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这些中医药获国家科技大奖!

2018-04-15 佚名 健康时报网

所谓匠心,一生只做一件事,做好这件事;所谓传承,继承先辈之精华,并钻研之。正如今年在全国两会的部长通道上,原国家中医药管理局局长王国强所说,真正让中国中医药走向世界,能够更好造福人类健康,中国首先要做好自己的事情。无论是在疑难病,还是常见病、慢性病的诊治上,中国中医药都在继承中发展。日前,健康时报记者采访了自2010年至2017年八年间国家科学技术进步奖中医药项目的部分专家团队,详细了解这些

所谓匠心,一生只做一件事,做好这件事;所谓传承,继承先辈之精华,并钻研之。

正如今年在全国两会的部长通道上,原国家中医药管理局局长王国强所说,真正让中国中医药走向世界,能够更好造福人类健康,中国首先要做好自己的事情。无论是在疑难病,还是常见病、慢性病的诊治上,中国中医药都在继承中发展。日前,健康时报记者采访了自2010年至2017年八年间国家科学技术进步奖中医药项目的部分专家团队,详细了解这些创新给百姓带来的实惠。

“手法+”治疗颈椎病

■项目名称:

神经根型颈椎病中医综合方案与手法评价系统(2017年国家科技进步二等奖)

■领衔专家:

朱立国,中国中医科学院望京医院院长、脊柱科主任医师;擅长:应用中西医结合的方法治疗各种类型的颈椎病、腰椎间盘突出症、腰椎滑脱等疾病;出诊时间:周三上午

■联合专家:

冯敏山,于杰,魏戌,王平,李金学,高景华,黄远灿,孙树椿,杨克新

(健康时报记者 林 敬)目前我国颈椎病发病率约17.6%,其中神经根型颈椎病占60%~70%。

在中医理论中,神经根型颈椎病常被称为“骨错缝,筋出槽”。中国中医科学院望京医院院长朱立国介绍,相较于其他类型的颈椎病,有发病率高、复发率高、医疗费用高的特点。

朱立国与他的团队经多中心随机对照试验及临床再验证,制订了基于“内外兼治、筋骨并重、医患配合”理念的中医综合方案(旋提手法+颈痛颗粒+颈椎康复操)。朱立国介绍,旋提手法是中医综合方案的关键技术。该手法能够解除肌肉痉挛,纠正关节错位,松解神经根与关节周围的粘连,解除滑膜嵌顿,消除炎症,缓解疼痛。

操作时,一般要求患者端坐位,医生站于患者身后,采用按、揉等手法来放松颈部软组织3~5分钟,患者头部主动水平旋转至极限角度,最大屈曲达到有固定感方可。医生以肘部托患者下颌,纵行向上牵引3~5秒钟,肘部快速垂直向上提拉。最后,用提、拿手法放松颈部软组织2~3分钟,这样,一次旋提手法治疗就完成了。

“内外兼治”也是团队秉承的指导理念,在患者完成旋提手法治疗后,医生一般还会为患者开点颈痛颗粒,成分包括葛根、白芍、桂枝、川芎等,可活血化瘀,行气止痛。为了预防颈椎病复发,朱立国与他的团队还设计了颈椎康复操,包括前屈后伸、旋颈望踵等动作。若想达到最佳治疗效果,患者一定要配合医生坚持做康复操。

中药治抑郁7天起效

■项目名称:

抑郁症中医证候学规律的研究(2010年国家科技进步二等奖)

■领衔专家:

唐启盛,原北京中医药大学第三附属医院院长,脑病科主任医师,教授,博士生导师,中华中医药学会中医内科学会常委;擅长:焦虑、抑郁、精分、癫痫、中风、失眠、头痛、眩晕、帕金森等疾病中药干预研究;出诊时间:周二上午

■联合专家:

曲淼,朱跃兰,周东丰,■,包祖晓,裴清华,赵晶

(健康时报记者 董颖钰)抗抑郁药物治疗,西医药是不少人的选择。首都医科大学宣武医院神经内科主任医师曲淼表示,其实中医治疗抑郁有非常显着的优势,但在2002年之前国内对抑郁症缺乏认识,临床上缺少统一的中医药规范和诊断标准,也缺乏具有说服力的临床证据,成为了制约中医药治疗抑郁症发展的瓶颈。

经过20余年的研究,北京中医药大学唐启盛教授带领团队探索出了抑郁症中医诊断标准和临床治疗方案。2010年,唐启盛领衔的团队凭借其突破性的研究成果,获国家科技进步二等奖。

“经过临床验证,中药治疗抑郁症的起效时间平均是7天,而西药却要21天。”曲淼表示,比起西药,辨证使用中药的效率平均高出5%至8%!中药可以快速改善疲劳无力、食欲不佳、睡眠困难等周边症状,从而极大地减少了患者的痛苦。较少副作用、患者接受度高、节省费用等,使中医治疗优势凸显。

唐启盛团队通过对1221例患者中医证候学的调查分析,将抑郁症划分为肾虚肝郁证、肝郁脾虚证、肝胆湿热证、心肾不交证、心脾两虚证及心胆气虚证6种证型,制订了《抑郁症中医诊断标准和治疗方案》。团队在全国范围内进行了1800例抑郁症患者的临床治疗研究。该研究成果被写入中医药行业标准,发布于《中医内科常见疾病诊疗指南》,在全国推广应用。

目前,20多个省市30余家三甲医院印证了其推广性。曲淼表示,现在团队在科技部重大行业专项课题资助下,在全国11家精神专科医院及三级甲等中医、中西医结合医院开展大样本抑郁症中医药治疗队列研究。

中西医结合治疗红斑狼疮

■项目名称:

从毒瘀虚论治系统性红斑狼疮的增效减毒方案构建与应用(2011年国家科技进步二等奖)

■领衔专家:

范永升,曾任浙江中医药大学校长、现为国家973首席科学家、中国中西医结合学会风湿病专委会主任委员;擅长:中西医结合治疗系统性红斑狼疮等;出诊时间:周四上午(浙江中医药大学附属第三医院)

■联合专家:

温成平,姜泉,苏励,吴华香,刘维,谢志军,李秀央,李永伟,王新昌

(健康时报记者 吕 霖 浙江中医药大学附属第二医院 阮芝芳)红斑狼疮是神出鬼没的“狼”,很难知道它会以哪种表现形式出现在眼前,而且特别爱“咬”女性。浙江中医药大学附属第二医院风湿科医生王新昌说,女性患者甚至有因红斑狼疮造成的“抽搐,癫痫症状”误去精神科就诊的。

目前,西医在治疗上用药一般含有糖皮质激素,具有强大的抗炎和免疫抑制作用,疗效相对较快。但同时激素和免疫抑制剂也存在副作用多、复发率高等问题,容易出现“三高”、继发感染消化道溃疡、骨质疏松等问题。

范永升教授在整理研究古籍的基础上,结合临床对红斑狼疮进行了深入研究,发现热毒、血瘀、阴亏是红斑狼疮发病的主要病机,提出解毒祛瘀滋肾法作为治疗红斑狼疮的基本方法。

由此,范永升教授组建的团队又通过临床研究和动物实验,使解毒祛瘀滋肾法的疗效机理研究不断深入。毒瘀虚论治红斑狼疮的增效减毒方案从2003年起先后在全国多家医院推广应用,使得狼疮患者高脂血症、高血压消化性溃疡、骨质疏松、继发感染的发生率极低。

范教授表示,轻型的系统性红斑狼疮可以单吃中药治疗,不必吃激素,甚至可痊愈;而重患者,适当适时使用中药,除了可增强治疗效果外,还可以增强人体免疫能力和减少西药带来的毒副作用,起到“增效解毒”的作用。今后三年,范永升团队将携手北京协和医院风湿科开展“系统性红斑狼疮”国家中西医重病协作试点项目,共同寻求红斑狼疮最优诊疗方案。

治颈腰椎病有益气化瘀方

■项目名称:

益气化瘀法治疗椎间盘退变性疾病的基础研究和临床应用(2011年国家科技进步二等奖)

■领衔专家:

王拥军,上海中医药大学附属龙华医院副院长,上海中医药大学脊柱病研究所所长;擅长:颈腰椎疾病、脊柱肿瘤、骨质疏松症等;出诊时间:周五下午(总院)

■联合专家:

施杞,石仰山,卞化石,周泉,崔学军,周重建,梁倩倩,卞琴,李晨光

(健康时报记者 梁 缘 上海中医药大学附属龙华医院 周雨花)过了60岁,几乎没人能逃过颈腰椎病。中医骨伤“石氏伤科”传人、上海中医药大学附属龙华医院骨伤科主任医师施杞指出,95%以上的颈椎病和腰椎间盘突出症都可通过中药、针灸、推拿、按摩等方法治疗,不必手术。对于颈腰椎病的早中晚期,“益气化瘀”都能大显神通!

2011年,由上海中医药大学附属龙华医院、黄浦区中心医院等共同完成的“益气化瘀法治疗椎间盘退变性疾病的基础研究和临床应用”项目获国家科技进步二等奖。项目领衔专家、上海中医药大学脊椎病研究所所长王拥军表示,在椎间盘退变早期使用益气化瘀方法可有效改善椎间盘微循环,缓解缺血缺氧状态,增加椎间盘营养供应,减轻软骨钙化,防止骨赘形成;中期以益气化瘀通络方法抑制炎性因子释放,减轻疼痛麻木等;后期以益气化瘀补肾方法减缓细胞凋亡、椎间盘退变以及脊髓、神经根损伤进程。

施杞指出,颈椎病(排除因车祸等所致急性伤害)在中医里属“痹症”范畴,是气血运行不畅所致。“益气化瘀”系列方的功能是改善椎间盘微循环,增加椎间盘营养供应,抑制局部炎症反应,减轻软骨钙化,并促使受损的神经、脊髓、血管、韧带、小关节恢复功能。这是中医治疗颈椎病的优势和科学基础。

无排卵不孕的元凶找到了

■项目名称:

多囊卵巢综合征病证结合研究的示范和应用(2014年国家科技进步二等奖)

■领衔专家:

吴效科,黑龙江中医药大学附属第一医院妇产科主任,中国中西医结合学会妇产科专业委员会副主任委员;擅长:多囊卵巢综合症,不孕症等妇科疑难杂病;出诊时间:周一上午、周四上午

■联合专家:

尤昭玲,邹伟,俞超芹,连方,梁瑞宁,吴鸿裕,张跃辉,匡洪影

(健康时报记者 乔靖芳 黑龙江中医药大学第一附属医院 张 锐)“说实话,门诊中遇到那么多人因为多囊卵巢综合征(PCOS)而怀不上孩子,我也痛在心里。”黑龙江中医药大学附属第一医院妇产科主任吴效科说,不孕不一定是PCOS,但是PCOS的最大杀伤力就是导致不孕,不少家庭因此而破碎。

多年来,PCOS的发病原因不明,临床治疗也是困难重重。吴效科主任及其团队成员率先找到了PCOS致无排卵不孕的“元凶”——卵巢内胰岛素抵抗,并发现针药“补肾化痰祛瘀法”及中药制剂就可改善卵巢内胰岛素抵抗,并且显着提高了妊娠成功率,为PCOS患者带来希望。

2015年,课题组发现黄连素能够促进多囊卵巢综合征不孕患者排卵,提高受孕率,更重要的是通过连续服用6个月黄连素,多囊卵巢综合征不孕患者的活产率达到22%,疗效类似于国际公认的一线药物。吴效科主任介绍,黄连素具有促进排卵,提高受孕率和活产率的疗效,可通过解除卵巢胰岛素抵抗,促进排卵、降低雄激素合成。相关成果已刊发于《柳叶刀》上。

近几年,“黄连素治疗不孕症研究”“针刺联合西药克罗米芬治疗多囊卵巢综合征不孕症”,已帮助400多位女性“圆了妈妈梦”。

吴效科主任说,肥胖、痤疮、多毛、月经紊乱、男性化……这是PCOS常见表现,几乎每10个育龄女性中有一个。女性朋友一定要注意保护好卵巢。

补肾活血法治疗帕金森

■项目名称:

补肾活血理论在治疗帕金森病中的应用  (2012年国家科技进步二等奖)

■领衔专家:

杨明会,解放军总医院中医院院长,全军中医研究所所长;擅长:中西医结合诊治心脑血管疾病、呼吸消化系统疾病等;出诊时间:周二上午,周三上午

■联合专家:

陈建宗,李绍旦,史恒军,雒晓东,窦永起,王振福,刘毅,康晓刚,李刚

(健康时报记者 梁 缘) 很多中老年人患帕金森病首先想到的是用西药。其实中医也有很好的疗效。2012年解放军总医院中医院院长杨明会教授领衔的“补肾活血理论在治疗帕金森病中的应用”项目团队获国家科技进步二等奖。

目前主要通过左旋多巴药物进行的西医治疗一度被当做是治疗帕金森的“金标准”,殊不知西药治疗的“蜜月期”非常短。三五年后,开关现象、异动症、剂末现象、冻结现象等并发症接踵而至。

“帕金森病不是由单一因素引起的,多巴胺减少只是其原因之一。”在中医领域深耕三十多年的杨明会教授正是看到了西药治疗的短板,同时也看到传统中医对脑病认识的不足。杨明会教授认为,帕金森病大多出现在肾精逐渐衰退的生理阶段,发病位置在脑,症状以肌张力增高等为主,基本病机是肾虚血瘀,所以应采用补肾活血法来治疗。

在总结各家观点的基础上,杨明会团队发展了关于帕金森病“诸风掉眩,皆属于肝”的理论,提出帕金森的基本病因病机为“肾虚血瘀”的观点,治当以“补肾活血”为大法。临床实践也践行了这一点:补肾活血中药加上常规西药治疗,不仅能改善症状、延缓病情进展,还可减轻西药的不良反应、减少西药用量、延长西药作用时间。针对中医研究中临床症状缺乏量化的问题,杨明会团队还将肌肉状态测试系统和脑电超慢涨落图分析仪等引入研究。

创新灸法解决肠腑病难题

■项目名称:

灸法治疗肠腑病症的技术与临床应用(2013年国家科技进步二等奖)

■领衔专家:

吴焕淦,上海中医药大学附属岳阳中西医结合医院针灸科教授,上海市针灸经络研究所所长;擅长:针灸治疗溃疡性结肠炎、肠易激综合征等胃肠道疾病;出诊时间:周二、六下午

■联合专家:

刘慧荣,施茵,余曙光,赵百孝,姚礼庆,马晓芃,王晓梅,常小荣,赵琛

(健康时报记者 乔靖芳 上海中医药大学附属岳阳中西医结合医院 沈 莉)肠病无小事,尤其是面对溃疡性结肠炎(UC)、克罗恩病(CD)、肠易激综合征(IBS)这三种中医难治性肠腑病,医生头疼、病人遭罪。

执着于中医针灸的上海中医药大学附属岳阳中西医结合医院针灸科吴焕淦教授可不信这个邪,他带领团队历经30多年的临床探索和实践,终于攻克了这个难题,创建了三项效果确切的中医艾灸治疗难治性肠腑病症的新技术,并于2013年获得国家科技进步二等奖。

“自从学中医以来,我心里一直牢记元代医家罗天益提出的‘艾灸温养脾胃’,也正是这句话启发了我。”吴焕淦教授及团队成员将灸法应用于难治性肠腑病症的治疗,如应用隔药饼灸治疗溃疡性结肠炎等,并系统地运用循证医学方法开展临床研究,最终形成“艾灸温养脾胃理论与治法”,以艾灸温养脾胃为总治则,在溃疡性结肠炎中注重调和阴阳,在克罗恩病中重在补肾通络,在肠易激综合征中侧重疏调肠腑气血。三种肠腑病症治疗上各有侧重,通过艾灸、药饼和穴位的协同作用,或辅以针刺调理,大部分轻中度溃疡性结肠炎患者的症状可缓解,同样也可控制轻中度克罗恩病病人的腹痛、腹泻等症状,减轻肠易激综合征患者的病痛。

疾病防为先,吴焕淦教授提醒,平时尽量少吃生冷、油腻的食物,也要注意胃肠保暖,并且尽可能保持平静的心情,对保护肠胃也很重要。

中医控糖有了指南

■项目名称:

肝脾肾同治法辨证治疗2型糖尿病临床研究(2011年国家科技进步二等奖)

■领衔专家:

高思华,北京中医药大学首席专家,北京中医药大学首席专家;擅长:中西医结合治疗糖尿病、甲状腺病、内分泌失调、心脑血管疾病、失眠、脾胃病、月经病等;出诊时间:周一上午、周四下午

■联合专家:

龚燕冰,倪青,罗增刚,赵进喜,杨晓晖,冯兴中,刘铜华,马晓北,胡春宇

(健康时报记者 林 敬)自宋朝到明清,临床上多以消渴病的三消分治来认识和辨治2型糖尿病。北京中医药大学东直门医院内分泌科主任医师赵进喜认为,消渴症最典型的症状是“三多一少”,但在实际中2型糖尿病的患者中90%都没有这样的症状。

“《黄帝内经》中对消渴病的认识是比较强调脾胃的,到了医圣张仲景时便明确提出中医糖尿病的定位是脾胃肝肾,这与后世强调从肺、胃、肾论治糖尿病的说法不一致”,赵进喜说。

于是北京中医药大学前校长高思华教授和团队历时近20年完成了“肝脾肾同治法辨证治疗2型糖尿病的临床研究”课题,证实了2型糖尿病的中医病理定位离不开肝脾肾,使2型糖尿病的临床辨治有法可循。

高思华领衔的团队提出以“肝脾肾三脏同病,立足于中医脏腑辨证,兼顾其兼挟证的相互关系”来论治2型糖尿病模式,并创制肝脾肾三脏同调的系列方剂。降糖消渴1方,以益肾平肝为主,健脾为辅,气阴两补佐以清热祛湿活血;降糖消渴2方,以疏肝为主,健脾益肾为辅,气阴两补佐以清热祛湿活血;降糖消渴3方,以健脾为主,疏肝益肾为辅,气阴两补佐以祛湿活血。

脾胃肝肾同治的核心定位确立后,我们又进一步研究确认“热伤气阴”的发病病机,赵进喜介绍,当然,具体用药时需根据患者的具体情况有所侧重。

中西医融合治肺癌

■项目名称:

中医治疗非小细胞肺癌体系的创建与应用(2016年国家科技进步二等奖)

■领衔专家:

林洪生,中国中医科学院广安门医院肿瘤科主任,中华中医药学会肿瘤专业委员会副主任委员;擅长:肺癌乳腺癌淋巴瘤等;出诊时间:周二、周四上午(特需)

花宝金,中国中医科学院广安门医院副院长,中国中医科学院肿瘤研究所常务副所长;擅长:运用中西医结合方法诊治肺癌、消化系统肿瘤;出诊时间:周三上午

■联合专家:

侯炜,李杰,张培彤,王沈玉,解英,贾立群,杨宇飞,李萍萍

(健康时报记者 吕 霖)人体和肿瘤的关系就像土壤和种子,种子长到土壤里,把它切掉,但土壤没改变就不能根治。2006年,世界卫生组织就已经把肿瘤定位为“可以控制的慢性疾病”,在治疗上中医成为一个亮点,中西医结合治疗也升级为“中西医融合”。

中国中医科学院肿瘤研究所花宝金教授所在的团队就是用“中西医融合”治疗非小细胞肺癌。花宝金表示,非小细胞肺癌与小细胞癌相比,其癌细胞生长分裂较慢,扩散转移相对较晚。但非小细胞肺癌约占所有肺癌的80%,近3/4的患者发现时已处于中晚期,5年生存率很低。中医应早介入,不同阶段、不同类型、不同年龄都应辨证施治。

而常规的治疗往往只将目光盯着肿瘤,如今,肿瘤患者的生存期已在延长,患者也越来越注重身体与心理的综合健康。 中国中医科学院肿瘤研究所通过不断摸索,建立了中医药、心理干预、营养指导和体能锻炼为一体的中医综合康复疗法,也就是中西医融合治疗。

花宝金认为,治疗疾病的目的是为了让患者更好地生活,中医治疗肿瘤的优势就在于把疾病看作一个整体,通过调节人的机体状况来达到治病目的,所以不仅需要中医药,还需要心理干预、营养指导和体能锻炼的参与。在中西医融合治疗中,广安门医院肿瘤科还在前期扶正培本理论的基础上,对传统抗癌名方西黄丸进行加味,创制了西黄解毒胶囊,适用于胃癌、肠癌、肝癌、乳腺癌、肺癌等常见的中晚期恶性肿瘤,目前在临床上也取得了一定疗效。

中西医融合治疗,通过长期的干预和调节可巩固其治疗效果,患者可长期带瘤生存。尤其是对于高龄、体质较差及不耐受放化疗的患者,中西医融合治疗优于单纯对症支持治疗。

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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9572310056, createdName=12225669m29暂无昵称, createdTime=Mon Apr 16 07:37:13 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306264, encodeId=d838306264f1, content=为中华医学鼓掌, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Mon Apr 16 07:24:15 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306246, encodeId=30e0306246f4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Apr 16 06:52:16 CST 2018, time=2018-04-16, status=1, ipAttribution=)]
    2018-04-17 驹迷一生

    中医博大精深.大有前途

    0

  4. 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createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Apr 16 06:52:16 CST 2018, time=2018-04-16, status=1, ipAttribution=)]
    2018-04-17 cathymary
  5. 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createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Apr 16 06:52:16 CST 2018, time=2018-04-16, status=1, ipAttribution=)]
    2018-04-17 戒馋,懒,贪

    谢谢分享

    0

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    2018-04-17 青山颖钰

    学习了

    0

  7. 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    2018-04-16 龙胆草

    学习谢谢分享

    0

  8. 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    2018-04-16 12225669m29暂无昵称

    学习

    0

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    2018-04-16 871538379

    为中华医学鼓掌

    0

  10. 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    2018-04-16 Y—xianghai

    学习了新知识

    0

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