针刺新设穴治疗神经根型颈椎病颈痛即时镇痛效果的临床观察

目的:观察针刺新设穴对神经根型颈椎病颈痛的即时镇痛效果。方法:将60例符合纳入标准的神经根型颈椎病患者随机分为两组,每组各30例。治疗组以针刺新设穴治疗,对照组以针刺风池穴治疗,均留针30 min,出针后以疼痛视觉模拟评分(VAS)法评价两组患者首次治疗前后即时颈痛程度变化情况,对比两组患者的首次针刺治疗效果。结果:两组治疗后即时VAS评分均较本组治疗前明显下降,比较差异有统计学意义(P0.05);两组间治疗前后差值比较差异亦有统计学意义(P0.05),治疗组镇痛效果优于对照组。结论:针刺新设穴对神经根型颈椎病颈痛有显著的即时镇痛效果。     

单穴次髎与关元针刺治疗原发性痛经疗效比较

目的比较次髎穴与关元穴治疗原发性痛经的镇痛特异性。方法将60例原发性痛经患者随机分为关元组、次髎组,采用视觉模拟评分(VAS)法分别记录针刺前即时、针刺留针期间、起针后多时点的即时疼痛指数,并进行比较。结果两组均在针刺后迅速产生止痛作用并持续加强,次髎组优于关元组,且次髎穴临床止痛效能在起针后30 min达到最大峰值。结论次髎穴即时针刺镇痛效果优于关元穴。     

灵龟八法针刺治疗坐骨神经痛的即时镇痛效应观察

目的观察灵龟八法针刺治疗坐骨神经痛的即时镇痛作用。方法采用随机数字表法将符合纳入标准的128例患者随机分到观察组(灵龟八法组)和对照组(常规针刺组),每组64例。观察组采用灵龟八法针刺治疗,对照组采用常规针刺治疗。评估针刺前,进针10 min、20 min、30 min,取针后8 h、24 h的视觉模拟量表(visual analogue scale,VAS)评分和疼痛强度数字等级量表(pain intensity numerical rating scale,PINRS)评分,比较两组患者在不同时间点的镇痛效果。结果观察组针刺前、留针10 min、留针20 min、取针后24 h VAS评分与对照组比较差异均无统计学意义(P>0.05),在留针30 min、取针后8 h有统计学差异(P<0.01,P<0.05);观察组针刺前、留针10 min、留针20 min及取针后8 h、24 h PINRS评分与对照组比较差异均无统计学意义(P>0.05),在留针30 min有统计学差异(P<0.01)。结论灵龟八法针刺治疗坐骨神经痛在留针30 min出现显著的镇痛效果,其即时镇痛作用和镇痛持续效果明显优于常规针刺。     

肺切除术后应用电针的疗效观察

目的:观察术后电针干预对肺切除术后镇痛效果及术后恢复的影响。方法:选取择期行肺切除术患者60例,随机分为电针组(30例)及对照组(30例)。两组均使用静脉药物镇痛进行术后基础镇痛(常规用药浓度1/2)。电针组于术后48h内应用电针刺激,取双侧太冲、阳陵泉、外关、尺泽,每12h刺激1次,频率2Hz,每次30min,刺激强度3~5mA。观察患者术后24、48h疼痛视觉模拟评分(VAS),血浆内啡肽含量,追加镇痛药用量,恶心、呕吐评级,术后排气、排便时间的变化。结果:电针组术后48hVAS较对照组降低(P0.05);电针组针刺后血浆β-内啡肽和亮啡肽含量均较针刺前增高(P0.01),对照组无明显变化(P0.05);与对照组比较,电针组术后镇痛药追加量减少(P0.01),恶心程度减轻(P0.05),排气和排便时间提前(P0.01)。结论:术后电针刺激联合静脉镇痛可减少肺切除术后镇痛药用量,达到更好的镇痛效果,减轻恶心程度,加快肛门排气、排便时间,促进患者恢复。     

针刺配合经皮穴位电刺激治疗瘀滞型肩关节周围炎疗效观察

目的观察针刺配合经皮穴位电刺激对瘀滞型肩关节周围炎(简称肩周炎)治疗后的活动度及镇痛效果的影响。方法将100例瘀滞型肩周炎患者随机分为治疗组和对照组,每组50例。治疗组采用针刺配合经皮穴位电刺激治疗,对照组采用单纯针刺治疗。隔日1次,10次为1个疗程,共治疗1个疗程。治疗前后分别采用视觉模拟评分法(visual analogue scale,VAS)对两组患者镇痛效果进行评价,采用肩关节活动功能评分对肩关节活动度进行评估,比较两组临床疗效。结果两组治疗后VAS评分和肩关节功能评分与同组治疗前比较,差异均具有统计学意义(P0.05);治疗组治疗后VAS评分和肩关节功能评分与对照组比较,差异均具有统计学意义(P0.05)。治疗组愈显率为74.0%,对照组为50.0%,两组比较差异具有统计学意义(P0.05)。结论针刺配合经皮穴位电刺激治疗肩周炎疗效显著,患者的肩关节活动度及疼痛均得到显著改善。     

电针耳穴体穴对2型糖尿病猴即时空腹血糖的影响(英文)

目的:观察电针耳穴体穴对2型糖尿病(T2DM)模型猴即时空腹血糖的影响。方法:10只2型糖尿病模型猴均行电针干预,选取"足三里""三阴交"耳穴"降糖点"三穴同时电针干预,持续5天,频率2/15 Hz(2 Hz和15 Hz,每秒转换),强度2 mA,每天1次,每次30 min。测量针刺前、针刺15 min和针刺30min空腹血糖。结果:第1天针刺30 min,T2DM模型猴的空腹血糖与针刺前相比,有显著降低且差异具有统计学意义(P0.01);第3、5天针刺15 min与30 min,T2DM模型猴的空腹血糖与针刺前相比,均有显著降低且差异具有统计学意义(P0.05);第4天针刺30 min,T2DM模型猴的空腹血糖与针刺前相比,有显著降低且差异具有统计学意义(P0.05);第5天针刺30min后,T2DM模型猴的空腹血糖与第1天针刺前相比,下降明显,经统计具有显著性差异(P0.05)。结论:(1)电针耳穴体穴对T2DM模型猴即时空腹血糖有显著降低作用;(2)电针刺激对T2DM模型猴即时空腹血糖的干预具有时间效应,针刺30min效果明显优于15 min;连续刺激4天及以上,效果明显优于连续刺激3天及以下。     

辨证取穴结合不同频率电针在痔疮手术麻醉中的镇痛作用研究

目的:探讨辨证取穴结合不同频率电针用于痔疮手术辅助麻醉中的镇痛效果。方法:将80例需要行痔疮手术的患者随机分为四组,每组20例,在辨证取穴后运用不同频率的电针在痔疮手术辅助麻醉过程中进行干预。其中A组选用2Hz连续波针刺刺激,B组选用15Hz的连续波进行针刺刺激,C组选用100Hz的连续刺激波进行针刺刺激,D组为对照组,给予针刺,但不予电针刺激。每组的术中都给予芬太尼追加麻醉,剂量每次给予1μg/kg的追加,观察四组患者辅助用药量的情况,采用疼痛程度的分级评分标准进行镇痛效果的观察。结果:B组15Hz的镇痛效果最好,组间比较具有统计学差异;四组患者中D组术中辅助药的用量最多,与A、B、C组比较有显著性差异(P0.05)。结论:辨证取穴结合不同频率电针在痔疮手术麻醉中15Hz的效果最佳,可以减少麻醉药物的术中使用量,同时减轻患者的疼痛。     

针刺不同留针时间对无先兆型偏头痛患者眼部温度及即时镇痛效应的影响

目的:观察针刺不同留针时间对无先兆型偏头痛患者眼部温度及即时镇痛效应的影响。方法:将66例无先兆型偏头痛患者随机分为治疗1组、治疗2组、治疗3组,每组22例。3组患者均采用针刺治疗,针刺后分别留针15min、35min、1h。采用简氏Mc Gill疼痛量表评价3组患者治疗2h后的即时镇痛效应,比较治疗前及治疗后15min、35min、1h眼部温度的变化情况,并评估临床疗效。结果:3组患者治疗后疼痛分级指数(PRI)及视觉模拟评分(VAS)均较治疗前下降(P0.05),其中治疗2组与治疗3组治疗后PRI及VAS评分均明显低于治疗1组(P0.01);治疗35min后,治疗2组与治疗3组眼部温度的变化幅度均明显高于治疗1组(P0.01);治疗2组总有效率为90.9%,明显优于治疗1组的63.6%(P0.01)和治疗3组的86.4%(P0.01)。结论:针刺治疗无先兆型偏头痛患者不同留针时间对眼部温度的影响及即时镇痛效应有所差异,留针35min时,眼部温度变化幅度达到最高,镇痛效果最佳,随着留针时间的延长,眼温变化幅度呈下降趋势,而疗效并未增加。     

脑电双频指数对电针刺激复合硬膜外麻醉用于妇科手术的麻醉效果评价

目的 探讨BIS监测对电针刺激复合硬膜外麻醉用于妇科手术的麻醉效果评价。方法 择期妇科手术患者60例,ASA Ⅰ～Ⅱ级,年龄20～60岁,行硬膜外麻醉,随机分为3组：咪达唑仑组,给予咪达唑仑0.04 mg/kg;针麻组,足三里、三阴交穴位予以针刺连续刺激,频率30～100 Hz;咪达唑仑加针麻组,给予咪达唑仑0.04 mg/kg和足三里、三阴交穴位连续针刺刺激。监测3组患者围手术期脑电双频指数（BIS）值、血压（BP）、心率（HR）、血氧饱和度（SPO2）和术后视觉模拟评分（VAS）。结果 3组患者的BIS值与麻醉前比较均有下降（P<0.05）,但在切皮时针麻组BIS值最高（P<0.05）,咪达唑仑加针麻组BIS值最低（P<0.05）,填塞纱布时,针麻组BIS值高于其他两组（P<0.05）。咪达唑仑组患者VAS评分在术后8 h、24 h高于其他两组（P<0.05）。结论 BIS值可以作为针刺复合硬膜外麻醉效果评价的客观指标。针麻具有一定的镇静、镇痛作用,能有效的缓解术后疼痛。     

电针刺激合谷-内关的镇痛效果

日的:为了明确针刺合谷-内关减轻颜面疼痛的机理,通过疼痛程度的变化,疼痛对应电流、最小感知电流的变化,测定镇痛作用的特点与效果。 方法:以15名健康成人为对象,在颜面部左侧三叉神经第2支配区用小夹子夹捏或涂抹辣椒粉给予局部刺激。同侧合谷-内关电针刺激(1Hz)5min或20min,用疼痛量化系统记录针刺通电前、通电     

电刺激大鼠中脑中央灰质对针刺镇痛效应的影响

<正> 近年来的研究资料表明,中脑中央灰质是电刺激脑和吗啡、内啡肽脑内微量注射产生镇痛作用最有效的部位之一。中央灰质内阿片受体含量极为丰富。内啡肽含量很高,这些研究提示中央灰质可能在痛觉信息的整合中起重要的作用。我们前一工作曾表明,损毁大白鼠的一侧或两侧中脑中央灰质后,针刺镇痛效应明显降低,因而认为中脑中央灰质可能参与针刺镇痛过程,但是关于刺激中央灰质对针刺镇痛效应影响的观察,迄今未见报道。本文在于进一步阐明电刺激中央灰质的镇痛效应及其与针刺镇痛效应的相互关系。     

针刺超前镇痛对开胸手术患者围术期镇痛效果的影响

目的观察针刺超前镇痛对于开胸手术患者围术期镇痛效果的影响,对针刺具有超前镇痛效应提供临床依据。方法选择开胸肺癌手术患者120例,随机分为四组,每组30例。A组、B组术前3d予以针刺超前镇痛,每日1次,连续3d。A组、C组予以术后针刺镇痛。D组为全麻对照组。选取与镇痛相关的β-内啡肽和与应激相关的皮质醇为观察指标,检测四组患者手术前后的水平变化,统计四组患者术后镇痛药物芬太尼的具体用量。四组患者均控制疼痛指数在3以下。结果 A组术前一天β-内啡肽与C组和D组比较,均P〈0.05。B组术前一天与C组和D组比较,均P〈0.05。皮质醇数据自身比较,A组、B组、D组入院与拔管后一天比较,术前一天与拔管后一天比较,均P〈0.05;C组入院与拔管后一天比较,P〈0.05。四组患者术后镇痛泵的芬太尼含量经单因素方差分析P〈0.05,差异有统计学意义。结论超前镇痛在开胸手术患者应用中,具有提高镇痛指标β-内啡肽的效应,与传统的术后镇痛比较有明显优势。对于应激指标皮质醇则无明显差异,手术和拔管等刺激对机体产生较大的即时应激,针刺无明显优势。术后针刺可在一定程度上替代镇痛药物的使用量,此次配比减少20%。     

Influence of naloxone on electro-acupuncture analgesia using an experimental dental pain test. Review of possible mechanisms of action

The purpose of this study was to examine in man the analgesic effect of non-segmental electroacupuncture (EA) limited to a single point (Hoku hand point) and the influence of naloxone using an original modified electrical dental pain test. Results in the literature are still contradictory as to the degree and specificity of acupuncture analgesia and its opioid nature. Acupuncture techniques as well as experimental pain models are factors accounting for the discrepancies in the results. For this reason, we designed an experimental pain test characterized by a high degree of specificity, validity and reliability. We chose optimal conditions for eliciting specific acupuncture effect, i.e. non-segmental, low frequency and painful intensity range. A cross-over repeated measure experimental design was used. Five normal trained subjects participated in 65 sessions under four conditions (control, EA, EA+naloxone, EA+placebo). Changes in experimental dental pain thresholds served as indices of analgesia. The results indicated a 27% pain threshold increase after 30 minutes of EA stimulation (p less than .0001), with no differential effect between pain detection (mild pain sensation) and pain discomfort (strong pain sensation). This increase was partially blocked by the double blind injection of 0.8 mg naloxone IM (p less than .005). The experiment was designed in such a way as to prevent the occurrence of a stress analgesic effect. The endogenous opioid system was shown to be partially involved in acupuncture analgesia. Other mechanisms of action are discussed in view of the literature findings.     

A controlled trial on acupuncture for chronic neck pain

To evaluate the efficacy of Chinese medicine (CM) acupuncture for chronic neck pain (CNP), a single blind, controlled, crossover, clinical trial was undertaken. Twenty-nine volunteers with CNP were randomly recruited into two groups. Both groups received two phases of treatment with a washout period between the two phases. Group A (14 volunteers) received CM acupuncture in the first phase and sham acupuncture in the second, while Group B (15 volunteers) received sham in the first and real in the second. CM acupuncture was individualized and consisted of nine sessions on both local and distal points. Manual twisting of the needle was applied on all points plus strong electrical stimulation of distal points in CM acupuncture. Sham acupoints (lateral to the real) and sham (weak) electrical stimulation was used in the control group. Comparison of subjective and objective measures between the two groups was made at different periods, including baseline, after each phase of treatment, after washout, and after the 16th week follow-up. The subjective measures included pain intensity, duration per day, analgesic medication count, visual analogue scales (VAS) and neck disability index (NDI). The objective measures consisted of neck range of motion (ROM) and pain threshold (PT). Both the real and sham treatments significantly reduced subjective pain, without significant differences between groups for most subjective measures. Objective measures showed no significant change for either group before and after each period or by inter-groups analysis. A minimum 16-week effect of both real and sham acupuncture was found for subjective measures in the follow-up periods. Further study is recommended with an increased sample size, a longer washout period, and a longer baseline period.     

经皮穴位电刺激诱发的大脑fMRI信号与镇痛的关系

针刺主要是通过激发内源性阿片达到镇痛的目的。不同个体针刺镇痛效果的差异 ,与胆囊收缩素 (ＣＣＫ)等抗阿片物质的个体水平有关 ,那么 ,ＣＣＫ是通过何种通路来影响针刺镇痛的呢 ?我们应用功能性磁共振成像 (ｆＭＲＩ)针对这个问题进行了研究。实验采用两种频率 (2Ｈｚ,1 0 0Ｈｚ)的经皮穴位电刺激 (ＴＥＡＳ)模拟针灸的不同手法 ,其优点是镇痛效果肯定 ,刺激参数可以量化。以前的研究表明 ,不同的脑内神经通路分别介导低频和高频ＴＥＡＳ镇痛 ,中脑、丘脑和下丘脑的某些核团起着关键性的作用。 2 5名健康被试者随机分成两组 ,分别接受高…     

术前针刺对开胸手术患者围术期疼痛的影响(英文)

目的:观察术前针刺对开胸手术患者围术期镇痛效果的影响。方法:选择开胸肺癌手术患者 120例, 随机分为四组,每组 30 例。A组、B组术前 3 d予以针刺超前镇痛,每日 1 次,连续 3 d。A组、C组予以术后针刺镇痛。D组为全麻对照组。四组患者均控制疼痛指数在 3 以下。选取与镇痛相关的β-内啡肽和与应激相关的皮质醇为观察指标,检测四组患者手术前后的水平变化,统计四组患者术后镇痛药物芬太尼的具体用量。结果:A组术前一天β-内啡肽与C组和D组比较,均P<0.05。B组术前一天与C组和D组比较,均P<0.05。皮质醇数据自身比较,A组、B组、D组入院与拔管后一天比较,术前一天与拔管后一天比较,均P<0.05;C组入院与拔管后一天比较, P<0.05。四组患者术后镇痛泵的芬太尼含量经单因素方差分析,P<0.05,差异有统计学意义。结论:超前镇痛在开胸手术患者应用中,具有提高镇痛指标β-内啡肽的效应,与传统的术后镇痛比较有明显优势。对于应激指标皮质醇则无明显差异,手术和拔管等刺激对机体产生较大的即时应激,针刺无明显优势。术后针刺可在一定程度上替代镇痛药物的使用量,此次配比减少 20%。     

拔罐联合针刺激痛点治疗腰背肌筋膜疼痛综合征临床观察

目的:观察拔罐联合针刺激痛点治疗腰背肌筋膜疼痛综合征的疗效。方法:腰背肌筋膜疼痛综合征患者60例,随机分为针刺组和观察组,每组30例。针刺组给予激痛点针刺加TDP常规治疗;观察组根据肌肉紧张带位置,在肌筋膜线上密集拔罐,同时针刺。两组均隔天治疗1次,共治疗5次。以简化麦吉尔疼痛量表为观察指标,进行疼痛评定指数(pain rating index,PRI)、视觉模拟评分(visual analog score,VAS)和现时疼痛强度(present pain intensity,PPI)评定,观察治疗前、治疗结束时以及1个月后的评分变化并观察临床疗效。结果:治疗后,观察组总有效率为96.6%(29/30),高于针刺组的83.3%(25/30),总有效率比较差异没有统计学意义(P0.05);1个月后,针刺组的疗效减退,总有效率为40.0%(12/30),而观察组总有效率90.0%(27/30),两组差异有统计学意义(P0.05)。两组治疗后的PRI、VAS及PPI评分较治疗前均明显下降(P0.05),但两组比较差异无统计学意义(P0.05);1个月后,两组评分有所上升,但观察组的评分较针刺组低(P0.05)。结论:针刺激痛点对肌筋膜疼痛综合征有较好疗效,联合肌筋膜线拔罐可有更好的远期镇痛效果。     

平衡针改善腰椎间盘突出症疼痛的随机对照研究

目的:观察平衡针法改善腰椎间盘突出症疼痛症状的疗效。方法:采用随机对照试验,将纳入的受试者随机分为平衡针组143例和传统针组144例。平衡针组取平衡针腰痛穴,平刺进针,得气即出针;传统针组取阿是、委中、夹脊、肾俞等穴,留针30min。两组均每日治疗1次,共治疗20次。观察疼痛改善率和简式疼痛量表(包括疼痛分级指数、视觉模拟量表、现时疼痛强度)的变化情况。结果:两组治疗后比较,疼痛改善率及疼痛分级指数总分、视觉模拟量表评分、现时疼痛状况,平衡针组略显优势,既体现在即时效果,也表现在远期疗效方面(P<0.05)。结论:平衡针能很好地改善腰椎间盘突出症的疼痛症状,既有即时效果,也有远期疗效。     

PAIN AND SENSORY DETECTION THRESHOLD CAN BE MODULATED BY THE ASSOCIATION BETWEEN COPING STRATEGY AND ACUPUNCTURE SENSATION IN ACUPUNCTURE STIMULATION

Introduction: Although acupuncture reduces pain and is important in its effect, the role of coping strategy on acupuncture modulation of pain and sensory thresholds, and the association between acupuncture sensation and these modulatory effects, is currently unknown.Methods: Electroacupuncture(EA) was applied at acupoints ST36 and GB39 in 61 healthy adults.Two coping conditions were experimentally designed to form an active coping strategy group(AC group), who thought they could control EA stimulation intensity, and a passive coping strategy group(PC group), who did not think they had such control.However, the EA intensity was not changed.Quantitative sensory testing was performed before and after EA, and vibration(VDT), mechanical(MDT),warm(WDT), and cold(CDT) detection thresholds, and pressure(PPT), mechanical(MPT), heat(HPT) and cold(CPT) pain thresholds were measured.Autonomic measures, skin conductance response(SCR), were also acquired to quantify physiological response to EA under different coping conditions.Results: The AC group showed greater SCR to EA than the PC.Acupuncture sensation did not differ between the AC and PC groups.Increased pain/sensory threshold and acupuncture sensation were positively correlated in the AC group(VDT change vs.MI: r=0.58; CDT change vs.tingling: r=0.53; CPT change vs.tingling: r=0.55; CPT change vs.dull: r=0.55), and were negatively correlated in the PC group(CDT change vs.intensity: r=-0.52; WDT change vs.fullness: r=-0.57).Additionally, subjects in the AC group demonstrated reduced PPT following EA.Conclusion: Active coping strategy increased pain and sensory detection threshold when acupuncture sensation was high, while passive coping strategy produced an opposite association.Theassociation of descending cortical(psychological coping strategies) and ascending sensory afference(acupuncture sensation) might affect periaqueductal grey to modulate pain and sensory processing.Clinically, our findings suggest that acupuncture analgesia can be maximized by matching physical stimulation intensity with the psychological coping strategy inherent to different naturalistic subject-specific acupuncture contexts.     

电刺激和毁损大鼠延髓外侧网状旁巨细胞核对针刺镇痛的影响

<正> 近年来的研究资料表明:延髓外侧网状旁巨细胞核(RPGL)是电刺激脑镇痛和吗啡镇痛非常有效的部位。与其它参与吗啡镇痛的脑区(如下丘脑、中脑导水管周围灰质、第四脑室底等)相比,RPGL 对吗啡的敏感性最强。国外对此核团的镇痛机理方面亦做了大量工作,已证明它是痛