《内经》腧穴概念在热敏灸中的重要指导作用

目的：阐述《内经》腧穴概念在热敏灸中的重要指导作用。方法：从《内经》对腧穴内涵的原始定义及临床热敏灸感的现象入手,论述热敏灸感的出现部位与《内经》腧穴概念的关系。结果：（1）腧穴的原始内涵是指动态的、敏化态、疾病在体表的反映部位与针灸治疗部位;（2）产生热敏灸感的部位是热敏态穴位,是灸疗的最佳选穴,也是施灸的准确部位。结论：《内经》腧穴概念及探感定位技术能指导临床提高灸疗疗效。     

热敏灸疗法的研究现状及展望

热敏灸疗法是在继承传统艾灸疗法基础上进行创新的一种新灸法,它补充了灸法得气标准,其核心理论是通过艾灸热敏腧穴,使其产生透热、传热、扩热等热敏灸感,激发经络感传,使气至病所从而达到治疗疾病的作用,目前广泛应用于临床,且疗效明显。文章将从热敏灸的热敏腧穴客观化、作用机制、实验研究、临床疗效研究方面予以阐述,同时总结热敏灸在临床研究中存在的问题及展望。     

热敏灸治疗颈椎病颈痛60例临床观察

目的:观察热敏灸治疗颈椎病颈痛的临床疗效.方法:对60例患者施行热教灸法.在大椎穴、夹脊穴、风池穴、阳陵泉穴、手三里穴热敏化高发区寻找热敏穴,实施灸疗,每日1次,5日为一个疗程(月6、7日休息),连续治疗2个疗程后观察疗效.结果:治疗60例,治愈30例,显效17例,好转10例,无效3例,总有效率95％.结论:热敏灸疗法治疗颈椎病颈痛有明显的临床疗效,值得临床推广.     

灸感法与红外法检测偏头痛患者阳陵泉穴热敏态的对比研究

目的:采用灸感法与红外法对偏头痛患者患侧阳陵泉穴热敏态进行检测对比研究,探讨腧穴热敏态红外客观显示的可能性。方法:共纳入偏头痛患者54例。在自然状态下采用热断层扫描成像系统(TTM)拍摄腰部红外热像图,图像采集完毕,接受灸感法热敏检测(艾条悬灸患侧阳陵泉穴10分钟).悬灸结束后记录患侧阳陵泉穴产生扩热、透热的例数,后进行第2次红外辐射测量,记录艾灸后小腿外侧红外图像变化,比较两种检测法对偏头痛患者患侧阳陵泉穴热敏态的检测差异。结果:偏头痛患者患侧阳陵泉穴区发生热敏化时,其红外辐射强度多数显示高温特征,与灸感法比较,其敏感性(真阳性率)为88.5﹪,特异性(真阴性率)为71.4﹪,准确性为79.6﹪;艾灸偏头痛患者患侧阳陵泉穴区后,发生热敏化的患侧阳陵泉穴区产生明显的沿小腿外侧纵向扩散(胆经)或横向扩散的红外辐射增强区域,与灸感法比较,其敏感性(真阳性率)为87.9﹪,特异性(真阴性率)为76.2﹪,准确性为83.3﹪。结论:(1)偏头痛患者患侧阳陵泉穴区热敏态在一定程度上可被红外成像客观显示。(2)艾灸热敏腧穴产生的腧穴热敏现象(如扩热、传热),除了受试者的主观感觉,在一定程度上也能被红外成像客观显示。     

温度觉定量测定的正常值初步报告

为了解温度觉阈值的正常范围及其与年龄、性别、部位之间的关系，用温度觉分析议（ＴＳＡ－２００１）的Ｌｉ－ｍｉｔ程序测定了５０位正常自愿者（男２６人、女２４人；年龄２０～５６岁）四肢八个部位的冷觉、温觉、冷痛觉、热痛觉阈值。结果显示：右上臂的冷觉阈值、右手指和右上臂的热阈阔值、左手指的冷痛觉阈值与年龄有显著性相关；性别间各种感觉阈值无显著性差异；同一部位左右两侧各种感觉阈值无显著性差异；不同部位的冷、热觉阈值有显著性差异。而冷痛觉，热痛觉阈值无显著性差异。冷痛觉阈值变异程度较大。     

热敏灸疗法研究现状及展望

正热敏灸是一种以出现热敏现象为得气标准的新灸法,它是指机体在疾病或亚健康状态下,与疾病相关的腧穴对艾热刺激会出现特异性的艾灸反应,如热度扩散、热量循经向深部或者远部传导、非热感觉等,把这些出现热敏现象的腧穴叫热敏腧穴~([1])。艾灸热敏腧穴能够激发经气感传,气至病所,从而提高艾灸疗效。目前热敏灸技术已广泛应用于脊柱关节肌肉、免疫、消化等系统疾病中,并取得较好的临床疗效。本文将从热敏腧穴客观化、作用机理及临床研究等方面进行阐述,同时总结热敏灸在临床研究中存在的问题及展望。     

热敏灸治疗支气管哮喘(慢性持续期)技术简介

1热敏炙概述 热敏炙是采用点燃的艾材产生的艾热悬炙热 敏态穴位,激发透热、扩热、传热、局部不(微)热远 部热、表面不(微)热深部热、非热感觉等热敏灸感 和经气传导,并施以个体化的饱和消敏灸疗法。     

热敏灸治疗慢性前列腺炎不同灸位30例

目的:比较热敏灸治疗慢性前列腺炎不同灸位的临床疗效差异.方法:将60例慢性前列腺炎患者随机分为热敏腧穴悬灸试验组(以下简称试验组)和非热敏腧穴悬灸对照组(以下简称对照组),治疗组和对照组各30例.试验组采用热敏腧穴温和悬灸治疗,以热敏灸感消失为度,对照组采用非热敏腧穴温和悬灸治疗,每次40min,两组每日2次,共治疗5d,第6d开始每日1次,连续治疗25次,共治疗35次(共30d),于治疗结束后进行疗效评价.结果:与治疗前相比,两组在治疗后症状积分、NIH-CP-SI积分差异有统计学意义(P＜0.01),与对照组相比,试验组症状积分、NIH-CPSI积分、显愈率差异有统计学意义(P＜0.01,P＜0.05,P＜0.05).结论:热敏腧穴悬灸治疗慢性前列腺炎疗效优于非热敏腧穴悬灸,热敏腧穴准确定位能提高灸疗疗效.     

热敏灸治疗三叉神经痛不同灸位的临床疗效观察

目的 比较热敏灸治疗原发性三叉神经痛(PTN)不同灸位的临床疗效差异.方法 将62例PTN患者随机分为热敏腧穴悬灸试验组(以下简称试验组)32例和非热敏腧穴悬灸对照组(以下简称对照组)30例.试验组采用热敏腧穴温和悬灸治疗,以热敏灸感消失为度,对照组采用非热敏腧穴温和悬灸治疗,每次40 min,2组每日2次,共治疗5d,第6天开始每日1次,连续治疗25次,共治疗35次(共30d),观察治疗前后2组患者治疗疗效、视觉模拟评分(VAS)、头痛生活质量问卷(MSQ)量表计分等变化.结果 与治疗前相比,2组VAS计分、MSQ(即功能受限、功能障碍、情感3部分)评分差异有统计学意义(P＜0.05～0.01);与对照组相比,治疗组VAS计分差异有统计学意义(P＜0.05),且MSQ(即功能受限、功能障碍、情感三部分)评分有明显差异(P＜0.05～0.01);治疗组总有效率为78.13％,与对照组(53.33％)相比,P＜0.05.结论 热敏腧穴悬灸治疗PTN疗效优于非热敏腧穴悬灸,热敏腧穴准确定位能提高灸疗疗效.     

热敏灸膝骨性关节炎患者犊鼻穴的静息态功能磁共振研究

目的运用功能磁共振成像(fMRI)技术研究热敏灸膝骨性关节炎患者(KOA)左侧犊鼻穴前后的静息态脑功能变化,探索热敏灸的脑功能调节机制。方法选择左侧KOA患者30例,在热敏灸前、后分别进行静息态fMRI扫描,采用比率低频振幅(fALFF)和局部一致性(ReHo)的分析方法观测静息态脑功能的变化。结果热敏灸后,患者右大脑、外核、左小脑、左大脑、白质区的fALFF值较灸前增高,中央前回、额叶、枕叶的fALFF值较灸前降低(单体素阈值P<0.05,簇块体积阈值不小于85个体素);患者丘脑、外核、顶叶脑区的ReHo值较灸前显著增高,右大脑、左大脑、额叶的ReHo值较灸前降低(单体素阈值P<0.05,簇块体积阈值不小于80个体素)。结论热敏灸后引起多个脑区的显著变化,基本符合躯体的痛温传导路径,而躯体感觉系统的激活可能是经络感传现象的客观依据;热敏灸的脑功能调节并非通过单一的脑区而是由多个脑区组成的网络来实现。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.