糖尿病前期中医证型及证素特点分析＊

目的 探讨糖尿病前期的中医证型及证素分布特点。方法 检索中国知网、万方及维普三大数据库中收录的自建库以来有关糖尿病前期证型的临床研究文献，对中医证型进行规范整理，建立数据库，提取证素，运用数据挖掘技术中的关联分析、聚类分析探究证素分布规律。结果 共纳入10篇文献，总有效病例1620例，证型经规范处理后整理为18个，主要证型为脾虚痰湿证。共提取证素13个，主要病位证素为脾，主要病性证素为气虚、湿和痰，关联分析显示脾—湿支持度和置信度最高，聚类分析结果可得到3个聚类组。结论 糖尿病前期病位在脾，气虚、脾、痰、湿是常见证素，临床诊治糖尿病前期应注重从脾论治，需辨证施治。     

耳甲电针对冷应激大鼠脂蛋白代谢的调节作用

ObjectiveTo explore whether auricular concha eletroacupuncture (ACEA) is effective in regulating lipid-lipoprotein metabolism in rats submitted to cold stress.MethodsThirty-six adult male Sprague–Dawley rats were placed in four groups(9 rats in each group), the rats in three groups of which were submitted to cold stress for fourteen days, the last one of which was a control group. After the cold stress process, in those three groups, the rats of one group were with no treatment (stress only), two were treated with either ACEA or auricular margin eletroacupuncture (AMEA) repeated for fourteen days. On the 14th day, all the rats were sacrificed after all experimental procedure for blood sampling. Blood glucose, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were tested by using the collected serum. Plasma lecithin-cholesterol acyltransferase (LCAT) was measured with ELISA kit.ResultsACEA down-regulated the TG level (P < 0.05) and LDL-C level (P < 0.05), and up-regulated HDL-C level (P < 0.05) and LACT level (P < 0.05). AMEA did not regulate the bio-markers.ConclusionACEA played an important role in regulating lipid-lipoprotein metabolism in rats submitted to cold stress.     

耳甲电针治疗功能性消化不良的临床效果

目的:观察耳甲电针治疗功能性消化不良的疗效。方法:选取2018年6月至2019年5月北京同仁医院收治的功能性消化不良患者90例作为研究对象,按照随机数字表法分为对照组和观察组,每组45例,对照组采用对照刺激,观察组采用耳甲电针刺激,所有患者治疗前后均使用功能性消化不良主要症状评分表、功能性消化不良生命质量量表(FDDQL)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评估患者症状的严重程度,并参照功能性消化不良中医诊疗专家共识意见和功能性消化不良中西医结合诊疗共识意见的疗效评估方法,对比分析观察组与对照组治疗功能性消化不良的疗效。结果:观察组和对照组治疗前主要症状评分表、功能性消化不良生命质量量表(FDDQL)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)差异无统计学意义(P>0.05),治疗后观察组症状及量表评分与对照组差异有统计学意义(P<0.05)。观察组治疗有效率82.22%,对照组治疗有效率57.78%,差异有统计学意义(P<0.05)。结论:耳甲电针对于功能性消化不良的各项症状具有较好的疗效。     

经皮耳迷走神经刺激干预功能性消化不良模型大鼠的效应及机制研究

ObjectiveTo explore the effect and its possible mechanism of the intervention of transcutaneous auricular vagus nerve stimulation (taVNS) for the functional dyspepsia (FD) model rats.MethodsOf the 25 male SD rats, 6 rats were set as blank group, the other 19 rats were established to be the functional dyspepsia (FD) model by iodoacetamide intragastric administration, and 18 FD models were successfully established. The 18 model rats were randomly divided into a model group, a sham-taVNS group, and taVNS group, with 6 rats in each group. There was no intervention applied to the rats in the blank and model groups. Whereas, the rats in sham-taVNS group received stimulation to the rim of auricular concha of both sides, and those in taVNS group received stimulation to the cavity of auricular concha of both sides, for 30 min each time, once a day, 7 days in succession. After the intervention, the gastric sensitivity of the rats in each group under different pressure conditions in the stomach, the expressions of serum brain-gut peptide motilin (MTL), cholecystokinin (CCK), glucagon-likepeptide1 (GLP-1), and inflammatory factors IL-4, IL-10, and IL-1β were detected.Results(1) Gastric sensitivity: compared with the blank group, the gastric sensitivity of the model group was higher (P <0.05). Compared with the model group, the gastric sensitivity of the taVNS group was lower (P < 0.05). Compared with the sham-taVNS group, the gastric sensitivity of the taVNS group was lower (P <0.05).(2) Expression of brain-gut peptide: compared with the blank group, MTL was lower, CCK and GLP-1 were higher in the model group (all P <0.05). Compared with the model group, MTL was higher, CCK and GLP-1 were lower in the taVNS group (all P <0.05). Compared with the sham-taVNS group, CCK and GLP-1 were lower in the taVNS group (both P<0.05). (3)Expression of inflammatory factors: compared with the blank group, IL-4 and IL-10 were lower and IL-1β was higher in the model group (all P <0.05). Compared with the model group, IL-10 was higher and IL-1β was lower in the sham-taVNS group (all P <0.05), while IL-4 and IL-10 were higher and IL-1β was lower in the taVNS group (all P <0.05). Compared with the sham-taVNS group, IL-4 and IL-10 were higher and IL-1β was lower in the taVNS group (all P <0.05).ConclusionTaVNS can reduce the gastric sensitivity of FD model rats by peripheral anti-inflammatory action and regulating the abnormal secretion of brain-gut peptide.     

褪黑素及其受体介导的耳甲电刺激降糖效应机制研究进展及展望＊

2型糖尿病发病率逐年攀升，给社会、家庭和个人都带来巨大负担。大量临床研究表明，耳针对高血糖状态具有明显的改善作用，且具有方便、简捷、利于操作等优势。由于2型糖尿病的发生与褪黑素的低水平密切相关，本文试图从褪黑素及其受体的角度进一步揭示耳甲电针降糖效应机制，为临床治疗糖尿病提供科学依据。     

耳甲电针治疗腹泻型肠易激综合征的疗效

目的：观察耳甲电针治疗腹泻型肠易激综合征(IBS)的疗效。方法：选取2018年2月至2020年1月首都医科大学附属北京同仁医院收治的腹泻型IBS患者86例作为研究对象,按照随机数字表法分为对照组和观察组,每组43例,所有患者治疗前后均使用IBS症状评分表、肠易激综合征症状严重程度量表(IBS-SSS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、SF-36生命质量量表评估患者症状的严重程度。并参照肠易激综合征中医诊疗专家共识意见(2017)的疗效评估方法,比较分析观察组与对照组治疗腹泻型肠易激综合征的疗效。结果：观察组与对照组治疗前IBS症状评分表、IBS症状严重程度量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、SF-36生命质量量表各维度差异无统计学意义（P>0.05）,治疗后观察组与对照组IBS症状评分表、IBS症状严重程度量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、SF-36生命质量量表差异有统计学意义（P<0.05）。观察组治疗有效率85.4%,对照组治疗有效率58.5%,差异有统计学意义（P<0.05）。结论：耳甲电针对于腹泻型肠易激综合征的各项症状均具有较好疗效且值得推广。     

华佗牌针刺手法针疗仪治疗周围性面瘫疗效观察

目的:观察华佗牌针刺手法针疗仪(SXDZ-100)对周围性面瘫的临床疗效.方法:87例面瘫患者随机分入针刺手法针疗仪观察组(44例)和G 6805电针治疗仪对照组(43例),两组取穴相同,取患侧局部穴位和远端的合谷、三阴交、太冲等,对两组的治疗效果进行比较研究.结果:两组总有效率均为100.0%,在总有效率相同的情况下,观察组治愈率为90.9%,对照组为62.8%,经统计学处理,P＜0.05.两组均无不良反应出现.结论:采用华佗牌针刺手法针疗仪治疗周围性面瘫治愈率优于对照组.     

经皮耳穴-迷走神经电刺激对原发性失眠患者夜间自主神经功能的影响

目的：观察经皮耳穴-迷走神经电刺激（taVNS）对原发性失眠（PI）患者睡眠质量及夜间心率变异性（HRV）的影响。方法：纳入PI患者21例,于耳穴心、肾区,采用SDZ-ⅡB型电子针疗仪进行刺激,予疏密波,频率4 Hz/20 Hz,脉冲宽度（0.2±30%）ms,强度以患者能耐受为度。早晚各1次,每次30 min,共治疗4周。比较患者治疗前后匹兹堡睡眠质量指数量表（PSQI）评分、客观睡眠结构[总睡眠时间（TST）、睡眠潜伏期（SL）、入睡后清醒时间（WASO）、睡眠效率（SE）,非快速眼动1、2、3期和快速眼动期（REM）时间占TST的百分比（N1%、N2%、N3%、REM%）]及夜间心率变异性[高频（HF）、低频（LF）、低频/高频（LF/HF）比值、正常心动周期的标准差（SDNN）、相邻心动周期差值的均方平方根（RMSSD）、相邻RR间期差值超过50 ms的心搏数占总心搏数的百分比（PNN50%）、窦性RR间期的平均值（NNMean）]。结果：治疗后,患者PSQI各项评分及总分、SL较治疗前降低（P<0.01,P<0.001）,SE、N3%、LF、HF、LF/HF、SD...     

胃溃疡患者皮肤压痛阈及辨别阈的观察

压痛阈是传统评测痛觉的方法之一。机体的疼痛阈值代表机体对疼痛感觉的分辨水平。压痛阈是指受试者的皮肤在接受外部压力刺激时,最初能感受到由压力觉变为痛觉时的最小压力值。同时刺激皮肤上的两个点,当两点的距离小于一定程度时,会被感觉成一个点。这种能分辨皮肤上两点刺激的最小距离被称为两点辨别阈。笔者以人体穴位压痛阈和皮肤两点辨别阈为检测指标,观察正常人及胃溃疡患者在经线及非经线上的压痛阈值及两点辨别阈的变化,现报告如下。     

杜仲、千年健对去卵巢大鼠骨质疏松症的治疗作用及其机理探讨

目的:探讨具有温补肾阳作用的单味中药杜仲、千年健对去卵巢所致大鼠骨质疏松症的治疗作用及其机理。方法:将72只雌性Wistar大鼠随机分为空白对照组、假手术组、模型组、阳性对照组、杜仲组以及千年健组6组。给药3个月后,采用骨组织形态计量学方法对不脱钙骨切片进行形态计量,免疫组化和原位杂交法检测大鼠胫骨OB和MSC OPG、RANKL蛋白及其mRNA表达。结果:与模型组相比,杜仲组、千年健组胫骨TBV%显著增高,TRS%明显降低,千年健组TFS%、MAR、OSW明显降低,杜仲组无显著性变化;千年健组OB和MSC OPG蛋白及其mRNA的表达显著升高,RANKL蛋白及其mRNA表达明显降低;杜仲组OB和MSC RANKL蛋白及其mRNA表达明显降低。结论:千年健不仅可以增加OB和MSC OPG蛋白及其mRNA表达,还能抑制RANKL蛋白及其mRNA的表达,而杜仲是通过抑制OB和MSC RANKL蛋白及其mRNA表达达到治疗骨质疏松症作用的。