LECTURES ON ACUPUNCTURE—PartⅠ Clinical Acupuncture Lecture Nineteen INSOMNIA

Insomnia refers to a disorder in which patient can not have normal or enough sleep. Clinically, it has different manifestations. In mild cases, it is manifested as difficulty in getting to sleep, easy to wake up and unable to sleep again after waking. In severe cases, it is manifested as sleeplessness during the whole night.     

NEEDLING BODY ACUPOINTS COMBINED WITH OTOPOINT-PELLET PRESSING THERAPY FOR TREATMENT OF 43 CASES OF INSOMNIA

Insomnia is characterized by difficulty in falling asleep, being liable to wake up during sleep, and even being unable to sleep during whole night. The author of the present paper employed body aeupoints combined with otopoint-pellet pressing to treat insomnia and achieved satisfactory results. Here is the report.     

Shoulder Periarthritis Treated by Puncturing Acupoints of Lung Meridian： One Case Report

A 48 year-old female patient received treatment on Oct. 15, 2008. Chief complaint： Right shoulder pain lasting for a year. History of present illness： The right shoulder pain occurred after extracting cold a year ago, and it was diagnosed in the orthopedics as shoulder periarthritis. The patient did not feel any better after taking anti- inflammatory painkillers （the detailed information was unknown） plus functional exercises. Now the shape of the shoulder is normal, but the patient experienced a restricted range of motion and an inability to comb her hair. She also complained of a tenderness spot on the base of the fight palm near the thenar for years, along with slight redness and swelling. The patient＇s appetite and sleep are fine, with regular urination and bowel movements.     

Clinical Observation on Suspended Moxibustion at Baihui （GV 20） for Insomnia

Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients'daily life,work and study,so it should be treated as early as possible.A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs.The author treated insomnia with suspended moxibustion at Baihui(GV 20),the report is as follows.     

Dietotherapy for Hyperlipidemia

Hyperlipidemia is a pathological condition in which one or more than one ingredients of plasma lipoprotein is higher than normal in quantity. The primary hyperlipidemia is due to the congenital defect of lipid and lipoprotein metabolism and some environmental factors with unknown causes. And the secondary hyperlipidemia is caused by some diseases, such as diabetes, liver, kidney, and thyroid problems, as well as alcohol drinking, obesity, diet and life style. But no matter in primary or secondary cases, the incidence of hyperlipidemia in senile people is always higher than in people of other ages. In the early stage, there is no obvious symptoms. With the development of pathological condition, the patient will have dizziness, fullness in chest, shortness of breath, and tiredness, and become fat.     

Effect of spleen-invigorating,Qi-replenishing and blood-arresting formula on zebrafish models with simvastatin-induced hemorrhage caused by spleen failing to control blood,in terms of theory of Traditional Chinese Medicine

OBJECTIVE: To investigate the hemostasis effect of spleen-invigorating, Qi-replenishing and blood-arresting formula, on a zebrafish models with simvastatin-induced hemorrhage, and with symptom pattern caused by spleen failing to control blood, in terms of theory of Traditional Chinese Medicine(TCM).METHODS: In the first experiment, 60 AB strain wild type zebrafishes were randomly assigned into two groups: normal group and model group. The model group was treated with 50 μM simvastatinfor 24 h. The second experiment: The melanin allele mutated Albino strain zebrafishes were divided into normal, model, A group and B group. The observational parameters were as follows: blood flow, velocity of movement, hemorrhage ratio and improvement ratio of hemorrhage.RESULTS: Hemorrhage ratio: in the first experiment, brain hemorrhage ratio was 75%. In the second experiment, heart hemorrhage ratio was 65%.Blood flow: compared with the normal group,there was a significantly decrease in the model group(P 0.001). Velocity of movement: in the first experimental, compared with the normal group,there was a significantly decrease in the model group(P 0.001). Improvement ratio of hemorrhage: agents A had little effect in heart hemorrhage of the zebrafish; agents B could reduce heart hemorrhage ratio of the zebrafish, and increase the improvement ratio of hemorrhage.CONCLUSION: The manifestation of zebrafish model with simvastatin-induced hemorrhage is basically similar to that of the clinical symptom pattern caused by spleen's failure to control blood. The Spleen-invigorating, Qi-replenishing and Blood-arresting Formula can reduce the heart hemorrhage ratio of zebrafish induced by simvastatin, and increase the Improvement ratio of hemorrhage.     

Effect of Chinese Drugs for Promoting Blood Circulation and Eliminating Blood Stasls on Vascular Endothelial Growth Factor Expression in Rabbits with Glucocorticoid-induced Ischemic Necrosis of Femoral Head

Objective： To probe into the mechanism of Chinese drugs for promoting blood circulation and eliminating blood stasis in the prevention and treatment of glucocorticoid-induced ischemic necrosis of femoral head. Methods： Thirty New Zealand adult white rabbits were randomly divided into a normal control group （n=5） and a model group （n=25）. Hydroxyprednisone acetate was intramuscularly administered to the rabbits in the model group in a dosage of 7.5 mg/kg, twice per week for 6 weeks, to induce ischemic necrosis of femoral head and normal saline of the equal volume was intramuscularly administered to the rabbits in the normal control group, twice per week for 6 weeks. Then, the 5 rabbits from the normal control group and 5 rabbits selected randomly from the model group were sacrificed and the changes in histopathology and the expression of Vascular Endothelial Growth Factor （VEGF） were observed. The other 20 rabbits in the model group were randomly divided into the treatment group 1 and the treatment group 2, and the control group 1 and the control group 2, 5 rabbits in every group. Taohong Siwu Tang （桃红四物汤 Decoction of Four Drugs with Addition of Peach Kernel and Safflower） was orally administered to the rabbits in the treatment group 1 and the treatment group 2 in a dosage of 7 ml/kg, once daily and normal saline of the equal volume was orally administered to the rabbits in the control groupl and the control group, 2 once daily. After 10 weeks the rabbits in the treatment group 1 and the control groupl were sacrificed and after 13 weeks the rabbits in the treatment group 2 and the control group 2 were sacrificed, and the expression of VEGF was detected in these rabbits. Results： The expression of VEGF was significantly enhanced in rabbits of the model group as compared with the normal control group （P〈0.01）, and gradually reduced with the lapse of time. The expression of VEGF in the control groups was significantly reduced as compared with the treatment groups （P〈0.001）. Conclusion： Chinese drugs for promoting blood circulation and eliminating blood stasis can improve the microcirculation of femoral head in rabbits with glucocortieoid-induced ischemic necrosis of femoral head by promoting the expression of VEGF.     

Therapeutic evaluation on needling method of regulating the conception vessel and calming the mind for perimenopausal sleep disorder

Objective： To observe the clinical efficacy of needling method of regulating the Conception Vessel and calming the mind in treating sleep disorder in perimenopausal women, and to provide clinical evidence for future treatment of the disease, Methods： Sixty eligible subjects with perimenopausal sleep disorder were enrolled and randomized into an observation group and a control group, 30 cases in each group. The observation group was intervened by needling method of regulating the Conception Vessel and calming the mind, and the control group was treated by taking Yi Kun Yin orally. Two-week treatment was considered as a treatment course. Major symptoms of traditional Chinese medicine and Pittsburgh Sleep Quality Index （PSQI） were observed, and clinical efficacies were compared. Results： After treatment, the difference in total effective rate between the two groups was statistically significant （P〈0.05）; except for flaccidity of lumbar and knees, both groups achieved significant improvements in the other 5 symptoms of traditional Chinese medicine （P〈0.05 or P〈0.01）; PSQI global score and component scores dropped in both groups, and the improvements in the observation group were markedly superior to that in the control group （P〈0.05 or P〈0.01）. Conclusion： The needling method of regulating the Conception Vessel and calming the mind is better than Yi Kun Yin in improving traditional Chinese medicine symptoms and sleep quality in patients with perimenopausal sleep disorders.     

针刺配合刺络拔罐治疗三叉神经痛45例

The authors had treated 45 cases of prosopalgia with acupuncture in combination with blood-letting puncturing and cupping from June 1,2010to March 1,2011.The report is as follows. CLINICAL DATA All of the 45 cases of primary prosopalgia were the outpatients in Acupuncture-Moxibustion Department of our hospital and were diagnosed as the primary prosopalgia.Of them,18 cases were male and 27 cases were female,aged in the range from 38 to 75 years and being sick ranged from 3 days to 6 months.     

EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

Slowtransit constipation(STC),also called as“colonic inertia”,is thought to have a pri mary defectslower than normal movement of contents fromtheproxi mal to the distal colon and rectum.It belongs todysfunctional constipation and is mainly manifestedbylumpy or hard stools and decrease in the desire ofdefecation,someti mes,with concurrent abdominalpain and discomfort,etc.It constitutes about15%ofthe constipation patients[1]andis arefractory disease.The therapeutic effects of current remedies…     

张振贤教授基于“昼精夜瞑”理论辨治不寐病

不寐是指睡眠时间或质量不足，主要表现为入睡困难，或睡眠维持障碍、睡眠质量下降和总睡眠时间减少，同时伴有日间功能障碍。人的睡眠觉醒节律与自然界相应，“昼精夜瞑”是正常睡眠觉醒节律状态，即白天精力旺盛，夜晚沉睡安眠。张振贤教授经过长期临床实践运用中医药辨治不寐病，发现阴阳平衡、气血调和是正常睡眠发生的基本要素，不寐的主要病机责之于阴阳失衡、气血失常，以致睡眠觉醒节律紊乱，出现卫气白昼出营阴不利“昼不精”、卫气夜晚入营阴不利“夜不瞑”等病理现象。病位与五脏相关，辨证强调“五脏藏神”。临证重在恢复患者“昼精夜瞑”状态，总结出“育阴潜阳，水火相济”“调和气血，贯穿始终”“衷中参西，身心同治”等治疗原则，注重精神调摄，诊治中遵循五脏一体，形神合一，圆机活法，以致阴平阳秘、精神归平。     

从中医诊治探讨藏香治疗失眠的机理

失眠是以入睡及睡眠维持困难为特征的一种最常见的睡眠障碍,是睡眠质量或数量达不到正常需求的一种主观体验。失眠可影响患者的家庭、社交、和日常生活质量及事业。中医认为,失眠的发生,主要在于卫气行于阳不得入于阴,即阴阳不能相交,通过开郁可使阳顺利入于阴：藏医认为隆元紊乱是导致失眠的根本,藏香可调节隆元治疗失眠。藏香所选药物在中医看来,可使人体升降出入正常,五脏六腑各司其职,气血循常道正常运行,使阳能够顺利出入于阴而寤寐正常。     

不同证候原发性失眠症患者睡眠参数及整夜心率变化特征研究

目的观察原发性失眠症患者的睡眠特征和睡眠期心率的变化趋势特征。方法 24例原发性失眠症患者与15例健康对照者均接受睡眠检测,观察比较3组受检者的常规睡眠参数、短觉醒指数和整夜心率变化指标的异同。结果与对照组相比,2组患者的深睡比例减少,浅睡比例增多,夜间觉醒时间增多,短觉醒指数明显增大,虚证组睡眠潜伏时间延长;2组患者睡眠期和非快速眼动（NREM）睡眠期心率变异系数增大,第1个睡眠周期平均心率/睡眠期平均心率的比值增大;第1个睡眠周期的心率变异系数增大（P〈0.05）。2组之间相比,实证组短觉醒指数较大,实证组睡眠期和NREM睡眠期心率变异系数较大（P〈0.05）。结论失眠症患者在常规睡眠参数、短觉醒以及心率变化趋势上均存在异常表现,其中短觉醒指数、整夜及NREM睡眠期心率变异系数可能可以作为虚实辨证的参考指标。     

电针百会、足三里穴对睡眠剥夺大鼠学习记忆的影响

目的观察电针百会、足三里穴对睡眠剥夺(SD)后大鼠学习记忆能力的影响以及脑干中多巴胺(DA)和5-羟色胺(5-HT)含量的变化。方法将32只雄性SD大鼠随机分为正常组、睡眠剥夺组、假针组和电针组。采用Morris水迷宫实验和避暗实验分别在连续5 d的睡眠剥夺前后测试大鼠的学习记忆能力,并应用高效液相色谱(HPLC)和电化学检测器检测大鼠脑干中DA和5-HT含量。结果在Morris水迷宫实验中,睡眠剥夺组和假针组的潜伏期均高于正常组和电针组(P0.05);睡眠剥夺组和假针组的平台象限滞留时间均低于正常组和电针组(P0.05),电针组低于正常组(P0.05)。在避暗实验中,连续5 d的睡眠剥夺后睡眠剥夺组、假针组和电针组的步入潜伏期均低于正常组(P0.05),而电针组高于睡眠剥夺组和假针组(P0.05)。连续5 d的睡眠剥夺后,睡眠剥夺组和假针组大鼠脑干DA含量均低于正常组和电针组(P0.05),电针组低于正常组(P0.05);睡眠剥夺组和假针组大鼠脑干5-HT含量均高于正常组和电针组(P0.05),电针组高于正常组(P0.05)。结论电针可明显改善睡眠剥夺后大鼠的学习记忆能力,其机制可能与脑干中DA和5-HT含量的变化有关。     

从改善睡眠作用研究四逆散的疏肝解郁功效

对四逆散的改善睡眠作用进行药理学评价,深入研究四逆散疏肝解郁功效的科学内涵。以大鼠、小鼠和果蝇为模式生物,利用行为药理学、皮层脑电描记与分析、生物化学及分子生物学等实验方法与技术,开展四逆散改善睡眠作用的药理评价。四逆散能延长戊巴比妥钠所致小鼠睡眠时间,其作用存在着量效与时效关系;能延长正常或睡眠剥夺大鼠的慢波睡眠时间;对正常或睡眠剥夺大鼠脑中的多种神经递质、睡眠相关因子等均有影响。四逆散具有改善睡眠的作用,该作用与其疏肝解郁功效密切相关,是通过多途径、多靶点来实现的。     

推拿治疗失眠体会

失眠,指无法入睡或无法保持睡眠状态,导致睡眠不足.中医学又称其为＂不寐＂、＂不得眠＂、＂不得卧＂等,是以经常不能获得正常睡眠为特征的一种病证临床以不易入睡,睡后易醒,醒后不能再寐,时寐时醒,或彻夜不寐为其证候特点,并常伴有日间精神不振,反应迟钝,体倦乏力,甚则心烦懊恼,失眠严重者可引起焦虑、抑郁或恐惧心理,并导致精神活动效率下降,妨碍社会功能.失眠的病因有很多,大致可分为五类：①环境原因,②个体因素,③躯体疾病,④精神因素,⑤药物因素.失眠中医认为肝肾阴虚,脑髓空虚是失眠发生的基本病理变化,肝肾精气亏虚是其基本病机.笔者近几年治疗失眠患者总结如下.     

失眠的心理生理发病机制探讨

失眠是临床最常见的疾病和症状之一,失眠不仅仅是睡眠生理紊乱,还是睡眠心理的紊乱。在急性失眠的发作和急性失眠转变为慢性失眠过程中,人格、认知等因素起着十分重要的作用。失眠是内因和外因共同作用下扰乱了正常的心理生理过程而造成的。     

大学生易怒者睡眠及疲劳状况流行病学调查分析

目的:分析大学生睡眠和疲劳状况与怒的相关性。方法:采用斯皮尔伯格状态-特质怒表达量表(STAXI-2)、匹兹堡睡眠质量指数表(PSQI)及疲劳评定量表(FAI)对544名大学生自愿受试者进行流行病学调查。结果:易怒组睡眠质量得分以及日间功能得分与非易怒组比较有极显著性差异(P<0.001)。易怒组在疲劳的严重程度上得分高于非易怒组(P<0.05),在疲劳情境特异性方面的得分与非易怒组有极显著性差异(P<0.001),在可能导致的心理后果方面得分显著高于非易怒组(P<0.01)。结论:易怒特质人群发怒与睡眠质量差、日间功能障碍关系极为密切;易怒与疲劳严重程度呈正相关;易怒者疲劳具有明显的情境特异性,明显存在由于疲劳导致的缺乏耐心、注意力不集中等心理后果。     

新生儿游泳、抚触对新生儿生长发育的临床观察

目的：探讨新生儿游泳、抚触对新生儿生长发育及睡眠质量的影响.方法：选择我院2009年1～5月218例足月正常新生儿,均经家属同意后予游泳、抚触作为观察组,选择同期足月分娩正常新生儿未予游泳、抚触的218例作为对照组,观察两组婴儿生长发育及睡眠质量情况.结果：观察组新生儿7天体重（g） 3290±350,对照组新生儿7天体重（g） 的体重3090±380,P〈0.05,观察组新生儿睡眠质量良好率达90.8%,对照组新生儿睡眠质量良好率60.5%.P〈0.05.结论： 新生儿游泳、抚触能促进新生儿生长发育,体重增加明显,哭闹减少,睡眠质量好.