正常女大学生经期穴位体表温度与室内温度和湿度相关性分析

目的:通过观察正常女大学生经期经穴体表温度和同名穴位温差与室内温度和湿度的相关性,判断以这两个指标作为经穴反映胞宫功能状态的客观指标时,是否应考虑环境因素的影响。方法:正常女大学生49人,选取胞宫相关经穴血海、地机、中都、三阴交、太溪、太白、太冲、水泉,非相关经穴悬钟以及悬钟旁非经非穴,于经期第1天连续动态探测各测试点体表温度60min,每10min记录1次室内温度和湿度。利用发展模型建立因变量x(室内温度或温差)与y(体表温度或温差)之间的关系,进而判断两者的变化是否相关。结果:正常女大学生经期第1天双侧血海、地机、中都、悬钟、非穴的体表温度与室内温度呈正相关(P<0.05);各测试点同名穴位温差与室内温度相关性不显著(P>0.05);各测试点的体表温度与室内湿度相关性不显著(P>0.05);各测试点同名穴位温差与室内湿度相关性不显著(P>0.05)。结论:经穴体表温度较同名穴位温差易受室内温度的影响,两者均不易受室内湿度的影响,推测如果经穴体表温度作为反映胞宫生理及病理变化的客观指标时应该把室内温度作为协变量考虑,建议采用同名穴位温差作为穴位反映机体生理及病理变化的客观指标。     

足三阴经经穴体表微循环反映月经周期变化规律研究

目的:观察生理状态下胞宫相关经穴体表微循环在月经周期中的变化,探求生理状态下胞宫相关经穴体表微循环变化的特异性规律,为经穴反映功能的特异性提供实验依据。方法:招募90例健康女大学生,选取与胞宫相关的足三阴经原穴、郄穴、足三阴经交会穴(三阴交),脾经非特定穴(血海),非相关经穴(悬钟)以及非经非穴作为测试点,通过激光散斑血流成像技术观察这些测试点在月经期、卵泡期、排卵期和黄体期的微循环血流灌注量变化规律。结果:右侧地机穴月经期血流灌注量低于排卵期和黄体期(P0.05),卵泡期低于排卵期(P0.05);左侧中都穴月经期血流灌注量低于卵泡期、排卵期、黄体期(P0.05)。地机、三阴交、太溪、水泉穴在各时期同名穴位左侧血流灌注量均大于右侧(P0.05),悬钟穴在各时期右侧血流灌注量均大于左侧(P0.05);血海穴在排卵期左侧穴位血流灌注量大于右侧(P0.05),太白穴在月经期、非经非穴在黄体期右侧穴位血流灌注量均大于左侧(P0.05)。结论:脾经地机和肝经中都穴体表微循环可特异性反映生理状态下胞宫气血变化。     

足三阴经经穴体表电阻反映胞宫生理变化的规律研究

目的:通过观察正常女大学生在不同月经周期足三阴经的原穴、郄穴、交会穴、非特定穴的体表电阻变化,探寻胞宫相关经脉不同经穴体表电阻反映月经周期的特异性规律,为深入研究经穴反映脏腑功能的机制研究奠定基础,同时为临床和科研探讨正常女大学生月经周期相关经穴的生物物理特性提供参考依据。方法:招募正常女大学生90人,选取与胞宫位于邻近脊髓节段的足三阴经原穴、郄穴、交会穴、非特定穴,于月经期、卵泡期、排卵期、黄体期的相同时间点连续动态探测体表电阻30 min,观察各穴位电阻值在月经周期中的变化。结果:各穴位在月经周期中单侧穴位电阻值的变化均差异无统计学意义(P0.05)。相同时期,单侧3个原穴、3个郄穴、脾经不同穴位、腰4皮节上不同穴位间的电阻值比较,差异无统计学意义(P0.05)。同一穴位左右电阻比较:太冲在月经期电阻值左侧大于右侧(P0.05);太白在排卵期左侧大于右侧(P0.05);中都在卵泡期、排卵期、黄体期左侧均大于右侧(P0.05);太溪、地机、三阴交在4个时期的电阻值左侧均大于右侧(P0.05);水泉在4个时期左侧均小于右侧(P0.05)。结论:足三阴经相关经穴左右两侧电阻的变化趋势可以特异性地反映出胞宫在月经周期中的气血变化情况。肝经原穴、郄穴在月经期显示出了不同于其他时期的变化趋势,脾经原穴太白在排卵期显示出了不同于其他时期的变化趋势,体现了经穴反映功能上的特异性。经穴反映脏腑功能的机制不仅与经穴和脏腑所属的脊髓节段具有相关性,与经穴所属经脉及穴位属性也具有特异性关系。     

膀胱经、胆经特定穴皮肤电阻对腰椎间盘突出症患者的反应研究

目的:观察足太阳膀胱经、足少阳胆经特定穴、非特定穴、非经非穴皮肤电阻在腰椎间盘突出症患者中的表现,探寻哪些穴位可以特异性地反应腰椎间盘突出症。方法:本研究在北京中医药大学第三附属医院针灸科门诊进行,招募腰椎间盘突出症患者78例(膀胱经组38例和胆经组40例)、正常受试者36例。选取膀胱经的特定穴包括原穴京骨、郄穴金门、络穴飞扬、下合穴及合穴委中,胆经的特定穴包括原穴丘墟、络穴光明、郄穴外丘、下合穴及合穴阳陵泉,非特定穴包括膀胱经的秩边、胆经的风市,以及非经非穴,连续动态探测3组受试者的皮肤电阻30 min,以同名穴位电阻差值作为结局指标。结果:膀胱经组委中穴的左右两侧同名穴位电阻差值有显著性差异(P 0. 01),其他穴位无明显差异(P0. 05)。结论:初步推测膀胱经的下合穴及合穴委中可能是腰椎间盘突出症的1个反应点。     

原发性痛经患者任、督、冲三脉经穴体表微循环研究

目的：采用激光散斑血流成像技术观察原发性痛经患者任、督、冲三脉经穴体表微循环,为针灸治疗原发性痛经提供选穴依据。方法：招募月经周期规律的健康女大学生（正常组） 99名和原发性痛经女大学生（痛经组） 94名。经前、经期第1天和月经结束后第3天,采用激光散斑血流成像技术观察两组受试者任脉腹部经穴（阴交、气海、石门、关元、中极、曲骨）、冲脉交会腧穴（双侧肓俞、中注、四满、气穴、大赫、横骨）、督脉腰骶部经穴（悬枢、命门、腰阳关、腰俞）及2个非经非穴体表微循环。结果：经前,痛经组和正常组穴位体表血流灌注量比较,差异无统计学意义（P>0.05）;经期第1天,痛经组悬枢、命门、腰阳关和右侧肓俞体表血流灌注量大于正常组（P<0.05,P<0.01）;月经结束后第3天,痛经组右侧横骨体表血流灌注量小于正常组（P<0.05）。结论：原发性痛经患者经期第1天督脉悬枢、命门、腰阳关和冲脉交会腧穴右侧肓俞,月经结束后第3天冲脉交会腧穴右侧横骨体表血流灌注量异常,可为原发性痛经的针灸选穴提供依据。     

针刺足三阴经原穴对高血压、低血压动物模型血压影响的经穴特异性研究

目的观察针刺足三阴原穴对高血压、低血压动物模型血压的影响,探究足三阴原穴的经穴特异性作用。方法研究分为高血压和低血压部分。两部分均分为足三阴经原穴组、非穴组、模型组和空白组,每组6只。除了模型组和空白组外,其余各组均进行针刺治疗,连续7 d。治疗结束后均进行血压检测,每只大鼠连续测量5次,取平均血压值。结果各治疗组高血压大鼠各时间点血压均高于空白组,但血压均低于模型组,差异有统计学意义(P0.05),表明针刺足三阴经原穴具有降压作用。其中太冲与太溪降压效果较太白和非穴显著(P0.05),太冲与太溪降压效果相当(P0.05),太白降压效果与非穴相当(P0.05)。各治疗组低血压大鼠各时间点血压均低于空白组,但血压均高于模型组,差异均有统计学意义(P0.05),表明针刺足三阴经原穴具有升压作用。其中非穴组升压作用低于各治疗组(P0.05),太白与太溪升压效果相当,但升压作用弱于太冲(P0.05)。结论针刺足三阴经原穴具有双向调控血压的特异性作用,其中太冲穴的双向调节血压作用最佳。     

人体原穴漫反射光谱特征与反映气血变化的特异性

目的:观察手足部原穴在女性月经前后气血盈亏变化过程中的漫反射光谱特征及其差异性,初步探讨原穴在反映人体气血变化的特异性。方法:采用线阵CCD探测器的光纤光谱仪获取手足部6个原穴在月经前后不同时期400～700 nm范围内的反射光谱,对特定波长处的漫反射率进行了统计学分析。结果:随着月经前后机体气血盛衰的变化,手足部原穴的漫反射光谱表现出规律性的变化,即月经期的漫反射率最高,月经前居中,月经结束后最低。在血红蛋白可见光吸收峰附近,右侧太白穴及冲阳穴的月经中反射率与月经前、后反射率比较均有不同程度的显著性差异(P<0.05),太白穴更为明显,而两侧太冲穴月经前后不同时间比较均无显著性差异(P>0.05)。手部原穴太渊及神门仅在423.37nm处,月经中的反射率显著高于月经后(P<0.05),其余波长处前后比较无显著性差异(P>0.05)。结论:穴位组织漫反射光谱的变化与机体气血变化有着密切的关系,在月经气血变化过程中,脾经原穴太白和胃经原穴冲阳表现出特异性反应。     

经穴电阻反应特异性与证型相关

目的:探讨经穴反应特异性是否与证型相关。方法:对52例原发性痛经患者辨证后分别探测三阴交穴、悬钟穴和非穴的皮肤温度和电阻并比较。结果:寒湿凝滞证患者各点温差无显著差异;三阴交穴电阻失衡度显著高于悬钟穴。气滞血瘀证患者各点温差和电阻失衡度无显著差异。结论:提示经穴电阻反应特异性可能与证型相关。     

太冲穴的临床应用

太冲穴是足厥阴肝经的输穴、原穴 ,此穴具有舒肝解郁、理气止痛之功 ,临床运用甚广 ,疗效较为满意 ,现择其要者 ,报道如下 :1　痛经　　顾×× ,女 ,2 2岁 ,未婚 ,2 0 0 0年 3月 7日初诊。　　主诉 :经来少腹胀痛数年 ,患者初潮 1 5岁 ,月经每 30～ 40天 1次 ,每次 3～ 7天。自初潮起 ,每于经前一周烦躁易怒 ,喜叹息 ,两乳胀痛 ,经行第1、2天小腹胀痛 ,甚则伴有恶心呕吐 ,不思饮食 ,今晨月经来潮 ,小腹胀痛 ,经量中等 ,色紫 ,夹有小血块 ,舌质偏红苔薄白 ,脉弦。证属肝郁气滞 ,经血滞于胞宫 ,不通则痛。治拟舒肝理气 ,行瘀止痛。取双侧太冲…     

预先电针对实验性类痛经模型大鼠血浆血栓素B2及6-酮-前列腺素F_(1α)的影响

目的:观察电针预先介入对实验性类痛经大鼠血浆血栓素2(TXB2)及6-酮-前列腺素F1α(6-keto-PGF1α)的影响,初步探讨经穴调控胞宫疼痛的特异性。方法:SD大鼠随机分为盐水组、模型组、三阴交组、血海组、悬钟组、非穴组。采用苯甲酸雌二醇和缩宫素制备类痛经模型。电针组给予电针20min,每日1次,连续3d,盐水组和模型组不予电针处理。末次电针后观察大鼠扭体反应,并检测血浆TXB2、6-keto-PGF1α的含量。结果:与盐水组比较,模型组扭体潜伏期显著缩短(P0.01),扭体评分显著增高(P0.05),血浆TXB2含量、TXB2/6-keto-PGF1α比值均显著升高(P0.05);与模型组比较,三阴交组TXB2/6-keto-PGF1α比值显著降低(P0.05);各电针组之间比较,三阴交组的扭体评分较血海组、非穴组显著降低(P0.05)。结论:预先电针三阴交穴可能通过调节血浆TXB2/6-keto-PGF1α的失衡,改善血管内环境,缓解平滑肌的痉挛状态,进而缓解胞宫疼痛,血海穴、悬钟穴、非穴的调节作用不明显,推测三阴交穴具有调控胞宫疼痛的相对特异性。     

Comparative study on skin temperature response to menstruation at acupuncture points in healthy volunteers and primary dysmenorrhea patients

OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P 0.05).No significant differences of skin temperature were detected at other points(P 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.     

针灸治疗原发性高血压取穴规律的探讨

目的:总结和分析针灸治疗原发性高血压临床对照试验中的十四经腧穴取穴规律。方法:检索近30年来针灸治疗原发性高血压的随机临床对照/临床对照研究,对其取穴规律进行总结和分析。结果:共纳入文献80篇,使用腧穴分布于所有十四条经脉,其中足厥阴肝经的使用频数最大(52次),其次是足阳明胃经(50次)。80篇文献中十四经腧穴使用频数前12腧穴依次为:太冲(46次)、曲池(33次)、风池(30次)、足三里(28次)、太溪(24次)、三阴交(18次)、丰隆(18次)、肾俞(17次)、肝俞(1 4次)、内关(13次)、涌泉(13次)、百会(11次)。结论:针灸治疗原发性高血压经脉多选用足厥阴肝经和足阳明胃经,穴位多选用太冲、曲池、风池等,取穴遵循循经取穴、辨证取穴,局部取穴等原则。     

针刺“太溪”穴与肾脏组织蛋白质变化相关性研究

目的:研究针刺足少阴肾经原穴"太溪"穴与肾脏组织蛋白质变化的相关性。方法:健康8周龄雄性Wistar大鼠12只,随机分为空白组和针刺组,每组6只。针刺组电针双侧"太溪"穴,空白组大鼠在相同时间只予固定,不予针刺刺激。治疗结束后取出肾脏组织,提取肾脏组织总蛋白,用基质辅助激光解析电离质谱测定肽质量指纹图谱进行鉴定,比较分析针刺对肾脏组织蛋白质组的影响。结果:针刺"太溪"穴后肾脏蛋白质较空白组肾脏蛋白质显示9个3倍以上上调差异蛋白点,未发现下调蛋白质。经肽质量指纹图谱鉴定出2个蛋白质,分别是NAD依赖型异柠檬酸脱氢酶和醌氧化还原酶。结论:针刺足少阴经原穴"太溪"穴引起肾脏组织蛋白质NAD依赖型异柠檬酸脱氢酶和醌氧化还原酶表达增加,增强肾脏能量和物质代谢机能,提示"太溪"与肾具有相关性。     

基于网络分析的《千金方》脏腑辨证配穴规律研究

[目的]基于网络分析方法对《千金方》中所辑录的包含两个穴位及两个以上的针灸处方进行分析研究,总结《千金方》脏腑辨证的针灸选穴配穴规律。[方法]1)搜集整理《千金方》中包含两穴以上的多穴处方条文以及《脏腑虚实标本用药式》中所辑录的各脏腑所属本病及标病,分别建立肺-大肠、心-小肠、胃-脾、肝-胆以及肾-膀胱病证的穴位处方数据库。2)应用网络分析与可视化软件Cytoscape对穴位处方进行网络分析,总结《千金方》中的穴位配伍规律。[结果]1)《千金方》中治疗肺-大肠病症的高频腧穴为太溪、天突、章门、肺俞、巨阙,治疗心-小肠病症的高频腧穴为间使、巨阙、水沟、曲泉、大陵;治疗脾-胃病症的高频腧穴为章门、中脘、巨阙、厉兑、内庭、足三里;治疗肝-胆病症的高频腧穴为昆仑、肝俞、前谷;治疗肾-膀胱的高频腧穴为关元、复溜、涌泉、承筋、大墩。取穴频率最高的经脉为足太阳膀胱经,特定穴中使用频率最高的是五输穴和募穴。2)《千金方》治疗肺-大肠病症的核心穴位处方为太溪、中脘、厉兑、天容、尺泽、肺俞、章门、天突、云门、风门、然谷;治疗心-小肠病症的核心穴位处方为肝俞、阳陵泉、曲泉、支沟、百会、间使、心俞、合谷、肾俞、风池;治疗脾-胃病症的核心穴位处方为本神、昆仑、天柱、间使、曲池、支沟、肝俞、合谷、章门、肾俞;肝-胆病症的核心穴位处方是阳陵泉、百会、昆仑、天柱、肾俞、中渚、曲泉、通谷、侠溪、上关;肾-膀胱病症的核心穴位处方为复溜、太白、大墩、然谷、关元、太溪、涌泉、行间、承筋、阴陵泉。[结论]1)《千金方》在脏腑辨证指导下的选穴以膀胱经腧穴和特定穴为主。2)首次将网络针灸学分析方法用于经典医著《千金方》穴位处方的信息挖掘,为针灸处方选穴及其配穴规律研究提供一种新的技术手段,也为《千金方》配穴经验临床推广应用提供依据。     

Points selection pattern in acupuncture-moxibustion treatment of gouty arthritis: an analysis based on bibliometrics

Objective

To discuss the selection pattern of points and meridians in acupuncture-moxibustion treatment of gouty arthritis (GA) by analyzing clinical literatures related to GA, and to provide reference for acupuncture-moxibustion treatment of GA.

Methods

Clinical literatures related to GA treated with acupuncture-moxibustion published between January 1981 and July 2017 were collected from Chinese databases. The points, meridians, frequency and treatment methods were analyzed.

Results

A total of 78 studies were included. For meridians, the top 5 meridians used were the Spleen Meridian (67 times), Liver Meridian (59 times), Stomach Meridian (53 times), Kidney Meridian (49 times) and Large Intestine Meridian (44 times). For points selection, the leading 5 points were Taichong (LR 3) (79 times), Taibai (SP 3) (68 times), Sanyinjiao (SP 6) (61 times), Taixi (KI 3) (57 times) and Yinlingquan (SP 9) (55 times). For major and adjunct points, the 5 most significant major points were Taichong (LR 3) (79 times), Taibai (SP 3) (68 times), Sanyinjiao (SP 6) (61 times), Yinlingquan (SP 9) (37 times) and Taixi (KI 3) (32 times). The 5 most significant adjunct points were Yanglingquan (GB 34) (31 times), Fenglong (ST 40) (30 times), Xuehai (SP 10) (29 times), Taixi (KI 3) (25 times) and Quchi (LI 11) (21 times). For treatment methods, the top 5 methods used were acupuncture-moxibustion alone for 15 studies, acupuncture combined with medicinal herbs for 11 studies, acupuncture-moxibustion combined with medicinal herbs for 10 studies, acupuncture alone for 7 studies, and electroacupuncture combined with bloodletting for 5 studies.

Conclusion

The main meridians chosen in acupuncture-moxibustion treatment of GA were the Spleen, Liver, Stomach, Kidney and Large Intestine Meridians, conforming to the syndrome differentiation principle of tonifying spleen and kidney, clearing heat and draining dampness. Points mainly locate at lower limbs and feet around the affected area, which was a reflection of peripheral treatment function of points. The data mining results of meridian and point selection in acupuncture-moxibustion treatment of GA conform to the disease and syndrome differentiation theory and provide references for acupuncture-moxibustion treatment of GA.

     

Research on the body surface resistance imbalance degree at yuan-source points of three yin meridians of foot in the patients with primary dysmenorrhea

ObjectiveTo explore whether or not the changes in body surface resistance at yuan-source points of three yin meridians of foot can specifically responds the onset of primary dysmenorrhea (PD) in females of menstrual period and the before and after, so as to provide the evidence for acupoint selection in clinic.MethodsA total of 90 cases of PD were recruited in a PD group and 90 healthy female undergraduates were recruited in a normal group. The yuan-source of points of three yin meridians of foot were selected, i.e. Tàibái (太白SP3), Tàichōng (太冲LR3) and Tàixī (太溪KI3). The acupoints for control were Xuèh?i (血海SP10), the non-special acupoint, Xuánzhōng (悬钟GB39), the acupoint not on the relevant meridian, as well as a non-meridian point. Successively, before menstruation, on Day 1 during menstruation and on Day 3 after menstruation, the body surface resistance at the above-mentioned test sites was detected in the participants of two groups each day. The resistance imbalance degree (RID) of the bilateral acupoints was taken as the outcome indicator. The observation lasted one menstrual cycle.Results(1) Intra-group comparison: at LR3, the RID was lower on Day 1 during menstruation than that before menstruation significantly in the normal group (P ≤ 0.05). There was no significant change in RID at the same time points, but RID on Day 3 after menstruation was lower significantly than that before menstruation in the PD group (P ≤ 0.05). At SP3, KI3, SP10, GB39 and sham acupoint, there were no significant differences in RID among different time points within the same group (all P > 0.05). (2) Inter-group comparison: there were no significant differences in RID among different time points at the same point. (all P > 0.05).ConclusionRID at yuan-source points of three yin meridians of foot cannot specifically respond to PD. However, at LR3, before and after menstruation, RID changes are different between PD patients and healthy female undergraduates, which needs a further study in the future.     

正常成年人下肢穴位疼痛阈值检测

目的:比较人体下肢穴位与非穴位痛阈的差异,探讨穴位的相对特异性。方法:制定人体随机测量数据表和人体体表图。选无心理和生理疾病的66名成年人,用Von Frey测量小腿和足部感受器阈值,分析对比穴位与非穴位痛阈值的异同。结果:膀胱经承山、昆仑、京骨和束骨的痛阈显著低于非穴位,昆仑的痛阈值最低(P<0.05);足三里同一水平节段穴位足三里、阴陵泉和阳陵泉与同一水平节段的非穴位比较,穴位处的痛阈值明显低于非穴位(P<0.05);下巨虚同一水平节段的穴位下巨虚、外丘、阳交、飞扬、漏谷与同一水平节段的非穴位比较,穴位处的痛阈值明显低于非穴位(P<0.05);解溪同一水平节段的中封、商丘、解溪、申脉相比较,解溪穴的痛阈值最高(P<0.05);分布于趾间的荥穴之间比较,侠溪穴和大都穴的痛阈值较高(P<0.05);位于足少阴肾经的水泉、太溪、筑宾和足太阴脾经的漏谷之间比较,漏谷的痛阈值最高,水泉次之(P<0.05)。结论:穴位的痛阈值明显低于非穴位,且穴位之间的痛阈值也存在差异,表明穴位确实具有相对特异性,从而为临床选穴规范化提供了依据。