小柴胡汤是《伤寒杂病论》中的一首经典方剂，是和解法的基础方，后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索，探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用，有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂，小柴胡汤亟需进一步的发扬与创新，以期更有效地应用于未来的临床实践。

    Xiaochaihu Decoction，as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases，laid the foundation for reconciliation．It has a wide range of applications in the treatment of gynecological diseases．Through a literature search，this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application．This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain，bleeding，leucorrhea disease，tumors and other related diseases．Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea，pelvic inflammatory disease，menstrual irregularities，gynecological tumors，and perimenopausal syndrome through its role of soothing the liver and promoting bile flow，strengthening the spleen and stomach，and harmonizing and releasing the pivot．As a commonly used gynecological prescription in clinical practice，Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future．

      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

探讨改良拔尿管方法在妇科腹腔镜术后留置尿管患者临床的影响。方法 选取2025年2月7日—2025年10 月10日我院妇科腹腔镜手术术后留置尿管患者60例为研究对象。本研究采用随机数字表法将研究对象分为对照组与观察组，两组各纳入30例。比较两组首次拔管尿路疼痛评价、首次排尿时间、患者尿潴留例数。结果 观察组首次拔尿管尿路疼痛程度显著低于对照组，两组差异有统计学意义（P<0.05）。观察组首次排尿时间显著少于对照组，两组差异有统计学意义（P<0.05）。观察两组尿潴留发生率差异无统计学意义（P>0.05）。结论 本次研究采用改良后的尿管拔除方法，虽未明显降低妇科腹腔镜术后患者的尿潴留发生率，但能有效降低拔尿管时患者的不适感 ，减少尿道损伤，缓解疼痛，加快患者自主排尿，具有积极临床实践意义。

探讨改良拔尿管方法在妇科腹腔镜术后留置尿管患者临床的影响。方法 选取2025年2月7日—2025年10 月10日我院妇科腹腔镜手术术后留置尿管患者60例为研究对象。本研究采用随机数字表法将研究对象分为对照组与观察组，两组各纳入30例。比较两组首次拔管尿路疼痛评价、首次排尿时间、患者尿潴留例数。结果 观察组首次拔尿管尿路疼痛程度显著低于对照组，两组差异有统计学意义（P<0.05）。观察组首次排尿时间显著少于对照组，两组差异有统计学意义（P<0.05）。观察两组尿潴留发生率差异无统计学意义（P>0.05）。结论 本次研究采用改良后的尿管拔除方法，虽未明显降低妇科腹腔镜术后患者的尿潴留发生率，但能有效降低拔尿管时患者的不适感 ，减少尿道损伤，缓解疼痛，加快患者自主排尿，具有积极临床实践意义

目的 分析丹珍头痛胶囊联合疏肝调神针法治疗肝阳上亢型偏头痛患者的效果。方法 回顾性收集我院2023年8月～2025年4月148例肝阳上亢型偏头痛患者临床资料，依照治疗方案不同分为两组，各74例。对照组接受疏肝调神针法治疗，观察组接受丹珍头痛胶囊联合疏肝调神针法治疗，比较两组疗效、治疗前后临床症状[中医证候积分、发作情况（发作次数、持续时间、疼痛程度）]、睡眠质量[匹兹堡睡眠质量量表（PSQI）评分]、炎性相关因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、细胞间黏附分子-1（ICAM-1）、白细胞介素-10（IL-10）]水平、安全性（不良事件、不良反应）。结果 观察组总有效率较对照组高（P＜0.05）；治疗后，两组临床症状均减轻，且观察组中医证候积分较对照组低，发作次数较对照组少，持续时间较对照组短，疼痛程度较对照组低（P＜0.05）；治疗后，两组睡眠质量均提升，且观察组PSQI评分较对照组低（P＜0.05）；与治疗前相比，两组治疗后血清TNF-α、IL-6、ICAM-1均降低，IL-10均升高，且观察组优于对照组（P＜0.05）；两组治疗期间均未发生断针等不良事件及恶心呕吐等不良反应。结论 丹珍头痛胶囊联合疏肝调神针法治疗肝阳上亢型偏头痛患者，能有效改善临床症状，提高睡眠质量，调节炎性相关因子水平。

目的 观察腰舒汤联合针灸推拿治疗气滞血瘀型腰椎间盘突出（LDH）的临床效果。方法 选取2023年1月～2025年12月收治的气滞血瘀型LDH患者104例，采用计算机随机分为参考组（52例采用针灸推拿治疗，因擅自使用方案外的药物剔除1例，）和综合组（52例采用腰舒汤联合针灸推拿治疗，因主动退出脱落1例）。比较两组中医证候评分、疼痛视觉模拟（VAS）评分、核因子-κB（NF-κB）信号通路指标、日本矫形外科学会（JOA）评分、腰背肌生物力学性能、脊旁肌横截面积（CSA）以及不良反应/事件发生率。结果 两组基线时中医证候评分、VAS评分、NF-κB信号通路指标、JOA评分比较差异不显著（P>0.05）；两组治疗后JOA评分均较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后中医证候评分、NF-κB信号通路指标、VAS评分均较基线时降低，同时综合组低于对应时间参考组（P<0.05）。两组基线时60°/s角速腰背肌生物力学性能比较差异不显著（P>0.05）；两组治疗后W、PT均较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后F/E均较基线时降低，同时综合组低于对应时间参考组（P<0.05）。两组基线时脊旁肌CSA比较差异不显著（P>0.05）；两组治疗后L3、L4、L5的Sm/Sv均较基线时降低，同时综合组低于对应时间参考组（P<0.05）；两组治疗后L3、L4的Se/Sv较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后L5的Se/Sv以及L3、L4、L5的Sp/Sv与基线时比较差异不显著（P>0.05）。两组不良反应/事件发生率比较，差异不显著（P>0.05）。结论 腰舒汤联合针灸推拿治疗气滞血瘀型腰椎间盘突出可缓解症状、抑制炎症、改善腰背肌功能与形态，且安全性相当。

目的 探讨清咳平喘颗粒联合乙酰半胱氨酸对痰热闭肺型大叶性肺炎（LP）患儿的治疗效果。方法 回顾性选取我院收治的118例痰热闭肺型LP患儿（选例时间：2023年1月~2025年11月）为研究对象，根据治疗方案分为参照组（59例，采用乙酰半胱氨酸治疗）、联合组（59例，采用清咳平喘颗粒联合乙酰半胱氨酸治疗）。对比两组临床疗效、不良反应及治疗前、后肺功能［潮气量（VT）、达峰时间比（TPTEF/TE）、吸呼比（Ti/Te）、达峰容积比（VPEF/VE）］、中医证候、免疫功能、炎症因子［白细胞介素-8（IL-8）、趋化因子配体3（CCL3）、肿瘤坏死因子-α（TNF-α）、高迁移率族蛋白B1（HMGB1）］水平。结果 联合组总有效率为96.61%，高于参照组的83.05%（P＜0.05）；与参照组相比，治疗后联合组各中医证候积分均较低（P＜0.05）；联合组治疗后VT、TPTEF/TE、Ti/Te、VPEF/VE水平均较参照组高（P＜0.05）；联合组治疗后CD8+水平较参照组低，CD3+、CD4+、CD4+/CD8+水平较参照组高（P＜0.05）；治疗后联合组血清IL-8、CCL3、TNF-α、HMGB1水平均较参照组低（P＜0.05）；不良反应发生情况组间比较，无明显差异（P＞0.05）。结论 清咳平喘颗粒联合乙酰半胱氨酸可提高痰热闭肺型LP患儿治疗效果，减轻临床症状，改善肺功能、免疫功能，降低机体炎症反应程度。

Objective To explore the therapeutic efficacy of Qingke Pingchuan granules combined with acetylcysteine on children with lobar pneumonia (LP) of phlegm-heat obstructing lung type. Methods A total of 118 children with LP of phlegm-heat obstructing lung type admitted to our hospital from January 2023 to November 2025 were retrospectively selected as the research subjects. According to different treatment regimens, they were divided into the control group (59 cases, treated with acetylcysteine) and the combined group (59 cases, treated with Qingke Pingchuan granules combined with acetylcysteine). The clinical efficacy, adverse reactions, as well as the levels of pulmonary function indicators [tidal volume (VT), time to peak tidal expiratory flow ratio (TPTEF/TE), inspiration-expiration ratio (Ti/Te), volume to peak tidal expiratory flow ratio (VPEF/VE)], traditional Chinese medicine (TCM) syndrome scores, immune function and inflammatory factors [interleukin-8 (IL-8), C-C motif chemokine ligand 3 (CCL3), tumor necrosis factor-α (TNF-α), high mobility group box 1 protein (HMGB1)] before and after treatment were compared between the two groups. Results The total effective rate of the combined group was 96.61%, which was higher than 83.05% of the control group (P<0.05). After treatment, the TCM syndrome scores of the combined group were lower than those of the control group (P<0.05). The levels of VT, TPTEF/TE, Ti/Te and VPEF/VE in the combined group were higher than those in the control group after treatment (P<0.05). After treatment, the level of CD8? in the combined group was lower, while the levels of CD3?, CD4? and CD4?/CD8? were higher than those in the control group (P<0.05). The serum levels of IL-8, CCL3, TNF-α and HMGB1 in the combined group were significantly lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of Qingke Pingchuan granules and acetylcysteine can enhance the therapeutic efficacy on children with LP of phlegm-heat obstructing lung type, relieve clinical symptoms, improve pulmonary function and immune function, and reduce systemic inflammatory response.

目的：探讨填髓益精法联合环孢素A治疗再生障碍性贫血（AA）的临床疗效，及其对骨髓造血功能、免疫功能及生活质量的影响。方法：选取2021年1月—2026年1月收治的AA患者65例，随机分为对照组（21例）、中药组（23例）、综合组（21例）。对照组予环孢素A口服；中药组在对照组基础上加用填髓益精方口服；综合组在中药组基础上联合督灸、艾灸、耳针治疗。连续治疗24周，观察三组临床疗效、血常规、免疫指标、生活质量及不良反应。结果：对照组、中药组、综合组总有效率分别为76.19%、86.96%、85.71%，中药组与综合组均显著高于对照组（P<0.05）。治疗后，三组红细胞、血红蛋白、血小板均较治疗前升高（P<0.05），IL?2水平下降，CD3?、CD4?、CD4?/CD8?升高，中药组与综合组改善优于对照组（P<0.05）。生活质量评分综合组改善最优，三组不良反应发生率差异无统计学意义（P>0.05）。结论：填髓益精法联合环孢素A可有效提高AA临床疗效，改善骨髓造血与免疫功能，提升生活质量，安全性良好，值得临床推广。

Objective To investigate the clinical efficacy of traditional Chinese medicine (TCM) method of tonifying marrow and nourishing essence combined with cyclosporine A in the treatment of aplastic anemia (AA)， and its effects on bone marrow hematopoiesis， immune function and quality of life. Methods A total of 65 patients with AA admitted from July 2014 to January 2024 were randomly divided into control group (21 cases)， TCM group (23 cases) and comprehensive group (21 cases). The control group was treated with oral cyclosporine A; the TCM group was additionally given Tonifying Marrow and Nourishing Essence Decoction; the comprehensive group was further combined with governor vessel moxibustion， moxibustion and ear acupuncture on the basis of the TCM group. All patients were treated for 24 weeks. The clinical efficacy， blood routine， immune indexes， quality of life and adverse reactions were observed. Results The total effective rates of the control group， TCM group and comprehensive group were 76.19%， 86.96% and 85.71%， respectively. The TCM group and comprehensive group were significantly higher than the control group (P<0.05). After treatment， red blood cells， hemoglobin and platelets in the three groups were increased compared with those before treatment (P<0.05)， the levels of IL?2 were decreased， and CD3?， CD4? and CD4?/CD8? were increased. The improvements in the TCM group and comprehensive group were better than those in the control group (P<0.05). The quality of life score of the comprehensive group was the best， and there was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion TCM method of tonifying marrow and nourishing essence combined with cyclosporine A can effectively improve the clinical efficacy of AA， ameliorate bone marrow hematopoiesis and immune function， and improve quality of life with good safety， which is worthy of clinical promotion.

意识障碍（Disorders of Consciousness, DoC）是颅脑损伤、脑卒中、缺血缺氧性脑病等严重脑损伤后的常见并发症，其康复治疗是神经科学领域的重大挑战。重复经颅磁刺激（Repetitive Transcranial Magnetic Stimulation, rTMS）作为一种无创神经调控技术，通过调节皮层兴奋性、促进神经可塑性及改善脑血流灌注，在DoC治疗中展现出独特优势。本文系统梳理近年研究，从作用机制、临床证据及未来方向等方面进行综述，旨在为临床精准治疗提供理论依据。

目的 研究温肾利水汤联合贝前列素钠对老年原发性肾病综合征（PNS）患者T淋巴细胞亚群及肾功能的影响。方法 回顾性收集我院106例老年PNS患者临床资料（2024年4月-2026年1月），按照不同治疗方法分为研究组（n=55，温肾利水汤联合贝前列素钠）、对照组（n=51，贝前列素钠治疗）。比较两组治疗效果、中医证候积分、治疗前后肾功能[血尿素氮（BUN）、白蛋白（ABL）、血肌酐（SCR）]、T淋巴细胞亚群[CD4+、辅助性T细胞17（Th17）、CD3+]、不良反应。结果 治疗3个月后，研究组总有效率（92.73%）高于对照组（P<0.05）；治疗3个月后，研究组主证积分、次证积分均低于对照组（P<0.05）；治疗3个月后，研究组血清BUN、SCR水平低于对照组，ABL水平高于对照组（P<0.05）；治疗3个月后，研究组CD4+、CD3+高于对照组，Th17低于对照组（P<0.05）；两组不良反应发生率（5.45% VS 9.80%）相比，差异无统计学意义（P>0.05）。结论 温肾利水汤联合贝前列素钠治疗老年PNS患者能提高治疗效果，改善T淋巴细胞亚群水平，促进肾功能恢复。