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.     

麦粒灸对佐剂性关节炎大鼠细胞免疫功能的影响

目的　探讨麦粒灸对佐剂性关节炎 ( A A)大鼠细胞免疫功能的影响。方法　以佐剂性关节炎作为类风湿关节炎大鼠模型 ,分为正常对照组、模型组、麦粒灸治疗组、麦粒灸加去肾上腺组、麦粒灸加假手术组。麦粒灸“肾俞”、“足三里”,检测IL-1、IL-2、IL-6含量变化。结果　模型组大鼠腹腔巨噬细胞 IL-1、IL-6的活性比正常大鼠明显升高 ( P<0 .0 1)。麦粒灸组大鼠 IL-1、IL-6活性较模型组比明显下降 ( P<0 .0 5 )。麦粒灸加去肾上腺组 IL-1、IL-6活性未见明显变化 ( P>0 .0 5 ) ,假手术组IL-1活性极显著降低 ( P<0 .0 1) ,IL-6比模型组明显为低 ( P<0 .0 5 )。模型组大鼠脾脏 IL-2活性降低 ( P<0 .0 5 ) ,麦粒灸治疗后可使 IL-2活性极显著升高 ( P<0 .0 1) ,麦粒灸加去肾上腺组 IL-2活性与麦粒灸组及假手术组比 ( P<0 .0 5 ) ,但与模型组比无显著性差异 ( P>0 .0 5 )。假手术组 IL-2活性亦明显提高 ( P<0 .0 1) ,而与正常组无差异。结论　麦粒灸可抑制 AA大鼠 IL-1、IL -6活性。摘除肾上腺后则麦粒灸不能降低 IL -1、IL -6活性 ;麦粒灸可明显提高 IL -2活性 ,摘除肾上腺后麦粒灸则对 IL -2活性无明显影响 ;麦粒灸对 A A细胞免疫功能的调整与下丘脑 -垂体 -肾上腺的完整有关     

针灸抗化疗骨髓抑制提升白细胞机制

目的：肯定针灸抗化疗骨髓抑制，提升白细胞的疗效，揭示其作用机制。方法：采用动物实验和临床研究相结合的方法，动态观察针灸对化疗中骨髓及白细胞的影响，用生物培养法检测造血干祖细胞数量、血清集落刺激因子的活性。结果和结论：针灸抗化疗骨髓抑制，提升白细胞的机制在于促进骨髓细胞向外周血中释放、延长白细胞寿命、通过提高血清集落刺激因子的活性，促使造血干祖细胞尽快增殖、减轻造血干祖细胞受化疗药物的损伤，；实验有迹象表明针灸还可能作用于造血微环境。     

针灸治疗贝尔麻痹临床多中心随机对照试验研究

目的:证实针灸治疗贝尔麻痹的临床疗效.方法:4个中心共480例患者纳入研究,439例完成整个研究过程.所有病例随机分为对照组(基础组)和治疗组(基础加针灸组、针灸组).基础组治疗用强的松、维生素B1、维生素B12及地巴唑,针灸组治疗用毫针刺加灸,基础加针灸组则二者结合.共治疗4周.采用症状体征、House-Bfackmann分级量表、面部残疾指数(FDI)评分量表进行疗效评价.结果:4个中心完成情况良好,4个中心疗效差异无显著性,研究方案执行较好.3个组分组均衡,基线状况良好,可比性强(P＞0.05);3个组的疗效差异有显著性,其中治疗组疗效优于对照组、针灸组疗效最好(P＜0.05,P＜0.01).轻度面瘫和急性期面瘫疗效优于重度面瘫和非急性期面瘫(P＜0.01).比较治疗前后House-Brackmann量表分级和治疗前后面部残疾指数躯体功能评分(FDIP),治疗组疗效优于对照组(P＜0.01).结论:针灸治疗贝尔麻痹临床疗效肯定,其效果优于基础对照组和基础加针灸组.     

Feishu Acupuncture Inhibits Acetylcholine Synthesis and Restores Muscarinic Acetylcholine Receptor M2 Expression in the Lung When Treating Allergic Asthma

Acupuncture was proven beneficial in treating allergic inflammation. We aimed to explore the regulation underlying the effects of acupuncture on Feishu, an acupoint most commonly used in the acupuncture therapy for respiratory diseases, with respect to the system of sympathetic nerve neurotransmitter acetylcholine (Ach). Male Wistar rats were randomly grouping. No treatment was taken in the normal group. Allergic asthma was induced using ovalbumin on the model, Feishu acupuncture, and sham acupuncture groups; then control or acupuncture treatment lasting for 3 weeks was performed. Bronchoalveolar lavage fluid (BALF) from the four groups was examined. And pulmonary tissues were subjected to histological analysis with H&E staining; besides, immunofluorescent staining, quantitative PCR, and western blot were used to detect synthetase (ChAT) and Ach hydrolase (AchE), and its muscarinic receptors (mAchRs) M1-M3. There was inflammatory infiltration in the lung upon allergic asthma, which was alleviated by the Feishu acupuncture. The eosinophilic granulocytes, neutrophils, and lymphocytes in BALF from the Feishu acupuncture group were all significantly decreased compared with those of the model and sham acupuncture groups. The specific acupuncture on Feishu upon allergic asthma put down the pulmonary expression of ChAT, repaired at the level of gene expression the pulmonary expression of mAchR M1, and restored the pulmonary expression of mAchR M2 (especially in the bronchiolar epithelium) which has a role in inhibiting Ach release; while sham acupuncture had no effect. These results confirmed the therapeutic effects of Feishu acupuncture on allergic asthma, suggesting that the mechanisms may involve suppression of the Ach signal both from its synthesis and during its release.     

中药疗法治疗肩手综合征的临床疗效的Meta分析

目的运用Meta分析方法比较中药疗法与其他干预措施治疗肩手综合征临床疗效。方法收集2010年1月至2014年12月的中药治疗肩手综合征临床观察文献,对中药和其他干预措施的临床随机对照试验进行Meta分析。结果共纳入20篇符合要求的文献,Meta分析其总有效率,上肢运动功能和疼痛评分。结果显示,3个检测指标均具有统计学意义。结论现有的证据表明,中药治疗肩手综合征能明显改善上肢运动功能,减轻患者的疼痛,较其他干预措施疗效好。但是受纳入研究文献数量和质量限制,中药治疗肩手综合征疗效和安全性需要更多高质量的随机双盲试验加以证实。     

《医学衷中参西录》外治法运用浅述

对《医学衷中参西录》中所涉及的中医外治法进行归纳总结。该书中所涉及的外治法有简、便、廉、验的特点,往往内治与外治相结合,尤其是将针灸、刮痧等方法应用于时疫的治疗,为后世治疗时疫提供了宝贵的经验。     

电针治疗功能性消化不良大鼠海马体NMDA受体的调节机制

目的:探讨电针治疗功能性消化不良大鼠海马体NMDA受体的调节机制。方法:本项目采用电针足三里、中脘穴作为干预因素,以功能性消化不良大鼠为受试对象,运用免疫组化等多种技术手段,从边缘系统-脊髓-胃肠多水平研究电针对功能性消化不良大鼠胃肠吸收、胃肠动力及神经递质的影响,探讨电针功能性消化不良大鼠海马体NMDA受体通路的分子机理。结果:电针对功能性消化不良大鼠胃肠吸收功能、胃肠动力等有明显影响,电针对功能性消化不良大鼠海马体NMDA受体有显著调节作用。结论:电针治疗功能性消化不良,可能是通过海马体的NMDA受体通路对认知情感中枢与神经内分泌系统进行良性平衡调节而实现的。这一作用的完成,可能是通过通过拮抗海马NMDA受体,进而纠正海马的"兴奋-抑制"失衡,重建稳态来实现的。     

Mechanisms of Electroacupuncture on Alzheimer's Disease: A Review of Animal Studies

Alzheimer's disease(AD) is the main type of dementia affecting elderly people. The medicines used for treating AD have limits in their ability to alleviate cognitive and functional decline. Electroacupuncture(EA), an economical alternative and complementary therapeutic measure used in Chinese medicine, has strong clinical applicability, and its treatment effects are more reliable as its stimulation factors can be standardized. EA has been effectively used for ameliorating spatial learning and memory impairment in AD patients and rodent AD models. Here, we summarized the mechanisms of EA on rodent AD models, aiming to provide a theoretical basis for identifying new targets and research directions, and exploring appropriate EA stimulation parameters, then provide a detailed methodology to optimize the effects of EA, ultimately reducing the heavy burden of treating AD patients on families and countries. Our review showed that 8 acupoints were used when treating AD animals; Baihui(GV 20) was the most frequently used. Four mechanisms of EA were studied:(1) protection of cerebral neurons from oxidative stress, apoptosis, neuroinflammation, synaptic plasticity and hormone levels;(2) regulation of metabolism, including glucose metabolism and plasma metabolism;(3) regulation of brainderived neurotrophic factor; and(4) regulation of β-amyloid peptide protein deposition.     

脑肠互动与针刺治疗功能性胃肠病的相关性

功能性胃肠病是临床上常见的消化系统疾病,也是针刺治疗的优势病种.近年来的研究表明,脑肠轴功能失调是功能性胃肠病发病的重要原因,而针刺对脑肠轴的调节作用是其治疗功能性胃肠病的主要着眼点.随着脑功能成像技术的发展和脑肠肽研究的进展,功能性胃肠病与中枢神经系统及脑肠肽代谢相关性的研究日益增多.针灸作为传统中医疗法的一部分,治疗功能性胃肠病疗效显著,被广泛运用于临床.大量研究显示,针刺既能调节中枢神经系统,也能调控脑肠肽代谢.本文拟从中枢神经系统、脑肠肽代谢两方面,探讨脑肠互动与针刺治疗功能性胃肠病的相关性.