四渎穴穴性辑考及临床发挥

四渎穴首见于《针灸甲乙经》,为手少阳三焦经穴,位于人体前臂肘尖下5寸,桡、尺骨中间。现代研究发现,针刺四渎穴可以通筋活络,疏散气血,还可调节全身水液代谢、气机运行。除此之外,曾国藩曾在《兵鉴》中提出四渎一词与人体五官相对应,故临床中针刺四渎穴还可以疏通、调节人体五官之气,治疗眼、耳、口、鼻经气闭阻所引起的一系列疾病。     

电针对血管性认知障碍大鼠学习记忆与海马内血管内皮生长因子及其受体1、2 mRNA表达的影响

目的:探讨电针对血管性认知障碍大鼠学习记忆及海马内血管内皮生长因子(VEGF)及其受体1(VEGFR-1/Flt-1)、受体2(VEGFR-2/Flk-1)mRNA表达的影响,为临床治疗血管性认知障碍提供理论和实验依据。方法:Wistar大鼠60只,随机选取12只作为假手术组,其余大鼠采用改良的四血管阻断法进行血管性认知障碍模型复制,将模型复制成功的大鼠保留36只,随机分为模型对照组、电针治疗组和西药治疗组,每组12只。电针治疗组大鼠电针"大椎""百会""水沟""神庭"穴,西药治疗组予茴拉西坦0.0625g/kg灌胃,均1次/d,10次为1个疗程,共治疗2个疗程。采用跳台实验测试各组大鼠学习记忆成绩,测定各组大鼠的神经行为学评分,RT-PCR法检测大鼠海马VEGF、Flt-1、Flk-1mRNA的表达。结果:模型对照组大鼠学习成绩表现为反应时间延长、错误次数增多,记忆成绩表现为潜伏时间缩短、错误次数增多,神经行为学评分显著升高,海马内VEGF、Flt-1、Flk-1 mRNA表达增强,与假手术组比较差异有统计学意义(均P0.01);电针治疗组大鼠学习记忆成绩改善明显,神经行为学评分显著降低,海马内VEGF、Flt-1、Flk-1mRNA表达明显增强,与模型对照组比较,差异有统计学意义(均P0.01)。电针治疗组大鼠学习成绩、神经行为学评分、海马内VEGF mRNA及Flt-1 mRNA与西药治疗组比较差异亦有统计学意义(均P0.05)。结论:电针能显著提高血管性认知障碍大鼠学习记忆成绩,上调海马内VEGF、Flt-1、Flk-1mRNA的表达,促进了要害部位的血管生成,可能是其治疗血管性认知障碍的重要作用机制之一。     

针刺心包经、心经对急性心肌缺血模型大鼠心肌肌钙蛋白T的影响

目的:观察电针心包经、心经对急性心肌缺血模型大鼠心肌和血清心肌肌钙蛋白T(cTnT)的影响,比较针刺心包经和心经干预急性心肌缺血作用。方法:将SD大鼠随机分为正常对照组、伪手术组、模型组、肺经组、心经组、心包经组。采用冠状动脉左降支结扎复制大鼠急性心肌缺血模型。肺经组选取"太渊(LU9)–列缺(LU7)"段,心包经组选取"大陵(PC7)–内关(PC6)"段,心经组选取"神门(HT7)–通里(HT5)"段。观察急性心肌缺血大鼠心肌和血清cTnT的变化。结果:与伪手术组比较,模型组心肌和血清cTnT具有显著性差异(P<0.01);与模型组比较,心经组、心包经组均具有显著性差异(P<0.01),而肺经组则无显著性差异(P>0.05);与肺经组比较,心经、心包经均有显著性差异(P<0.01),而心经组、心包经组之间比较,差异无显著性(P>0.05)。结论:电针心包经、心经可显著降低急性心肌缺血大鼠心肌和血清cTnT的含量,且优于肺经,对急性心肌缺血具有保护作用。     

近5年针灸治疗便秘临床研究进展

正中医学将便秘分为阴结和阳结两类。《伤寒论》提出"其脉浮而数,能食,不大便者,此为实,名曰阳结也。其脉沉而迟,不能食,身体重,大便反硬,名曰阴结也。"《景岳全书·秘结》也把便秘分为阴结、阳结两类,有火是阳结,无火是阴结。现代医学将便秘分为器质性和功能性两类,器质性多见于肿瘤、炎症、手术等因素造成的梗阻性便秘,神经     

中医药治疗脑心综合征的研究进展

脑心综合征（cerebral—cardiac syndrome,CCS）,又称脑-心综合征,脑心卒中,脑-心卒中,脑、心同源卒中,脑心反应,“脑源性”心脏损害等,是指因急性脑病,主要为脑出血、脑梗死、蛛网膜下腔出血或急性颅脑外伤等,累及下视丘、脑干和植物神经系统等所引起的类似急性心肌梗死、心肌缺血、心律失常或心力衰竭。亦即某些颅内或脑部疾病导致心脏形态及功能发生一系列特征性改变的病症。随着人们饮食富态化及我国人口的快速老龄化,脑血管病发病率明显增高。因其死亡率、致残率高,已受到广泛关注,但脑血管病引起的心脏改变,却没有引起人们的足够重视。急性脑血管病时,由于脑血液循环障碍对心血管系统,尤其是心肌有一定的影响,可引起心脏活动的改变,这不仅使脑血管病的病程延长,而且有时可成为病人死亡的直接原因。近年来中医药治疗脑心综合征已取得一系列研究成果,现综述如下。     

隔三七饼灸对佐剂诱导型RA大鼠脊髓AST大麻素受体及P38MAPK表达的影响及机制探讨

目的:探讨隔三七饼灸对佐剂诱导型类风湿性关节炎(RA)大鼠脊髓星形胶质细胞(AST)大麻素受体及促分裂原活化蛋白激酶(P38MAPK)表达的影响及作用机制。方法:采用足垫部皮下注射弗式完全佐剂(FAC)复制RA大鼠模型,将大鼠随机分为假手术组、隔三七饼灸治疗组(艾灸组)、模型组和红外线照射(TDP)治疗组(TDP组),每组10只,艾灸组取内膝眼、外膝眼、血海、足三里穴,予以隔三七饼灸治疗,每次每穴灸五壮,隔日1次,10次为1个疗程;TDP组予以TDP照射治疗,每次30分钟,隔日1次,10次为1个疗程;模型组、假手术组平行饲养,只在鼠板上固定而不作其他处理。在造模成功后、治疗一个疗程后分别观察记录踝关节疼痛试验评分、热痛阈和机械性痛阈,并采用免疫组织化学技术,观察大麻素受体CB1、CB2在脊髓背角的表达及P38MAPK在脊髓AST内表达。结果:造模后,与假手术组比较,模型组、艾灸组和TDP组大鼠的疼痛试验评分显著升高(P<0.01),热痛阈和机械痛阈显著降低(P<0.01);治疗1个疗程后,与模型组比较,艾灸组和TDP组的疼痛试验评分和P38MAPK的表达降低(P<0.01,P<0.05),热痛阈、机械痛阈以及CB1、CB2表达升高(P<0.01,P<0.05);与TDP组比较,艾灸组的疼痛试验评分和P38MAPK的表达明显降低(P<0.05),热痛阈、机械痛阈以及CB1、CB2表达明显升高(P<0.05)。结论:隔三七饼灸对RA大鼠产生的疼痛有良好的改善作用,能增强脊髓大麻素受体CB1、CB2表达,抑制P38MAPK的表达,其机制可能是艾灸通过调控脊髓大麻素受体CB1、CB2的表达,抑制P38MAPK的通路而对佐剂性关节炎产生镇痛作用。     

电针百会、风府穴对脑I/R损伤大鼠海马区CPG15表达的影响

目的:探讨电针对局灶性脑缺血再灌注大鼠神经功能的恢复及海马区CPG15表达影响的情况。方法:60只SD大鼠,雌雄各半,随机分为正常对照组、模型组、电针经穴组、电针非经穴组、西药对照组。采用线栓法制备局灶性脑缺血再灌注模型,电针经穴组电针"百会、风府"穴,电针非经穴组电针大鼠臀部非经非穴位置,电针以疏波2Hz,强度3～5mA,持续电针30min,每天1次,连续治疗2周。西药对照组以尼莫地平20mg/(kg.d)灌胃,每日2次,连续灌胃2周。2周后longa5分法对大鼠神经功能缺损评分,并取材,运用免疫组化法检测大鼠缺血侧海马区CPG15表达情况。结果:模型组大鼠神经功能缺损评分及缺血侧海马区CPG15表达显著高于正常对照组,(P0.01);电针经穴组与西药治疗组大鼠神经功能评分及海马区CPG15表达差异不显著,(P0.05),而较模型组二者均有显著性差异,(P0.01);电针非经穴组大鼠神经功能缺损评分及缺血侧海马区CPG15表达与模型组比较差异不明显,(P0.05)。结论:电针可改善脑缺血再灌注大鼠神经功能并提高海马区CPG15的表达,电针对脑缺血再灌注后脑细胞的神经可塑性有促进作用。     

Effect of acupuncture in intervening heroin-induced brain damage via regulating ubiquitin-proteasome pathway

Objective

To observe the effect of acupuncture in regulating ubiquitin-proteasome pathway (UPP), and discuss the action of acupuncture in intervening heroin-induced brain damage.

Methods

Thirty male Sprague-Dawley (SD) rats were divided into a control group, a model group and an acupuncture group by using the random number table. Rats in the model and acupuncture groups received intramuscular heroin injection for successive 8 d at a progressively increased dose. Afterwards, the injection was suspended for 5 d for withdrawal. The heroin relapse rat model was established by repeating the drug addiction and withdrawal process for 3 times. The control group followed the step of the model establishment, but was given intramuscular injection of normal saline at the stage of addiction and no intervention at the stage of withdrawal; the model group was given intramuscular heroin injection at a progressively increased dose at the addiction stage and no intervention at the withdrawal stage; the acupuncture group was dealt in the same way as the model group at the addiction stage, but received acupuncture at Baihui (GV 20) and Dazhui (GV 14) at the withdrawal stage, with the needles retained for 30 min each time, 1 session a day, for successive 5 d. On the 39th day, brain tissues were extracted from the hippocampus and ventral tegmental area (VTA) of the three groups of rats. The apoptosis of brain nerve cells was detected by using terminal deoxynucleotidyl transferase-mediated nick and labeling (TUNEL). The mRNA and protein expressions of ubiquitin (Ub), ubiquitin protein ligase (E3) and 26S were examined by immunohistochemistry and quantitative real-time polymerase chain reaction (RT-qPCR).

Results

Compared with the model group, rat’s hippocampus and VTA in the acupuncture group showed significantly fewer cells positively stained by TUNEL staining (P<0.01), and its mRNA and protein expressions of Ub, E3, 26S were significantly lower (P<0.01).

Conclusion

Reducing nerve cell apoptosis and regulating the mRNA and protein expressions of Ub, E3 and 26S in rat’s hippocampus and VTA are possibly one of the action mechanisms of acupuncture in intervening heroin-induced brain damage.