张之文“从气治痰”学术思想浅析

气病可生痰饮,痰病亦可阻碍气机,两者互为因果。对外感或内伤所致的夹痰之疾,张之文教授皆主张"从气治痰"。治痰之法,运用补气、化气、宣气、理气、降气、行气等手段,以增强脏腑的运化功能,消痰之本,才是治痰之大法。张老在临床上诊治气虚不足兼痰证,每于化痰之中佐以补气之品,以增强痰液的消散和化解;肾阳不足,水饮内停证在真武汤基础上,加入枳壳、桔梗、陈皮等,配合附片、干姜温肾化气,行水消痰;肺气失宣,水津不布而生痰者,常用药如麻黄、枳壳、枳实、桔梗、杏仁、紫苏子等,主轻浮,不用重浊厚味,是所谓微辛则开,微苦则降,合乎轻清娇脏之治;肝气抑郁、气机不畅者,以柴胡和枳实为君药,随症加青皮、佛手、木香、半夏、陈皮、川芎、白芍、香附、茯苓、炙甘草等;痰涎壅盛、喘嗽短气、气逆痰多之证,在苏子降气汤的基础上加用镇逆之品。     

缺血中风荣气虚滞病机源流

依据历代关于中风病病因病机的文献,对缺血中风荣气虚滞病机理论源流加以探讨,结论如下:①源于内虚邪中说,即认为风邪侵袭人体是中风发病的主要致病因素,同时认识到机体虚弱,脏腑失和,营卫失调,血气不足是中风发病的内在基础;②融合于火、气、痰等内风诸说,即认为中风病发病之初多由痰、瘀、气、火等有形实邪过于壅盛,气血运行不畅,瘀血留滞,停于脑脉,导致脑络闭阻所致;③拓展于阴虚血瘀说,即认为中风的发病是在阴津、精血等真阴不足的基础上,因外邪乘隙而入或七情内伤,酒色过度,忧思恼怒等引起痰瘀阻滞经脉,脑脉闭塞所致;④阴虚血瘀说向荣气虚滞说嬗变,即认为肾阴不足、元气亏虚、风、火、痰、湿、瘀是缺血中风的重要病机。     

消法在小儿内伤咳嗽治疗中的运用

治疗内伤咳嗽要辨清热痰、湿痰、气虚、阴虚等,治疗时则要强调"消法"的运用。此法适用于痰、瘀积聚所致的顽固性内伤咳嗽,具体可分为"祛痰""化瘀""消积"三类。采用渐消缓散的方法,达到祛除痰、瘀以治病的目的。     

《先醒斋医学广笔记》内伤三证治疗特色浅探

通过对缪希雍《先醒斋医学广笔记》中脾胃、中风、消渴三证的证治特色进行总结,得出缪希雍治中风详辨真中、类中,重视痰热生风之病机,治以清热养阴、行气化痰;治脾胃强调脾胃分治,重视补养脾阴,并佐以健脾除湿、制肝清热、温肾暖土等法;治消渴则以滋阴润燥、清热养阴为主,重视药物用量、剂型与煎煮方法。缪希雍治疗内伤病用药甘柔清灵、重视脾胃,在明末医界中独树一帜,开创了新局面。     

胃溃疡证候要素分布组合规律文献研究

目的探讨胃溃疡证候要素分布、组合规律。方法检索中国知网数据库1982年1月至2013年12月关于中医药治疗胃溃疡证候分型的相关文献,建立胃溃疡证候文献研究数据库,对其病性、病位证候要素的分布及组合规律进行统计和分析。结果经检索并筛查共纳入325篇文献,共提取病位要素4个,分别为胃、脾、肝、胆;病性证候要素10个,分别为气滞、血瘀、热(火)、气虚、阳虚、阴虚、湿、寒、痰、食积;共挖掘出4对正相关关系的证素对,支持度从高到低依次为气滞-血瘀、湿-热(火)、气虚-气滞、气虚-血瘀。结论胃溃疡的病位证候要素按构成比从高到低依次为胃>脾>肝>胆;病性证候要素按构成比从高到低依次为气滞>血瘀>热(火)>气虚>阳虚>阴虚>湿>寒>痰>食积;证素组合规律中出现频次>50次者,由高到低为脾+胃+阳虚>肝+胃+气滞>气滞+血瘀>脾+胃+气虚>胃+阴虚。     

宋桂华以保和丸为主治疗小儿反复呼吸道感染

宋桂华主任根据多年儿科临证经验认为,小儿反复呼吸道感染常见"正虚犹存,邪实凸显",以食积为先,食滞痰蕴致反复呼吸道感染更为多见,故临床采用保和丸加减治疗,辅以益气健脾,标本同治,虚实兼顾。宋师运用炒麦芽、山楂、炒莱菔子三大消食药使食积得消,陈皮、姜半夏、茯苓使痰湿得化,佐以连翘使痰食积滞之热得清,再加黄芪、防风、白术,煅龙骨、煅牡蛎使卫表得固,最终脾胃功能恢复运转,肺气得以宣降,大肠传导功能正常,机体重新恢复稳态,气血充盈,从而抵御外邪能力增强而不得病。     

史纪教授诊治小儿肾系疾病合并感冒经验

肾系内伤基础上的小儿感冒,往往发病或急或缓,病程可明显延长,临床症状缠绵难愈,这与肾脏疾病基础的患儿往往表现为肺、脾、肾三脏功能失调及气、血、精、阴、阳的亏损有关,一但感受外邪,往往形成虚实夹杂之证,外感病与肾系疾病的临床特征可同时出现,也可先后而至,且轻重有别,外感病邪会对肾系疾病产生影响,加重原有的肾脏损伤,同时病邪也易传变入里,导致外邪难以清除,故肾系内伤疾病基础上的感冒,临床症状呈现为非典型性、复杂性和多样性的特点。中医药治疗应注意先后有序、内外兼顾,三焦辨证、补通兼施,注重扶正,邪不可干。标本兼治或急则治标,继而调理内伤,从根本祛除诱发外感的内伤基础,减缓病情。     

冯世纶教授运用柴胡加龙骨牡蛎汤经验

柴胡加龙骨牡蛎汤系临床常用经方,一般认为该方具有和解少阳、通利三焦、镇静安神的功效,可用于外感病,少阳枢机不利兼见烦惊者,内伤病、肝胆郁热、痰火扰心者。基于《伤謇论》六经来自八纲的学说,冯世纶教授认为柴胡加龙骨牡蛎汤主治三阳太阴合病兼水饮内停证,适用于存在精神神经症状病证的治疗。临证时只要严格遵循先辨六经、继辨方证的原则和程序,即可准确用之。运用之时,不必拘泥于仲景原方,针对具体患者、病情,应随其兼夹的方证、药证的有无,灵活地联用经方、加减药味,才能真正做到方证、药证皆相应。     

湿邪与小儿哮喘的相关性

小儿哮喘内因责之于"伏痰",与肺、脾、肾三脏功能不足有关;外因则与六淫之邪、饮食调护、环境因素、情志因素等有关。湿邪与小儿哮喘具有重要的相关性,主要包括:脾虚生湿酿痰,上贮于肺,留为伏痰;肺脏气机失调,湿由内生,哮喘迁延;肾虚水湿上泛,聚而为痰,动则为喘;湿邪侵袭肺卫,触动伏痰,发为哮喘。无论内伤或外感,湿邪在小儿哮喘的发生发展中起到了不可忽视的作用,故在本病的治疗中应注意祛湿方药的使用。     

马云枝治疗内伤头痛经验

头痛的主要病变脏腑在肝,瘀血为顽固性头痛的主要致病因素。基于偏头痛的病因病机,马云枝教授将内伤头痛分为肝阳头痛、血虚头痛、气虚头痛、痰浊头痛、肾虚头痛、瘀血头痛6型进行论治。内伤头痛多属虚证或虚实夹杂证,虚证以补养气血或益肾填精为主,实证当平肝、化痰、行瘀,虚实夹杂者,酌情兼顾并治。马教授临证顺应异法方宜,注重祛风,审因论治,重视活血化瘀,善用引经药,重视虫类药,妙用对药,注重疏解情志,疗效显著。     

浅析高速公路工程招投标中的最低评标价法

结合目前高速公路施工项目招投标活动的实际情况,阐述了最低评标价法的概念,归纳了其优点及存在问题,对完善最低评标价法提出几点策略,以期促进招标投标市场更加规范有序。     

Place-Making in Megaprojects in Melbourne

This article analyses state-led place-making practices in Melbourne. The two levels of government that influence planning in Melbourne make much of the city as ‘culturally vibrant’ and ‘creative’, and have incorporated creative city-inspired place-making principles into many layers of the planning system. An examination of the development of two mixed-use megaprojects in central Melbourne reveals however that ideals of culturally engaging public places, and indeed of creative landscapes for middle-class consumption, wither in the face of more basic imperatives for economic development. In these case studies the ‘creative city’, no matter how the idea is interpreted, has little traction either as a set of inclusive place-making principles or as a gentrification strategy. The article concludes that the creative city-inspired place-making objectives in the planning system at both state and local levels are ambiguous in their overall intents and completely unsupported by statutory controls. Such place-making objectives as are realised are the compromised results of the interplay of uncoordinated decisions, delivered at the pleasure of the developer.     

Pathogens in septage in Vietnam

Septage is widely acknowledged as a major source of infectious pathogens while disposal of septage, and the operation and maintenance of septic tanks, is not regulated in many developing countries. Twenty untreated septage and septage sludge samples were taken from Can Tho City, Vietnam to examine their pathogen content, and indicator micro-organisms. Escherichia coli and Enterococcus spp. were detected in all samples, regardless of sludge storage time. Phages were detected in 80% of samples. Salmonella spp. were detected in 70% of the untreated septage and 60% of septage sludge samples. Concentrations of phages and bacteria tested in septage sludge after many years of tank storage were much higher than the expected levels. Helminth ova were present in 95% of untreated septage samples with an average of 450 ova l^− 1, and were detected in all septage sludge samples with an average of 16,000 ova l^− 1. Twelve varieties of helminth ova were identified. More helminth ova varieties in higher concentrations were found in septage than those reported from stool samples. The varieties' frequency ranged from 10% to 50% and Ascaris lumbricoides predominated. Results show that pathogens and indicator micro-organisms, especially helminth ova, accumulate in sludge. Thus helminth ova should be considered when septage sludge is treated and used for agriculture. Proper health protection measures must be applied for people handling septage.     

在市场中实践在实践中学习在学习中进步--工程公司市场化进程的回顾与展望

近两年来，工程公司在提高市场竞争意识、推动市场化进程中做了大量工作，其中坚持走出去的方针是我们自我加压、推行加快市场化步伐的一个重要战略步骤。     

新时期广东城市化的新特点

新时期广东城市化出现以下特点:知识源导向、城市由单体向群体化发展、产业集群推动、政府主导自上而下的集约化发展、城镇化向城市化转变、由重“数量”发展向重“质量”发展的转变。     

新形势下高校强化基建财务管理的探讨

在市场条件下高校基建财务人员在加强日常财务管理的同时,必须树立起高度的工作责任心,抓好事前监督、事中监督、事后监督三个环节,全面理解、贯彻执行《高等学校财务制度》,管好用好各项基本建设资金,提高基建财务管理水平,更好地完成高校各项基建任务,以有限的投资,最快的建设速度,获得最大的投资效益。     

2005年北京办公物业市场七大趋势

趋势一:CBD区域写字楼集中放量从各区域规划方案上看,CBD区域多数项目在03～04年处于项目的报批手续及拆阶段,预计2005年正式推向市场,因此2005年CBD区域将成为北京市场供应集中的域,区域即将供应的项目有北京财富中心(二期)、金地国际花园、万达广场、SOHO尚都、万通中心、世纪财富中心、怡禾国际中心、光华国际等。除去未知项目,2005CBD写字楼办公面积的供应量为60万平方米左右。中关村区域经过一段时间的集中供后开始逐步放缓,2005年供应的体量相对较大的项目有中关村金融中心、新中关。金街区域可能开盘的项目只有2个:英蓝国际中…     

浅谈我国工程项目建设成本控制存在的问题

结合目前我国施工企业工程项目成本管理现状,对工程项目成本管理过程中存在的问题进行了较详细的分析,并提出了一些解决问题的办法,以做好项目成本控制工作,进而增强企业经济实力。     

Variation in property taxation in Tulsa

Conclusions It may be reasonably concluded from this study that the range of variation in these ratios of assessed to actual value are of a reasonable size for the great majority of cases. The frequency distribution of these sample ratios was not normal, however, as was assumed a process of this type would produce. On the other hand, the failure of the regression analysis to identify any significant variables which would explain these variations would tend to re-enforce the assumption that the fluctuations were indeed of a random nature.To sum it up in one paragraph, aside from a few extreme cases, the assessing process appears to give estimates which are more consistent than would be expected under the assumption that any errors would be of a random nature, but the regression analysis was unable to isolate any particular socioeconomic characteristics which would explain the variation which was present.Financial support for this research project was furnished by the University of Tulsa.