缪刺考

At present, most physicians hold that Miu Ci is "left and right cross collateral prick-ing",but it does not conform to the original meaning of "Suwen·Miucilunpian"(Plain Questions ·Trea-tise on Miu Ci). Miucilanpian holds that Miu Ci is the extension and perfection of Ju Ci (contralateral me-ridian needling), which mainly pricks the collateral but is not limited to the collateral, as it also pricks the acupuncture point. As for the "left and right cross" point selection, it is one step in the procedure of the treatment in the process of contralateral collateral needling instead of being a principle.     

风门穴与肺俞穴针刺安全深度及角度的应用解剖研究

采用钢针标定法和层次解剖法,在46具成年人尸体上,研究风门穴与肺俞穴的解剖结构和针刺深度及角度。结果显示:向下直刺的解剖结构依次是皮肤、浅筋膜、斜方肌、菱形肌、上后锯肌、竖脊肌、肋提肌、肋间内膜、胸内筋膜、肋胸膜,向下直刺的平均危险深度,风门穴为49.51 mm,肺俞穴为44.88 mm;向外下斜刺,当针体与矢状面夹角在20~25°时,危险深度最小;向内下斜刺,当针体与矢状面夹角大于20°时,比较安全。     

针灸上病下取治疗急性期肩周炎临床观察

目的:寻找治疗急性期肩周炎的最佳治疗方法.方法:针灸上病下取,治疗组在肩部病变处采用针刺,用梅花针重叩出血,局部拔火罐,再取膝以下穴位强刺激的方法;对照组采用常规针刺疗法.结果:治疗1疗程后,治疗组有效率98%,对照组有效率62%,两组痊愈率比较,差异有显著性意义(P＜0.05).结论:急性期肩周炎采用上病下取法疗效显著,治愈率高.     

湿温汗下润忌宜及儿科临床

<温病条辨>上焦篇湿温门云:"头痛恶寒,身重疼痛,舌白不渴,脉弦细而濡,面色淡黄,胸闷不饥,午后身热,状若阴虚,病难速已,名日湿温,汗之则神昏耳聋,甚则目瞑不欲言,下之则洞泄,润之则病深不解".     

田维柱教授关于透穴应用的见解

田维柱教授从事针灸的医疗、教学和科研工作30余载,经验颇丰,临证治疗尤以透穴针法应用得心应手.针对目前针灸发展的现状,田师结合自己的教学经验及治疗心得,提出了有关腧穴的应用操作应与透穴相结合并形成规范的设想.     

舒筋散温熨配合针刺治疗中风偏瘫软瘫期疗效观察

目的:观察舒筋散温熨配合针刺治疗中风偏瘫软瘫期的临床疗效。方法:脑血管意外致偏瘫患者80例,随机分为治疗组与对照组。以简化Fug-Meyer运动功能评分法[1]做指标,观察治疗前后患者症状变化。结果:治疗组疗效优于对照组。结论:舒筋散温熨配合针刺治疗中风偏瘫软瘫期患者具有明显的治疗作用。     

腕踝针对腰痛止痛作用的针刺点特异性随机对照临床研究

目的研究腕踝针的"针刺点"与"身体分区"的对应关系是否具有特异性,即腕踝针针刺点作用的特异性。方法采用随机对照临床试验,将90例急性腰痛患者随机分为三组,每组30例。三组受试者均采用腕踝针治疗1次,留针30 min。特异针刺点组根据腕踝针"按身体分区选择针刺点"的理论针刺下6或下5针刺点;非特异针刺点1组和2组分别针刺下2和上5针刺点。治疗前3 min和治疗过程第5、10、15和第30 min,分别用简式Mc Gill疼痛问卷(SF-MPQ)评价受试者活动腰部时疼痛情况,用重复改良的Schober试验(MMS)观察腰椎活动度,用预期和治疗信任度问卷(ETCS)评价三组患者治疗前后预期的变化。结果三组治疗前SFMPQ、MMS和ETCS各项差异均无统计学意义(P0.05)。三组SF-MPQ评分在第5、10、15和30 min与治疗前相比均降低(P0.05)。在第5、10和15 min,特异针刺点组的SF-MPQ多项评分(除PPI外)与治疗前的差值高于非特异针刺点1组和2组(P0.05)。治疗30 min后,特异针刺点组的SF-MPQ所有项目评分与治疗前的差值均高于非特异针刺点1组和2组(P0.05)。三组MMS治疗后均高于治疗前(P0.05),特异针刺点组MMS治疗后与治疗前差值高于非特异针刺点1组和2组(P0.05)。特异针刺点组的ETCS所有项目评分在治疗后与治疗前相比均升高(P0.05)。非特异针刺点1组和2组的ETCS所有项目评分在治疗后与治疗前相比,差异无统计学意义(P0.05)。结论腕踝针针刺点对急性腰痛具有止痛和改善腰椎前屈活动度作用,具有一定的特异性。     

Impact of physical therapists’ instructions on function and the perception of post-dry needling soreness in mechanical cervical pain; a randomized clinical trial

BackgroundTo investigate the impact of physical therapists’ instructions on the perception of post dry needling (DN) soreness and function in patients with mechanical neck pain.MethodsSeventy-five patients with neck pain were randomly assigned to three groups: “positive” group (n = 25) received positive verbal input; “negative” group (n = 25) received negative verbal input, and control group (n = 25) did not receive any input about post-needling soreness. All three groups received DN of a trigger point in the upper trapezius muscle. The subjective pain experience, pressure pain threshold (PPT), and neck disability Index (NDI) were assessed before and after DN.ResultsPatients in all groups showed improvement in pain, PPT and NDI. There were no significant differences in pain (P = 0.41) and PPT (P = 0.68) in the positive and negative groups compared with the control group. Significant difference in function was seen with the NDI after DN of patients in the positive and negative groups compared with the control group (P = 0.011, standard error: 1.08–1.5).ConclusionConsidering that the power of our study may be too low to draw more definitive conclusions, DN appears to be an effective technique to improve pain and mechanical hyperalgesia. The experience of post-needling soreness does not appear to influence the outcome of DN on pain, PPT, and NDI. Post-needling soreness does not seem to be a limiting factor in achieving acceptable outcomes, especially when clinicians offer DN within a therapeutic emphasizing a positive patient response. This study questions whether any treatments need to be offered to patients receiving DN.     

四维盆底超声对温针灸联合盆底肌锻炼治疗SUI的疗效评估

目的：通过四维盆底超声观察温针灸联合盆底肌锻炼治疗女性压力尿失禁（SUI）的疗效及优势。方法：筛选70例符合条件的SUI患者，随机分成对照组35例，试验组35例。对照组采用单纯盆底肌锻炼，试验组采用温针灸联合盆底肌锻炼。一月后行疗效评估及经会阴四维盆底超声检查，四维成像得到完整的肛提肌裂孔图像。分别测量治疗前后两组被试静息和Valsava状态下肛提肌厚度(MLT)、肛提肌裂孔左右径（LHW）和面积（LHA）、膀胱颈移动度（BLM），并记录，采用独立样本t检验（P<0.05）。结果：两组被试治疗后临床症状均改善，试验组为著，静息和Valsava状态下MLT增厚、LHW、LHA和BLM减小，试验组更显著，具有统计学差异（P<0.05），LHW差异明显（P<0.01）。结论：温针灸联合盆底肌锻炼更有效提高单纯盆底锻炼治疗SUI的疗效，LHW变化最显著。     

Tiempo de isquemia caliente y complicaciones postoperatorias después de la nefrectomía parcial por carcinoma de células renales

ObjectiveTo evaluate the correlations between PADUA and RENAL scores, WIT and postoperative complications in a cohort of patients who underwent elective open or minimally invasive nephron sparing surgery for renal cell carcinoma.Material and methodsWe analyzed 96 consecutive patients who underwent partial nephrectomy for renal cell carcinoma between 2004 and 2013 at our Institution. The Spearman test was used to compare categorical variables. For all statistical analyses, a two-sided P < .05 was considered statistically significant.ResultsThe median (IQR) PADUA score was 7 (7-8) and the median (IQR) RENAL score was 7 (6-8). The median (IQR) warm ischemia time was 14 min (8-20). Low grade and high grade postoperative complications were found in 27 (28.1%) and 6 (6.3%) patients, respectively. PADUA risk group categories significantly correlated with WIT > 20 minutes and high grade postoperative complications, respectively (P = .04), regardless of the surgical approach. RENAL risk group categories significantly predicted longer hilar clamping time in our cohort (P = .04), but no statistically significant correlations with high grade postoperative complications were found.ConclusionsIn our retrospective series nephrometric scores demonstrated to significantly predict longer warm ischemia time and higher postoperative complications, especially in those patients with more challenging and complex renal tumors. Therefore, when planning to perform partial nephrectomy, urologists should widely use these comprehensive tools.