针刺治疗三叉神经痛48例临床观察

采用从下关穴进针,刺激蝶腭神经节为主的方法,治疗25例原发性三叉神经痛,取得比较满意的疗效.蝶腭神经节是头面部一个重要的植物神经节.通过临床观察到,针刺该神经节对三叉神经痛可产生明显的止痛作用.     

针刺治疗原发性三叉神经痛

采用从下关穴进针 ,刺激蝶腭神经节为主的方法 ,治疗 2 5例原发性三叉神经痛 ,取得比较满意的疗效。蝶腭神经节是头面部一个重要的植物神经节。通过临床观察到 ,针刺该神经节对三叉神经痛可产生明显的止痛作用     

经颞下窝入路毫针盲刺蝶腭神经节可行性及安全性评估

目的:明确经颞下窝入路毫针盲刺蝶腭神经节的可行性及安全性,为临床操作和临床非即刻不良反应的预防提供解剖学依据。方法:观察60具干颅骨,选取面颅宽度测量点,观察翼腭窝变异情况。对6具成人湿颅取脑后,行经颞下窝入路针刺操作,打开翼腭窝后壁暴露翼腭窝,精细分离辨认蝶腭神经节,原位保留上颌动脉翼腭段,观察针灸针是否进入翼腭窝。测量进针深度、面颅宽度、针与蝶腭神经节间距离、针与上颌动脉翼腭段间距离、上颌动脉翼腭段与翼腭窝内走形的上颌神经间距离。结果:选取两侧眉弓下稍凹陷处距离作为面颅宽度,3具干颅存在翼腭窝变异。对湿颅行双侧针刺操作(共12次),针均进入翼腭窝;进针深度与两侧眉弓下稍凹陷处距离间比例关系区间为44%~54%。12次操作中仅2次针尖触碰蝶腭神经节,针与蝶腭神经节平均距离:左侧(5.88±3.70)mm、右侧(6.43±5.54)mm。针与上颌动脉翼腭段平均距离:左侧(2.77±3.99)mm、右侧(2.53±3.10)mm,上颌动脉翼腭段与翼腭窝内走形的上颌神经间平均距离:左侧(2.83±4.05)mm、右侧(2.67±4.95)mm,以上各测量维度中双侧数据间均数比较差异均无统计学意义(均P0.05)。结论:1经颞下窝入路毫针盲刺蝶腭神经节操作时针具可进入翼腭窝,但直接触碰蝶腭神经节的概率不高;2临床治疗鼻炎疗效可能与针具近神经相关;3临床非即刻不良反应可能是针具刺中上颌动脉翼腭段造成;4面颅宽度与进针深度存在比例区间关系,综合考虑临床操作安全性、有效性,建议针对不同患者进针深度选取面颅宽度与进针深度比例区间下限。     

维生素B12由下关穴行蝶腭神经节浸润对原发性三又神经痛的研究

目的探讨维生素B12由下关穴行蝶腭神经节浸润对原发性三叉神经痛的临床疗效。方法60例原发性三叉神经痛患者,随机分成成4组。治疗组采用大剂量维生素B12由下关穴进行蝶腭神经节浸润,对照1组采用针刺治疗,对照2组采用卡马西平口服治疗,对照3组采用维生素B12臀部肌肉注射。结果3个疗程后,治疗组优于对照3组（P〈0．05）,对照2组组止痛效果亦优于对照3组（P〈0.05）。结论维生素B12由下关穴行蝶腭神经节浸润对原发性三叉神经痛安全而有效。     

揿针联合针刺蝶腭神经节治疗变应性鼻炎的临床观察

摘要：目的：观察揿针联合针刺蝶腭神经节治疗变应性鼻炎(allergic rhinitis,AR)的临床疗效。方法：将符合纳入标准的108例AR患者随机分为揿针组、针刺蝶腭神经节组（针刺组）、揿针联合针刺蝶腭神经节组（联合组）,每组 36例。揿针组穴取迎香、印堂、肺俞穴,留针2 d,间隔1 d;针刺组取蝶腭神经节针刺,每7d治疗1次;联合组采用揿针联合针刺蝶腭神经节进行治疗。治疗30天后,观察三组患者治疗前后血清总IgE水平、RQLQ评分、鼻炎症状评分变化并比较临床疗效。结果：治疗后,与揿针组和针刺组比较,联合组患者血清总IgE水平、RQLQ评分和鼻炎症状评分均明显降低 (P＜0.05);揿针组、针刺组、联合组总有效率分别为77.8%、75.0%、94.4%,揿针组和针刺组总有效率明显低于联合组(P＜0.05)。结论：揿针联合针刺蝶腭神经节可显著降低AR患者血清中总IgE水平、改善AR患者生活质量和临床鼻炎症状,具有较好的临床疗效,值得在临床中进一步推广应用。     

针刺蝶腭神经节联合调身调息法治疗过敏性鼻炎的临床疗效研究

目的：评价针刺蝶腭神经节联合调身调息法治疗过敏性鼻炎(AR)的临床疗效,以期探索出高效、高接受度、低复发率的优效治疗方案。方法：将201例AR患者随机均分为3组,西药对照组(1组,口服氯雷他定片)、针刺蝶腭神经节对照组(2组,给予针刺蝶腭神经节)、针刺蝶腭神经节联合调身调息法组(3组,在针刺蝶腭神经节基础上联合调身调息法),均连续治疗4周。治疗结束后,分别评价3组患者的鼻炎症状量表(TNSS)总评分、鼻结膜炎生存质量问卷调查量表(RQLQ)总评分、鼻分泌物中嗜酸性粒细胞(EOS)计数、临床总有效率、患者接受度及随访复发天数。结果：(1)研究中共剔除脱落患者9例,最终纳入疗效统计的病例数为192例。(2)各组患者治疗各时间点TNSS、RQLQ总评分、鼻分泌物中EOS计数均较同组治疗前下降(P<0.05)。3项评分各时间点组间比较,针刺蝶腭神经节联合调身调息法组下降程度均优于其他2个对照组(P<0.05);(3)各组患者的临床总有效率、患者接受度及随访复发天数比较差异均具有显著性(P<0.05),针刺蝶腭神经节联合调身调息法组的临床总有效率及患者接受度最高,随访复发天数最...     

下关穴不同深度针刺治疗肝阳上亢型三叉神经痛:随机对照研究

目的:观察深刺及浅刺下关穴治疗肝阳上亢型原发性三叉神经痛(PTN)的疗效差异。方法:选择肝阳上亢型原发性三叉神经痛63例,随机分为深刺组(32例)和浅刺组(31例),两组均取患侧下关,双侧合谷、太冲及与病变神经干分支相应的攒竹、四白、夹承浆穴。深刺组针刺下关至蝶腭神经节(SPG),攒竹、四白、夹承浆分别刺入眶上孔、眶下孔、颏孔;浅刺组行常规针刺,针刺后均接G6805电针仪,每次通电30min,隔日1次。治疗2个疗程后,观察患者疼痛指标、中医证候指标及临床疗效。结果:深刺组患者疼痛视觉模拟评分(VAS)、中医证候各项评分(疼痛程度、疼痛次数、心烦、目赤、口苦、胁痛)均较治疗前明显降低(均P<0.01);浅刺组除胁痛(P>0.05)以外,其余以上指标均明显降低(P<0.01,P<0.05);两组治疗后比较,深刺组VAS评分、中医证候中疼痛程度、目赤及总分减少更显著(均P<0.05)。深刺组、浅刺组疾病总有效率分别为93.8%(30/32)和87.1%(27/31),深刺组疗效优于浅刺组(P<0.05)。两组均未观察到不良反应。结论:电针治疗肝阳上亢型三叉神经痛疗效显著,深刺下关透蝶腭神经节较常规针刺下关疗效更佳。     

针刺蝶腭神经节治疗中重度持续性变应性鼻炎的疗效分析

目的：评价针刺蝶腭神经节治疗中重度持续性变应性鼻炎的临床疗效。方法本研究为非随机对照研究。将符合纳入标准的患者按就诊顺序以1∶1比例分为2组,每组25例。针刺蝶腭神经节组采用毫针刺激蝶腭神经节,1～2次/周;常规针刺组采用传统针刺方法,以迎香、印堂、风池、风府、足三里等为主穴,以上星、合谷、禾髎、肺俞、脾俞、肾俞、三阴交等为配穴,每次取主穴、配穴各1～2穴,2次/周。2组均连续治疗4周。采用鼻炎症状总分量表(2004版)、鼻炎症状总分量表(total nasal symptom score, TNSS)、鼻炎伴随症状总分量表(total non-nasal symptom score, TNNSS)评价症状改善情况;采用鼻结膜炎生活质量量表(rhinoconjunctivitis quality of life questionnaire, RQLQ)评价生活质量;比较2组患者针刺起效时间、疗效持续时间,以及治疗后1个月复发天数。结果针刺蝶腭神经节组治疗后鼻炎症状总分[(99.74±31.89)分比(196.83±31.22),t＝-4.912]、TNSS[(165.18±51.06)分比(209.37±53.31)分,t＝-4.032]、TNNSS[(33.63±12.37)分比(71.82±19.21),t＝-3.463]均明显低于常规针刺组(P 均＜0.05)。与常规针刺组比较,针刺蝶腭神经节组针刺后症状改善起效时间[(13.85±4.21)min 比(45.63±7.87)min;t＝-1.763,P＝0.008]更短,而疗效持续时间[(37.92±9.94)h 比(3.35±1.23)h;t＝7.637,P＜0.01]更长。针刺蝶腭神经节组治疗后4周RQLQ评分[(8.48±3.71)分比(37.68±12.46)分,F＝-7.312]低于常规针刺组(P＜0.01)。治疗后1个月针刺蝶腭神经节组复发天数[(4.12±2.15)d 比(23.53±4.63)d,t＝-8.879]明显少于常规针刺组(P＜0.01)。结论针刺蝶腭神经节治疗中重度持续性变应性鼻炎优于传统针刺方法。     

针刺蝶腭神经节结合脐贴治疗变应性鼻炎临床研究

目的:分析针刺蝶腭神经节结合脐贴治疗变应性鼻炎的疗效.方法:选取132例变应性鼻炎患者,随机分为观察组与对照组各66例.对照组口服氯雷他定片,急性发作期加用糠酸莫米松鼻喷雾剂;观察组在对照组基础上接受针刺蝶腭神经节结合脐贴治疗.治疗前后评价测定患者鼻炎症状量表(TNSS)分数和鼻炎伴随症状量表(TNNSS)评分、血清免...     

下关穴治疗三叉神经痛刺灸方法概述

下关穴是治疗三叉神经痛的常用穴位之一,属于足阳明胃经,位于面颊部,距离三叉神经节及蝶腭神经节都非常近,针刺可以疏通局部经络气血,促进局部的血液循环,加速局部功能的恢复,以达到止痛的目的。下关穴治疗三叉神经痛的刺灸方法包括针刺、电针、穴位注射、隔姜灸、皮内针等,毫针刺法包括合谷刺、齐刺、芒针深刺、透刺等。针感以酸胀感和电击感为主。在本文所检索的文献中,大部分都是采用了深刺的方法,或是向对侧目内眦、乳突透刺,或是刺入三叉神经节或蝶腭神经节部位,以有放射性针感或酸胀感为佳,大部分的学者皆认同深刺下关穴可以取得更好的止痛效果。但是,还有很多文献因没有清楚准确的描述下关穴的刺灸方法而没有纳入本研究,而且也没有严格的临床试验来证实各种刺灸方法的疗效差异,所以认为深刺下关穴一定好于浅刺的论点尚显证据不足,需要更严格的试验来为临床医生提供确切的科学证据。     

Clinical observation on 48 cases of peripheral facial paralysis treated by acupoint-penetrating acupuncture

针刺患侧阳白透鱼腰、地仓透颊车、下关透颊车、四白透颧髎、百会透太阳、印堂透山根、攒竹透晴明、合谷透劳宫，并根据症状增加穴位，治疗了48例周围性面瘫患者，痊愈39例，显效7例，无效2例，治愈率为81．2％，有效率95．8％。     

Treatment of 32 Cases of Primary Trigeminal Neuralgia by Acupuncture plus Moxibustion with Warming Needle on Xiaguan （ST 7）

以下关、三间、陷谷、足临泣、三阴交和太溪为主穴,下关穴用温针灸,泻健侧三间、患侧陷谷和足临泣,补患侧三阴交和太溪,另根据发作部位局部选穴,眼支加阳白,上颌支加颧髎,下颌支加颊车.32例患者,经24次针灸治疗后,治愈4例,显效19例,好转7例,无效2例.     

NEURONS DISCHARGE AND C-FOS EXPRESSION IN NTS FOLLOWING ELECTROACUPUNCTURE AT ACUPOINTS OF STOMACH MERIDIAN OF FOOTYANGMING

The nucleus of solitary tract(NTS) is a primary center for both visceral afferents and somatic afferents.Previous experiments demonstrated that NTS is associated with the connection of the stomach and acupoints in Stomach Meridian of Foot-Yangming(ST Meridian).In this study, extracellular recording and immunochemistry method were used to analyze the discharging neurons and c-Fos protein expression in NTS after electroacupuncture at different acupoints and non-acupoint.A total of 104 discharging neurons were detected in the NTS of 52 rats, of which, 86 were provided with complete data.After acupuncturing at Sibai(ST2), Zusanli(ST36), Neiting(ST44), Quanliao(SI18) and non-acupoint, the response neuron occurring rates(RNORs) in NTS were 65.12%, 51.16%, 46.51%, 34.88% and 31.40% respectively.For RNORs, there was a significant difference among Sibai(ST2), Zusanli(ST36), Neiting(ST44), Quanliao(SI18) and nonacupoint(P0.01 or P0.05).Accordingly, in other 48 rats, the number of c-fos immunoreactive(c-fos-IR) neurons in the NTS after electroacupuncture(EA) at Sibai(ST2) was significantly higher than that of at other acupoints and non-acupoint(P0.05 or P0.01).Both EA at Zusanli(ST36) and Neiting(ST44) increased c-fos-IR neurons significantly compared with that of at Quanliao(SI18) and non-acupoint(P0.05 or P0.01), while there was no difference between EA at Quanliao(SI18) and nonacupoint(P0.05).The experiments demonstrated that the afferent convergence in NTS is different by body surface point stimulus, which suggested that NTS might be a primary center in the central nervous system(CNS) which received acupoint stimulus from ST Meridian.     

针刺大鼠“四白”传入信息对孤束核神经元放电的影响

目的:比较足阳明经中远近腧穴及手太阳小肠经腧穴和非经非穴点的传入信息在孤束核(NTS)的差异。方法:采用细胞外记录方法,以足阳明胃经“四白”穴为刺激点,并以同名经的“地仓”和“内庭”、手太阳小肠经的“颧”、非经非穴“四白”旁开点为对照,在刺激点上用手针施以捻转手法刺激30 s,在NTS寻找对来自体表刺激点有反应的神经元。结果:52只大鼠记录到资料完整的86个NTS神经元中,针刺“四白”后NTS有反应神经元出现的机率(含兴奋和抑制性神经元)为65.12%,而针刺“地仓”“内庭”“颧”“四白”旁开点有反应神经元出现的机率分别为50.00%、46.51%、34.88%、31.40%。统计表明,针刺“四白”后NTS有反应神经元出现的机率均极显著地高于针刺“地仓”“内庭”“颧”“四白”旁开点后有反应神经元出现的机率(P<0.01);针刺“地仓”和“内庭”后NTS有反应神经元出现的机率均显著高于刺激“颧”和“四白”旁开点的有反应神经元出现机率(P<0.05)。针刺上述穴和非穴区,NTS神经元主要是以兴奋为主。针刺“四白”“地仓”“内庭”“颧”“四白”旁开点,其兴奋性神经元频率变化率分别为(35.08±4.80)%、(28.25±5.46)%(、27.57±4.87)%、(20.02±4.23)%(、18.55±2.49)%,“四白”与各组之间有显著性或极显著性差异(P<0.05或P<0.01),“地仓”“内庭”与“颧”“四白”旁开点亦有显著性或极显著性差异(P<0.05或P<0.01)。结论:与手太阳小肠经穴以及非经非穴点比较,足阳明经穴与NTS的关系更密切;足阳明经中远近腧穴的信息传入在NTS亦存在着一定的差异,这提示腧穴均有一定的特异性。     

齐刺法治疗原发性三叉神经痛疗效观察

目的:探寻治疗三叉神经痛的有效方法.方法:将49例原发性三叉神经痛患者随机分成两组,治疗组31例采用齐刺颧髎加阳陵泉、丰隆穴治疗,对照组18例以口服卡马西平治疗.结果:治疗组总有效率为90.3%,对照组总有效率为72.2%.两组比较,差异有非常显著性意义(P<0.01).结论:以齐刺颧髎穴为主治疗三叉神经痛疗效优于卡马西平药物对照组.     

基于集合可视化分析系统探索针灸治疗面肌痉挛的选穴规律

目的:基于集合可视化分析系统与Apriori算法探索针灸治疗面肌痉挛的选穴规律.方法:检索中国知网(CNKI)、维普网和万方数据建库至2019年9月27日中有关针灸治疗面肌痉挛的相关文献.对符合研究标准的文献进行相关内容提取及录入,利用R3.6.1进行集合可视化分析与Apriori算法分析针灸治疗面肌痉挛的选穴规律.结...     

NEURON DISCHARGE AND C-FOS EXPRESSION IN NUCLEUS OF THE SOLITARY TRACT FOLLOWING ELECTROACUPUNCTURE AT ACUPOINTS OF STOMACH MERIDIAN OF FOOT-YANGMING

Objective: The nucleus of the solitary tract(NTS) is a primary center for both visceral afferents and somatic afferents.Previous experiments demonstrated that NTS is associated with connection of the stomach and acupoints in the Stomach Meridian of Foot-Yangming(ST Meridian).In this study, an extracellular recording and immunochemistry method was used to analyze the neuron discharge and c-fos protein expression in the NTS following acupuncture at different acupoints and non-acupoint.Methods: A total of 104 discharging neurons were detected in the NTS of 52 rats, of which, 86 were provided with complete data.Results: After acupuncture at Sibai(ST2), Zusanli(ST36), Neiting(ST44), Quanliao(SI18) and non-acupoint, the response neuron occurring rates(RNORs) in the NTS were 65.12%, 51.16%, 46.51%, 34.88% and 31.40%, respectively.For RNOR,there was a significant difference among ST2, ST36, ST44, SI18 and non-acupoint(P0.01 or P0.05).Accordingly, in other 48 rats, the number of c-fos immunoreactive(c-fos-IR) neurons in the NTS after electroacupuncture(EA) at ST2 was significantly higher than at other acupoints and non-acupoint(P0.05 or P0.01).Both EA at ST36 and at ST44 increased c-fos-IR neurons significantly as compared with EA at SI18 and non-acupoint(P0.05 or P0.01), while there was no difference between EA at SI18 and at non-acupoint groups(P0.05).Conclusion: The experiment demonstrated that the afferent convergence in the NTS was different by body surface point stimulus, which suggested that NTS might be a primary center in the central nervous system receiving acupoint stimulus from ST Meridian.     

Neuron Discharge and c-Fos Expression in the Nucleus of the Solitary Tract Following Electroacupuncture at Acupoints of the Yangming Stomach Meridian of Foot

The nucleus of the solitary tract (nucleus tractus solitarii; NTS) is a primary center for both visceral afferents and somatic afferents. Previous experiments have demonstrated that the NTS is closely connected to the stomach and acupoints in the Yangming Stomach Meridian of Foot (ST Meridian). In this study, extracellular recording and immunochemistry methods were used to analyze the discharge of neurons and c-Fos protein expression in the NTS following acupuncture at different acupoints and a nonacupoint. A total of 104 discharging neurons were detected in the NTS of 52 rats, of which 86 provided complete data. After acupuncture at Sibai (ST 2), Zusanli (ST 36), Neiting (ST 44), Quanliao (SI 18), and the nonacupoint, the neuron response rate in the NTS was 65.12%, 51.16%, 46.51%, 34.88% and 31.40% respectively. For neuron response rate, there was a significant difference among Sibai (ST 2), Zusanli (ST 36), Neiting (ST 44), Quanliao (SI 18), and the nonacupoint (p < 0.01 or p < 0.05). In the other 48 rats, the number of c-Fos immunoreactive neurons in the NTS by electroacupuncture (EA) at Sibai (ST 2) group was significantly higher than that EA at other acupoints and the nonacupoint (p < 0.05 or p < 0.01). EA at both Zusanli (ST 36) and Neiting (ST 44) increased c-Fos immunoreactive neurons significantly over EA at Quanliao (SI 18) and the nonacupoint (p < 0.05 or p < 0.01), while there was no difference between EA at Quanliao (SI 18) and the nonacupoint group (p > 0.05). The experiments demonstrated that the afferent convergence in NTS are different by body surface points stimulus, which suggests that the NTS might be a primary center in the central nervous system receiving acupoints stimulus from the ST Meridian.     

THE EXTENSIVENESS AND SPECIFICITY OF EFFECT OF ELECTROACUPUNCTURE AT DIFFERENT ACUPOINTS ON NOCICEPTIVE RESPONSE OF CONVERGENT NEURONS IN TRIGEMINAL NUCLEUS CAUDALIS

Experiments were carried out on rats anaesthetized with uraethane. The sponta-neous discharges and nociceptive responses of convergent neurons in the right trigerninal nucleus cau-dalis(TNC) to noxious stimuli at receptive field (cheek) were recorded extracellularly with glass mi-cro-electrode. Electroacupuncture (EA ) was applied at bilateral " Xiaguan" (ST 7 on face ) or "Zusanli" (ST 36 on shank) acupoint with Iow (2V) and high (18V) intensity. The noclceptive re-sponse of convergent neurons in TNC could be inhihited by low intensity EA applied at "Xiaguan" butnot "Zusanlil", showing the specificity of acupoints. High intensity EA at either "Xiaguan" or "Zusan-li" also reduced the nociceptive responses, showing the analgesic extensiveness of acupoints. We sug-gest that "the gate of control" mechanism plays a main role in low intensity EA and "diffuse noxiousinhibitory controls" (DNIC) rnechanism does so in high intensity EA.The results suggest that we should pay attention to the location of acupoints,