Overview of researches on central action mechanism of needling Zusanli (ST 36)

The contents about the central action mechanisms of needling Zusanli (ST 36) were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that: by comparing acupuncture at Zusanli (ST 36), other acupoints or sham points, most studies showed that Zusanli (ST 36) had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli (ST 36) were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli (ST 36) had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.     

针刺治疗小儿脑瘫腧穴配伍规律文献研究

目的:探究针刺治疗小儿脑瘫的腧穴配伍规律。方法:检索中国知网、万方数据库、维普数据库和PubMed,根据纳入与排除标准筛选文献,提取文献信息构建数据库,采用频数、关联规则及复杂网络进行核心腧穴及配伍规律分析。结果:322篇文献共提取针刺处方332个,涉及腧穴201个,总使用频数为2874次。频数分析显示,高频腧穴前三个依次为百会、足三里和四神聪;腧穴归经分别与经外奇穴、督脉和胆经等密切相关;特定穴中五输穴与下合穴最常用。关联规则分析示脑三针-智三针-颞三针(置信最高96.296%)、合谷-曲池-足三里等腧穴组合联系最紧密。复杂网络分析提示核心节点腧穴为足三里、百会、合谷、三阴交、曲池、太冲等。结论:针刺治疗小儿脑瘫常用靳三针腧穴及督脉穴,头部选穴与体穴相结合,重视特定穴的应用,常用核心腧穴为足三里、百会、合谷、三阴交、曲池、太冲等。     

针灸对结肠癌肝转移患者外周血T淋巴细胞亚群和NK细胞活性的影响

目的:研究针灸对结肠癌肝转移患者免疫功能的影响。方法:60例经病理和影像学诊断明确的结肠癌肝转移患者,采用针灸治疗。针刺取足三里、三阴交、内关、上巨虚、合谷、太溪、太冲、阴陵泉、阳陵泉等穴位;艾灸取神阙、关元、气海、足三里穴。在治疗前后用流式细胞仪检测CD_3、CD_4、CD_8 T细胞和自然杀伤(NK)细胞的数量变化。结果:治疗后T细胞亚群CD_3、CD_4、CD_8和NK细胞的数量变化较治疗前均有明显的升高,具有统计学意义。结论:针灸可以提高结肠癌肝转移病人的免疫功能。     

Differences in thermal effects of moxibustion at Zusanli (ST 36) and Hegu (LI 4) on various facial areas in healthy people

Objective

To study the effects of temperature on different facial areas by suspended moxibustion at two points, Zusanli (ST 36) and Hegu (LI 4), and probe the phenomena underlying self-regulation in the human body after thermal stimulation.

Methods

Thirty healthy volunteers accepted moxibustion over Zusanli (ST 36) and Hegu (LI 4), and the order of moxibustion points was randomly determined. Moxibustion method: suspension of moxibustion over Zusanli (ST 36) and Hegu (LI 4) on both sides was performed using an ignited moxa stick stuck in a support for 20 min. Observation method: An infrared thermal image of the face was taken before and after suspended moxibustion using a CK350 medical infrared thermal imaging instrument. Data analysis: A thermal microscopic section view system (TMTSys) was used to analyze the change in temperature in special facial areas. Statistical analysis was carried out using SPSS 14.0 software.

Results

Before moxibustion was suspended, the facial thermal image showed a T-shaped thermal area related to the vascular distribution with even temperature and good symmetry on both sides. Suspended moxibustion over Zusanli (ST 36) have a very significant increase in temperature at the forehead, around the nose, at the corners of the mouth, and at the cheeks and lips (P<0.01). Suspended moxibustion over Hegu (LI 4) also have a significant (P<0.05) increase in temperature around the nose, the corners of the mouth, the cheeks, and lips, where has a new high temperature area was formed (P<0.01). Suspended moxibustion over Hegu (LI 4) raised the temperature at the middle point of the lips more obviously than did Zusanli (ST 36) in the same person,(P<0.05). After 10 min of moxibustion over Zusanli (ST 36) and Hegu (LI 4), the change in temperature in the facial area reached its peak value.

Conclusion

Facial infrared thermography of healthy people revealed a T-shaped thermal area reflecting a physiological thermal area. Moxibustion over Zusanli (ST 36) or Hegu (LI 4) raised the temperature in this facial T-shaped thermal area. Hegu (LI 4) led to the formation of a new thermal area in the lips. The time required for moxibustion to regulate human body temperature was 10 min.     

窦汉卿针灸处方特点及规律探讨

总结针灸古代文献中窦汉卿针灸处方特点和规律,为研究窦汉卿学术思想以及现代针灸临床提供参考。对窦氏针灸处方的文献进行收集、整理、录入,建立窦汉卿针灸处方数据库,对处方中的腧穴进行频次分析,并采用Apriori算法分析处方用穴规律。共收录窦汉卿针灸处方446个,针灸处方最多用穴12个。治疗病种以内科病症、头面躯体痛症及五官科病症最多。窦汉卿所有处方中总共用穴205个,包括25个奇穴。窦汉卿针灸处方中关联程度较强的穴对有7组,分别为合谷-足三里、足三里-中脘、合谷-曲池、合谷-委中、曲池-肩井、委中-曲池和委中-足三里。选穴原则以近部选穴和远部选穴为主;配穴方法以上下配穴、本经配穴和表里经配穴为主;注重刺灸法与腧穴的配合,注重针刺顺序。     

灸刺足三里治疗难治性面瘫临床观察

目的:观察采用灸刺足三里激发“循经感传”治疗难治性面瘫的临床疗效。方法:60例患者随机分为灸刺足三里组(试验组)、常规治疗组(对照组)各30例,对照组取合谷、太冲、头维等穴,试验组在对照组取穴基础上加灸刺足三里,以患者自觉有温热感沿针体传入穴位深层为度。结果:试验组总有效率为93·3%,明显优于对照组的76·7%(P<0·05);试验组中,有循经感传者的总有效率为100·0%,明显优于无循经感传者的80·0%(P<0·05)。结论:灸刺足三里激发“循经感传”治疗难治性面瘫具有较好疗效,值得推广应用。     

Study of Neuropathways of Acupuncture Effect on Functional Regulation and Disease Treatment

目的：探讨针刺信息调整自主神经功能和治疗疾病的神经通路机制，揭示针刺穴位和靶组织、器官效应的相互关系。方法：以大鼠和小鼠为对象，对躯体性针刺或电刺激下的传入神经反应特征、自主神经功能调控的重要机制之一的躯体-交感反射（一种躯体-自主神经反射）、谷氨酸神经递质的中枢性调控作用以及相应靶组织和靶器官反应的研究进行了回顾和分析。结果与结论：手针或电针刺激动物后三里穴位可以诱发支配后三里穴区的传入神经放电，而直接电刺激传入神经可模拟此过程。在外周躯体传入神经如胫神经直接给予电刺激，可在支配内脏的自主神经传出神经如交感神经上反射性诱发一个电位，该过程定义为躯体-交感反射。研究显示中枢神经系统的兴奋性谷氨酸类神经递质参与了该反射的调控。另一方面，研究显示动物后三里等穴位的躯体刺激如电针刺激可抑制小鼠后肢炎症痛的躯体感觉传入和肠易激综合症大鼠的结直肠痛的内脏感觉传入，其中脊髓GABA和NMDA受体被证明分别参与了前后过程。     

Treatment of hand-foot itch in old people with acupuncture

手部瘙痒取患侧肩髃、曲池、手三里、合谷和中渚,足部瘙痒取足三里、三阴交、解溪、然谷、太冲和足临泣.针刺配合TDP治疗老年人手足瘙痒患者33例.痊愈26例,好转7例.     

面部穴位血流量及针刺对其影响的激光血流成像显示

目的:观察正常人面部穴区血流灌注量,并分析针刺对该血流灌注量的调整作用。方法:使用激光多普勒血流成像仪采集30例健康人自然状态和针刺合谷穴30min前后面部血流图像,统计穴区血流灌注量,分析对称性以及针刺对面部左右侧穴区血流灌注量的影响。结果:正常人面部穴位血流灌注量大多都在0.73～1.17PU范围之间,以巨髎、口禾髎、四白、承泣等血流量较大,下关、牵正、丝竹空等穴血流量较小。自然状态30min前后,正常人面部血流灌注量无明显的升降变化,左右侧同名穴血流灌注量存在小幅差异。针刺30min后正常人面部穴区血流灌注量显著增加(P<0.05,P<0.01),其中左侧巨髎、左侧承泣、左侧丝竹空、左右侧夹承浆和右侧大迎血流灌注量的增加值与自然状态下的变化值相比,差异具有统计学意义(P<0.05,P<0.01)。结论:面部左右侧穴位血流灌注量存在较小差异,针刺可以增加面部双侧穴位血流灌注量。     

针刺配合灸法治疗慢性疲劳综合征的临床随机对照研究

目的:观察、对比针刺法及针加灸法治疗慢性疲劳综合征(chronic fatigue syndrome,CFS)的临床疗效。方法:将133例CFS患者随机分为3组,即针刺组(n=47)、针加灸组(n=44)及非穴组(n=42)。针刺组予针刺百会、膻中、气海、关元、足三里、合谷、太冲、三阴交治疗;针加灸组予膻中、合谷、太冲、三阴交针刺治疗,百会、气海、关元、足三里温针灸治疗;非穴组在上两组所选腧穴周围1~2cm非腧穴点给予针刺。均留针30min,每日1次,10次为一疗程,共治疗2个疗程。应用Chalder疲劳量表和患者满意度自评量表对治疗后疲劳改善情况及治疗效果给予评估。结果:(1)疲劳积分改善情况:与治疗前比较,针刺组及针加灸组治疗后体力疲劳积分、脑力疲劳积分及疲劳总积分显著降低(P0.05,P0.01);与非穴组相比,治疗后针刺组及针加灸组上述3项指标显著降低(P0.05,P0.01);治疗后针加灸组的体力疲劳积分及疲劳总积分显著低于针刺组(P0.05)。(2)各组临床满意度比较:针加灸组满意率明显高于针刺组和非穴组(P0.05),而针刺组与非穴组相比差异无统计学意义(P0.05)。结论:无论单纯针刺法或温针灸法治疗CFS均具有良好的疗效,二者相比,又以温针灸法更优。     

针刺足三里PET脑功能成像

目的：探讨针刺足三里穴PET脑功能成像的实验方法。寻找针刺足三里脑功能变化的实验依据。方法：用PET对6例男性健康志愿者行针刺右侧足三里前后的^18FDG-PET脑功能成像，用SPM软件处理脑内葡萄糖代谢率变化的实验数据。获得脑功能变化的可视性实验依据。结果：针刺右侧足三里穴引起视丘下部，尾状核头部，小脑，颞叶，中央后回，脑千的葡萄糖代谢增加，结论：针刺足三里穴可引起与内脏功能有关的皮质下植物神经中枢葡萄糖代谢增加，PET是研究针灸中枢机制的可行性方法之一。     

NEUROANATOMICAL CHARACTERISTICS OF ACUPUNCTURE POINTS DETERMINED BY NEURAL TRACING TECHNIQUE

Objective: To investigate the regular distribution of neurons associated with different acupuncture points by using neural tracing technique.Methods: This experiment was carried out with rats, in which"Hegu"(LI4), "Quchi"(LI11), and "Jianyu"(LI15) in the large intestine meridian of hand-Yangming; as well as "Neiting"(ST44), "Zusanli"(ST36), and "Futu"(ST32) in the stomach meridian of foot-Yangming were chosen as the representative acupuncture points.Three days later, Alexa Fluor 594 conjugated cholera toxin subunit B(AF594-CTB) was respectively injected into each acupuncture point; the rats were perfused, and the dorsal root ganglia and the spinal cord were dissected out.The tissue sections were observed with a laser scanning confocal microscope to determine the distribution of neurons associated with different acupuncture points.Results: The sensory and motor neurons associated with LI4,LI11 and LI15 were located at the segments correlated with spinal cervical enlargement.In contrast, the sensory and motor neurons associated with ST44, ST36 and ST32 were located at the segments correlated with spinal lumbar enlargement.In addition, the closer to the body trunk the acupuncture point is,the higher the neurons associated with the corresponding acupuncture point situated in the spinal segment.Moreover, the motor neurons associated with the acupuncture points on the proximal, mid, and distal parts of limb regularly distribute from the lateral part to the medial part of spinal ventral horn.Conclusion: The sensory and motor neurons associated with different acupuncture points are located at definite spinal segments and regions in the nervous system.These neuroanatomical characteristics may play an important role in selecting proper acupuncture points in clinical treatment.     

针刺抑制直结肠伤害性扩张引起的大鼠脊髓背角神经元反应

目的:探讨针灸缓解内脏痛的机制.方法:选用SD大鼠,采用直结肠扩张(CRD)作为内脏的伤害性刺激.微电极细胞外记录L1～L3节段脊髓背角广动力型神经元活动.针刺选用与直结肠同神经节段支配的同侧和对侧"足三里"穴位.结果:内脏伤害性传入能明显激活脊髓背角会聚神经元,对侧体表机械刺激和"足三里"穴位手针刺激可抑制这种伤害性反应.急性脊髓化实验,针刺对侧"足三里"穴位抑制CRD反应的效应完全消失.结论:针刺和内脏伤害性传入信号在脊髓水平发生会聚和相互作用,针刺穴位能够抑制内脏伤害性传入所激活的背角神经元反应,且这种作用需要脊髓上中枢参与.     

电针正常人足三里和关元穴中枢效应的fMRI脑功能成像比较

目的:利用fMRI脑功能成像,比较电针时位于肢体的足三里穴及腹部的关元穴激活的脑功能区及其功能区网络连接的异同。方法:21名健康志愿者参加电针足三里穴、关元穴时的fMRI试验。分别在针刺前静息状态、留针、电针(15Hz,3次30s,间隔1min)、拔针后静息态采集fMRI脑功能数据,并记录电针任务时针感。采用t检验及卡方检验分析针感,SPM 2、短程和长程"中心度"法分析脑激活功能区及其之间的功能网络连接。结果:在电针电流无显著性差异条件下,电针足三里穴较关元穴诱导出了更强的胀满感及麻木感。电针两穴均产生了相似的前下扣带回-额叶内侧回网络的显著负激活效应,留针及电针能改变脑静息态脑功能默认功能模式,于额叶内侧回、扣带前回前下部短程脑功能网络出现了明显的即时针刺后效应。足三里穴较关元穴产生了更强的短程脑功能网络连接。结论:针刺足三里、关元穴具有显著相似的对脑边缘叶-额叶内侧皮层脑网络的调制作用,但也存在小的差异,体现穴位脑效应的相对特异性。     

针麻与硬膜外麻醉行阑尾切除术效果比较研究

<正> 本组病例行阑尾切除术,随机以针刺麻醉40例,硬膜外麻醉40例进行比较术中镇痛效果,生命体征的平稳情况,术后胃肠功能的恢复时间,排气时间,镇痛药物的使用情况,抗生素的使用及切口愈合情况,住院天数以及观察两种麻醉方法的术中镇痛及术后     

远取足三里、厉兑结合面部深透刺治疗周围性面瘫临床观察

目的:观察远取穴位对针刺疗效的影响.方法:将125例周围性面瘫患者随机分为两组.观察组75例,在面部取穴的基础上根据不同的辨证结果,分别选取足三里、厉兑穴;对照组50例,单纯面部取穴治疗,观察比较两组疗效.结果:观察组治愈率69.3%、显效率17.3%;对照组治愈率48.0%、显效率20.0%.观察组疗效优于对照组(χ2=7.337,P<0.05).结论:远取足三里、厉兑可提高针刺治疗周围性面瘫的疗效.     

不同方法治疗颈性眩晕疗效对比观察

目的:比较常规针刺、电针、电针配合穴位注射治疗颈性眩晕的疗效差异.方法:采用随机的方法,将91例颈性眩晕患者分成常规针刺组(30例)、电针组(31例)和电针穴位注射组(30例),3组均取足三里、风池、安眠、太阳、合谷、印堂、百会、四神聪,常规针刺组用平补平泻法针刺,电针组加用G 6805电针治疗仪,电针穴位注射组在电针组治疗基础上,于风池或安眠穴采用维生素B120.5 mg及0.2%利多卡因2 mL穴位注射,治疗4周共20次.观察治疗前后椎动脉、基底动脉的平均血流速度的变化,采用颈性眩晕症状与功能评分法在治疗前后进行评分,并进行疗效评定.结果:3组治疗后椎动脉、基底动脉的平均血流速度及颈性眩晕症状与功能评分均较治疗前明显提高(均P＜0.01),电针穴位注射组较其他两组改善更明显(P＜0.05,P＜0.01),电针组优于常规针刺组(P＜0.05);常规针刺组总有效率为63.3%(19/30),电针组为80.6%(25/31),电针穴位注射组为90.3%(28/30),3组疗效比较差异均有统计学意义(P＜0.05,P＜0.01).结论:常规针刺、电针、电针配合穴位注射治疗颈性眩晕均有效,其中电针穴位注射组疗效最好,电针组疗效次之,说明常规针刺、电针、穴位注射治疗在颈性眩晕上疗效有叠加效应.     

手针刺激“足三里”穴局部肥大细胞活动与外周神经放电的相关性研究

目的:探讨穴位处肥大细胞的激活及穴区胶原与支配该区域的神经束放电变化之间的关系。方法:雄性SD大鼠30只,随机分为空白组、对照组、手针足三里组、手针+色甘酸钠组(穴区肥大细胞拮抗)、手针+胶原酶组(穴区胶原纤维溶解),每组6只。动物麻醉后,分离左侧"足三里"穴区坐骨神经干,手针提插刺激大鼠"足三里"穴20min,记录刺激前、刺激时和刺激后神经束诱发放电信号。对穴位组织进行组织学观察,统计肥大细胞脱颗粒率。结果:与对照组、手针+色甘酸钠组和手针+胶原酶组相比,手针足三里组诱发的坐骨神经放电活动明显增强(P<0.01);同时手针足三里组肥大细胞脱颗粒率显著升高(P<0.01),而手针+色甘酸钠组和手针+胶原酶组肥大细胞脱颗粒率与对照组相比差异无统计学意义(P>0.05)。结论:手针刺激大鼠"足三里"穴位可诱发支配该区域的外周神经束放电;穴位区注射色甘酸钠可抑制肥大细胞脱颗粒,针刺引起的外周神经放电减弱;穴位区注射胶原酶阻断针刺应力在穴位组织中传输,可以抑制肥大细胞脱颗粒,同样,针刺引起的外周神经放电也减弱。     

调理脾胃针法对糖尿病周围神经病变神经传导功能的影响

目的:探讨糖尿病周围神经病变的较佳针灸治疗方案。方法:将患者随机分为观察组和对照组,每组40例。观察组采用调理脾胃针法治疗,针刺曲池、合谷、血海等穴;对照组应用甲钴胺500μg肌肉注射。两组均每日治疗1次,共治疗4周。比较两组治疗前后神经传导功能及疗效。结果:观察组总有效率为95.0%(38/40),优于对照组的82.5%(33/40)(P<0.05);治疗后观察组患者胫神经的运动、感觉功能均优于对照组(P<0.05,P<0.01)。结论:调理脾胃针法治疗糖尿病周围神经病变的疗效优于甲钴胺治疗,并能有效提高神经传导功能。     

针刺老年大鼠"足三里""关元"穴对NO、SOD、MDA以及免疫影响的实验研究

目的：探讨针刺抗衰老的作用机理,方法：针刺老年大鼠的“足三里”“关元”穴,观察对脑、心、肝、肾组织中一氧化氮（NO）、超氧化物歧化酶（SOD）、丙二醇（MDA）变化以及对单核巨噬系统吞噬功能的影响。结果：针刺能调节脑心肝肾组织中NO的含量;能提高脑心肝肾组织中抗氧化能办,使SOD的含量增高,MDA的含量降低;能提高单核巨噬系统的吴噬指数,结论：针刺“足三里”“关元”穴有明显抗衰作用。