从国际视野看针刺镇痛发展前景（英文）

<正>Pain is one of the most common clinical symptoms and has been identified by the World Health Organization (WHO) as the"fifth vital sign"after blood pressure,respiratory rate,pulse rate,and body temperature.For the first time,in June 2018,the WHO included chronic pain in the International 11th revision of the International Classification of Diseases as a separate disease [1].In recent years,Chinese medicine,and acupuncture in particular,     

基于复杂网络的《新针灸学》与《经络腧穴学》比较分析研究（英文）

提取《新针灸学》《经络腧穴学》中穴位名称、主治病症信息,基于复杂网络建立穴-症网络,分析两者穴位数量、相互关联程度及主治规律变化,借助拓扑学数据解释变化原因,为传统针灸知识体系的结构化、标准化研究提供具体思路和方法。共纳入《新针灸学》386穴、773种症状、形成152163个穴位配伍对,《经络腧穴学》403穴、253种症状、28755个穴位配伍对。两本教材的穴-症网络存在丰富的差异性,其所载的病症结构化程度随医学知识的更新而提升。《新针灸学》模型具有更加典型的小世界效应,或因其以病症为主要分类手段的优势体现。两本教材穴位定位与主治方面发生许多变化,学科发展、时代背景等方面是变化的主要原因。     

Meta-analysis of the efficacy of acupuncture in the treatment of the vascular cognitive impairment associated with cerebral small vessel disease

ObjectiveTo systematically evaluate the efficacy and safety of acupuncture in the treatment of the vascular cognitive impairment (VCI) associated with cerebral small vessel disease (CSVD–VCI) and to provide a theoretical basis for clinical acupuncture treatment for CSVD–VCI.MethodVarious databases, including China National Knowledge Infrastructure, Wanfang Data, Chinese Science and Technology Journal Database, Chinese BioMedical Literature Service System, PubMed, the Cochrane Library, and EBSCOhost, were searched for randomized controlled trials (RCTs) related to acupuncture treatment for CSVD–VCI. The quality of the included trials was evaluated, and a meta-analysis was conducted using the Review Manager 5.4 software.ResultsTen articles on RCTs were included, involving 761 patients, i.e., 381 in the acupuncture group and 380 in the control group. The meta-analysis results indicated that the use of acupuncture alone and acupuncture alongside other therapies for CSVD–VCI could improve the overall clinical response rate [odds ratio = 3.51, 95% confidence interval (CI) = (2.05, 6.00), P < 0.00001], increase the patients’ Montreal Cognitive Assessment scores [mean difference (MD) = 3.33, 95%CI (2.98, 3.68), P < 0.00001], Mini-Mental State Examination scores [MD = 2.78, 95%CI (2.51, 3.06), P < 0.00001], and activities of daily living scores [MD = 6.30, 95%CI (4.22, 8.37), P < 0.00001], and shorten the latency of auditory evoked potential P300 [MD = −14.67, 95%CI (−19.54, −9.80), P < 0.00001].ConclusionAcupuncture alone and acupuncture alongside other therapies are superior to non-acupuncture-based therapies in the treatment of CSVD–VCI. However, due to the small number of relevant available articles and their general low quality, this conclusion may be biased. More clinical RCTs with a larger sample size and higher quality are needed to support this theory.     

Can dogs serve as stress mediators to decrease salivary cortisol levels in a population of liberal arts college undergraduate students?

The steroid hormone cortisol can be used to measure physiological stress in humans. The hypothalamic-pituitary-adrenal (HPA) axis synthesizes cortisol, and a negative feedback cycle regulates cortisol depending on an individual's stress level and/or circadian rhythm. Chronic stress of college undergraduate students is associated with various adverse health effects, including anxiety and depression. Reports suggest that stress levels have risen dramatically in recent years, particularly among university students dealing with intense academic loads in addition to COVID-19 pandemic-related uncertainty. The increasing rate of mental illness on college campuses necessitates the study of mediators potentially capable of lowering stress, and thus cortisol levels. Research on mediation techniques and coping mechanisms have gained traction to address the concerning levels of stress, including the employment of human-animal interaction sessions on college campuses. In this study, human-canine interaction as a stress mediation strategy for undergraduate students was investigated. We measured salivary cortisol levels in 73 college undergraduate students during a 60-min interaction period with a dog to determine whether human-canine interactions are effective in lowering cortisol levels and potentially reducing chronic stress typical of undergraduate students. Our results indicate that a human-canine interaction for 60 min is an effective method for significantly reducing salivary cortisol and stress levels among undergraduate college students. These findings support the expansion of animal visitation programs on college campuses to help students manage stress.     

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.     

子宫内膜异位症从蓄血证论治

[目的]探讨以《伤寒论》蓄血证理论治疗子宫内膜异位症的可行性。[方法]通过跟师学习,结合《伤寒论》中蓄血证相关理论,从病机、证候、治疗几方面阐述子宫内膜异位症与蓄血证之间的相互关系,并列举验案加以分析佐证。[结果]从临床角度看,蓄血证与子宫内膜异位症有相似之处,离经之血瘀滞,瘀热互结下焦是其病因病机,以少腹硬满胀痛、血下则缓为主要临床表现。破结逐瘀是其治疗大法,以抵当汤为治疗主方。临证施治时,根据月经周期、患者体质,在破结逐瘀泻热基础上,佐以补肾、健脾、温经、解痉,并配合针灸治疗。文中所附子宫内膜异位症病案,皆为瘀热互结下焦,从蓄血证论治,以水蛭、地鳖虫祛瘀消散离经之血,以大黄、猫爪草等泻热解毒,并防止病灶的异常出血,取得较好疗效。[结论]以《伤寒论》蓄血证理论治疗下焦瘀热互结的一类疾病,如子宫内膜异位症等,疗效良好,值得临床推广应用。     

阿魏酸对大气细颗粒物PM2.5诱导的小鼠主动脉炎症的干预作用

目的 探讨大气细颗粒物PM2.5对小鼠主动脉Toll样受体（Toll-like receptors,TLRs）信号通路的影响及阿魏酸的干预作用。方法 采用气管滴注方法以10,20 mg·kg^-1的PM2.5处理小鼠,并用40,80 mg·kg^-1的阿魏酸对部分20 mg·kg^-1 PM2.5处理后的小鼠进行治疗。2周后处死小鼠,血液细胞分析仪检测小鼠血液中炎症细胞水平,ELISA检测血清中IL-1β和IL-6的含量,并用荧光定量PCR检测主动脉中IL-1β和IL-6的mRNA水平,Western blot检测各组小鼠主动脉组织中TLR2、TLR4、MyD88、NF-κB p65蛋白的表达,免疫组化技术观察TLR2和TLR4在小鼠主动脉中的水平。结果 PM2.5能提高血液中NEUT、EOS的数量及其在总细胞中的比率,增加血液和主动脉组织中炎症因子IL-1β、IL-6的含量,上调主动脉组织中的TLRs通路相关分子TLR2、TLR4、MyD88、NF-κB p65的表达;而用阿魏酸干预后,血液中白细胞数量、EOS数量、NEUT与EOS的比率明显降低,IL-1β、IL-6水平下降。同时主动脉组织中的TLRs通路相关分子的表达下调。结论 PM2.5可能通过TLRs通路诱导小鼠主动脉炎症的产生,而阿魏酸可能通过抑制TLRs通路相关因子的表达而发挥抑制PM2.5诱导的小鼠主动脉炎症的作用。     

基于自主神经功能的不同选穴原则对无先兆性偏头痛患者针刺干预的随机对照研究

目的:基于自主神经功能探讨不同选穴原则干预无先兆性偏头痛患者的治疗效果。方法:2016年11月至2018年6月收集浙江中医药大学附属第三医院针灸科符合纳入标准的偏头痛患者84例,随机分为自主神经组41例(脱失1例)和常规治疗组40例(脱失2例),治疗频率为3次/周,均治疗2周,8周后回访。缓解期检测心率变异性特征,包括频域指标和时域指标,于发作期、首次治疗后及疗程结束3个时点同时进行心率变异性特征检测和简式McGill疼痛评分,治疗8周后回访时再次进行简式McGill疼痛评分,且全程对安全性指标进行检测。结果:两组患者缓解期时心率变异特征、治疗后各时间段频域指标无显著差异。时域指标中,与本组发作时比较,首次治疗后两组患者的24h全部正常N~N间期标准差(SDNN)均有显著差异(P<0.05),自主神经组首次治疗后与发作时比较,24h全部正常N~N间期每5min平均值的标准差(SDANN)也有显著差异(P<0.05)。治疗8周后回访时,自主神经组McGill量表中感觉项、VAS项评分均显著低于常规治疗组(P<0.01,P<0.05),两组8周随访时的总有效率分别是85.4%和80.0%,且均未发生严重不良事件。结论:针刺对偏头痛患者有即时和远期的疗效,常规取穴和自主神经取穴均可使交感神经活性增强,针对自主神经功能取穴具有一定的优势,对临床针刺治疗无先兆性偏头痛如何选穴具有一定的参考价值。     

银杏叶提取物对慢性阻塞性肺疾病急性加重期患者血管内皮功能的影响

目的探讨银杏叶提取物对慢性阻塞性肺疾病急性加重期（AECOPD）患者血管内皮功能的影响。方法将60例AECOPD患者随机分为常规治疗组（CT组）,银杏叶组（GBLE组）,每组30例;并选择同期30例健康体检者作为对照组。两组常规治疗相同,GBLE组每日加用舒血宁注射液20 mL静脉滴注,连用2周。酶联免疫吸附法检测血清一氧化氮（NO）、血栓调节蛋白（TM）和血管假血友病因子（vWF）。结果两个治疗组治疗前NO,TM显著低于对照组（P〈0.01）,vWF显著高于对照组（P〈0.01）。治疗后,两组NO,TM水平较治疗前显著升高（P〈0.01）,而GBLE组升高更为显著,与CT组比较有统计学差异（P〈0.01）;两组vWF水平较治疗前显著下降（P〈0.01）,GBLE组下降较CT组更为显著（P〈0.01）。结论银杏叶提取物有显著改善AECOPD患者血管内皮细胞功能的作用,可预防血栓性疾病。     

非布司他片多条溶出曲线对比研究

目的 通过试验建立有区分能力的溶出曲线测定条件,考察自制片与原研片体外溶出曲线的一致性.方法 分别在美国食品药品监督管理局公布的溶出曲线条件(pH 6.0缓冲液),转速50 rpm和75 rpm,溶出介质900 mL;在不同浓度(0.2%、0.3%、0.5%)十二烷基硫酸钠(SDS)的水溶液,转速50 rpm,溶出介质900 mL;不同pH(1.2、4.5、6.8)缓冲液,转速50 rpm,溶出介质900 mL条件下进行溶出曲线考察.结果 原研片在0.3%十二烷基硫酸钠溶出曲线条件认为有区分能力,自制片与原研片在多条溶出介质中的f2值大于50或15 min累积溶出大于85%.结论 通过试验建立了有区分力的体外溶出曲线条件,试验结果 表明自制片与原研片的溶出行为基本一致,为一致性评价提供试验依据.