针刺干预对肌萎缩侧索硬化症模型小鼠脑及脊髓中IBA-1和TNF-α表达的影响

目的:探讨电针治疗肌萎缩侧索硬化症(ALS)的机制。方法:将SOD1^G93A转基因小鼠随机分为正常组、模型组、针刺组及利鲁唑治疗组,每组各8-10只。小鼠日龄30 d后,针刺组选取双侧天枢穴(ST25)及足三里穴(ST36)予以电针治疗。利鲁唑治疗组按照30 mg/(kg·d)的剂量予以90 d日龄小鼠灌胃治疗,1次/d。模型组及对照组常规饲养,不予干预。于小鼠电针治疗前及治疗后分别对4组进行体质量记录及行为学观察。采用免疫组化法检测各组小鼠脑干及脊髓中IBA-1和TNF-α表达变化。结果:正常组小鼠精神状态及运动功能良好,针刺组及利鲁唑组小鼠较模型组精神状态及运动功能明显改善; 转棒实验结果显示针刺组及利鲁唑组小鼠潜伏期较模型组延长; 免疫组化检测结果表明在模型组脑干IBA-1阳性细胞表达高于正常组(P<0.05); 而利鲁唑组IBA-1阳性细胞表达虽有降低,但组间无统计学差异(P>0.05)。该结果与IBA-1阳性细胞在脊髓L_4-5节段表达趋于一致(P<0.05)。针刺治疗后脊髓中促炎因子TNF-α表达明显减少(P<0.05),但利鲁唑组较模型组无统计学差异(P>0.05)。结论:电针治疗及利鲁唑灌胃治疗均可以改善小鼠运动功能及生存质量,但早期针刺干预明显减少脑干及脊髓中小胶质细胞的活化,抑制促炎因子TNF-α释放,表明电针治疗ALS有效,其机制可能与针刺抑制神经炎症产生有关。     

Dry needling technique decreases spasticity and improves general functioning in incomplete spinal cord injury: A case report

Context: Spasticity in neurological disorders (i.e. stroke patients and cerebral palsy) is positively improved by dry needling. However, reports are scarce regarding the potential effects of dry needling in reducing spasticity and improving functionality in patients with an incomplete spinal cord injury. The aim of this case report was to study the immediate, short-term effects of dry needling treatment (10 weeks) on spasticity, dynamic stability, walking velocity, self-independence, and pain in a single patient with an incomplete spinal cord injury.

Findings: The dry needling treatment resulted in immediate, short-time effects on basal spasticity in the upper (reduction from 2 to 0 point median) and lower (reduction from 2 to 0 point median) limbs, as measured by the modified Ashworth Scale. Dynamic-stability, assessed by trunk accelerometry, improved more than 50% (Root Mean Squared of acceleration, Root Mean Squared of Jerk and step variability), and gait speed improved by 24.7?s (i.e. time to walk 20?m). Self-independence and pain were respectively scored by the Spinal Cord Independence Measure (21 points improvement) and visual analog scale (4 points improvement).

Conclusions: This case report demonstrates that dry needling treatment can have positive effects on spasticity, dynamic stability, walking velocity, self-independence, and pain in patients with incomplete spinal cord injury. Further research is needed in a larger patient population to deeply understand the mechanism(s) associated with the obtained results and regarding the clinical significances of dry needling treatment for incomplete spinal cord injury.     

“标本配穴”电针对慢性心肌缺血模型大鼠线粒体结构及呼吸酶活性的影响

目的:以心肌线粒体为切入,观察“标本配穴”电针对慢性心肌缺血模型大鼠心肌线粒体结构、GAPDH、CS、CCO的酶活性及心肌组织ATP含量的影响,探讨“标本配穴”电针对慢性心肌缺血模型大鼠心肌线粒体的保护机制。方法:将30只Wistar雄性大鼠随机分为空白组、模型组、标本配穴组,每组10只。模型组、标本配穴组大鼠皮下注射盐酸异丙肾上腺素制备慢性心肌缺血大鼠模型。标本配穴组在造模结束后取“内关”“足三里”“关元”电针干预10 min,疏密波,2~100 Hz,1 mA,连续21天。运用透射电镜观察心肌线粒体结构变化,采用试剂盒检测3-磷酸甘油醛脱氢酶(GAPDH)、柠檬酸合成酶(CS)、细胞色素C氧化酶(CCO)的酶活性及心肌组织ATP含量。结果:与空白组比较,模型组线粒体结构破坏明显,大部分线粒体出现变形空泡化;而与模型组比较,标本配穴组线粒体结构损伤程度明显减轻。与空白组相比,模型组、标本配穴组心肌组织ATP含量、GAPDH、CS、CCO活性均明显降低(P<0.01)。但与模型组相比,标本配穴组4指标均显著增高(P<0.01),且心肌组织ATP含量与GAPDH、CS、CCO活性成线性相关。结论:在慢性心肌缺血状态下,标本配穴电针可提升线粒体呼吸酶活性,增加有氧呼吸产能效率,改善心脏能量代谢,从而减轻心肌细胞的结构破坏,对心肌组织起到保护作用。     

耳穴贴压联合俞募配穴针刺治疗中风后便秘疗效观察

目的观察耳穴贴压联合俞募配穴针刺治疗中风后便秘(虚秘)的临床疗效。方法将80例中风后便秘(虚秘)患者随机分为治疗组40例、对照组40例。在中风常规治疗、护理及康复训练下,治疗组采用耳穴贴压联合俞募配穴针刺,对照组采用普通针刺法。对两组患者临床疗效、便秘症状积分、胃肠激素水平及生存质量进行比较。结果两组治疗后胃肠激素P物质(SP)水平及便秘患者生存质量量表(PAC-QOL)评分均有显著提高(P<0.01),且治疗组治疗后明显高于对照组(P<0.01),两组治疗后便秘症状积分、胃肠激素血管活性肠肽(VIP)水平均显著降低(P<0.01),且治疗组治疗后低于对照组(P<0.01)。治疗组总有效率为87.5%,两组疗效比较差异有统计学意义(P<0.05)。结论耳穴贴压联合俞募配穴针刺治疗中风后便秘(虚秘)具有良好疗效。     

环境水样中痕量铜的浊点萃取-火焰原子吸收光谱测定法

目的建立环境水样中痕量铜的浊点萃取(cloud point extraction,CPE)-火焰原子吸收光谱(flame atomic absorption spectrometry,FAAS)测定法。方法样品在p H 9.5的条件下,加入0.4 ml的1 mmol/L 2-(5-溴-2-吡啶偶氮)-5-二乙氨基酚(5-Br-PADAP)溶液,0.1%氯化钙溶液0.1 ml,5%(W/V)Triton X-114溶液0.8 ml,40℃加热15 min后离心,采用火焰原子吸收光谱法进行检测。结果在2~240μg/L的线性范围内,所得回归方程为A=0.002 7c+0.024 6,r=0.995 8。以3倍信噪比计算,方法的检出限为0.62μg/L,富集倍数为36.58倍,平均加标回收率为96.28%~98.08%,RSD为1.67%~3.13%。结论该方法简单、灵敏,具有良好的重现性,适用于环境水样中痕量铜的测定。     

Relationship among Cervical Spine Degeneration,Head and Neck postures,and Myofascial Pain in Masticatory and Cervical Muscles in Elderly with Temporomandibular Disorder

ObjectivesThe aim of the study was to verify associations among degenerative changes in the cervical spine, head and neck postures, and myofascial pain in the craniocervical musculature in elderly with myofascial temporomandibular disorders (TMDs).MethodsA total of 120 participants (mean age, 68.3 ± 7.5 years) were included: 45 participants had no signs of orofacial or cervical pain, 26 participants had myofascial TMD only (mTMD), and 49 participants had both myofascial TMD and cervical pain (cerTMD). Participants were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Cervical spine degeneration and head and neck postures were identified using the lateral cephalogram. Myofascial trigger points (TrPs) were evaluated in the temporalis, masseter, trapezius, sternocleidomastoid, sub-occipitalis, and splenius capitis muscles. Relationships among number of TrPs, head postures, and cervical degeneration were investigated using repeated-measure analysis of variance and Pearson’s correlation coefficient.ResultsThe cerTMD showed higher number of active TrPs in the masticatory and cervical muscles, greater forward head posture, and more severe degenerative changes in the cervical spine than mTMD did. The degenerative changes in each level of the cervical spine had complex interactions with head postures. Cervical degeneration, particularly at level of second to third vertebra appeared to be linked to the development of active TrPs in the masticatory and cervical muscles.ConclusionsThe results of this study demonstrated that degenerative changes in the cervical spine were related to altered head postures and the development of active TrPs in the craniocervical musculature in elderly with myofascial TMD.     

针刀松解激痛点治疗颈源性头痛39例影响

目的分析针刀松解激痛点治疗方法用于颈源性头痛患者的效果。方法对医院接受针刀松解激痛点治疗的39例颈源性头痛患者纳入试验组,选于2017年2月—2018年9月,抽取同期接受针刺治疗的39例颈源性头痛患者纳入对照组,评比两组治疗有效总计率、治疗前和治疗3个疗程后头痛程度评分值、头痛维持时间、头痛发生频率。结果试验组治疗有效总计率明显高于对照组统计值(P<0.05)。试验组治疗3个疗程后头痛程度评分值、头痛维持时间、头痛发生频率显著低于治疗前及对照组统计值(P<0.01)。结论对颈源性头痛患者实行针刀松解激痛点治疗的效果较优。