艾灸神阙穴对不同程度力竭运动大鼠海马区单胺类神经递质的影响

目的:探讨艾灸神阙穴对不同程度力竭运动大鼠海马区单胺类神经递质的影响。方法:将72只SD雄性大鼠按随机数字表法分为正常组8只、模型组和艾灸组各32只,根据造模或治疗时间将模型组和艾灸组随机分为1、4、7、10次亚组,每亚组8只,采用游泳实验建立力竭模型。艾灸各亚组大鼠造模后即刻温和灸神阙穴15min,隔日1次,各亚组大鼠完成相应力竭运动后24 h检测海马组织5-HT、DA、NE的含量。结果:与正常组比较,模型各亚组5-HT含量均明显升高,模型1、4、7次亚组NE含量均明显升高,模型1次亚组DA含量明显升高,模型10次亚组却明显降低。与相应模型亚组比较,艾灸4次亚组NE含量明显升高,艾灸7、10次亚组5-HT含量显著降低,DA、NE含量明显升高。结论:艾灸神阙穴可以通过调节反复力竭运动大鼠海马区神经递质,促进神经细胞的功能恢复,改善机体疲劳状态,为今后临床应用提供一定的实验基础。     

穴位注射疗法治疗呃逆的系统评价分析

目的通过对收集的穴位注射疗法治疗呃逆有关的文献资料进行筛选、总结及提炼,按照循证医学的原则和方法进行系统评价分析,得出结论,以更好的为医务工作者的临床决策提供证据。方法使用计算机全面检索相关文献,按照拟定的标准筛选、总结及提炼文献信息,并按照Jadad评分量表对纳入研究质量评估,并采用Review manager5.1软件统计测量指标。结果 Meta分析纳入17个研究,异质性检验χ2=25.28,P=0.06,具有临床及统计学意义上的同质性,可用固定模型技能型分析。穴位注射组与对照组比较,合并OR=0.17,95%可信区间为(0.11,0.25),整体效果检验z=8.78,P0.00001,差异极具有显著性,穴位注射疗法对呃逆的治疗效果优于对照组,但纳入的论文均为低质量论文,存在发表性偏倚,影响结果的真实可靠性。结论纳入Meta分析的论文的质量研究指数偏低且存在潜在发表性偏倚,但是低级证据并不代表无临床实用性,只是其内在真实性可能较低。现有证据表明穴位注射疗法对于呃逆确实有效,施加的干预措施有利于疾病的改善。     

芒针温针灸对慢传输型便秘肠道传输功能的影响

目的观察芒针温针灸对慢传输型便秘(STC)的治疗效果。方法将209例STC患者随机分为治疗组(106例)和对照组(103例),治疗组采用芒针温针灸治疗,对照组采用西沙必利口服,分别对两组治疗效果和结肠传输功能进行疗效评估。结果经治疗后,治疗组总有效率为92.45%,明显高于组总有效率(79.61%,P0.05)。与治疗前比较,两组均可加速肠道内标记物清除速度(P0.01),治疗组肠道内标记物的清除速度更快(P0.01)。结论芒针温针灸治疗可明显改善STC患者结肠传输功能。     

穴位埋线疗法的优势病种及应用规律

目的:分析穴位埋线疗法在临床各科疾病中的优势,并探讨其临床应用规律,为临床治疗提供参考依据。方法:采用现代计算机技术,建立穴位埋线数据库,对近40年来与穴位埋线相关的文献进行筛选、录入、审核、提取、统计分析。结果:①录入1075篇文献,穴位埋线疗法在临床各科均有应用,尤其在内科中治疗病种最多,占所有病种的48.54%(50/103),以治疗胃脘痛为主,频次为102次,肥胖病频次为74次;其次是外科疾病,占所有病种的14.56%(15/103),以治疗腰腿痛为主,频次为79次;皮肤科以治疗牛皮癣为主,频次30次;五官科以治疗重睑术为主,频次为30次。②纳入的文献研究中,穴位选择以近部选穴和远部选穴为主;埋线工具有多种,主要以改制的腰穿针为主,在线的选择上以不同型号羊肠线为多。③疗效分析显示,穴位埋线疗法治疗各科疾病疗效显著,尤其以外科和皮肤科最为突出,总有效率均达90%以上。结论:穴位埋线疗法主要优势病种是内科的胃脘痛、肥胖病、痫证、哮喘、腹痛、面瘫、便秘;外科的腰腿痛;皮肤科的牛皮癣和五官科的重睑术。     

穴位埋线疗法病谱初探(英文)

目的:初步探讨穴位埋线疗法的临床适用病种,整理并分析穴位埋线疗法病谱。方法:采用文献研究方法及数据挖掘技术,经过对1971年—2011年6月发表的与穴位埋线疗法相关的临床研究论文进行筛选、录入、审核、提取有效信息等环节后,归纳总结穴位埋线疗法病谱。结果:穴位埋线疗法适用于103种疾病,涉及6个科属。内科最多,共50种,占总病谱的48.54%;其余依次是外科、五官科、妇科和皮肤科,分别为15种、12种、11种、11种;儿科最少,共4种。同时,按照"效能针灸等级病谱"的规则,初步对该疗法治疗的病种进行等级分类,获得穴位埋线疗法Ⅰ级病谱26种,Ⅱ级病谱30种,Ⅲ级病谱8种。结论:穴位埋线疗法临床运用广泛,病谱不断扩大,值得临床推广应用。     

Effect of low-frequency electroacupuncture on pancreatic endocrine system in patients with simple obesity

Objective

To observe different efficacies of low-frequency electroacupuncture (EA) on pancreatic endocrine system in male and female patients with simple obesity due to spleen deficiency-related dampness.

Methods

A total of 80 simple obesity patients were assigned to a male group (n=37) and a female group (n=43). Both groups received a 30-minute low-frequency EA at Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Fenglong (ST 40), Quchi (LI 11), Tianshu (ST 25), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Guanyuan (CV 4). The treatment was done once a day, and 10 times made up a course of treatment. Patients in both groups were treated for 2 courses. Then the changes in body mass index (BMI), serum insulin, insulin antibodies and leptin level in the two groups were observed and analyzed.

Results

After treatment, the BMI, serum insulin, insulin antibodies and leptin levels were significantly reduced in both groups (P<0.01 or P<0.05); the BMI and serum insulin concentration were more significantly reduced in the male group than those in the female group (both P<0.01); and the leptin level was more significantly reduced in the female group than that in the male group (P<0.01).

Conclusion

EA can significantly regulate BMI and pancreatic endocrine system in both men and women with simple obesity; however, there is a gender difference: better effect for men in reducing BMI and serum insulin and better effect for women in reducing serum leptin level.

     

针刺配合耳穴贴压对经行头痛患者血清PGF_(2α)含量的影响

目的探讨针刺与耳穴贴压并用治疗肝火旺盛型经行头痛的作用机制。方法将85例患者随机分为两组。治疗组43例,采用针刺与耳穴贴压并用的方法治疗;对照组42例,口服盐酸氟桂利嗪胶囊。观察两组临床疗效,并同时对两组各30例患者治疗前后经期血清前列腺素F2?(PGF2?)进行检测。结果治疗组疗效明显优于对照组(P0.01)。两组患者治疗前血清PGF2?含量较正常组明显升高(P0.01),治疗后血清PGF2?含量较治疗前均有不同程度降低(P0.01,P0.05),但治疗组较对照组降低更加明显(P0.05),且恢复至正常组水平。结论针刺与耳穴贴压并用对肝火旺盛型经行头痛疗效显著,其作用机制可能是通过调节血清PGF2?的异常水平而发挥止痛效应。     

Effects of electroacupuncture of different frequencies on free radicals in hippocampus of mice with vascular dementia

Objective

To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz, 80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.

Methods

A total of 100 Kunming mice were randomly divided into a sham operation group, a model group, a 2 Hz EA group, an 80 Hz EA group and a 2 Hz/80 Hz EA group, with 20 mice in each group. The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries. Mice in EA groups began EA treatment on the 4th day after the operation. Baihui (GV 20), Dazhui (GV 14), Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument, with different waves of 2 Hz, 80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly, once a day. During the jumping stand experiment, the learning performance, memory performance and hippocampal calcitonin gene-related peptide (CGRP), nitric oxide synthase (NOS), malondialdehyde (MDA), changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed. In hippocampus, the CGRP level was determined by radioimmunoassay; the MDA level was determined by thiobarbituric acid colorimetric method; the activities of NOS and TChE were determined by spectrophotometry; the activity of SOD was determined by xanthine oxidase method.

Results

Compared with the sham operation group, the performances of learning and memory decreased significantly in the model group (P<0.01); in hippocampus, the CGRP level decreased, the MDA level increased, the activities of NOS and TChE increased, and the activity of SOD decreased in the model group. Compared with the model group, the learning and memory performances of the EA groups were significantly improved (P<0.05 or P<0.01); in hippocampus, the CGRP level increased, the MDA level decreased, the NOS and TChE activities decreased, and the SOD activity increased (P<0.05 or P<0.01). Among EA groups, the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P<0.05 or P<0.01).

Conclusion

EA can improve the cognitive impairment of mice with ischemia-reperfusion VD. The mechanism may be related to the improvement of cerebral blood circulation, regulation of the central neurotransmitters, fighting lipid peroxidation and promoting nerve cell repair. The therapeutic effects of EA with different frequencies were different, and the intervention effect by EA at 2 Hz/80Hz is the most significant.

     

基于“医教协同”背景下中医临床人才培养的思索

用"早临床、多临床、反复临床"的教育理念从宏观与微观角度对临床人才培养体系进行分析,诠释中医特色临床人才培养。     

穴位埋线疗法病谱初探

目的:初步探讨穴位埋线疗法的临床适用病种,整理并分析穴位埋线疗法病谱.方法:采用文献研究方法及数据挖掘技术,经过对1971年-2011年6月发表的与穴位埋线疗法相关的临床研究论文进行筛选、录入、审核、提取有效信息等环节后,归纳总结穴位埋线疗法病谱.结果:穴位埋线疗法适用于103种疾病,涉及6个科属.内科最多,共50种,占总病谱的48.54％;其余依次是外科、五官科、妇科和皮肤科,分别为15种、12种、11种、11种;儿科最少,共4种.同时,按照“效能针灸等级病谱”的规则,初步对该疗法治疗的病种进行等级分类,获得穴位埋线疗法Ⅰ级病谱26种,Ⅱ级病谱30种,Ⅲ级病谱8种.结论:穴位埋线疗法临床运用广泛,病谱不断扩大,值得临床推广应用.