薛氏针刺手法治疗脑血管后遗症52例疗效观察

薛崇成教授是中国中医研究院针灸研究所神经精神科、神经外科和针灸学专家.他根据现代神经生理学关于大脑皮层的兴奋与抑制可调节的事实,结合《内经》对徐疾、捻转、提插补泻等手法的论述,以及自己的临床实践,形成独特的针灸手法.笔者1981年在北京针灸研究所有幸随薛师学习后,对其手法的渊源和操作受益颇多,对治疗神经系统疾病效果显著,故笔者称之为薛氏针刺手法.并运用薛氏针刺手法治疗脑血管后遗症52例,疗效满意,报道如下.     

关于针刺“气至”的研究

得气又称"气至",乃是针刺疗法取得疗效的关键。针刺"气至"的概念,首见于《黄帝内经》,其后,诸多针灸典籍均有记述。然而,关于针刺"气至"的定义和内涵却多有争议,至今尚未有定论。自从《黄帝内经》确定了针刺"气至"的基本定义以来,后世历代医家各有所阐发。通过系统梳理各代中医文献有关针刺"气至"含意的演变历程,并且在100例志愿者身上验证针刺得气的感觉,以期有益于针灸学理论的继承与发展。     

西医院校《中医学》五版教材针灸学部分浅析

提出《中医学》五版教材针灸学部分存在编辑错误 ;针刺工具图示不足 ;腧穴部位简繁失宜 ;部分腧穴分类欠准确 ,定位前后描述不一致 ;部分针灸处方欠妥当等     

宋金元时期针灸学的发展

宋金元时期针灸学发展到一个新阶段，对后世影响深远。概括起来有以下几个方面。国家对针灸学关注，如设置“校正医书局”校勘针灸著作、“太医局”注重针灸教育、组织编纂《铜人腧穴针灸图经》等；经络学说内容进一步充实完善，使经穴理论条理化、系统化、规范化；提倡针灸并举，总结针刺手法与开穴规律；创立实验针灸教学方法；诸多学说与学术流派形成。     

对《推拿手法学》实践教学相关环节的改革

[目的]观察《推拿手法学》的实践教学改革对实际教学效果的影响。[方法]选取广西中医学院2006级高职针灸推拿专业共97人为观察组。2003级本科针灸推拿专业共69人为对照组，两组统一教材、授课教师及总学时数（共36学时），分别采用改革后的新的实践教学方案及传统的实践教学方案，教学结束后评估两组的教学效果及理论与实践成绩。[结果]两组理论考试成绩差异无统计学意义（P〉0．05），但观察组学生对教学的满意程度记分及临床实践能力成绩明显优于对照组（P〈0．01）。[结论]在《推拿手法学》教学中，新的实践教学方案较传统的实践教学方案能取得更好的教学效果。     

《针灸学》求疵

[目的]探索在《新二版针灸学》中可能存在的美不中足之处,以利于"第3版修订提高"。[方法]认真阅读全书,参阅《神应经》、《针灸大成》、《内经》等相关书籍,并结合自己的临床体会。[结果]在《新二版针灸学》中发现7处有待商榷的地方。[结论]尽管在本书中存在着少许排印校对上的错误,但本教材仍不失为"新世纪全国高等教育优秀教材"。而本文所述纯属一已之见,仅供专家与读者的参考。     

古典文献中针刺量效关系的雏形

针刺手法定量化是目前针灸学研究的重要内容,也是未来针灸学发展的方向,古典针灸医籍对针刺手法的量化有着丰富的记载,文章针对针刺深浅、补泻、得气、留针时间等针刺重要因素回顾了历代针灸文献中关于针刺量化的记载,从文献角度为针刺的量学研究提供理论基础。     

《推拿手法学》网络课程教学应用效果评价

[目的]对广西中医学院采用《推拿手法学》网络课程教学后的效果进行评价。[方法]2004级针灸推拿本科班72名学生应用《推拿手法学》网络课程教学，并与未开展网络课程教学的2003级针灸推拿本科班70名学生作比较，对比二者的理论考试成绩和手法考核成绩。[结果]2003级针灸推拿本科班学生的理论考试成绩和手法考核成绩低于2004级针灸推拿本科班学生的理论考试成绩和手法考核成绩，差异具有统计学意义（P〈0．05）。[结论]《推拿手法学》网络课程的教学有助于学生掌握手法特点，同时对理论学习也有很大的促进作用，能显著提高教学效果。     

《郑魁山教授传统针刺手法》电视录像内容介绍

郑魁山教授继承家传针灸技术,并结合传统手法,形成了独具风格的针刺手法。《郑魁山教授传统针刺手法》电视录像片分三集真实地纪录了郑魁山67种传统针刺手法操作,已在针灸教学中使用,为针灸教学提供了良好的视听教材。现将本片内容简介如下:     

《黄帝内经》的美容观及其对针灸美容的临床指导

[目的]挖掘《黄帝内经》(以下简称《内经》)的美容思想,为现代针灸美容临床提供指导。[方法]研读《内经》并整理与针灸美容相关内容,从《素问》中的阴阳、五行、藏象、气血津液学说与《灵枢》中的经络学说、针刺原则、古典针刺法等角度入手,探讨《内经》在理法方穴术各个方面对针灸美容临床的指导。[结果]《内经》整体美容观中蕴含了以五脏为基础的表里统一美容观和以经络与精气血津液为物质基础的形神统一美容观,其为针灸美容的辨证施治、取经用穴提供了理论指导,使针灸美容成为一种调内养外的健康自然美容法。《灵枢》则指导针灸美容要明确病位深浅、选择合适的针具、应用适宜的针刺手法,使针灸美容在整体调治的同时兼具局部美容的效果。此外,从古典针刺法中五刺、九刺、十二刺总结而来的“刺皮三法、刺肉之法、刺脉之法、刺筋之法”等在现代也有新的发展,丰富了针灸美容的方式。[结论]《内经》的整体美容观在理论层面为针灸美容奠定了基础,《灵枢》的刺法在操作层面为针灸美容提供了技术指导。     

Acupuncture

NIN Consensus Development Panel on Acupuncture

JAMA. 1998;280:1518-1524.

Objective.— To provide clinicians, patients, and the general public with a responsible assessment of the use and effectiveness of acupuncture to treat a variety of conditions.

Participants.— A nonfederal, nonadvocate, 12-member panel representing the fields of acupuncture, pain, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, family practice, internal medicine, health policy, epidemiology, statistics, physiology, biophysics, and the representatives of the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1200. Presentations and discussions were divided into 3 phases over 2 days: (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that were part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third. The conference was organized and supported by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md.

Evidence.— The literature, produced from January 1970 to October 1997, was searched through MEDLINE, Allied and Alternative Medicine, EMBASE, and MANTIS, as well as through a hand search of 9 journals that were not indexed by the National Library of Medicine. An extensive bibliography of 2302 references was provided to the panel and the conference audience. Expert speakers prepared abstracts of their own conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience.

Consensus Process.— The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in the open forum and scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions within a few weeks of the conference. The statement is available at http://consensus.nih.gov.

Conclusions.— Acupuncture as a therapeutic intervention is widely practiced in the United States. Although there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations, such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

     

试论针刺反应与针刺效应的关系

针刺反应与针刺效应密切相关,针刺反应可在穴位局部及全身形成相互联系的网络,其中被证实有关键响应介质的参与,使在穴区的神经细胞、肥大细胞以及相关化学物质形成良性循环的小网络,其中一些介质激活全身性的神经-免疫-内分泌大网络循环,若阻断关键响应介质可明显减低局部小网络的反应程度以及相应的针刺效应。因此,关键响应介质是维持针刺反应网络中各单元相互联系的枢纽,是针刺反应中不可缺少的一部分,并且支撑着反应网络内部的脆弱联系,但从反应到效应的具体路径和机制尚不明确。     

针灸治疗中风偏瘫的疗效评价与针灸医学的发展

针灸疗法对脑卒中运动功能障碍有显著的疗效，但是缺乏统一的，与其他学科相比较的中风偏瘫疗效评定标准，以现代中风偏瘫恢复理论为基础，以残损－残疾－残障为模式的现代康复医学整体评价体系应作为针灸临床中风偏瘫疗效评定标准，并已影响针灸的临床实验。     

耳针、体针、耳体针结合治疗单纯性肥胖病临床疗效比较

目的：观察耳针、体针、耳体针结合单纯性肥胖病的疗效。方法：将195例单纯性肥胖病人分为耳针组，体针组，耳体针结合组分别施治，并视不同证型施以相应补泻手法。结果：体针组与耳体针结合组疗效明显优于耳针组，体针组证型与疗效无明显关系，而耳针组胃肠实热型疗效高于脾虚湿阻型，肾气不足型和肝郁气滞型。结论：耳体针结合治疗单纯性肥胖疗效较好。