电针结合重复经颅磁刺激对脑缺血大鼠海马突触素的影响

目的：研究电针结合重复经颅磁刺激对脑缺血大鼠海马突触素的影响。方法：120只Wistar大鼠随机分为正常组、模型组、电针组、重复经颅磁刺激组和电针结合重复经颅磁刺激组, 根据不同时间点每个组又细分为7d、14d和28d组3个亚组。复制大脑中动脉栓塞模型,分别给予电针、磁刺激和电针结合磁刺激干预。免疫荧光标记方法观察缺血侧海马CA3区突触素的表达,蛋白印迹技术定量分析不同时间点、不同组别之间缺血侧海马突触素表达的差异。结果：电针、磁刺激和电针结合磁刺激都能显著上调3个时间点海马突触素的表达。从时间上看,随着治疗时间的增加,突触素的表达逐步上调;不同组间比较,第28天时电针结合磁刺激海马突触素的表达最显著。结论：三种干预方法都能促进脑缺血大鼠海马突触素的表达,其中第28天时电针结合磁刺激效果最显著。     

Isoflurane and the Analgesic Effect of Acupuncture and Electroacupuncture in an Animal Model of Neuropathic Pain

The present study aimed to determine whether isoflurane interferes with the analgesic effects of acupuncture (Ac) and electroacupuncture (EA), using a neuropathic pain (NP) rat model. In total, 140 male Wistar rats were used; isoflurane-induced nociceptive response was evaluated using the von Frey test, serum calcium-binding protein β (S100β) levels and nerve growth factor (NGF) levels in the left sciatic nerve. The NP model was induced by chronic constriction injury of the sciatic nerve at 14 days after surgery. Treatment was initiated after NP induction with or without isoflurane anesthesia (20 min/day/8 days). The von Frey test was performed at baseline, 14 days postoperatively, and immediately, 24 h, and 48 h after the last treatment. Results of the nociceptive test and three-way analysis of variance were analyzed by generalized estimating equations, the Bonferroni test, followed by Student–Newman–Keuls or Fisher's least significant difference tests for comparing biochemical parameters (significance defined as p ≤ 0.05). At baseline, no difference was noted in the nociceptive response threshold among all groups. Fourteen days after surgery, compared with other groups, NP groups showed a decreased pain threshold, confirming establishment of NP. Ac and EA enhanced the mechanical pain threshold immediately after the last session in the NP groups, without anesthesia. Isoflurane administration caused increased nociceptive threshold in all groups, and this effect persisted for 48 h after the last treatment. There was an interaction between the independent variables: pain, treatments, and anesthesia in serum S100β levels and NGF levels in the left sciatic nerve. Isoflurane enhanced the analgesic effects of Ac and EA and altered serum S100β and left sciatic nerve NGF levels in rats with NP.     

电针联合艾灸治疗蛛网膜下腔出血后脑血管痉挛的临床观察

[目的]观察电针联合艾灸治疗蛛网膜下腔出血后脑血管痉挛的临床疗效,并探讨其对一氧化氮(NO)及内皮素1(ET-1)水平的影响.[方法]将120例蛛网膜下腔出血后脑血管痉挛患者随机分为治疗组和对照组,每组各60例.2组患者均给予吸氧、镇静、脑神经保护等基础常规处理.治疗组在常规处理的基础上,给予电针联合艾灸治疗,对照组在...     

针灸疗法治疗肩手综合征疗效的Meta分析

目的:评价针灸治疗肩手综合征的有效性。方法:检索2005年至2010年国内发表的针灸疗法治疗肩手综合征临床随机对照试验研究,进行文献筛选并予Jadad评分,分析采用Review Manager 5.0软件。结果:29篇文献符合纳入,经Jadad评分均属低质量文献,共累计病例2 302例。依据治疗干预措施的不同,归纳3组比较疗效,所用文献21篇,分析数据结果显示,单纯针刺疗法与穴位封闭治疗的疗效OR[95%CI]4.80[2.02,11.41],P<0.05;电针疗法与单纯针刺疗法的疗效OR[95%CI]4.60[2.08,10.17],P<0.05;针灸结合其它疗法与单纯针刺疗法OR[95%CI]3.31[2.30,4.77],P<0.05。另8篇文献因治疗干预措施各不相同,不做Meta分析。结论:针灸疗法治疗肩手综合征有效;临床治疗中电针疗法疗效优于单纯针刺疗法,单纯针刺疗法疗效优于穴位封闭疗法,针灸结合其它疗法疗效优于单纯针刺疗法;针灸治疗肩手综合征的疗效分析仍需进行大样本、多中心、高标准的临床随机对照试验以补充说明。     

神经阻滞复合电针对特殊群体运动员腰腿痛治疗效果的评价

目的:探讨神经阻滞复合电针对特殊群体运动员腰腿痛治疗效果的评价。方法:运动员和非运动员各20例,非运动员随机分两组:Ⅰ组骶管注射组;Ⅱ组椎旁神经阻滞组。药物组成:2%利多卡因3mL,甲钴胺注射剂0.5mg,地塞米松5mg,0.9%NaCl共20mL。运动员随机分为两组:Ⅲ组骶管注射+针刺取穴联合治疗组,IV组椎旁神经阻滞+针刺取穴联合治疗组。在神经阻滞治疗同时,根据中医经络学说理论取穴:针刺,求得气感,接电针刺激仪,调整刺激强度,以达到患者能承受的最大强度。观察20min,神经阻滞药物治疗中除去地塞米松。治疗结束后,再次对四组患者疼痛程度和症状、功能及临床疗效进行评分。结果:4组患者的症状和主观疼痛感明显减轻,且椎旁神经阻滞+针刺取穴联合治疗组和骶管注射+针刺取穴联合治疗组与单纯的椎旁神经阻滞组和骶管注射组效果相当。结论:电针复合骶管或椎旁神经阻滞是治疗运动员腰腿痛的理想治疗方法。     

督脉电针结合超短波疗法对大鼠脊髓全横断损伤后脑源性神经生长因子和神经轴突生长抑制剂-A表达的影响

目的:通过检测大鼠脊髓损伤(SCI)后运动功能恢复情况和脑源性神经生长因子(BDNF)、神经轴突生长抑制剂-A(Nogo-A)的表达来探讨联合应用督脉电针和超短波疗法对SCI的作用机制。方法:复制并评价脊髓全横断损伤大鼠模型,100只雌性大鼠随机分为5组:假手术组、SCI组、SCI+督脉电针组、SCI+超短波组、SCI+督脉电针+超短波组(n=20),检测各组7d、14d、21d、28d这4个时间点BDNF和Nogo-A表达,对各组大鼠进行BBB评分。结果:与模型组相比,各治疗组的BBB评分显著增加,联合组在术后第7d、14d、21d、28d较超短波组和督电组BBB评分显著增加,具有显著性差异(P0.01)。与模型组相比,各治疗组BDNF的表达均显著增加,Nogo-A的表达均显著减少,联合组在术后第7d、14d、21d、28d较超短波组和督电组BDNF的表达显著增加,Nogo-A的表达显著减少,具有显著性差异(P0.01)。结论:(1)联合应用督脉电针与超短波治疗,能够提高SCI后BDNF的表达及抑制Nogo-A的表达来促进神经的修复。(2)联合疗法对大鼠运动功能恢复更佳。     

Effect of electroacupuncture on the mRNA and protein expression of Rho-A and Rho-associated kinase Ⅱ in spinal cord injury rats

Electroacupuncture is beneficial for the recovery of spinal cord injury, but the underlying mechanism is unclear. The Rho/Rho-associated kinase(ROCK) signaling pathway regulates the actin cytoskeleton by controlling the adhesive and migratory behaviors of cells that could inhibit neurite regrowth after neural injury and consequently hinder the recovery from spinal cord injury. Therefore, we hypothesized electroacupuncture could affect the Rho/ROCK signaling pathway to promote the recovery of spinal cord injury. In our experiments, the spinal cord injury in adult Sprague-Dawley rats was caused by an impact device. Those rats were subjected to electroacupuncture at Yaoyangguan(GV3), Dazhui(GV14), Zusanli(ST36) and Ciliao(BL32) and/or monosialoganglioside treatment. Behavioral scores revealed that the hindlimb motor functions improved with those treatments. Real-time quantitative polymerase chain reaction, fluorescence in situ hybridization and western blot assay showed that electroacupuncture suppressed the m RNA and protein expression of Rho-A and Rho-associated kinase Ⅱ(ROCKⅡ) of injured spinal cord. Although monosialoganglioside promoted the recovery of hindlimb motor function, monosialoganglioside did not affect the expression of Rho-A and ROCKⅡ. However, electroacupuncture combined with monosialoganglioside did not further improve the motor function or suppress the expression of Rho-A and ROCKⅡ. Our data suggested that the electroacupuncture could specifically inhibit the activation of the Rho/ROCK signaling pathway thus partially contributing to the repair of injured spinal cord. Monosialoganglioside could promote the motor function but did not suppress expression of Rho A and ROCKⅡ. There was no synergistic effect of electroacupuncture combined with monosialoganglioside.     

早期电针治疗联合康复训练对急性脑梗死运动功能及生存质量的影响

目的探讨早期电针治疗联合康复训练对急性脑梗死患者运动功能恢复及生存质量提高的作用。方法将130例急性脑梗死患者随机分为两组,治疗组65例,对照组65例。对照组给予常规治疗,治疗组在此基础上给予早期电针治疗加康复训练,疗程3个月。两组患者治疗前后进行运动功能评分及生存质量评定。结果两组治疗后运动功能评分较治疗前明显改善(治疗组P<0.01,对照组P<0.05),治疗组优于对照组(P<0.05);两组治疗后生存质量较治疗前均显著升高(P<0.01),治疗组优于对照组(P<0.05)。结论早期电针治疗联合康复训练不仅能改善急性脑梗死患者的运动功能,而且能提高生存质量,值得临床推广和深入研究。     

电针配合西医综合疗法对突发性耳聋不同频率听力损害的临床观察（英文）

目的:比较电针配合西医综合疗法与单纯西药综合疗法对突发性耳聋患者不同频率听力损害的临床疗效差异。方法:将58例患者随机分为针药组28例(32只患耳)和西药组30例(34只患耳)。针药组采用电针配合西医综合疗法治疗,电针主穴选择耳门、听宫、听会、翳风等,西医疗法使用扩血管药物、促进神经功能药物、缓解内耳水肿药物和高压氧综合治疗;西药组单纯采用西医综合疗法治疗,10天为一疗程,治疗2个疗程。治疗1、2个疗程后,对患者进行疗效观察及电测听评定,并进行血常规和肝肾功能检测。结果:针药组总有效率为50.0%(16/32),西药组为55.9%(19/34),两组疗效相当(P>0.05);治疗1个疗程、2个疗程后,在250 Hz、500 Hz和1 kHz水平,两组电测听数值均较治疗前有显著恢复(均P<0.01);在2 kHz水平,针药组在治疗1疗程、2个疗程后较治疗前电测听数值有显著改善(P<0.05, P<0.01);在4 kHz水平,两组治疗前后比较差异无统计学意义(均P>0.05)。两组治疗前后血常规和肝肾功能检测无异常。结论:电针配合西医综合疗法与单纯西医综合疗法对于突发性耳聋的低频听力损害均有效,高频听力损害均无效,对中频听力损害,电针配合西医综合疗法优于单纯西医综合疗法。     

电针对脑缺血再灌注大鼠脑皮层超微结构及Nogo-A表达的影响

目的探讨电针对脑缺血再灌注(ischemia reperfusion,IR)大鼠不同时间点皮层超微结构及轴突再生抑制因子Nogo-A表达的影响。方法 130只雄性SD大鼠随机数字表法分为电针组(30只)、假穴位组(30只)、模型组(30只)、假手术组(30只)和空白组(10只)。电针、假穴位、模型3组采用改良的ZeaLonga法制备左侧大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型。电针组术后选取督脉"大椎"、"百会"穴每天给予电针治疗。假穴位组术后选取督脉"大椎"、"百会"穴旁开1寸处给予电针治疗。模型组仅作MCAO缺血再灌注模型处理,假手术组仅做手术创伤,空白组不作任何处理。运用免疫组织化学染色法及透射电镜技术观察电针对IR后1、7、28d各组大鼠脑皮层缺血区细胞超微结构及Nogo-A表达的干预作用。结果电针组脑皮层缺血区神经元、胶质细胞及血脑屏障等超微结构的损伤均较假穴位组、模型组减轻。电针组大鼠脑缺血再灌注后第1、7、28d脑皮层缺血区Nogo-A的表达均低于同期假穴位组及模型组,差异有统计学意义(P<0.05),但假穴位组与模型组同期比较,差异无统计学意义(P>0.05)。结论电针对大鼠脑缺血再灌注损伤的保护作用,可能与其减轻脑细胞超微结构的损害、下调中枢神经轴突再生抑制因子Nogo-A的表达等机制密切相关。