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《广州医药》编辑部

广州医药杂志服务号
专家共识

老年性肩周炎中医全周期康复广东专家共识(2026年版)

Guangdong Expert Consensus on Traditional Chinese Medicine(TCM)Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)

:402-412
 
    因气候与生活习惯影响,广东地区老年性肩周炎临床特点及康复需求具有独特性,亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案,广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起,省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识(2026年版)》。该共识以ICF框架为基础,立足肩周炎康复循证医学证据,结合多学科专家产教研实践经验,对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布,将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。
   Due to climatic and lifestyle influences,the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features,necessitating the development of standardized and locally tailored rehabilitation protocols.To formulate regionally differentiated rehabilitation plans,the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)” through collaboration with multiple provincial institutions and experts.Based on the International Classification of Functioning,Disability and Health(ICF)framework and evidence-based rehabilitation medicine for periarthritis of the shoulder,this consensus integrates multidisciplinary expertise from industry,academia,and research to establish unified guidelines on ICF assessment,application of appropriate TCM techniques and rehabilitation therapies,implementation of stepwise intervention measures,and integrated TCM-Western medicine full-cycle rehabilitation approaches.The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder.
综述

中医药调控 CD4+ T 细胞亚群防治动脉粥样硬化的研究进展

Research progress on the regulation of CD4+ T cell subsets by traditional Chinese medicine for the prevention and treatment of atherosclerosis

:24-29
 
       动脉粥样硬化(AS)是一种起始于炎症介导的内皮损伤的慢性血管疾病,其本质是免疫炎症驱动的病理过程,是众多心血管疾病的病理基础。CD4+  T细胞亚群[包括辅助性T细胞1型(T helper 1 cell,Th1)、Th2、Th17、调节性T细胞等]通过分泌特异性细胞因子参与AS的炎症反应,其中促炎性CD4+  T细胞与抗炎性CD4+  T细胞的抗炎功能失衡是推动斑块进展的关键环节,在AS斑块形成与发展中起关键作用。近年来,多项研究表明某些中药单体、经典复方及其有效成分,具有多靶点、多层次机制调控CD4+  T细胞分化及功能,这些作用共同减轻血管内皮炎症反应、抑制巨噬细胞泡沫化及平滑肌细胞迁移等,延缓AS斑块形成与发展,为AS防治提供了新思路,展现了中医药在该领域的研究展现出独特优势与广阔前景,本文综述了中医药通过干预CD4+  T细胞亚群平衡防治AS的最新研究进展,及其影响相关细胞因子网络及关键信号通路的作用机制,为开发具有多靶点协同优势的创新中药与中西医结合治疗方案提供了关键理论依据与实践方向。
       Atherosclerosis(AS)is a chronic vascular disease that originates from inflammation mediated endothelial 
damage.Its essence is a pathological process driven by immune inflammation,and it is the pathological basis of many cardiovascular diseases.CD4+  T cell subsets(including Th1,Th2,Th17,Treg,etc.)participate in the inflammatory response of AS by secreting specific cytokines.The imbalance of anti-inflammatory function between pro-inflammatory CD4+  T cells and anti-inflammatory CD4+T cells is a key link in promoting plaque progression and playing a crucial role in the formation and development of AS plaques.In recent years,a number of studies have shown that the monomers,classic prescriptions and their effective ingredients of Chinese herbs have the effect of multi-target,multi-level mechanism to regulate the differentiation and function of CD4+  T cells.These effects together reduce the inflammatory reaction of vascular endothelium,inhibit the foam formation of macrophages and smooth muscle cell migration,delay the formation and development of AS plaque,provide new ideas for the prevention and treatment of AS,and make the research of Chinese medicine show unique advantages and broad prospects in this field.This article  reviews the latest  research progress of Chinese medicine in the prevention and treatment of AS by intervening in the balance of CD4+  T cell subsets,as well as the mechanism of its effects on related cytokine networks and key signal pathways.This provides a key theoretical basis and practical direction for the development of innovative traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment plans with multi-target synergistic advantages.
论著

中医药治疗儿童哮喘随机对照试验结局指标现状

Current status of outcome indicators of randomized controlled trials of traditional Chinese medicine for the treatment of childhood asthma

:1531-1541
 
       目的   剖析中医药治疗儿童哮喘的随机对照试验(RCT)结局指标,为中医药治疗该病临床试验的核心指标集构建提供初步依据。方法   检索中国知网(CNKI)、万方(WanFang)、维普网(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane Library、EmBase、Web of Science。时间跨度为建库至2024年7月1日。此次检索全面覆盖了中医药疗法治疗儿童哮喘的临床随机对照研究,由两名研究者根据纳排标准独立完成文献筛选和资料提取,提取文献基本特征和结局指标。结果   初步检索出2 449篇文献,最终纳入165个RCT,包括205个结局指标,分为症状/体征、中医症状/证候、理化检查、生活质量评价、远期预后、安全性指标六域。结论   中医药治疗儿童哮喘尚存在中医证候诊断和疗效标准不完善、主要和次要结局指标界限不清等问题,应当构建统一规范且广为认可的核心指标集,以促进儿童哮喘核心指标集的完善。
        Objective  To analyze the outcome indicators of randomised controlled trials(RCTs)of traditional Chinese medicine(TCM)for the treatment of childhood asthma,and to provide a preliminary basis for the construction of a core set of indicators for clinical trials of TCM for the treatment of this disease.Methods  A database search was conducted on China Knowledge Network(CNKI),WanFang,VIP,SinoMed,PubMed,Cochrane Library,EmBase,and Web of Science,covering the period from the establishment of the database to 1 July 2024.The search comprehensively covered clinical randomised controlled studies of TCM therapies in the treatment of childhood asthma,and was completed independently by two investigators who screened the literature and extracted information according to the criteria,and extracted the basic characteristics of the literature and outcome indicators.Results  Initially,2 449 literatures were retrieved,and 165 RCTs were finally included,including 205 outcome indicators,which were classified into six domains:symptoms/signs,TCM symptoms/evidence,physical and chemical examination,quality of life evaluation,long-term prognosis,and safety indicators.Conclusions  Currently,there are problems such as imperfect diagnostic and efficacy criteria for TCM evidence,and unclear boundaries between primary and secondary outcome indicators in the treatment of childhood asthma with TCM.A unified,standardised and widely recognised core indicator set should be constructed to promote the improvement of the core indicator set for childhood asthma.
医学教育

混合教学模式在中医诊断学中的教学现状与实践探索

Teaching status and exploration practice of blended teaching mode in diagnostics of traditional Chinese medicine

:1462-1466
 
中医诊断学是一门中医学专业的主干课程, 也是连接基础理论与临床实践的桥梁课程,其知识点繁杂、实践性强导致学生感觉枯燥无味, 教师教学质量欠佳。随着“互联网+教育”的高速发展, 混合式教学作为一种创新型教学模式,有诸多优势, 但也存在一些不足。文章从多元化教学方法、思政教育、多元化评价三个方面出发, 研究创新混合教学模式措施, 以期提升教学效果,提高学生的中医思维能力和临床水平, 培养学生的医德医风,实现知识传授与价值引领, 为社会输送德才兼备的中医药人才。文章研究了中医诊断学课程混合教学模式的教学现状和实践探索, 以进一步提高教学质量, 可为各大中医院校混合教学模式的开展提供借鉴。
Traditional Chinese medicine(TCM)diagnostics is a main course of TCM specialty, and it is also a bridge course connecting basic theory and clinical practice.Its complex knowledge and strong practicability lead to students feeling bored and poor teaching quality.With the rapid development of “Internet + Education”, blended teaching, as an innovative teaching mode,has many advantages, but it also has some shortcomings.This paper starts from three aspects of diversified teaching methods, civic education and diversified evaluation to study the measures of innovative mixed teaching mode, with a view to enhancing the teaching effect, improving the students’ thinking ability and clinical level of Chinese medicine, cultivating the students’ medical ethics and medical style,realizing the knowledge pass on and value leadership, and delivering both moral and talented talents in traditional Chinese medicine for the society.This paper studies the teaching status and practical exploration of the mixed teaching mode of TCM diagnostics curriculum in order to further improve the teaching quality and provide reference for the development of the mixed teaching mode in major TCM colleges.
综述

中医理论体系下西药的运用——西药中药化的方法探究

The application of western medicine under the theoretical system of traditional Chinese medicine:The method of expounding western drugs by TCM views

:99-105
 
随着中西医结合的不断深入,医学工作者在临床工作中发现,西药因囿于西医体系,很难在中医药理论体系指导下的临床诊疗上发挥作用,极有必要走西药中药化之路,以弥补这一方面的不足。本文以阿司匹林为主要范例,从推测西药的中药性质入手,总结归纳几种研究方法及注意事项,并大致总结目前研究西药中药化上的诸多不足,同时收集汇总目前相关文献中提到的西药的中药性质,以抛砖引玉,供后续研究者参考。
With the continuous deepening of Chinese medicalization of western medicine,it is not difficult to find that western medicine is limited to the western medicine system,which is hard to play a role in clinical diagnosis and treatment under the guidance of traditional Chinese medicine(TCM)system.It is extremely necessary to take the road of TCM of western medicines to make up for the deficiencies.In this paper,we take aspirin as the main example,start from the speculation of the nature of western medicines,summarize several research methods and notes,and generally summarize the many shortcomings of the current research on the Chinese medicalization of western medicines,and at the same time,collect and summarize the TLM nature of western medicines mentioned in the relevant literature,to provide a reference for the subsequent researchers.
中西医结合/中医研究

老年人工股骨头置换术后隐性失血的中医病机探讨

Discussion on traditional Chinese medicine pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly

:423-426
 
老年人工股骨头置换术后隐性失血是影响手术的重要因素之一,手术后机体生理、病理的变化是一个较为复杂的过程。目前中医对其病因病机尚无系统研究。临床中常存在辨证思维局限,难以客观、全面揭示该病病因病机的特点,进而导致遣方用药难以把握。该文旨在对老年人工股骨头置换术后隐性失血的病因病机进行探讨,认为该病的证候特点为气血亏虚兼瘀,病性为本虚标实,病位肝脾肾,其中气血亏虚贯穿疾病始终,而气为关键。
Hidden blood loss after artificial femoral head replacement in the elderly is one of the important factors affecting the operation,and the change of physiology and pathology after operation is a complicated process.At present,there is no systematic study on its etiology and pathogenesis in traditional Chinese medicine.In clinical practice,there are limitations of dialectical thinking,which make it difficult to Objective ly and comprehensively reveal the characteristics of the etiology and pathogenesis of the disease,and difficult to prescribe.The purpose of this paper is to explore the etiology and pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly.It is considered that the syndrome of the disease is characterized by deficiency of qi and blood and blood stasis,and the disease is based on deficiency of liver,spleen and kidney,in which deficiency of qi and blood runs through the disease all the time,and qi is the key.
中医研究

中药配伍禁忌十八反临床应用启示

Enlightenment on the clinical application of Eighteen Antagonisms contraindications to the compatibility of Traditional Chinese Medicine

:1117-1121
 
前人总结的用药禁忌十八反未必是绝对禁忌,笔者从广东省名中医陈国成主任独创星夏止痛膏外治中得到反药“乌头-半夏”的配伍启示。本文简要叙述反药配伍的源流及应用,重点对陈国成使用乌头配半夏外用的经验及思路进行论述,认为乌头与半夏配伍可通过多种方式减毒增效,为临床安全使用该配伍药物提供新的思路。
The eighteen antagonisms summarized by predecessors may not be absolute contraindications.The author obtained the inspiration of the antagonism medicinals “aconite-pinellia” from the external treatment of Xingxia painkiller ointment created by Chen Guocheng.The present paper provides a concise overview of the origin and application of anti-drug compatibility,with a specific focus on Chen Guocheng's expertise and insights regarding the external use of aconite combined with pinellia.It is postulated that diverse approaches can be employed to modulate the compatibility between aconite and pinellia,thereby offering novel perspectives for ensuring the safe utilization of this drug combination in clinical practice.
综述

基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究进展

Research about Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway

:1255-1263
 
慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。
Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure.Therefore,it usually leads to decreased patient compliance.It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically.However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment.This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade.It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years.This paper is based on “deficiency in origin” and “excess in superficiality” principle.Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality.By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis.It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices.
论著

基于中药处方数据挖掘探索中医药治疗盆腔炎用药规律

Exploration on regularity of traditional Chinese medicine for pelvic inflammatory disease based on large data mining of Chinese herbal medicine prescriptions

:72-80
 
目的 探究中医药治疗盆腔炎的用药规律,为中医临床辩证用药提供借鉴。方法 采用主题词联合自由词相,全面检索CNKI、VIP、Wangfang、CBM、PubMed和EMbase、数据库及Cochrane图书馆,收集中、西药对比治疗盆腔炎的随机对照试验。严格按照纳入、排除标准挑选随机对照试验中涵盖的中药药方,采用Excel表格统计分析药方中药的四气、五味、归经和用药频率,随后利用系统聚类软件对使用频率高的中药开展关联、聚类和主成分分析。结果 本文共纳入235个随机对照试验,涉及320首中药处方,平均用药味数13.29味,使用频率前五位的药分别为延胡索、赤芍、当归、蒲公英、丹参;关联规则共得出41对高关联药对,其中包括赤芍-延胡索、莪术-三棱-败酱草等。高频率使用的前30味中药可分为五大类,获取的9个主成分分析结果与系统聚类中的结果一致。结论 本研究采用循证医学和系统聚类分析方法,剖析中医药治疗盆腔炎的用药规律,为临床用药提供参考。
Objective To discuss the medication regularity of traditional Chinese medicine (TCM) in the treatment of pelvic inflammatory disease, and provide new thinking for effective medication in clinical medicine. Methods Keywords combined with free word were used to comprehensively search CNKI, VIP, Wangfang, CBM, PubMed and EMbase, databases and Cochrane library to collect randomized controlled trials of comparative treatment of pelvic inflammatory disease between Chinese and Western drugs. The TCM prescriptions covered in the randomized controlled trial were selected in strict accordance with the standard inclusion and exclusion criteria. Excel was used to statistically analyze the four properties, five flavors, meridian and medication frequency of TCM prescriptions. Then, systematic clustering software was used to carry out correlation, clustering and principal component analysis for the Chinese medicines with high using frequency. Results The study included 235 randomized controlled trial and 320 prescriptions of traditional Chinese medicine were involved, the average number of herbs was 13.29, which Yanhusuo, Chishao, Danggui, Pugongying, Danshen were with top five frequency. A total of 41 drug pairs with high association were obtained by association rules, including Chishao-Yanhusuo, Eshu-Sanleng-Baijiangcao, etc. Thirty traditional Chinese medicine with high using frequency can be divided into 5 categories according to the effect. The obtained results of 9 principal component analysis were consistent with those in the system cluster. Conclusions In this study, evidence-based medicine and systematic cluster analysis were used to analyze the medication regularity of traditional Chinese medicine in the treatment of pelvic inflammatory disease, so as to provide reference for the clinical medication.
论著

中药熏蒸配合穴位按摩的健康管理对稳定期肺肾气虚型慢阻肺的疗效

Efficacy of traditional Chinese medicine fumigation combined with acupoint massage on stable COPD with lung-kidney deficiency

:70-75
 
目的 探讨基于中药熏蒸配合穴位按摩的健康管理对稳定期肺肾气虚型慢阻肺的疗效。方法 选取2020年1月—2021年1月在我院接受治疗的稳定期肺肾气虚型慢阻肺患者120例为研究对象,随机分为对照组和干预组。对照组采用西医常规干预,干预组在此基础上实施为期1年的中药熏蒸配合穴位按摩的健康管理,比较干预前后2组患者肺功能、血氧指标以及生活质量的差异。结果 干预前,2组患者第1秒用力肺活量(FEV1)、第1秒用力肺活量占预计值百分比(FEV1%)、用力肺活量(FVC)、第1秒用力肺活量占用力肺活量的比值(FEV1/FVC%)等指标比较差异无统计学意义(P>0.05),干预后,2组患者的FEV1、FEV1%、FVC、FEV1/FVC%明显上升,且干预组患者优于对照组(P<0.05);实施相关干预前,干预组和对照组患者的血氧指标比较差异无统计学意义(P>0.05),干预后,2组患者的PaO2、和SpO2上升,PaCO2下降,且干预组的变化幅度大于对照组(P<0.05);干预前2组患者在圣乔治问卷(SGRQ)生活质量评分比较差异无统计学意义(P>0.05),干预后2组患者的SGRQ生活质量评分降低,且干预组患者的SGRQ生活质量指标评分更低(P<0.05)。结论 中药熏蒸配合穴位按摩应用于稳定期肺肾气虚型慢阻肺患者中,能够提高患者的肺功能,改善血氧指标,提高患者的生活质量。
Objective To explore the effect of health management based on traditional Chinese medicine fumigation combined with acupoint massage on stable chronic obstructive pulmonary disease(COPD)with lung-kidney deficiency.Methods A total of 120 patients with stable COPD and lung-kidney deficiency who received treatment in our hospital from January 2020 to January 2021 were selected as the study objects and randomly divided into control group and intervention group.The control group received conventional Western medicine intervention,and the intervention group received 1-year traditional Chinese medicine fumigation combined with acupoint massage on the basis of Western management.The differences of lung function,blood oxygen index and quality of life between the two groups were compared before and after intervention.Results Before intervention,there were no significant differences in forced expiratory volume in one second(FEV1),the first second forced vital capacity percentage of expected value(FEV1%),forced vital capacity(FVC),the ratio of the first second forced vital capacity of forced vital capacity(FEV1/FVC%)between the two groups(P>0.05),but after intervention,the FEV1,FEV1%,FVC,FEV1/FVC% of the two groups increased significantly,and those in the intervention group were better(P<0.05).Before the implementation of relevant intervention,there was no difference in blood oxygen index between the two groups(P>0.05).After the intervention,PaO2 and SpO2 of the two groups were significantly increased,while PaCO2 was significantly decreased,and the change in the intervention group was significantly greater(P<0.05).Before intervention,there were no significant differences in the quality of life scores of St George’s Respiratory Questionnaire(SGRQ)between the two groups(P>0.05).After intervention,the scores of SGRQ of the two groups were significantly decreased,and the scores of the intervention group were significantly lower(P<0.05).Conclusions Traditional Chinese medicine fumigation combined with acupoint massage can significantly improve lung function,blood oxygen index and life quality of stable COPD patients with lung-kidney deficiency.
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