针刺留针时间长短与针刺升温作用关系的热像图观察

<正> 留针法是针刺治疗中的一个重要环节、古代文献中对此具有专门的论述、如“热则疾之,寒则留之”(灵枢·经脉),“久病者、深内久而久留之”(灵枢·终始),“婴儿者,浅刺而疾发针”(灵枢·逆顺肥瘦)等,并且认为留针是否得当可直接影     

基于正交设计针刺治疗中风后肩手综合征优化方案研究

目的筛选针刺治疗中风后肩手综合征(SHS)的临床优化方案。 方法收集2015年1月至2016年6月上海浦东新区中医医院、上海中医药大学附属龙华医院针灸科或康复科住院及门诊就诊的中风后SHS受试者90例,采用随机数字表法随机分为9组,每组10例。按正交设计方案设立SHS治疗的4个因素穴位配伍(A)、留针时间(B)、频次(C)、疗程(D)及3个常见水平。选取有代表性的9种治疗方案：(1)头皮针配阳经穴,留针10 min,隔日1次,疗程2周;(2)头皮针配阳经穴,留针20 min,每日1次,疗程4周;(3)头皮针配阳经穴,留针30 min,每日2次,疗程8周;(4)头皮针配阴经穴,留针10 min,每日1次,疗程8周;(5)头皮针配阴经穴,留针20 min,每日2次,疗程2周;(6)头皮针配阴经穴,留针30 min,治疗隔日1次,疗程4周;(7)头皮针配阴、阳经穴,留针10 min,每日2次,疗程4周;(8)头皮针配阴、阳经穴,留针20 min,隔日1次,疗程8周;(9)头皮针配阴、阳经穴,留针30 min,每日1次,疗程2周。对9组受试者进行治疗,观察治疗前后疼痛视觉模拟评分(VAS)、Fugl－Meyer上肢运动功能评分、改良的Barthel(BI)指数评分的变化,从而对中风后SHS患者针刺治疗方案进行优选。基线资料采用方差分析及秩和检验进行统计分析,VAS评分、FMA评分、BI评分比较资料采用正交设计极差分析及方差分析进行统计学分析。 结果9组中风后SHS受试者治疗前年龄、病程,VAS评分、FMA评分、BI评分比较差异无统计学意义。对于VAS评分的改善方面,A、C、D为显著因素(F＝7.382、3.742、15.775,P均<0.05),最优方案为头皮针＋阳、阴经穴,隔日1次,留针20 min,疗程8周。对FMA评分的改善方面,A、B、D为极显著因素(F＝5.629、11.006、32.305,P均<0.01),最优方案为头皮针＋阳、阴经穴,隔日1次,留针20 min,疗程4周。对于BI评分的改善方面,B、D为极显著因素(F＝6.269、19.919,P均<0.01),最优方案为头皮针＋阳、阴经穴,隔日1次,留针20 min,疗程4周。根据临床经验可知,治疗时间长则疗效更佳。 结论选取头皮针加阳、阴经穴,留针20 min,隔日1次,治疗8周,为针刺治疗中风后SHS的优选方案,能有效减轻患肢的疼痛程度,改善上肢运动功能,提高日常活动能力。     

颈项针为主治疗假性球麻痹疗效观察

目的观察针刺颈项部穴位为主治疗假性球麻痹的临床疗效。方法将120例确诊为假性球麻痹患者随机分为观察组和对照组,每组60例,分别给予颈项针刺法和舌三针针刺法治疗,1个月后对主要症状、体征进行系统的比较和评估。结果观察组治愈率和总有效率为41．7％和90．0％,均明显优于对照组的26．7％和81．7％,差异有统计学意义（P〈0．01）。结论颈项针刺法对假性球麻痹有明显的治疗作用,能减轻乃至消除患者的相关症状和体征。     

针刺治疗中风上肢瘫痪临床分析

目的探讨针刺治疗中风后上肢瘫痪的最佳方法和介入时机。方法将符合病例纳入标准的80例患者随机分为治疗组和对照组各40例,治疗组采用头穴久留针加电针神经干法,对照组采用常规针刺阳明经穴法。同时用简化Fugl-Meyer(FMA)运动量表作为疗效评定标准进行上肢功能针刺效应评定。结果两组患者在入组时,上肢的运动功能差异没有统计学意义(P>0.05);治疗1疗程(4星期)后治疗组和对照组上肢的运动功能差异有统计学意义(P<0.01)。结论运用头穴久留针加电针神经干的方法治疗早期中风上肢瘫痪效果好。     

刺痛感对寒湿凝滞型痛经患者针刺疗效的影响

目的:探讨针刺过程中刺痛感对寒湿凝滞型痛经患者针刺疗效的影响。方法:96例寒湿凝滞型原发性痛经患者,随机分为期望得气组和期望不得气组,于痛经发作第1天,且腹痛视觉模拟评分(VAS)≥40mm时,予针刺双侧三阴交穴30min,其中期望得气组予粗针、深刺、平补平泻的手法,期望不得气组予细针、浅刺、不施手法。采用VAS评价针刺前后以及起针后10min患者主观疼痛程度,并于针刺后记录患者有无刺痛感。结果:期望得气有刺痛组起针即刻VAS评分较针刺前降低,且起针后10min VAS评分较起针即刻降低(P0.05);期望得气无刺痛组、期望不得气有刺痛组和期望不得气无刺痛组起针即刻、起针后10min VAS评分较针刺前降低(P0.05),但起针后10min VAS评分较起针即刻降低差异无统计学意义(P0.05)。期望得气有刺痛组与期望得气无刺痛组组间各时点VAS差值比较差异均无统计学意义(P0.05),期望不得气有刺痛组与期望不得气无刺痛组组间各时点VAS差值比较差异均无统计学意义(P0.05)。结论:无论是粗针、深刺、行平补平泻手法还是细针、浅刺、不施手法针刺三阴交穴,有无刺痛感对寒湿凝滞型原发性痛经镇痛效应的影响无明显区别,均有较好的针刺即刻镇痛效应。     

针刺单穴 多穴治疗原发性痛经止痛作用时效规律的初步比较

方法:将符合纳入标准的20例原发性痛经患者随机分为针刺十七椎单穴组、针刺十七椎等多穴组,均留针30min,分别记录针刺前即时、进针5、10、20、30min及起针后30、60、120min的VAS读值,然后进行统计分析。结果:针刺后,两组的止痛作用迅速产生,留针30min内,两组患者的止痛作用均持续加强,直至起针;进针20min时多个穴位组的即时止痛作用明显优于针刺单穴组(P0.05),这一差别在起针后不久又逐步缩小。结论:单刺十七椎、针刺十七椎等多个穴位对原发性痛经患者均有明显的即时止痛作用,且两组针刺作用的时效规律具有相同的变化趋势,但针刺多个穴位组的即时止痛作用在多个时点明显优于针刺十七椎单穴组。     

Comparative Analgesia Between Acupuncture and Dipyrone in Odontalgia

The aim of this study was to assess whether the effectiveness of acupuncture is similar to the use of analgesics in the management of toothache. The research included 56 volunteers who were divided into 4 groups: Real Acupuncture group, Placebo Acupuncture group, Real Dipyrone group, and Placebo Dipyrone group. The interventions of the study were performed before the dental care. Inclusion criteria were toothache of pulpal origin with pain scale (Visual Analogue Scale) above 4, absence of medication for the pain, and aged over 18 years. The Real Acupuncture volunteers received a session of acupuncture using piercing needles, while volunteers from the Placebo Acupuncture group received an acupuncture session using non-piercing sham needles. Volunteers from the Real Dipyrone group received a dipyrone tablet and the Placebo Acupuncture group received a tablet with no active ingredient. Before any therapeutic intervention, we collected samples from the volunteers’ saliva to analyze the salivary cortisol, the volunteers rated the intensity of their pain using VAS, and we measured their energy level by the Ryodoraku method. After 20 minutes of treatment, all the volunteers’ analysis parameters were collected again. The Real Acupuncture group presented a greater reduction of VAS than the reduction obtained by the Real Dipyrone group (p<0.05). There was no statistically significant difference between the groups for the salivary cortisol and energy level variables. It can be concluded that acupuncture was more effective in reducing odontalgia than the dipyrone and that it can be an alternative for odontalgia management.     

针刺单穴与多穴治疗痛经时止痛作用时效规律的比较

目的与方法随机观察单刺十七椎、针刺十七椎等多穴对重度原发性痛经患者止痛作用的时效规律,每组观察15人次。均留针30min,分别记录针刺前即时,进针5min、10min、20min、30min,及起针后30min、60min、120min的VAS读值,然后进行统计分析。结果针刺后,两组的止痛作用产生迅速,留针30min内,两组患者的止痛作用均持续加强,直至起针;进针20min时多穴组的即时止痛作用明显优于单穴组（P〈0.05）,这种趋势一直维持到起针后2h。结论单刺十七椎、针刺十七椎等多个穴位对重度原发性痛经患者均有明显的即时止痛作用,且两组针刺作用的时效规律具有相同的变化趋势,但针刺多个穴位的即时止痛作用在多个时点明显优于单刺十七椎。     

头穴久留针对血管性痴呆病人认知和生活能力及P_(300)的影响

目的:观察头穴久留针治疗血管性痴呆的临床疗效及对患者P300的影响。方法:将65例血管性痴呆患者随机分成两组,其中对照组32例,针刺组33例。对照组给予都可喜口服,每次1片,每日2次,治疗8周;针刺组在口服都可喜的基础上给予头穴针刺,取顶中线、额中线、双侧顶旁一线,静留针10 h,每日1次,每周休息2 d,共治疗8周。观察两组的临床疗效、治疗前后认知能力和生活能力及P300的变化。结果:对照组基本控制1例,显效4例,有效16例,无效11例,总有效率为68.75%;针刺组基本控制2例,显效9例,有效18例,无效4例,总有效率为87.88%;两组总有效率比较差异有统计学意义(P<0.05)。两组经治疗后认知能力、生活能力及P300(潜伏期缩短,幅度增大)均较治疗前有明显改善(P<0.05,P<0.01),针刺组患者认知能力、生活能力和P300潜伏期的缩短优于对照组(P<0.05,P<0.01)。结论:头穴久留针能提高大脑皮层的兴奋性,从而促进血管性痴呆患者智能和日常生活能力的康复。     

针刺不同留针时间对面神经麻痹疗效观察

目的观察不同留针时间对面神经麻痹疗效的影响。方法将92例面神经麻痹患者按病情程度分层随机分为A组、B组和C组,针刺留针时间分别为12 min、19 min和30 min,比较临床疗效及痊愈时间。结果 A组疗效与B组和C组比较,差别均有统计学意义（均P〈0.05）。A组痊愈时间与B组和C组比较,差异均有统计学意义（均P〈0.05）。结论 19 min可以作为针刺治疗面神经麻痹留针时间的临床依据。     

耳针与体针治疗花粉症疗效比较

目的：对比耳针与体针治疗花粉症的疗效。方法：体针组取印堂、迎香、合谷、太阳、太冲等穴位加辨证取穴；耳针组取内鼻、外鼻、眼、肾上腺、肝、脾、肺等穴位加毫针点刺放血。结果：体针组与耳针组在临床控制率及总有效率上基本一致，取得疗效时间上体针组显著短于耳针组。结论：体针治疗花粉症比耳针起效快，且对于痰热夹瘀型花粉症患者体针效果好于耳针，而对于肺脾气虚型耳针效果明显优于体针。     

Comparison between superficial and deep acupuncture in the treatment of the shoulder's myofascial pain: a randomized and controlled study

The principle aim of the present work is the evaluation of the importance of the variable "depth" of needle insertion in the determination of acupuncture's therapeutic results. A randomized clinical trial carried out on 44 patients belonging to two groups of 22 each, suffering from shoulder myofascial pain: group A: superficial acupuncture; group B: deep acupuncture. All of them subjected to the same model of treatment with 13 needles and the treatment of the most painful 4 trigger points (TP) found in the shoulder's area. In the group A patients, the needles were introduced in the skin at a depth of 2 mm, on the TP. In the group B patients, the needles were placed deeply both in the muscular acupuncture points and in the TP. The treatment was planned for a cycle of 8 sessions, the first 4 to be performed twice a week, the last 4 weekly. The intensity of pain was evaluated with the McGill Pain Questionnaire before beginning the therapy, at the end of the therapy, and at the follow-up after 1 and 3 months. Both techniques had efficacy in controlling pain. A statistically significant difference rose between the two needling techniques at the end of the treatment and at the follow up after one and three months. Deep acupuncture shows to be better at all times and this underlines the importance of the muscular afferences in acupunctural stimulation in the control of pain.     

针刺委中穴对轻中度腰痛局部温度变化的影响

目的:利用红外热成像仪观察针刺委中穴、曲泉穴及非经非穴对轻中度腰痛患者腰部局部的温度变化响。方法:2016年11月至2017年3月从北京中医药大学的在校学生中招募腰痛ODI评分为50%以下的轻中度腰痛受试者75例,随机分观察组(针刺委中穴)25例、对照组1(针刺曲泉穴)25例、对照组2(针刺非经非穴)25例。分别利用红外热成像仪观察针刺前、针刺后2 min、5 min、10 min、15 min、20 min、25 min、30 min、出针后5 min的腰部局部温度变化。结果:3组受试者在针刺过程中腰部温度均有不同程度的变化,针刺委中组相对于针刺曲泉组和非经非穴组温度升高的时间长,升高的总例数高于其他组(P0.05),温度升高节段多聚集在L3~5。结论:针刺委中及腘膝部其他穴位均能使腰部局部温度升高,但委中组温度升高幅度大、持续时间长。     

透刺结合温针治疗肩关节周围炎疗效观察

目的观察应用透刺结合温针治疗肩周炎的疗效。方法将120例肩周炎患者随机分为两组,每组60例。治疗组采用75舢针灸针,从肩谬穴透刺极泉穴,肩内陵透刺肩贞穴,行泻法,然后用长2cm的清艾条插入针柄末端,灸2壮,每日1次,10次为1个疗程。对照组采用40mm针灸针,针刺肩髑、肩谬、肩内陵、肩贞、曲池,每日1次,10次为1个疗程。两组在治疗2个疗程后进行疗效评定。结果治疗组总有效率为95．0％,对照组总有效率为85．0％,二组比较差异有统计学意义（P〈0．05）。结论透刺结合温针治疗肩周炎总有效率优于对照组。     

鼻针治疗顽固性呃逆的临床疗效观察

临床资料共收治60例，均为顽固性呃逆病人，其中门诊26例，住院病人34例；纳入标准：①持续或间歇性呢逆24小时以上；②经其它方法治疗无效；③手术后出现顽固性呃逆。随机分为鼻针组和体针组，两组各30例。其中具体资料列表如下：治疗方法鼻针组：治则：宽胸理气、平胃降逆。取穴：胸点。定位：眉棱骨之下方，目窝内上交点处（鼻穴）。方法：常规消毒，32号1寸毫针，直立以轻缓手法，快速捻转刺入皮下，然后向下斜刺，待得气后留针20分钟。每隔10分钟轻缓捻转行针1次，每日1次，重者2次；体针组：治则：和中解郁，利隔降逆。取穴：隔俞、内…     

针刺治疗小儿急性上呼吸道感染高热的近远期疗效观察

目的 观察针刺治疗小儿急性上呼吸道感染(acute upper respiratory infections,AURI)高热的疗效.方法 将150例患儿按随机数字表法随机分为两组各75例.针刺治疗组采用针刺法针刺单侧四关穴、耳尖放血法、温水擦浴降温治疗；西药治疗组采用口服布洛芬混悬液、外用退热医用贴、酒精擦浴降温治疗,...     

岭南飞针疗法之腹针治疗卒中后尿潴留疗效观察

目的：明确岭南飞针疗法之腹针治疗卒中后尿潴留的临床疗效。方法：将60例卒中后尿潴留患者随机分为治疗组和对照组各30例，在基础治疗上，治疗组采用岭南飞针疗法之腹针治疗，对照组采用常规针刺治疗，5天为1个疗程，3个疗程后观察两组患者首次排尿时间、膀胱功能积分及残余尿量，评价两组临床疗效。结果：治疗组总有效率为96.7%，高于对照组的73.3%（P<0.05）。治疗后，治疗组首次排尿时间短于对照组（P<0.05）；两组患者膀胱残余尿量均较治疗前减少，且治疗组改善更显著（P<0.05）。结论：岭南飞针疗法之腹针治疗卒中后尿潴留可显著缩短首次排尿时间，减少膀胱残余尿量，值得临床应用推广。     

CLINICAL OBSERVATION ON TREATMENT OF STUBBORN HICCUP BY ACUPUNCTURE WITH DIFFERENT NEEDLE RETAINING TIME

Hiccupmayinfluence patients’dailylifeandworktodifferentdegrees.Thelightcasecanrecoverspontaneously ,buttheseriousonere sultingfromvariousacuteandchronicdiseasesmaykeepfordays,months,even years,nomatterdayornight,attackingintermittently .Acupuncturecantreatsuchsymptomeffectively ,butitisstilleasytoreoccurparticularlyinpa tientswithweakconstitution .Weacquiredsatis fiedtherapeuticresultthrough prolongingnee dle retainingin 45casesofstubbornhiccuppa tients.Followingisthereport.1　CLINICALDA…     

温针灸治疗脑卒中后尿潴留患者的临床观察

目的:观察温针灸在脑卒中后尿潴留患者中的治疗作用。方法:24例脑卒中后尿潴留患者随机分为两组,治疗组12例采用温针灸治疗,对照组12例采用单纯针灸治疗,2个疗程后进行疗效评定。结果:治疗组总有效率为98%,对照组89%治疗组疗效优于对照组(P0.05);两组治疗后有效病例起效时间比较,治疗组优于对照组(P0.05)。结论:温针灸治疗脑卒中后尿潴留有一定的临床意义,值得临床采用。     

The soreness and numbness effect of acupuncture on skin blood flow

The purpose of this study was to investigate the effect of the De-Qi sensations of acupuncture (sourness-distension and distension-numbness) stimulation. Fifty-two healthy medical student volunteers were given acupuncture at the Hoku (LI-4) acupoint as they were resting. During a test that lasted 30 minutes, their skin blood flow was measured at the Quchi (LI-11) acupoint and their palm temperature was measured. Our results indicated that acupuncture increased blood flow when the De-Qi sensation occurred. If the needle was twirled a few minutes thereafter and the De-Qi feeling again occurred, the same blood flow increase was seen again. If the needle was not twirled, but the test person felt soreness, numbness and heat sensation within a few minutes after needle insertion, the same blood flow increase was also seen. After acupuncture, Quchi did not show continuous increase of blood flow as did Hoku. Hoku acupuncture also increased palm temperature suggesting that the blood flow increased from cutaneous vessel vasodilation. In conclusion, when the test person felt the sore and numb De-Qi sensation, there was an increase of blood flow at the acupuncture points. Thus, our results suggest that increased flow may be one of the mechanisms accounting for meridian system responses during acupuncture.