基于复杂网络的《新针灸学》与《经络腧穴学》比较分析研究（英文）

提取《新针灸学》《经络腧穴学》中穴位名称、主治病症信息,基于复杂网络建立穴-症网络,分析两者穴位数量、相互关联程度及主治规律变化,借助拓扑学数据解释变化原因,为传统针灸知识体系的结构化、标准化研究提供具体思路和方法。共纳入《新针灸学》386穴、773种症状、形成152163个穴位配伍对,《经络腧穴学》403穴、253种症状、28755个穴位配伍对。两本教材的穴-症网络存在丰富的差异性,其所载的病症结构化程度随医学知识的更新而提升。《新针灸学》模型具有更加典型的小世界效应,或因其以病症为主要分类手段的优势体现。两本教材穴位定位与主治方面发生许多变化,学科发展、时代背景等方面是变化的主要原因。     

Acupoint stimulation for long COVID: A promising intervention: 穴位刺激治疗长新冠:一种有前景的干预措施

“Long COVID” is a sustained symptom following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). According to recent statistics, at least 65 million people have long COVID, which poses a long-term threat to human health. The pathogenic mechanisms of coronavirus disease 2019 (COVID-19) are complex and affect multiple organs and systems. Common symptoms include palpitations, breathing difficulties, attention and memory deficits, fatigue, anxiety, and depression. It is difficult to achieve satisfactory treatment effect with a single intervention. Currently, treatment strategies for long COVID are still in the exploratory stage, and there is an urgent need to find appropriate and effective methods for long COVID treatment. Traditional Chinese medicine is effective in treating the various phases of COVID-19. Previous studies have shown that acupoint stimulation therapy is effective in improving palpitations, dyspnea, cognitive impairment, anxiety, depression, and other symptoms in patients. According to previous studies, acupoint stimulation may improve various symptoms related to long COVID. This paper discusses the potential application value of acupoint stimulation in the treatment of long COVID-related symptoms, based on the common sequelae of various systems involved in long COVID, and the effect of acupoint stimulation in the treatment of similar symptoms and diseases in recent years.     

The efficacy and safety of traditional Chinese medicine Guilu Erxian Jiao in the treatment of knee osteoarthritis: A systematic review and meta-analysis

ObjectiveA systematic review was conducted to investigate the efficacy of Guilu Erxian Jiao (GEJ) in the treatment of knee osteoarthritis (OA).MethodsWe searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese Electronic Periodical Services, and ClinicalTrials.gov to identify relevant randomized controlled trials or controlled clinical trials, from the inception of each source to April 20, 2021. Primary outcome included overall efficacy, pain score, and Lequesne index score; secondary outcome included adverse events. Methodological quality was assessed using the Cochrane risk of bias tool (RoB 1.0). The meta-analysis was performed based on a random-effects model due to anticipated clinical heterogeneity. The grading of overall evidence was assessed using the GRADE system. The study protocol was registered on PROSPERO (CRD42021233573).ResultsEight studies were included. Compared to controls, GEJ exhibited superior overall efficacy for treating OA (risk ratio (RR) = 1.20; 95% confidence interval (CI) = 1.06–1.35). Regarding pain score, there was no statistical difference between GEJ and controls (standardized mean difference (SMD) = 0.27; 95% CI = −0.91 – 1.46). No significant difference was found in Lequesne score between GEJ and controls (MD = −0.25; 95% CI = −0.52 – 0.01). No statistical difference in adverse reactions was observed between GEJ and controls (risk difference (RD) = −0.01; 95% CI = −0.05–0.03).ConclusionOur findings suggest that GEJ may have positive effects on overall efficacy in treating OA. However, there is insufficient evidence regarding pain score, Lequesne score, and knee joint function score.     

百会穴治疗颈性眩晕的临床应用与机理研究

颈性眩晕是临床常见的眩晕类型之一,多由于颈椎病或颈部软组织病造成椎-基底动脉供血不足所致,属于祖国医学＂眩晕＂的范畴。现代医学是以药物、颈椎牵引、理疗等方法为主,一般疗程长且疗效欠佳,给患者带来精神负担与不便。传统医学在对本病的治疗上有其独特的优势。百会穴为治疗眩晕的要穴,临床上运用其治疗颈性眩晕的方法有很多,如针刺、压灸、温灸、化脓灸等,且疗效显著。本文综述了近年来临床应用百会穴治疗颈性眩晕的多种疗法和作用机理,为临床工作者治疗颈性眩晕提供依据。     

Effects of dry needling plus exercise therapy on post-stroke spasticity and motor function: A case report

Background and purposeThe use of dry needling (DN) with other treatments may be more beneficial in managing post-stroke spasticity. We report the effects of DN plus exercise therapy (ET) on wrist flexor spasticity.Patient presentationThe patient was a 45-year-old man with an 8-year history of stroke. The outcome measures included the Modified Modified Ashworth Scale (MMAS), H_max/M_max ratio, H-reflex latency, Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), and range of motion (ROM) which were assessed before (T1), after (T2), and after 3-week follow-up (T3).ConclusionThe MMAS was improved at T2 from “3” to “2”. The H_max/M_max decreased from 0.77 to 0.53 at T3. The H-reflex latency increased from 15.4 ms to 18.5 ms at T3. The wrist active and passive ROM increased ∼30° and ∼20° at T2, respectively.A 4-session DN plus ET may improve spasticity and ROM. No meaningful improvement was observed in function.     

Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

BackgroundSome depressed patients receive acupuncture as an adjunct to their conventional medications.ObjectiveThis review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategyEnglish and Chinese databases were searched for randomized controlled trials (RCTs) published until December 1, 2021.Inclusion criteriaRCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysisMeta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence in the included studies.ResultsThis review included 16 studies (with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17 (HAMD-17) scores (standard mean difference [SMD] ?0.44, 95% confidence interval [CI] ?0.55 to ?0.33, P < 0.01; I² = 14%), Self-rating Depression Scale (SDS) scores (SMD ?0.53, 95% CI ?0.84 to ?0.23, P < 0.01; I² = 79%), and the Side Effect Rating Scale (SERS) scores (SMD ?1.11, 95% CI ?1.56 to ?0.66, P < 0.01; I² = 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores (SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01; I² = 15%), decreased the number of participants who increased their antidepressant dosages (relative risk [RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01; I² = 0%), and resulted in significantly higher remission rates (RR 1.52, 95% CI 1.26 to 1.83, P < 0.01; I² = 0%) and treatment responses (RR 1.35, 95% CI 1.24 to 1.47, P < 0.01; I² = 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.ConclusionAcupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.     

儿科临床研究协调员职业培训现状的调查与需求分析

目的 了解儿科临床研究协调员（clinical research coordinator,CRC）职业培训现状,探讨儿科CRC基地化培训建设,以促进儿科CRC的能力提升。方法 采用匿名问卷调研法,于2023年7月25日至10月16日期间,通过问卷星向调查对象发放自行设计的问卷,以进行儿科CRC职业培训及基地化培训需求相关情况的调查分析。采用Excel对数据进行整理。计数资料以例数或者率表示。结果 回收有效问卷328份。调查结果显示,认为当前CRC培训充分且可以满足实际工作需求的仅为7.62%（25人）,另有4.88%（16人）的人认为没有CRC培训,46.34%（152人）的人认为培训不足以支撑实际工作的要求。87.50%（287人）的人认为CRC需要持续的培训。46.95%（154人）的人选择了有经验的CRC是较为合适的带教人员之一,但是需要3年及以上CRC工作经验。46.95%（154人）选择了CRC合适的培训时长为3个月。培训方式的选择从高到低为：有经验的CRC带教实习（90.85%,298人）、实操技能手把手带教（88.41%,290人）、案例分析讨论（87.20%,286人）、流程模拟（83.23%,273人）、授课（76.52%,251人）。培训后考核方式的选择从高到低为：案例分析（76.52%,251人）、操作模拟（74.09%,243人）、流程模拟（73.17%,240人）、笔试（66.16%,217人）、面试（63.72%,209人）。结论 目前,儿科CRC的培训还不足以满足实际工作需求,急需制定一个符合工作需要的CRC培训体系并进行推广实践,从基础上促进中国儿科临床研究健康生态的构建。     

电针对神经病理性疼痛伴发焦虑大鼠行为学及缰核HCN1表达的影响

[目的]观察电针(electro-acupuncture, EA)对神经病理性疼痛伴发焦虑大鼠行为学的干预作用,以及对缰核中超极化激活环核苷酸门控通道蛋白1(hyperpolarization-activated cyclicnucleotide-gated channels 1,HCN1)和c-fos表达的影响,部分阐明神经病理性疼痛伴发精神障碍的发病机制及EA的干预机制。[方法] 32只雄性SD大鼠按完全随机法分为空白对照组、假手术组、坐骨神经分支选择性损伤(sciatic nerve branch selective injury,SNI)组和EA组,每组8只。SNI组和EA组以SNI法制备神经病理性疼痛模型,模型制备第8天起,EA组选取"足三里""昆仑"两穴,以EA治疗,每次30min,1次/d,共3次,其余组别不予治疗。造模前,造模后l、3、5、7、8、9和10d检测机械性缩足反射,造模后第10天采用旷场实验观察大鼠的焦虑情绪,免疫荧光检测缰核HCN1与c-fos的表达。[结果]造模第1天起,与空白对照组比较,假手术组大鼠患侧机械性痛阈各时点差异无统计学意义(P0.05),SNI组大鼠较假手术组下降(P0.01);与SNI组比较,EA组大鼠各时点机械性痛阈均上升(P0.01);4组大鼠健侧机械性痛阈无明显变化(P0.05)。旷场实验中,SNI组大鼠运动总距离、进入中央区次数、中央区运动距离均低于假手术组(P0.01,P0.01,P0.05),而中央区停留时间仅低于空白对照组(P0.05),EA组大鼠运动总距离、进入中央区次数和中央区停留时间均少于SNI组(P0.05,P0.01,P0.01),中央区运动距离差异无统计学意义(P0.05)。各组大鼠健侧内侧缰核(medial habenular nucleus,MHb)、外侧缰核外侧部分(lateral habenular nucleus lateral part,LHb L)和外侧缰核内侧部分(lateral habenular nucleus medial part,LHbM)的HCN1表达差异无统计学意义(P0.05);与假手术组比较,SNI组患侧各部分HCN1表达水平均增高(P0.01,P0.01,P0.01);与SNI组比较,EA组患侧HCN1表达水平均降低(P0.01,P0.01,P0.01)。各组大鼠健侧MHb与LHb L的c-fos表达差异无统计学意义(P0.05);与假手术组比较,SNI组健侧LHbM以及患侧MHb、LHbL的c-fos表达也显著增高(P0.01,P0.05,P0.01),而两组患侧LHbM的c-fos表达差异无统计学意义(P0.05);EA组双侧c-fos的表达均低于SNI组同侧(P0.01,P0.01)。[结论]大鼠患侧缰核HCN1通道可能参与了神经病理性疼痛伴发焦虑的发生,而干预缰核HCN1的表达可能是EA调控神经病理性疼痛伴发精神障碍的机制之一。     

崔云教授治疗少弱精子症对药与角药探颐

目的 总结崔云教授治疗少弱精子症常用对药与角药理法方药经验。 方法 通过采集与分析崔云教授治疗少弱精子症的临床病例,在充分认识病因病机的基础上,对崔云教授诊治少弱精子症常用对药与角药进行归纳,总结崔云教授诊治少弱精子症常用对药与角药经验,对其用药思路及用药理论进行深入探讨,并举案例予以佐证。 结果 崔云教授认为少弱精子症的病因与肾、肝、心、脾、肺等脏腑以及气血和湿热浊毒关系密切。治疗上针对其病机特点,选取“肝肾同治”“悦心安神”“疏肝(补肾)和胃”“金水相生”“调和气血”“解毒祛浊”等对药与角药来改善精子质量。常用对药与角药有“女贞子-旱莲草”“柴胡-续断”“生地黄-山药-山茱萸”“五味子-茯苓”“远志-石菖蒲”“大枣-黄芩”“生谷芽-生麦芽”“山楂-五味子”“麦冬-五味子”“黄芪-党参-丹参”“当归-川芎”“地榆-虎杖”“贯众-升麻-豨莶草”等。崔云教授治疗少弱精子症理论上善于创新,以肝肾为中心进行脏腑辨治,临证运用对药与角药谨守病机,扶正祛邪,通补相济,涩利兼施,用药温而不燥,滋而不腻,于平凡中寓深意,理、法、方、药经验独到。 结论 崔云教授治疗少弱精子症的常用对药与角药理法方药学术经验深刻、独到,值得学习与借鉴。      

前扣带皮层区域磷酸激酶Czeta在弗氏安全佐剂致炎性痛大鼠情绪反应中的作用

目的 观察CFA致炎性痛模型大鼠的情绪反应,探讨前扣带皮层（ACC）磷酸激酶Czeta（PKCzeta）与炎性痛大鼠情绪反应的关系。方法 24只清洁级雄性SD大鼠随机分为空白对照组和模型对照组。足底皮下注射弗氏完全佐剂建立慢性炎性痛模型。动态观察各组大鼠造模前（base）、造模后3、7、14、21和28 d的体重和痛阈变化;观察造模后14、21、28 d所有大鼠在高架O迷宫中的总运动距离、开放臂运动距离、开放臂进入次数和开放臂停留时间百分比。观察造模后14、29 d所有大鼠在旷场中的总运动距离、中央象限运动距离、中央象限进入次数和中央象限停留时间。采用免疫印迹法检测造模后14 d和29 d健侧和患侧ACC区域PKCzeta蛋白表达。结果 各个时间点两组大鼠体重差异无显著性（P>0.05）。造模前,两组大鼠痛阈差异无显著性（P>0.05）;造模后1 d,模型对照组大鼠痛阈显著降低（P<0.05）,且在整个实验过程中均显著低于空白对照组（P<0.05）。与空白对照组比较,模型对照组大鼠于模后28 d开放臂运动距离和开放臂停留时间百分比显著减少（P<0.05）,于模后29 d中央象限运动距离和中央象限进入次数明显减少（P<0.05）。造模后29 d,模型对照组大鼠患侧ACC区域PKCzeta蛋白表达明显多于空白对照组（P<0.05）。且开放臂运动距离、开放臂停留时间百分比、中央象限运动距离、中央象限进入次数与患侧PKCzeta蛋白表达变化呈负相关。结论 CFA诱导的慢性炎性痛大鼠可出现异常情绪行为;慢性炎性痛情绪样行为可能与ACC区域PKCzeta的高表达相关。