壮医火功加熨浴疗法治疗痹病89例临床观察
<div><br/></div><div><br/></div><div><br/></div><div><br/></div><div><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; color: rgb(69, 69, 69); "><h1 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 10px; padding-right: 10px; padding-bottom: 10px; padding-left: 10px; float: left; width: 705px; font-size: 16px; background-color: rgb(235, 244, 253); border-bottom-width: 1px; border-bottom-color: rgb(182, 209, 236); border-bottom-style: double; text-align: center; border-top-width: 0px; border-right-width: 0px; border-left-width: 0px; border-top-style: double; border-right-style: double; border-left-style: double; border-top-color: rgb(182, 209, 236); border-right-color: rgb(182, 209, 236); border-left-color: rgb(182, 209, 236); overflow-x: hidden; overflow-y: hidden; ">壮医火功加熨浴疗法治疗痹病89例临床观察</h1><dl style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 6px; padding-right: 12px; padding-bottom: 6px; padding-left: 12px; line-height: 28px; "><dt style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 4px; padding-right: 12px; padding-bottom: 4px; padding-left: 12px; line-height: 28px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; overflow-x: hidden; overflow-y: hidden; border-style: initial; border-color: initial; text-align: center; "><a href="http://www.shouxi.net/" style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; color: rgb(102, 102, 102); text-decoration: none; "> </a> 2007年8月14日 医药信息杂志 临床报道</dt><dt id="ADleftTop" style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 4px; padding-right: 12px; padding-bottom: 4px; padding-left: 12px; line-height: 28px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; overflow-x: hidden; overflow-y: hidden; border-style: initial; border-color: initial; "></dt><dt style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 4px; padding-right: 12px; padding-bottom: 4px; padding-left: 12px; line-height: 28px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; overflow-x: hidden; overflow-y: hidden; border-style: initial; border-color: initial; "><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; text-align: center; ">作者：王柏灿 作者单位：广西壮医医院,广西 南宁 530001 <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></p></dt><dt class="q_p_line" style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 4px; padding-right: 12px; padding-bottom: 4px; padding-left: 12px; text-align: center; border-bottom-width: 1px; border-bottom-color: rgb(137, 178, 219); border-bottom-style: dashed; line-height: 28px; border-top-width: 0px; border-right-width: 0px; border-left-width: 0px; border-top-style: dashed; border-right-style: dashed; border-left-style: dashed; border-top-color: rgb(137, 178, 219); border-right-color: rgb(137, 178, 219); border-left-color: rgb(137, 178, 219); overflow-x: hidden; overflow-y: hidden; "><br/></dt></dl><dl class="page_txt" style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 6px; padding-right: 12px; padding-bottom: 6px; padding-left: 12px; font-size: 14px; color: rgb(102, 102, 102); line-height: 28px; "><div id="Reading" style="margin-top: 0px; margin-right: 15px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; float: left; "></div><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "><br/></strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; ">【关键词】</strong> 痹病；壮医；火功疗法；熨浴疗法</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); ">火功疗法,亦称神火疗法,为采用经壮药酒泡制过的干植物藤茎(如吹风藤、钩吻藤、牛耳枫、毛杜仲藤等),点燃后取暗火,隔牛皮纸灸灼穴位或患部。熨浴疗法,即以壮药加水煎煮,先以药渣熨烫,再以药液洗浴。笔者在临床中运用此两种疗法配合治疗痹病89例,收到满意效果,现小结如下。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 1 一般资料<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></strong> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 本组89例,男性41例,女性48例；年龄13～68岁,其中<30岁者11例,30～40岁者23例,>40～50岁者18例,>50～60岁者24例,>60岁者13例,以青壮年多见；病程<1年者39例,1～5年者25例,>5～10年者14例,>10年者11例；类风湿性关节炎10例,风湿性关节炎37例,风湿寒性关节痛42例；其中工人31例,农民22例,教师12例,干部15例,学生5例,其它4例,以工人与农民居多,其次为教师与干部。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 2 诊断标准<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></strong> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> ①症状：关节、肌肉、筋骨等部位疼痛或肿胀,麻木重着,或肌肉萎缩,活动不利等。②发病特点：多与气候变化有关。③年龄特点：青壮年多见,女性多于男性。④实验室检查：血沉(ESR)加快或“抗0”(ASO)增高,或类风湿性因子(RF)阳性,X线可有骨质损害。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 3 治疗方法</strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "><br/></strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> 3.1 壮医火功疗法<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> ①用壮药酒泡制过的干吹风藤一根(长约15～20 cm,直径1～2.5 cm),边长约10 cm的方牛皮纸数张,酒精灯1个。②嘱患者坐或卧,以术者方便、患者舒适为原则,令患者暴露预定施术部位。③点燃酒精灯,将药藤的一端置于火焰上燃烧,取暗火,用药藤的燃端隔2～3层牛皮纸置于患处及其周围的穴位上按压捻转,以患者能承受的温热麻胀感为度,火灭后重新点燃,如此反复,每穴位治疗2～3 min,每日治疗1次,10 d为1个疗程,共治疗2～5个疗程。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> 3.2 壮医熨浴疗法<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 取壮药丢了捧30 g、伸筋草30 g、十八症30 g、红鱼眼30 g、宽筋藤30 g、了刁竹20 g、九龙藤20 g、鸡血藤20 g、过江龙20 g,粉碎,将药粉装入布袋包好,加水1 500 mL左右煎煮,沸后15 min,将药袋趁热(患者能忍受、不起泡为度)反复熨烫患处及关节,药袋凉后,再用药水浴洗患处及关节,每日1剂1次,10 d为1个疗程,共治疗2～5个疗程。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/>壮医火功与熨浴疗法相隔4～6 h交替进行。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 4 疗效标准<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></strong> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 临床治愈：症状全部消失,功能活动恢复正常,ESR、ASO、RF、X线征正常；显效：全部或主要症状消失,关节功能基本正常,能正常生活与工作,ESR、ASO、RF、X线征等基本正常；好转：主要症状基本消失,关节功能基本恢复正常或有明显改善,生活由不能自理转为能自理,劳动能力有所恢复,ESR、ASO、RF、X线征等指标有所改善；无效：与治疗前相比,症状、体征均无改善。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 5 结果</strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "><br/></strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> (见表1～表3)表1 89例痹病患者治疗后症状、体征改变情况(略)</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/>表2 89例痹病患者治疗后实验室指标检测结果(略)表3 89例痹病患者治疗后综合疗效评定结果(略)</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><br/></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "> <strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "> 6 讨论<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></strong> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 广西地处岭南,气候炎热,多雨潮湿,历代为痹病多发地区。壮医称痹病为“发旺”,壮医认为,痹病是由于各种邪毒(风、湿、痧、热、寒等)内侵,阻滞人体“三道”、“两路”,留著于关节筋肉,致天、地、人三气不能同步而成。由于邪毒性质及留着部位不同,可表现为不同的症状体征。如风毒致病,多为游走性关节肌肉疼痛；湿毒致病,多为关节肌肉重着麻木；热毒致病,多为关节肿痛红热；寒毒致病,多为关节疼痛,手足不温；邪毒日久,四肢关节肌肉“两路”不通,可致功能受限、关节畸型甚则残废。<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 壮医火功主要通过药物、穴位、温热剌激起作用,熨浴疗法具有祛风逐湿、活血舒筋、散寒止痛、祛瘀消肿作用。笔者采用壮医火功加熨浴疗法配合,治疗痹病89例,经2～5个疗程治疗后,总有效率达91.01%,综合评定效果满意。其中,对风湿寒性关节痛的疗效最好,其次为风湿性关节炎,再次为类风湿性关节炎。经治疗后,绝大部分患者症状体征消失或有明显改善,实验室检查ESR、ASO恢复正常或有明显改善,但RF阳性的阴转尚不理想。<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> <br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 壮医火功疗法和壮医熨浴疗法均来自本院对壮族民间经验的整理总结,其优点为简便易行,费用低廉,疗效确切,无不良反应,为痹病患者多提供了一种选择。壮医火功和熨浴疗法的作用机理,有待进一步探讨。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "><br/></strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><strong style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; ">【参考文献】</strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 10px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 24px; color: rgb(0, 0, 0); "><span style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; "></span><b><br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/></b> 蒋 明,张奉春.风湿病诊断与诊断评析.上海：世纪出版集团、上海科技出版社,2004.89.<br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/><br style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; clear: both; "/> 庞声航,王柏灿,莫 滚.中国壮医内科学.南宁：广西科技出版社,2004.104.</p></dl></span></div><div><br/></div><div><br/></div><div><br/></div><div><br/></div><div><br/></div> <p>神秘也不失为很的商业炒作便于传播与推广。呵呵。如苗药藏药。</p><p>要知道壮族的东西没有什么神秘性了，不具吸引力啊。</p> <p>其实就是艾线点灸吧？</p><p>怎么看起来这么神秘啊 。</p>
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