資料來源：中國中醫藥信息雜誌 所屬地區：中國大陸
李 岩 孫向紅 呂麗萍（山東省濟南市第二人民醫院 濟南 250001）
腎結石屬中醫學砂淋、石淋、血淋等範疇。自古至今，治療腎結石的方法很多，根據臨床辨證分型不同，方劑也不同。近代經驗方如加減石韋湯、二金排石湯、化石通淋湯、補腎排石湯、利尿排石湯等方中均應用雞內金，取其利尿化堅消食之功效。筆者臨床常配合金錢草、海金沙同用以增強利尿排石之效，配合山楂、麥芽等治療飲食停滯、腹脹噁心等症配合桑螵蛸、黃耆、龍骨、牡蠣等治療遺尿、小便頻數等。
１.治療方法
將雞內金洗淨、焙乾、研細末，分裝於０.５ｇ空心膠囊內，裝瓶備用。每日３次，每次１ｇ，成人可酌情加量，飯前、飯後服用均可，連續服用，至結石完全排出體外為止。 病案舉例：患兒，男，１２歲，１９９７年９月２３初診。主訴：腰痛，以左側為重，血尿３ｄ，伴上腹部不適，食欲不振，腹脹滿，無力，舌苔白膩，微黃，脈弦細。查體：左側腎區叩痛，上腹部有輕度壓痛；尿常規示：白細胞（++），紅細胞（++++），尿蛋白（++）：腎臟Ｂ超示：腎集合系統下端探及一強光團反射，大小為（１ｘ０.８ｘ０.２）ｃｍ3試用單味中藥雞內金，因其既能健脾和胃，改善脾胃虛弱症狀，又能化堅消石，使結石逐漸軟化，排出體外。服藥１個月後，脾胃症狀消失，查腎臟Ｂ超示：左腎結石呈０.８ｃｍＸ０.４ｃｍ大小。連續服藥３個月後，復查Ｂ超，腎結石完全消失，輸尿管及膀胱均未見結石。隨訪１年未再復發。
２. 體會
雞內金為家禽類雞胃的內膜，其性甘、平、微苦，入脾、胃、膀胱經，有健脾和胃、固精止遺、化瘀通經、化堅消石之功效。《醫林集要》中有單用本品治療“小便淋瀝，痛不可忍者”的記載。《本草經疏》曰：“肫是雞之脾，乃消水榖之所，其氣通大腸，膀胱二經。”《名醫別錄》中記載：“主小便，利遺溺。”《醫學衷中參西錄》記載：“雞內金，雞之脾胃也......中有瓷、石、鋼、鐵皆能消化，其善化瘀可知......（脾胃）居中焦，以升降氣化，若有瘀積，氣化不能升降，是以易至脹滿，用雞內金為臟器療法，若再與白朮等分併用，為消化瘀積之要藥，更為健脾補胃之妙用，脾胃健壯，益能運化藥力，以消積也......不但能消脾胃之積，無論臟腑何處有積，雞內金皆能消之。
根據現代藥理學研究表明，雞內金主要成分是胃激素、角蛋白等，當服用雞內金後，胃液的分泌量、酸度及消化力均增高，胃動力機能加強，排空率加快。雞內金本身不含消化酶，其作用為吸收到血液後，通過體循環，興奮胃壁的神經肌肉而起作用。服藥後，藥力出現較晚，但維持時間較長。
另外，本藥還能加速放射性鍶排泄有一定作用，其酸提取效果較煎劑子。臨床研究表明，鍶、鋅、鋁、鉬、錳、鈷等元素能抑制尿石形成，或使已形成的結石發生溶解作用。鍶及鉬是草酸鈣結晶的抑制因子，實驗證明，鍶可阻止1.25(OH)2D3的生成，並有使已形成的草酸鈣結石解體，或使之縮小的作用。鍶元素一般是通過腸道排泄。一般認為以上這些微量元素作用機制有(1)與結石成核離子竟爭成核部位，干擾結石形成；(2)置換或吸附於晶體的某些生長連接點，抑制結晶的生成或使之溶解；(3)抑制礦化必需酶的活性，影響結石形成；(4)改變尿液成分及比例，破壞結石形成的環境。
筆者認為，通過臨床察結果不難看出，雞內金經口服後，通過血液循環而到達全身各臟器。故大量持續地服用雞內金，血液中能始終保持一定濃度。可能是鍶元素在藥物作用下，通過腎臟排泄，作用於結石，使之解體或縮小。
（收稿日期：2001-12-10）摘自《中國中醫藥信息雜誌2002年5月 第９卷 第５期》
2008年12月17日 星期三
2008年12月4日 星期四
Chickenpox
Treatments and drugs
In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course.
For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications.
If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (IGIV). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but have been approved for use only in adults. In some cases, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity.
If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary.
Don't give anyone with chickenpox — child or adult — any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome.
In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course.
For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications.
If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (IGIV). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but have been approved for use only in adults. In some cases, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity.
If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary.
Don't give anyone with chickenpox — child or adult — any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome.
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