膏摩临床应用研究进展

综述近20年膏摩临床应用文献,分析其在骨科、儿科、皮肤科、内科疾病中的临床应用现状。     

椎体外部连接固定系统的制备及评价方法

脊柱推拿是治疗脊柱伤病安全有效的方法。但是,其传统的病理机制机械压迫和炎性刺激学说尚不能满意的解释脊柱推拿所有的临床现象。因此,寻找新的病理学说已成为研究人员关注的热点之一。脊柱推拿的重要概念"亚脱位"具有关节解剖位置微细改变和节段活动减小的基本特性。然而,其缺乏合理有效基础研究动物模型。研究介绍一种用于诱导亚脱位大鼠模型的椎体外部连接固定系统及其评价方法。     

大鼠腰椎亚脱位模型节段活动范围减小的研究

目的:观察大鼠腰椎亚脱位动物模型基本特性:节段活动范围减小。方法:将108只350～450g雄性SD大鼠随机分为实验组(单纯固定组、旋转固定组)和假手术组。再将各组按固定时间分为2、4、8和12周4个亚组。单纯固定组和旋转固定组分别植入外部连接固定系统进行造模,假手术组仅行手术干预。在各连接期结束时,X线片观察3组造模节段椎体后缘沿线夹角;脊柱刚度测试系统检测单纯固定组和旋转固定组刚度。结果:影像学检测结果显示,实验组大鼠椎体后缘所成的锐角(posterior body angle,PBA)变化呈逐渐减小趋势;而且,各连接期结束时,单纯固定组与旋转固定组间PBA变化差异无统计学意义(P>0.05),实验组与假手术组间PBA变化差异有统计学意义(P<0.05)。刚度检测结果显示实验组大鼠脊柱造模节段刚度随连接时间的延长而增加,2组之间刚度比较差异无统计学意义(P>0.05)。结论:外部连接固定系统诱导的大鼠腰椎亚脱位模型,可有效导致大鼠造模节段脊椎生物力学特性的变化,即节段活动范围减小,且此种变化与时间相关。     

经络系统与针刺效应机制的科学评价

ObjectiveTo search all available sources to find incontrovertible scientific explanation of the meridian system and mechanism of acupuncture action.MethodsExtensive search of electronic databases was carried out to identify all published scientific articles, research papers and experimental findings regarding meridian system, acupuncture points and mechanisms of acupuncture action, from both English and Chinese language journals, from inception till date.ResultsThere are many hypotheses and studies about meridian system such as, primovascular system as meridian, nuclear tracers study to locate the track of meridian, infrared imaging studies to prove existence of meridians, investigations about anatomical structure of acupoints, etc. There are many researches and theories about mechanism of acupuncture action such as gate control theory of acupuncture analgesia, neurotransmitters, neuro-endocrine-immune network, fMRI evidences of brain's processing of pain signal etc.ConclusionResearchers over half a century discovered many factual information about meridian system, acupoints, neuro-transmitters and acupuncture analgesia, neuro-hormonal mechanism etc. All these important discoveries contributed to clarify the mysteries of meridian system and acupuncture action, but they still fell short of providing an incontrovertible scientific explanation.Further coordinated studies are warranted to explore more plausible and scientifically valid explanation of meridian system and acupuncture action.     

Muscle energy technique for chronic obstructive pulmonary disease: A feasibility study

ObjectiveThis study aimed to investigate the feasibility of implementing a manual therapy technique (muscle energy technique, MET) protocol in a hospital pulmonary rehabilitation (PR) program for patients with moderate to severe chronic obstructive pulmonary disease (COPD).Please cite this article as: Baxter DA, Coyle ME, Hill CJ, Worsnop C, Shergis JL. Muscle energy technique for chronic obstructive pulmonary disease: A feasibility study. J Integr Med. 2023; 21(3): 245–253.MethodsParticipants aged 40 years and over, with moderate to severe COPD, were recruited into this 12-week study. The primary outcome measures were feasibility (acceptability of the intervention and attendance/adherence to the trial) and safety (adverse events, AEs). All participants received the MET and PR therapies. Participants and assessors were unblinded. Semi-standardized MET was delivered on 6 occasions (a maximum of once per week) at the hospital directly before a PR session. Participants undertook PR sessions as per the hospital program at a frequency of two days per week for 8 weeks. Participants were contacted 4 weeks after their final MET treatment via a telephone call to assess acceptability of the intervention.ResultsThirty-three participants were enrolled, with a median age of 74 years (range 45–89 years). The median number of MET sessions that participants attended was 5 (range 0–6) out of a possible 6 sessions (83% attendance). At follow-up, participants overwhelmingly enjoyed the MET treatment with some subjectively reporting improved breathing. There were no major AEs related to the intervention, with the majority of AEs classified as expected events related to COPD exacerbations.ConclusionIt is feasible to implement a manual therapy protocol using MET as an adjunct to PR in a hospital setting. Recruitment rates were satisfactory and there were no AEs related to the MET component of the intervention.     

脊柱微调手法治疗腰椎间盘突出症急性期临床观察

目的观察脊柱微调手法治疗腰椎间盘突出症急性期的临床疗效。方法将36例腰椎间盘突出症急性期患者随机分为实验组和对照组,各18例;对照组给予甘露醇+地塞米松静脉滴注及中药热敷治疗,实验组在对照组基础上结合脊柱微调手法治疗。观察两组治疗前后疼痛VAS评分和Oswestry功能障碍指数(ODI)评分变化情况。结果治疗后,两组疼痛VAS评分均较治疗前显著降低(P0.01),但两组疼痛VAS评分降幅无显著性差异(P0.05);两组ODI评分均较治疗前显著降低(P0.01),且实验组ODI评分降幅大于对照组(P0.05)。结论脊柱微调手法可有效改善腰椎间盘突出症急性期疼痛和功能障碍。     

Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice

ObjectiveAbnormalities in the gut microbiota and intestinal short-chain fatty acid (SCFA) levels are implicated in the pathogenesis of functional constipation (FC). Electro-acupuncture (EA) has been shown to improve constipation-related symptoms and rebalance the gut microbiota. However, it is currently unknown whether the gut microbiota is a key mechanistic target for EA or how EA promotes gut motility by regulating the gut microbiota and SCFAs. Therefore, we assessed the effects of EA in FC mice and pseudo-germfree (PGF) mice to address these questions.MethodsForty female Kunming mice were randomly separated into a normal control group (n = 8), an FC group (n = 8), an FC + EA group (n = 8), a PGF group (n = 8) and a PGF + EA group (n = 8). The FC group and FC + EA group were treated with diphenoxylate to establish the FC model; the PGF group and PGF + EA group were given an antibiotic cocktail to initiate the PGF model. After maintaining the model for 14 d, mice in the FC + EA and PGF + EA groups received EA stimulation at the ST25 and ST37 acupoints, once a day, 5 times per week, for 2 weeks. Fecal parameters and intestinal transit rate were calculated to assess the efficacy of EA on constipation and gastrointestinal motility. Colonic contents were used to quantify gut microbial diversity using 16S rRNA sequencing, and measure SCFA concentrations using gas chromatography-mass spectrometry.ResultsEA significantly shortened the first black stool defecation time (P < 0.05) and increased the intestinal transit rate (P < 0.01), and fecal pellet number (P < 0.05), wet weight (P < 0.05) and water content (P < 0.01) over 8 h, compared with the FC group, showing that EA promoted gut motility and alleviated constipation. However, EA treatment did not reverse slow-transit colonic motility in PGF mice (P > 0.05), demonstrating that the gut microbiota may play a mechanistic role in the EA treatment of constipation. In addition, EA treatment restored the Firmicutes to Bacteroidetes ratio and significantly increased butyric acid generation in FC mice (P < 0.05), most likely due to the upregulation of Staphylococcaceae microorganisms (P < 0.01).ConclusionEA-mediated resolution of constipation occurs through rebalancing the gut microbiota and promoting butyric acid generation.Please cite this article as: Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. J Integr Med. 2023; Epub ahead of print.