针刺频次对针灸疗效影响的探索

为探寻临床疾病针刺治疗的最佳频次,查阅大量文献,对古今文献中针刺频次的论述做出总结,并结合现代时间生物学对针刺频次影响针灸疗效的机理做出论述。得出结论:针刺治疗的频次不仅要根据疾病的不同性质、不同的时期灵活掌握,还应考虑到患者的年龄、体质等各种因素。希望有标准的最佳治疗频次指南对临床工作进行指导,更好地提高疗效,为患者节约时间和开支。     

针刺治疗偏头痛取穴现状分析

目的：通过统计分析临床用穴,探索针刺治疗偏头痛的取穴规律。方法：搜集针刺治疗偏头痛的相关文献,对相关穴位的使用频次、归经情况等进行统计分析,并对主要穴位与头部血管的解剖生理学关系进行探讨。结果：纳入的144篇文献中,针刺治疗偏头痛涉及68个穴位11条经脉,其中43个穴位的使用频次不足0.1%,超过10%的穴位只有14个。所取穴位经脉排前三位的依次为胆经、膀胱经、三焦经。结论：针刺治疗偏头痛的疗效可以肯定,但用穴规律还不够明晰,作用机制也需要深入探讨。     

论针刺、得气与疗效关系

根据《灵枢》等古代文献的记载,得气是充分发挥针刺疗效的重要前提,这一观点也被后世的针灸从业者所继承。另一方面,近年来也涌现出了一批不追求出现得气感的针刺方法,如腕踝针等。该文通过查阅文献并结合自身临床经验,说明了得气对于发挥针刺疗效确有重要作用,一些临床研究的结果也支持了这一结论。该文还列举了影响得气的几个主要因素,即取穴、刺法和刺激量,并提出"反应量"的观点,以作为从患者的角度对针刺量学的补充。又探讨了针刺得气对患者心理可能产生的影响,说明了针刺疗法身心二元调节的作用。     

基于数据挖掘探讨针刺治疗小儿遗尿的选穴规律

目的 基于数据挖掘探讨针刺治疗小儿遗尿的选穴规律。方法 检索建库至2022年9月中国知网、万方数据库、维普网收录的针刺治疗小儿遗尿的临床研究文献,统计纳入文献处方中的腧穴及其使用频次、频率、归经、分布部位、特定穴情况,并分别采用IBM SPSS Modeler 18.0、IBM SPSS Statistics 19.0对腧穴处方进行关联规则及聚类分析。结果 共纳入75篇文献,包含75则针刺处方、62个腧穴,腧穴总频次为464次。高频腧穴依次为关元、三阴交、中极、肾俞、足三里;任脉和足太阳膀胱经为使用频次较多的经脉,所用腧穴多分布于胸腹、腰骶背部,募穴为使用频次最高的特定穴。关元-中极-三阴交为针刺治疗小儿遗尿的常用穴组。聚类分析得到5个聚类作为常用腧穴组。结论 针刺治疗小儿遗尿选穴注重小儿生理病理,以补为主,在辨病基础上辨证增穴以加强效果。     

针灸治疗面神经麻痹取穴现状分析

目的:根据经验统计探索分析针刺治疗面神经麻痹的取穴现状、取穴规律。方法:对相关穴位的使用频次、归经情况等进行统计分析。结果:纳入的1044篇文献中,针刺治疗面神经麻痹涉及14条经脉的134个穴位。所取穴位经脉归属前3位的依次为胃经、胆经、膀胱经。结论:目前针刺治疗面神经麻痹的取穴组方方面繁纷复杂,但仍有一定的规律可循。     

基于数据挖掘技术探讨针刺治疗干眼的临床选穴规律

目的 采用数据挖掘方法探讨针刺治疗干眼的临床选穴规律。方法 检索中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普中文期刊服务平台（VIP）、中国生物医学文献数据库（SinoMed）自建库至2022年9月30日收录的针刺治疗干眼的临床研究文献,按纳入、排除标准筛选文献,提取针刺处方建立数据库,并对数据进行频次、归经、分布及关联规则、聚类分析。结果 共纳入文献157篇,提取针刺处方157条,涉及腧穴84个,累计腧穴频次1336次。攒竹、睛明、太阳为使用频次最高的前3位腧穴,常选用经脉为足三阳经,常用腧穴主要分布在头面部,关联规则分析得出最常用的腧穴组合为“睛明–攒竹–太阳”,通过聚类分析得到5个聚类群。结论 针刺治疗干眼遵循“局部取穴为主,远端取穴为辅”的选穴原则;腧穴多选足三阳经腧穴,同时亦重视经外奇穴的运用。     

针刺治疗功能性消化不良频次与疗程的文献研究

目的总结分析针刺治疗功能性消化不良的频次与疗程特点,以期为临床针刺治疗功能性消化不良提供参考。方法检索CBM、CNKI、WF、VIP四大中文数据库,统计针刺治疗功能性消化不良的频次与疗程。结果经过最终筛查后纳入64篇文献,统计分析显示,针刺治疗功能性消化不良使用最多的频次为每日1次(占98.43%),使用最多的疗程为每周5次,共治疗4周(占45.31%)。结论每日1次,每周5次,共治疗4周可能是针刺治疗功能性消化不良最佳的频次与疗程。     

基于数据挖掘探讨针刺治疗围绝经期失眠症选穴规律

目的 基于数据挖掘探讨针刺治疗围绝经期失眠症的选穴规律。方法 计算机检索中国期刊全文数据库、万方数据知识服务平台、中国生物医学文献数据库2011年11月至2021年11月针刺治疗围绝经期失眠症的相关文献。运用SPSS Modeler 18.0 Apriori算法对腧穴进行关联规则分析并绘制复杂网络图,采用SPSS Statistics 25.0对腧穴进行聚类法绘制树状图。结果 最终纳入51篇文献,得出51首处方,涉及74个穴位,频次较多的穴位为三阴交、神门、心俞,排在前3位的经脉依次为足太阳膀胱经、督脉、任脉。涉及特殊穴的有37个腧穴,使用频次排在前3位依次为背俞穴、原穴、输穴。使用频次前20位的腧穴进行关联规则分析,得到18条腧穴强关联规则。腧穴配伍主要为5组。结论 围绝经期失眠症的治疗应重视全身脏腑功能的调节,并且根据围绝经期妇女的生理特点调理冲任督,再根据失眠的病理状态进行调神。     

基于古代文献挖掘的中医治疗郁证组方规律研究

目的基于中医传承辅助系统(V2. 5)软件,探讨《中华医典》中收载的所有治疗郁证的古方用药规律。方法收集《中华医典》光盘中历代治疗郁证的方剂,筛选符合纳排标准的方剂录入中医传承辅助系统软件,构建治疗郁证的古代文献数据库,确定处方中药物出现的频次、常用药对及组合,分析古代文献治疗郁证方剂的组方用药规律。结果共筛选出符合要求的方剂95首,涉及中药128味,古代文献中治疗郁证的药物使用频次的前十名依次为甘草、茯苓、陈皮、半夏、生姜、人参、香附、当归、川芎、酸枣仁。基于复杂系统熵聚类,出现频率最高的药物组合为茯苓—半夏,演化出3～4味药物的核心组合16个,新处方9个。结论古代医家治疗郁证时以调理气机为主,辅以化痰、活血、清热、补虚之法,可以为现代临床治疗抑郁症提供参考。     

针刺治疗胆系疾病取穴组方规律与经验分析

目的：根据经验系统分析针刺治疗胆系疾病（胆囊炎、胆石症）的取穴规律、组方规律。方法：对相关穴位的使用频次、组方、归经情况等进行统计分析。结果：纳入的118篇文献中,针刺治疗胆囊炎、胆石症涉及61个穴位,胆经、肝经和膀胱经是使用频次较高的三条经脉。在组方方面,选取单穴、双穴和三穴进行组方的较多,占文献总篇幅的66．9％,并且多是胆俞穴、胆囊穴、日月穴、期门穴、阳陵泉的相互组合。结论：穴位作用规律和穴位组方规律是现代针灸学迫切需要解决的两大问题。     

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.