrome,PCOS)治疗的临床效果。方法:检索中文中国知网、维普、万方以及英文Pubmed、CochraneLibrary等数据库自建刊以来至今相关的文献,用Revman5.3软件进行分析。结果:共检索文献2030篇,最终纳入RCT文献14篇,共计1057例患者,其中治疗组529例、对照组528例。结果:与对照组西药相比,疏肝法治疗组在临床总有效率、排卵率、周期排卵率及妊娠率等方面差异具有统计学意义,且无明显偏倚。结论:运用疏肝法对肝郁型多囊卵巢综合征治疗后临床总有效率以及排卵率、周期排卵率、妊娠率均有显著提高,且效果优于西药对照组,说明运用中医辨证治疗PCOS患者尤其要重视肝郁症,对临床治疗多囊卵巢综合征具有指导意义。国家自然科学基金面上项目(No:81673661

Principles for Formulating Prescriptions Based on Zang-Fu Organs,Origin and Superficiality,Deficiency and Excess,Cold and Heat Syndrome on guiding the clinical use of drugs on treatment of TCM liver diseases

《脏腑标本虚实寒热用药式》是张元素的代表作之一。张氏总结自己数十年的临床经验,阐述了以脏腑寒热虚实而言病机的学说,使得脏腑辨证说逐渐被后世医家所重视。该书中所记录的关于中医肝系疾病的处方用药方法简明扼要,既有对经典的继承也有个人的理论创新。把握五脏六腑生理,了解疾病病理发展,巧妙使用引经报使药物,从而达到提高药物疗效的目的,这一临床诊疗思路至今仍然具有指导作用。Principles for Formulating Prescriptions Based on Zang-Fu Organs,Origin and Superficiality,Deficiency and Excess,Cold and Heat Syndrome is one of ZHANG Yuansu＇s famous masterpieces.With decades of clinical experience,ZHANG Yuansu summarized his own pathogenesis theory corresponding to Zang-Fu organs,cold and heat syndrome,deficiency and excess syndrome.In his efforts,the theory of differentiation based on Zang-Fu organs was appreciated by doctors of later ages.Conciseness of the prescription and the medication rules on treatment of TCM liver diseases recorded in this book was the fruit of the combination of inheritance of the Classic and his own theoretical innovation.The clinical thought of diagnosis and treatment,including grasping physiological function of zang-fu organs,understanding progression of diseases,tactfully using medicines of guiding action and leading to improving the curative effects,is still of great clinical significance up to now.国家自然科学基金项目（No.81274155,No.81503529）; 福建省自然科学基金项目（No.2014J01374）; 厦门市科技计划资助项目（No.3502z20134020）; 福建省高等教育新世纪优秀人才支持计划项

中医病机指导下舌脉为主辨治失眠体会

在快节奏的社会环境下,失眠成为影响日常生活的重要因素。失眠的类型可分为入睡难型、多梦型、寐浅型、易早醒型和混合型5种。文章通过分析当代背景下失眠的病因,探讨心肝火旺、肝郁气滞、痰扰心神、瘀血内停、胃失和降、心脾两虚、心肾失交、肝肾阴虚、肾精不足9种不同常见病机指导下,以舌象脉象为主辨治失眠。最后介绍20味治疗失眠常用药的舌脉特点,为失眠症的治疗提供既简便又操作性强的方法,提高临床疗效。厦门市重大科技计划项目(No.3502Z20100006);;厦门市科技计划高校创新项目(No.3502Z20153027)~

李佩文教授治疗老年肿瘤经验学术思想探讨

中日友好医院李佩文教授从事肿瘤防治近50年,采用中西医结合治疗老年肿瘤,积累了丰富的临床经验。李佩文教授认为:老年肿瘤病机特点为虚实夹杂,虚多实少,久则阴阳两虚;治疗提倡扶正培本为主,抗癌解毒为辅,以提高生存质量,延长生存时间为目标,避免过度治疗;注重患者心理调摄和饮食调养,并创新性采用外治等治疗手段,取得较好的临床效果。厦门市第三批优秀中青年中医后备人才培养项目(No.2012-562);; 厦门市名老中医传承工作室建设项目(No.XMGZS201401

慢性乙型肝炎患者肝组织HBcAg表达模式与中医证型的关系

目的:观察慢性乙型肝炎(CHB)患者肝组织乙型肝炎核心抗原(HBcAg)表达模式与中医证型及肝组织炎症、纤维化等指标的关系并进一步探讨相应的机制。方法:选择CHB患者556例,均进行中医辨证分型及肝组织活检,测定肝组织HBcAg表达模式、炎症、纤维化程度及ALT、AST、HBV DNA水平。结果:(1)556例患者按中医辨证标准分为6组:瘀血阻络证44例、肝肾阴虚证42例、肝郁气滞证48例、肝郁脾虚证282例、湿热蕴结证140例、脾肾阳虚证0例;按HBcAg表达模式分HBcAg阴性组42例、胞浆型HBcAg组186例、胞浆优势型HBcAg组290例、浆核各半型HBcAg组38例。(2)经Spearman秩相关分析,肝组织HBcAg表达模式与肝组织炎症活动度、纤维化程度均呈负相关;经Fisher确切概率检验,肝组织HBcAg表达模式与中医证型分布具有相关性。结论:肝组织HBcAg表达模式与中医证型、肝组织炎症、纤维化程度均有相关性;HBcAg阴性组、胞浆型HBcAg组及肝郁脾虚证、湿热蕴结证多处于慢性乙型肝炎活动期,正气未伤,免疫功能较强,为抗病毒治疗的较佳时机。国家自然科学基金项目(No.81503529,No.81673660);;福建省科技计划引导性项目(No.2015D007,No.2016D012);;厦门市科技惠民项目(No.3502Z20174028);;厦门市重要重大疾病联合攻关项目(No.3502Z20179047);;福建中医药大学基金项目(No.XB2016080)~

从舌辨治月经后期临床体会

月经后期为妇科常见病证,临床常因无明显症状或症状多而杂,给辨证带来一定难度。舌诊作为中医诊病的特色诊法,辨治月经后期具有重要作用。文章通过医案2则,探讨舌诊在诊治月经后期中的临床意义,以期更好地指导临床诊疗。国家自然科学基金项目(No.81673660)~

Study on the Identification and Quality of Angelica Pieces from Different Areas

目的 对不同产地的当归饮片进行鉴别,并对其质量进行比较.方法 分别从甘肃岷县、漳县、渭源以及云南鹤庆等四地的中药材有限公司处收集不同产地当归饮片作为研究标本,对其性状特征、显微特征、理化特征等进行比较.结果 不同产地当归整体近于圆柱状,表面凹凸不平,并有纵向生长的褶皱和横向长皮孔样突起.当归的横断面存在点状分泌腔.味微苦,甘辛.其中甘肃岷县所产的当归表面为黄棕色,颜色相对较深,断面呈黄白色,有明显的点状分泌腔,且香气十分浓郁,油室最多,其木部导管排列散乱无序;韧皮的薄壁细胞呈纺锤形,壁稍厚,表面出现极微细斜向交错的纹理,质量最优.在理化性质的比较上,甘肃岷县、漳县、渭源、云南鹤庆所产的当归的含水量、醇溶出物含量、挥发油的含量也均以甘肃岷县最高,渭源最低.结论 甘肃岷县所产的当归质量最优,掌握其与其他产地当归各项特性上的差异,有利于采购以及后续医疗用途中当归的合理选择.Objective To identify the different habitats of angelica pieces and compare their quality. Methods Traits from Min county, Weiyuan, Zhang county in Gansu, and Heqing in Yunnan and other places of the four Chinese herbal medicine limited collection of angelica sinensis from different habitats were selected as research sample, its characters, microscopic characteristics, physical and chemical characteristics were compared. Results Angelica sinensis from different habitats was nearly cylindrical, uneven surface, and the longitudinal growth of the folds and transverse lenticel like protrusions. There was a punctate secretory cavity in the transverse section of angelica sinensis, camsing bitter. The surface of angelica sinensis produced in Min county, Gansuis yellow brown, the color was relatively deep, white section, had obvious punctate secretory cavity and the aroma was very strong, oil room at most, the arrangement of xylem ducts was disordered. The phloem parenchyma cells were spindle shaped, slightly thicker wall, the texture of the surface was very fine and oblique, and the quality was the best. In comparison of physical and chemical properties of angelica, Min county, Weiyuan Zhang county in Gansu, Heqing in Yunnan produced water and ethanol soluble extracts content, the content of volatile oil in Gansu were highest in Min county, lowest in Weiyuan. Conclusion The quality of angelica sinensis produced in Min county of Gansu province is the best, and it can be used as a reasonable choice for purchasing andsubsequent use of angelica sinensis

女子特殊生理时期的常见舌象探讨

女子在经期、妊娠、产后、哺乳、围绝经期等特殊生理时期,根据不同时期的需求,气血阴阳及脏腑功能随之变化,呈现出来的舌象也与\"淡红舌,薄白苔\"的正常舌象有所不同。文章根据这些特殊生理时期的体质特点,对其常见舌象做一探讨,以期对临床有所裨益。厦门大学大学生创新创业训练计划项目(No.103842017229)~