针刺和聚焦冲击波疗法对肩袖肌腱病的止痛作用:一项回顾性临床研究

ObjectiveThe purpose of the study is to evaluate whether the clinical effects of focused extracorporeal shockwave therapy (f-ESWT) and acupuncture anticipate the clinical response in patients with rotator cuff tendinopathy in the short term.DesignAn observational retrospective clinical study.Setting/LocationPhysical Medicine and Rehabilitation Unit, Sant'Andrea University Hospital in Rome, Italy.Subjects/InterventionsWe analyzed retrospectively thirty patients (22 females and 8 males) with rotator cuff tendinopathy.Fifteen patients underwent f-ESWT and acupuncture combined therapy (Group A) and fifteen patients underwent only f-ESWT therapy (Group B).Outcome measuresThe outcome measures were the Visual Analogic Scale (VAS), Assessment Shoulder and Elbow Scale (ASES) and Roles and Maudsley Score (RMS). The follow-ups were T0 (pre-treatment), T1 (3 weeks after the start of the treatment), and T2 (at 8 weeks). In order to compare groups, the ANOVA and Friedman tests were adopted.Group A patients had a more rapid and statistically significant improvement trend in VAS (P <0.001), ASES scale (P <0.001), and a higher level of satisfaction to treatment assessed by RMS (P<0.001) than group B in the short term.ConclusionsThe study showed that combined treatment decreases the recovery time of the shoulder involved in terms of pain and motor function in the short term. However, these results shall be confirmed by controlled randomized studies.     

股密葆方治疗早中期非创伤性股骨头坏死肾虚血瘀证的临床研究

目的:观察股密葆方治疗早中期非创伤性股骨头坏死肾虚血瘀证的临床疗效.方法:2010年1月至2018年12月收治57例(61髋)非创伤性股骨头坏死肾虚血瘀证患者,男33例、女24例;年龄28～63岁,中位数41岁;国际骨微循环研究学会(association research circulation osseous,AR...     

火针点刺承泣穴治疗周围性面瘫后遗溢泪症的临床观察

ObjectiveTo compare the clinical therapeutic effect on epiphora as sequela of peripheral facial paralysis treated with pricking technqiue of fire needling therapy at Chéngqì (承泣 ST1) and acupuncture treatment at conventional acupoints.MethodsFrom September 2018 through to October 2018, 64 cases of epiphora as sequela of peripheral facial paralysis were collected from the Department of Acupuncture-Moxibustion in Suzhou TCM Hospital. According to random number table, they were divided into an observation group and a control group, 32 cases in each one. In the observation group, pricking technique of fire needling therapy was used at ST1, once every two days. In the control group, acupuncture with filiform needle was applied to Jīngmíng (睛明BL1), Tàiyáng (太阳EX-HN5), Tóngzĭliáo (瞳子髎GB1), Sìbái (四白ST2) and Quánliáo (颧髎SI18) on the affected side as well as Hégŭ (合谷LI4) on the contralateral side, once per day. The 10-day treatment was as one 1 course and the consecutive 3 courses of treatment were required in either of the groups. Before and after treatment, Munk grade, clinical effective rate and the number of treatments were observed in the evaluation of therapeutic effect.ResultsAfter treatment, Munk grade was improved in the patients of the two groups (both P < 0.05). The improvement range in the observation group was larger than that of the control group (P < 0.05). The treatment in either group achieved the obviously therapeutic effect on epiphora as sequela of peripheral facial paralysis. The effective rate in the observation group was 90.32%, higher than 61.29% in the control group (P < 0.05). The mean number of treatments of the curative case were 5.11 in the observation group and were 13.73 in the control group, indicating the statistical significance in difference (P < 0.05).ConclusionPricking technique of fire needling therapy at ST1 achieves the better effect on epiphora as sequela of peripheral facial paralysis as compared with acupuncture at conventional acupoints.     

中药防风抗肝癌作用及机制的网络药理学和细胞实验研究

目的: 应用网络药理学和细胞实验,探究中药防风提取液的抗肝癌效应及可能机制,为防风在抗肝癌的临床应用提供依据。方法: 应用网络药理学方法筛选防风抗肝癌的有效成分及相应靶点,并建立"药物-成分-靶点"可视化网络;采用富集分析筛选信号通路;利用Autodock Vina软件验证效应成分与肝癌相关靶点结合力,MTT法测定细胞增殖率,流式细胞术检测细胞凋亡率,Western blot检测相关蛋白表达。结果: 通过多种数据库共筛选得到防风抗肝癌的15种有效成分和AKT1、CASP3、TP53、JUN、IL-6前5个核心靶点基因。富集分析显示细胞凋亡通路尤为集中。前5位的有效成分与核心靶点对接,结果显示其结合能均小于-20.92 kJ·mol^-1。与空白对照组比较,24和48 h时防风提取液对HepG-2细胞的抑制率随浓度升高而增大;细胞凋亡率亦升高;同时促使Caspase-3蛋白磷酸化,提高Bax/Bcl-2比值。结论: 防风提取液可抑制人肝癌细胞 HepG-2 的增殖,诱导人肝癌细胞 HepG-2凋亡,且呈剂量、时间依赖性,其作用机制可能是通过上调HepG-2细胞内Bax蛋白表达、下调Bcl-2蛋白并促进Caspase-3蛋白磷酸化发挥作用。     

苦味中药激活肠道苦味受体分泌胰高血糖素样肽-1的研究现状

胰高血糖素样肽-1(GLP-1)可以刺激胰岛素释放以及抑制胰高血糖素释放,与2型糖尿病有关.苦味中药可以激活肠道上的苦味受体(TAS2Rs),通过磷脂酶C通路和磷酸二酯酶通路刺激肠道内分泌L细胞未分泌GLP-1,广泛用于2型糖尿病的防治.本文综述了苦味中药对肠道TAS2 Rs介导的GLP-1分泌的调控作用,为苦味中药防...     

基于高通量测序研究半夏泻心汤对3-脱氧葡萄糖醛酮致糖尿病前期大鼠肠道菌群的影响

目的 研究半夏泻心汤对3-脱氧葡萄糖醛酮(3 DG)致糖尿病前期大鼠肠道菌群的影响.方法 大鼠连续灌胃3DG(50 mg·kg-1·d-1)2周制得糖尿病前期大鼠模型.将雄性SD大鼠随机分为3组:正常组(7只)、模型组(7只)和实验组(3只).造模后,实验组灌胃半夏泻心汤水煎液(5 mL·kg-1),正常组和模型组灌胃...     

正骨手法结合经皮椎体成形术与单纯经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床研究

目的: 探讨正骨手法结合经皮椎体成形术(percutaneous vertebroplasty,PVP)与单纯经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩性骨折(osteoporosis vertebral compression fractures,OVCFs)的临床疗效。方法: 回顾性分析2021年1月至2022年6月收治的80例单节段OVCFs患者的临床资料,根据手术方式不同分为治疗组和对照组,每组40例。治疗组男24例,女16例;年龄60~83(70.43±7.31)岁;骨密度-3.30~-2.50(-2.84±0.24) SD;T₁₀ 1例,T₁₁ 4例,T₁₂ 11例,L₁ 7例,L₂ 7例,L₃ 5例,L₄ 3例,L₅ 2例;采用正骨手法结合PVP治疗。对照组男27例,女13例;年龄60~82(68.98±6.94)岁;骨密度-3.40~-2.50(-2.76±0.23) SD;T₁₀ 2例,T₁₁ 3例,T₁₂ 13例,L₁ 11例,L₂5例,L₃ 3例,L₄ 2例,L₅ 1例;单纯PKP手术治疗。比较两组术前、术后3 d及术后3、12个月的疼痛视觉模拟评分(visual analogue scale,VAS)、腰椎Oswestry功能障碍指数(Oswestry disability index,ODI);并比较两组术前、术后3 d及术后12个月伤椎局部后凸角、椎体楔形角和椎体前缘高度比的变化情况。结果: 两组患者均顺利完成手术。两组均获得随访,治疗组随访时间13~22(16.82±2.14)个月,对照组随访时间13~23(16.45±2.56)个月。治疗组3例术中出现骨水泥渗漏;对照组1例术中出现骨水泥渗漏、1例术后出现下肢皮肤感觉障碍;两组并发症比较,差异无统计学意义(P>0.05)。两组术前VAS、ODI比较,差异无统计学意义(P>0.05);治疗后3 d,治疗组VAS (3.68±0.62)分与对照组(4.00±0.72)分比较,差异有统计学意义(P<0.05);两组术后3、12个月VAS、ODI比较,差异无统计学意义(P>0.05)。两组术后3 d及术后12个月局部后凸角、椎体楔形角、椎体前缘高度比较,差异无统计学意义(P>0.05)。结论: 正骨手法结合PVP治疗OVCFs相对于单纯PKP在术后早期疼痛缓解方面更具有优势;在椎体高度恢复方面,正骨手法结合PVP与单纯PKP疗效相近。     

自噬与凋亡的相互关系在肿瘤方面的研究进展

肿瘤是一类涉及基因、代谢和信号传导异常等多方面因素引起的疾病,其发生的分子机制相当复杂,但本质上仍与细胞增殖与死亡的动态失衡有关。程序性细胞死亡（programmed cell death,PCD）是由基因控制的自杀程序引起的主动性死亡,对于多细胞生物个体发育的正常进行,维持内环境稳态以及抵御外界各种干扰因素方面有着关键性的意义。I型PCD（经典细胞凋亡）和II型PCD（自噬性细胞死亡）调控着肿瘤细胞的增殖与消耗,与肿瘤的发生、发展密切相关。本文结合近年来国内外研究进展,重点就自噬在肿瘤中的作用以及与凋亡的相互关系作一综述。     

消髓化核汤保守治疗130例巨大型腰椎间盘突出症的疗效分析

目的:探讨保守治疗巨大型腰椎间盘突出症的临床疗效并分析影响其重吸收的因素。方法:2013年1月至2016年12月收集130例巨大型腰椎间盘突出症患者,按Iwabuchi位移、"牛眼征"改变特点分类,给予消髓化核汤为主的中医药保守治疗。其中男93例,女37例,年龄15～64(37.11±13.96)岁;病程1d～8年,平均(11.82±20.45)个月。观察并比较椎间盘突出率变化、症状改变情况,突出率采用富田庄司法测量,疗效评价采用腰椎JOA评分。结果:所有患者获得随访,时间13～48(21.45±11.87)个月,不同影像学类型患者随访时间差异无统计学意义(P0.05);95例持续保守治疗患者吸收率为(44.08±35.70)%,Iwabuchi位移阳性组、"牛眼征"阳性组患者吸收率明显高于平均值(P0.05);95例患者治疗后3、6、12个月JOA评分优良率分别为78.95%、81.05%、85.26%,JOA评分与治疗前比较,差异均有统计学意义(P0.05);35例(26.92%)选择了手术治疗,治疗后3、6、12个月JOA评分优良率均为100%(P0.05)。结论:消髓化核汤保守治疗巨大型腰椎间盘突出症的临床疗效满意,Iwabuchi位移阳性、"牛眼征"阳性改变患者发生了明显的突出物重吸收现象。