试论[自稳调节机制]与中医治疗观

试论“自稳调节机制”与中医治疗观湖北省襄樊市中医医院（４４１０００）冯辉一、“自稳调节机制”是健康与疾病的中介“内环境稳定”是法国生理学家ＣｌａｕｄｅＢｅｒｎａｒｄ提出来的。５０年代美国生理学家ＣａｎｎｏｎＷＢ对此深入研究时提出了“稳态学说”：机体内...     

复杂性视野下的内环境和内环境稳态

研究和总结了复杂系统的基本特征,从复杂性的角度讨论了内环境作为动态非线性系统存在具有的诸种性质和正反馈在维持、调节内环境稳定中的作用,指出现阶段需要重新认识内环境和内环境稳态的生理学机制。     

复杂性视野下的内环境和内环境稳态

研究和总结了复杂系统的基本特征,从复杂性的角度讨论了内环境作为动态非线性系统存在具有的诸种性质和正反馈在维持、调节内环境稳定中的作用,指出现阶段需要重新认识内环境和内环境稳态的生理学机制.     

人类性的生理需要及其满足的本质和意义

性活动源于性的需要.人类性的需要包括性的生理、心理和社会需要.性的生理需要是性的心理需要和社会需要的基础.性的生理需要可能是个体优化调节系统功能以维持内环境稳态的基本需要;性的活动能优化人体调节系统功能和人体整体层次的生理功能,从而提高人体对环境变化的适应能力.     

正念维持适应的机制:来自心率变异性自相似的初步证据

引入自相似的算法表征功能内稳态的过程,从功能内稳态的角度探讨特质正念与不同过程中心率变异性(Heart rate variability, HRV)自相似的关系,以揭示正念起作用的可能机制。功能内稳态是机体面对内外环境的变化保持自身功能相对稳定的一种能力或素质。研究设置静息态、冷加压任务、冷加压后恢复和正念练习4种不同的条件,并记录被试在这4个环节的HRV指标。结果显示, HRV自相似与特质正念之间存在显著相关,高HRV自相似组在冷加压环节的HRV各指标都比低HRV自相似组高。结果表明,正念维持适应的生理机制可能与功能内稳态有关。     

自噬与膀胱肿瘤

细胞自噬作为真核细胞的高度保守的细胞生物学行为,可将细胞内受损、变性衰老的蛋白质以及细胞器运输到溶酶体进行消化降解。在正常生理过程中,自噬可以清除细胞内的毒性物质、维持细胞内环境的稳态,而自噬过程中产生的氨基酸等营养物质可以被细胞代谢再利用,为细胞的生存代谢提供营养。在肿瘤发生发展过程中,自噬过程中产生的小分子物质可以促进肿瘤生长,其在肿瘤形成和治疗中扮演着双重角色。本文就近年来细胞自噬与膀胱肿瘤的研究进展作一综述。     

从进化观点看应激对健康的影响

从进化的观点解释了不同生物体应对应激的不同行为策略及其生理基础,和由此引起的对不同应激性疾病易感性的差异。行为策略和生理基础的差异使得一定环境条件下引发的应激反应对不同个体产生了不同的非稳态获益和代价（非稳态负荷)。非稳态的获益和代价影响了健康和疾病间的平衡：攻击性个体由于非稳态调质失调,更可能出现冲动控制障碍、高血压、自身免疫性疾病、慢性疲劳状态等;反之,非攻击性个体由于非稳调质过度释放,更易发生焦虑障碍、抑郁症、代谢综合症等     

骨搬移重建微循环的哲学启示

自前苏联Ilizarov医生发现慢性牵拉后组织再生的“张力 应力法则”至今,骨外固定系统已逐渐完善并形成了一种全新的骨科治疗体系.骨搬移技术对物质发展的根本规律、生物学的基础研究、自然重建理念的形成、多种外科疾病的诊治思路和诊疗方法皆产生了重要影响.本文从医学与哲学的角度,论述了骨搬移技术的发展、对牵拉区域微循环的重建及其中包含的哲学思想,为骨搬移技术治疗骨科及血管外科系统疾病提供了医学与哲学上的思路和方法.     

幸福感的稳态与跃迁：一个新的整合视角

以往的实证和理论研究对幸福感稳定性与变化性问题持有不同观点。设定点理论认为幸福感通常保持在设定点位置, 动态平衡理论(及其变式——主观幸福感稳态理论)进一步强调幸福感在围绕设定点的某个范围内波动而呈动态平衡状态, 享乐适应理论在动态平衡理论基础上从情绪适应的角度分析了幸福感维持稳定的原因, 这三个理论均强调幸福感维持在某个平衡水平。相反, 持续幸福理论强调幸福感是可以提升的, 能发生长期的变化。这些理论观点的差异本质在于如何看待幸福感的稳定性与变化性, 我们借用生物学中的“稳态”“稳态应激”概念及物理学中的“跃迁”思想, 认为幸福感不仅存在稳态, 也会出现稳态应激, 并可由此引起幸福感稳态的跃升。这一整合视角为幸福感研究提供了新的解释框架, 也对幸福感的持续提升有启发意义。     

骨搬移重建微循环的哲学启示

自前苏联Ilizarov医生发现慢性牵拉后组织再生的“张力 应力法则”至今,骨外固定系统已逐渐完善并形成了一种全新的骨科治疗体系.骨搬移技术对物质发展的根本规律、生物学的基础研究、自然重建理念的形成、多种外科疾病的诊治思路和诊疗方法皆产生了重要影响.本文从医学与哲学的角度,论述了骨搬移技术的发展、对牵拉区域微循环的重建及其中包含的哲学思想,为骨搬移技术治疗骨科及血管外科系统疾病提供了医学与哲学上的思路和方法.     

颈椎病现代针灸的腧穴谱

探讨颈椎病现代针灸的腧穴谱,对提高临床疗效至关重要。通过考察近十余年来期刊文献。对比分析得出针灸防治颈椎病的腧穴使用频率,推荐现代针灸防治颈椎病的常用腧穴有夹脊、风池等23个,少用腧穴有尺泽、鱼际等46个,与古代选穴明显不同。     

伴骨质疏松的交感神经型颈椎病的临床治疗

为了探讨骨质疏松在交感神经型颈椎病中的作用及临床治疗的方法,对交感神经型颈椎病患者34例,21例同时患骨质疏松症的患者进行研究,观察抗骨质疏松治疗、围领制动及手术治疗的效果。结果显示,13例单纯颈椎病组的抗骨质疏松、围领制动治疗后症状无明显缓解（P〈0．01）,21例伴骨质疏松症组抗骨质疏松、围领制动治疗后症状可缓解（P〈0．05）。因此,骨质疏松是导致交感神经型颈椎病的重要因素,手术治疗的同时抗骨质疏松治疗有良好的效果。     

Significant treatment factors in short-term group psychotherapy

The author briefly describes an approach to short-term group psychotherapy based upon an adult developmental model. By means of a clinical case example significant treatment factors are examined. Such an approach to planned short-term group therapy may force group members to confront and deal with important existential issues.     

人工颈椎间盘置换术能否取代ACDF

目前颈椎病的治疗主要采用切除病变椎间盘和椎体间融合的手术方法,而人工颈椎间盘置换术的临床应用预示着脊柱外科治疗学新纪元的开始。简要介绍了Byran人工颈椎间盘置换术,对其临床效果进行了随访和分析,总结了人工颈椎间盘置换术的治疗优势和临床应用中的问题。客观评价了人工颈椎间盘技术,为临床决策提供了实践依据。     

Beyond homeostasis: toward a concept of coherence

The concept of homeostasis has served as a major building block, if not the cornerstone, of family theory and family therapy. Designed to account for the perceived stability of systems (and symptoms), homeostasis is an epistemologically flawed concept that has repetitively been used in the service of dualistic, animistic, and vitalistic interpretations of systems. Accordingly, homeostasis has led to quirky clinical formulations and a great deal of fuzzy theorizing. This paper contends that the notion of homeostasis is fundamentally inconsistent with systemic epistemology and should be replaced with the more compatible concept of coherence. Whereas homeostasis is a heuristic concept that is not part of a more encompassing theory, the concept of coherence is inseparable from the epistemology in which it is embedded.     

Religion in Childhood and Adolescence: A Comprehensive Review of the Research (Book)

This research is based on the therapeutic strategy that I used in the treatment of three clients exhibiting various symptomatologies (i.e., manic-depressive psychosis, depression, and panic anxiety attacks). All three patients had atheism as the common belief system. I adopted a new method of treatment, in which the clients were gradually, undemandingly, and unobtrusively encouraged to renew their connection with God. The name given to this new approach is called third force therapy. Using the technique of third force therapy, the patients were fully recovered within a period of 6 months.     

‘Heart-talk:’ Considering the Role of the Heart in Therapy as Evidenced in the Quran and Medical Research

The emphasis on scientific approaches and evidence-based therapy has been a key force in developing and refining existing models of therapy. While this has been unquestioningly invaluable, it has similarly restricted the development and so implementation of those models that do not lend themselves easily to current research methodology, since the lack of evidence-practice research means they are not considered as ‘legitimate’ therapeutic practice. That the mind and body have an inter-dependent relationship is readily evidenced in numerous religious texts, but the lack of acknowledgement of that relationship in contemporary therapeutic approaches means that patients are not able to benefit from its use in sessions. Ironically, it is current developments in medical research that have discovered the reality around this relationship that have enabled such models to be further explore within an accepted context of evidence-based practice. This paper highlights the relationship between the heart and brain function as evidenced with brief reference to Quranic verses and medical (namely, neurocardiological) research. Further, it raises questions around the implications of this information for therapists working in both physical and mental health. The concept of ‘heart talk’ is an extension of the term ‘heart brain’ coined by Dr Armour (Professor of Pharmacology) in 1991 and is suggestive of its use in the world of psychological therapy. It relates to those cognitions which patients suggest come ‘from the heart’ which though previously dismissed are now suggestive of having some scientific basis and are potentially a legitimate source of information in understanding patients experiences.     

Sandplay therapy with couples within the framework of analytical psychology

Sandplay therapy with couples is discussed within an analytical framework. Guidelines are proposed as a means of developing this relatively new area within sandplay therapy, and as a platform to open a wider discussion to bring together sandplay therapy and couple therapy. Examples of sand trays created during couple therapy are also presented to illustrate the transformations during the therapeutic process.     

Allostasis,homeostats, and the nature of stress

This essay continues discussion of a new formulation of homeostasis that uses the concepts of allostasis and homeostats. The new formulation moves beyond Cannon's concept of "homeostasis," which posits an ideal set of conditions for maintenance of the internal environment. The notion of allostasis recognizes that there is no single ideal set of steady-state conditions in life, and different stressors elicit different patterns of activation of the sympathetic nervous and adrenomedullary hormonal systems. Allostasis reflects active, adaptive processes that maintain apparent steady states, via multiple, interacting effectors regulated by homeostatic comparators--"homeostats." "Allostatic load" refers to the consequences of sustained or repeated activation of mediators of allostasis. From the analogy of a home temperature control system, the temperature can be maintained at any of a variety of levels (allostatic states) by multiple means (effectors), regulated by the thermostat (homeostat). Allostatic load and risks of system breakdown increase when, for example, the front door is left open in the winter. Applying these notions can aid in understanding how acute and chronic stress can exert adverse health consequences via allostatic load.     

从耗散理论解读肿瘤的发病及治疗

肿瘤的综合治疗方案,即药物-社会-心理治疗已广泛地应用于临床,虽效果显著,但其机制尚缺乏确切的实验依据。笔者从耗散结构理论来解读这种综合疗法,认为药物、社会及心理治疗均是通过增加机体的负熵,使肿瘤患者的内环境处于有序平衡状态而改善其病情。从耗散理论出发可以将肿瘤的综合疗法更好地应用于临床。