电热砭石对手背局部皮肤血流影响的试验研究

[目的]观察电热砭石对手背局部皮肤血流灌注的影响,探讨砭石疗法的作用机制.[方法] 45℃电热砭石刺激健康受试者右手第3、4掌骨间,运用激光多普勒血流成像系统观察刺激前和刺激后不同时间段右手皮肤血流和脐周血流.[结果]在接受电热砭石刺激后,右手血流显著上升(P＜0.01).在30min内,升高的血流未见明显衰减,和接受刺激前比(P＜0.01).对照组在接受刺激后30 min内,脐周血流无明显变化.[结论]电热砭石刺激能最著提高刺激局部手背皮肤血流,而对脐周血流无明显影响.     

The influence of different methods of acupuncture on skin surface perfusion

Objective

To compare the effects on the body surface of different kinds of placebo/sham acupuncture with that of traditional needling sensation acupuncture.

Methods

Point Neiguan (PC 6) of 29 healthy subjects, 19 males and 10 females, was stimulated with needling sensation, shallow, placebo and deep acupuncture at the non-acupoint. After stimulation with different methods of acupuncture, the change in perfusion of the micrangium in the skin surface around the elbow joint, with Point Quze (PC 3) as its center, was observed with laser Doppler blood-flow imaging.

Results

Judging from the absolute value of perfusion of the skin surface micrangium, several methods of acupuncture can cause change in blood flow. The ratio of blood-flow perfusion in the meridian area in and around Quze declined before and after needling insertion in needling sensation acupuncture and shallow acupuncture. This observation did not occur in placebo and non-acupoint acupuncture. Needling sensation acupuncture at an acupoint can relatively reduce the perfusion of the micrangium in the projective area of the meridian where the acupoint is located on the body surface (P<0.05), indicating the specificity of meridians.

Conclusions

Stimulation of an acupoint or a point on the body surface with any type of acupuncture can cause change in blood flow in the skin near the needling point. However, the biological mechanism underlying this phenomenon needs to be further explored.     

温氧合血心停搏液微流量连灌与微温氧合血间灌心肌线粒体量化计分的对比研究

目的观察温氧合血（35℃）心停搏液微流量连灌与微温氧合血（26—28℃）间灌心肌线粒体量化计分及超微结构的变化。方法选择20例择期心脏瓣膜置换术,按机械分类法随机分为两组（每组10例）。A组采用常CPB温氧合血（35℃）心停搏液微流量连灌;B组采用浅低温CPB微温氧合血（26～28℃）心停搏液间灌。分别于主动脉阻断时和再灌注30分钟各取左室壁心肌（1～2mm3）,电镜观察并摄片。在电镜下选择5个视野,每个视野随机观察20个线粒体,依受损程度分为0～4级,将100个线粒体按级得分总和除以100即为该组得分数。结果两组在主动脉阻断时心肌超微结构基本正常,再灌注30分钟,A组得分（1．2346±0．2621）,B组得分（1．1632±0．2153）,两组间比较无显著性差异（P〉0．05）。结论在瓣膜置换术中两组含血心停搏液的心肌保护作用近似,微温血心停搏液具有更好的心肌保护作用。     

温氧合血心停搏液微流量连灌与微温氧合血间灌心肌酶谱变化的对比研究

目的观察温氧合血心停搏液微流量连灌与微温氧合血间灌后心肌酶谱的变化。方法选择40例择期心脏瓣膜手术随机分为两组（每组20例）。A组采用常温CPB,温氧合血心停搏液（35℃）微流量连灌（0．5ml／mg．min）;B组采用浅低温CPB,微温氧合血心停搏液（26—28℃）间灌。主动脉阻断时间大于60分钟。分别测定术前、术后16、40、64、88h肌酸激酶（CK）、心肌型肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）的变化,进行组内和组间对比研究。结果术后88h内,两组心肌酶均有不同程度升高,峰值多在术后16～40h,组内比较与主动脉阻断前差异有显著性（P〈0．05）,大部分在88h内降至正常。组间比较,两组在大部分时间点差异有显著性（P〈O．05）,B组心肌酶较A组低。临床结果证明,两组术后需循环和呼吸辅助时间短,心功能恢复迅速,稳定。结论微温氧合心停跳液间灌具有更好的心肌保护作用。     

Use of laser speckle contrast imaging to reveal changes in temperature and blood perfusion in the skin of healthy subjects after administration of heated moxa sticks and Daiwenjiu ointment

OBJECTIVE： To investigate the influence of heated moxa sticks（ ＂moxibustion＂） and Daiwenjiu ointment（DO） on changes in temperature and blood perfusion volume on the skin of the backs of healthy subjects.METHODS： DO was spread on the left side of the body, and the right side of the body was treated with a heated moxa stick. Images denoting blood perfusion and body temperature were collected 7-8 cm lateral to the spinous process of the sixth thoracic vertebra using laser speckle contrast imaging（LSCI）. Data obtained from eight-frame images were analyzed and used to calculate the mean blood perfusion volume. Simultaneously,blood-perfusion images were collected from the body surface and used to compare the change in blood flow on the body surface and the actual position of imaging.RESULTS： After moxibustion, a rapid increase in blood perfusion volume and body temperature was noted in the local skin surface. The maximum blood perfusion volume and body temperature was noted at 20 min（P〈0.05）. At 80-110 min after the spreading of DO, a gradual increase was noted in blood perfusion volume（P〈0.05） and body temperature（P〈0.05） compared with the baseline level. The maximum blood perfusion volume was at 110 min.CONCLUSION： Using LSCI, these data revealed a rapid and sharp increase in blood perfusion volume and body temperature after treatment with moxibustion, but the respective changes seen in the DO group were gradual and moderate.     

拔罐对健康人体背部皮肤血流量的影响

目的：观察拔罐对健康人体背部不同部位皮肤血流量的影响。方法：运用经络罐通仪控制罐压为-0．04MPa,在健康受试者大椎及双侧大杼穴拔罐10min,通过激光散斑血流监测视频系统对大椎、身柱、神道、双侧肺俞、双侧心俞拔罐前,拔罐后即刻及拔罐后第5min、第10min、第15min、第20min、第25min、第30min的血流量进行记录。结果：起罐即刻,大椎、身柱及双侧肺俞血流量较拔罐前明显升高（均P〈0．05）;与起罐即刻相比,大椎在起罐20min后各时间点,身柱在起罐后10min、15min,双侧肺俞在起罐即刻后各时间点,血流量均明显下降（均P〈0．05）。神道、双侧心俞血流量在拔罐前后的差异无统计学意义（均P〉0．05）。结论：拔罐疗法可引起皮肤血流量的变化,且距离拔罐区域越近血流变化越明显。     

刺络疗法对神经根型颈椎病患者局部血流灌注量的影响

[目的]通过观察神经根型颈椎病患者局部血流灌注量的变化,初步探寻刺络疗法治疗神经根型颈椎病的作用机制。[方法]分别运用刺络疗法与针刺夹脊穴的方法干预神经根型颈椎病患者共57例,在以疼痛评级指数（VAS）评价疗效的同时,运用激光散斑血流仪观察两组患者大椎、肩井（患侧）血流灌注量变化。[结果]两组患者干预前后VAS均有显著降低（P〈0.01）;两组患者两穴血流灌注量在干预后均有显著升高（P〈0.05）,刺络疗法组比针刺夹脊穴组升高幅度大（P〈0.05）。[结论]刺络疗法与针刺夹脊穴都能够增加神经根型颈椎病患者局部血流灌注量,其中刺络疗法的影响更突出。     

血必净注射液联合奥曲肽对重症急性胰腺炎患者胰腺血流灌注及血流动力学的影响

[目的]探讨血必净注射液联合奥曲肽对重症急性胰腺炎患者胰腺血流灌注及血流动力学的影响.[方法]选取2016年2月—2019年10月本院收治的重症急性胰腺炎患者(100例)进行随机对照单盲研究,按电脑数字表法随机分为两组,各50例,对照组患者采用奥曲肽和生理盐水治疗,观察组患者采用奥曲肽和血必净注射液治疗,疗程7d.对比...     

针刺时大肠经线下深部组织中氧分压与微循环血流灌注量的实验观察

目的 观察常态下大肠经线下深部组织氧分压与微循环血流灌注量及其在针刺过程中的变化,探讨与大肠经线相关组织的能量代谢特点.方法 沿大肠经脉循行线上取6个测试点,测试深度为皮下1.5 cm.其中4个为穴位(臂臑、手五里、手三里、上廉),两个为非穴位点(曲池臂臑中点、手三里上1寸).6个测试部位分为三组(臂臑-曲池臂臑中点,...     

夏至草提取物对血瘀大鼠器官血流量和血液流变学指标的影响

目的:从器官血流量和血液流变学角度,探讨夏至草提取物的活血化瘀作用。方法:用10%高分子右旋糖酐(Dextran 500)以10ml/kg经颈静脉注射,1min注完,诱导大鼠急性血瘀症模型。6min后经颈静脉给予夏至草提取物,测定器官微区血流量和血液流变学指标。结果:夏至草提取物能明显改善小肠、胃和肝脏的器官血流量,降低血粘度和红细胞聚集指数,提高红细胞变形性。结论:夏至草提取物可改善血瘀大鼠的血液流变性异常,提高器官血液灌流,具有良好的活血化瘀作用。     

复方灯盏花素对动物脑血流量、外周血管灌流量、血小板聚集及体外血栓形成的影响

用电磁流量计法、血管灌流法、比浊法、体外血栓形成实验法等观察了合用补阳还五汤和灯盏花素对家兔脑血流量、青蛙外周血流量、大鼠血小板聚集及体外血栓形成的影响。结果表明复方灯盂花素高、低二剂量均能增加家兔脑血流量,增加青蛙外周血管灌流量,具有扩血管的作用,同时对ADP诱导的大鼠血小板聚集及体外血栓形成有明显的抑制作用,在一定程度上揭示了临床联合使用补阳还五汤和灯盏花素治疗中风后遗症的药理学基础。     

硝酸甘油对犬心表冠状动脉和心肌微循环血流的影响

 目的　探讨硝酸甘油 (NTG)对犬心表冠状动脉和心肌微血管血流量的影响。方法　静脉注射NTG20μg·min^-1后 ,应用心肌对比超声心动图(MCE)测量心肌微血管血流量,动脉血流仪测量冠状动脉前降支血流量,超声心动图测量心脏腔径和容积。结果　NTG20μg·min^-1对心表冠状动脉和心肌微血管的血流量均无明显影响[注射NTG前后前降支血流量分别为:(13.94±2.92),(14.57±4.73)mL·min^-1;A·β值分别为:(45.49±14.28),(80.08±36.72),P均>0.05];NTG对心率、血压、平均动脉压、中心静脉压和冠状动脉血管阻力也无明显影响。但可明显减少心脏腔径和心腔容积,尤其右心腔径和容积减少更明显;与舒张末期容积比较,NTG对心脏收缩末期容积影响更大。结论　NTG对心表大冠状动脉和心肌微血管的血流量无影响。其抗心绞痛的作用是通过减少心脏容积和心室壁张力,继而减少心肌耗氧量而达到的。     

Effect of different twirling and rotating acupuncture manipulation techniques on the blood flow perfusion at acupoints

OBJECTIVE: To analyze the effect of different twirling and rotating acupuncture manipulation techniques on the blood flow perfusion at acupoints to provide a reference for the study of acupoint specificity and the quantification and effectiveness of acupuncture methods.METHODS: Twenty healthy male or female college students each received four different acupuncture manipulation techniques, including simple acupuncture, uniform reinforcing-reducing needling,twirling reinforcing needling, and twisting reducing needling.The self-control method was applied.Acupuncture was performed by an acupuncture manipulation simulator at Neiguan(PC 6) and Zusanli(ST 36).The process of twirling and rotating was divided into seven timepoints.The PeriCam Perfusion Speckle Imager(PSI) System was used to collect the blood flow perfusion data at each acupoint.The specificity of twirling and rotating acupuncture manipulation was analyzed based on changes in the curve, video, and numerical blood flow perfusion data at each timepoint.RESULTS: There were two peaks in the blood flow perfusion curve of twirling and rotating acupuncture manipulation; one appeared after 3 min of needle retention, and the other appeared 3 min after needle removal.The blood flow perfusion parameters showed that the greatest differences between the four manipulation techniques occurred after 5 and 10 min of needle retention.The specificity of various manipulation techniques was most obvious at these two timepoints.There were significant differences between the four manipulation groups in the blood flow perfusion and the relative change rates of blood flow perfusion at each timepoint.CONCLUSION: Laser speckle imaging enables the real-time, non-invasive, rapid, and accurate collection of blood flow perfusion data during acupuncture.This imaging technique enables the easy attainment of various parameters such as visual images, two-dimensional curves, and data tables.At various timepoints, the four groups significantly differed regarding changes in blood flow perfusion and relative change rates of blood flow perfusion,which facilitated the differentiation of the four acupuncture manipulation methods.Based on this, further analysis could be conducted to study spatial distribution characteristics such as the influence area and flare area.The frequency domain analysis of acupuncture manipulation curves is important in the study of the dose-effect relationship and specificity of acupuncture manipulation.     

天津地区季节及节气变化对不同人群血压影响临床观察

[目的]初步探索季节及节气变化对1级高血压、正常高值血压及正常血压受试者血压的影响规律。[方法]同期筛选符合纳入排除标准的1级高血压、正常高值血压及正常血压受试者各10例,记录全年血压数据,按季节、节气建立数据库,运用SPSS 19.0软件进行统计分析。[结果]1)季节变化对血压的影响:1级高血压组冬季收缩压(SBP)及舒张压(DBP)均较秋季升高(P0.05),春季均较冬季下降(P0.01);夏季SBP较春季下降(P0.05),秋季较夏季升高(P0.05)。正常高值血压组冬季SBP较秋季升高(P0.01),夏季较春季下降(P0.01),夏秋季节变化不明显(P0.05)。正常血压组SBP及DBP四季间均无明显变化(P0.05)。2)节气变化对血压的影响:1级高血压组SBP在霜降至立冬、立冬至小雪、冬至至小寒、立春至雨水节气交替时波动明显(P0.05),DBP在立冬至小雪、立春至雨水节气变化时波动明显(P0.05);正常高值血压组SBP在小寒至大寒的节气变化时也有明显波动(P0.05);正常血压组SBP、DBP在各节气转化时均较平稳(P0.05)。[结论]1级高血压、正常高值血压者的血压呈现季节性变化,总体呈春降、夏低、秋平、冬高的规律;1级高血压者血压在冬、春季节变化时波动明显,特别是在立冬、小雪、小寒、雨水节气到来时要加强血压管理。     

银杏总内酯注射液对实验性脑缺血及脑血流量的影响

目的:观察银杏总内酯注射液对实验性脑缺血及脑血流量的影响。方法:用小鼠结扎双侧颈总动脉和断头模型观察动物存活和喘息时间;大鼠结扎双侧颈总动脉,观察脑缺血大鼠脑血管通透性;大鼠脑缺血再灌试验,观察血清SOD、MDA的水平;以电磁流量计探头测定麻醉犬颈总动脉血流量,观察脑血流量和脑血管阻力的变化。结果:银杏总内酯注射液1.5mg/kg可明显延长小鼠存活和喘息时间,抑制大鼠脑血管通透性。3.0mg/kg可提高大鼠血清SOD含量、降低MDA水平。0.75mg/kg明显增加麻醉犬脑血流量,降低脑血管阻力。结论:银杏总内酯注射液对脑缺血及脑血流量具有明显改善作用。     

Infrared radiation temperature comparison on body surface of points between healthy people and patients with hyperplasia of mammary glands

目的：比较乳腺增生病患者与正常人穴位体表红外辐射温度的差异。方法：采用ThermaCAMTMP30红外热像仪，检测74名乳腺增生病患者和63名身体健康，无乳腺增生病的正常人四条经脉八个穴位的体表红外辐射温度。结果：乳腺增生病患者右幽门穴的体表红外辐射温度显著高于正常人的右幽门穴的体表红外辐射温度（P=0．009）.左幽门穴及所测其余各穴的红外辐射温度患者与正常人无明显差异（P〉0.05）.结论：乳腺增生病患者与正常人右幽门穴的红外辐射温度有显著差异，这种差异可能与乳腺增生病的病才暇幽门穴的特异性有关。     

不同电针刺激频率对脑卒中患者脑血流灌注和脑功能的影响

目的:寻找治疗脑卒中的适宜电针刺激频率.方法:47例脑卒中患者电针头皮运动区,根据其频率分为2 Hz、2/15 Hz、100 Hz组,应用单光子发射型计算机断层(SPECT)观察3组患者电针前和电针中脑血流灌注和脑功能的变化.结果:三种不同的电针刺激频率均能改善脑卒中患者的局部脑血流灌注和脑细胞功能活动,2/15 Hz和100 Hz组较2 Hz组为强.结论:在刺激强度固定的条件下,2/15 Hz、100 Hz的刺激频率治疗脑卒中疗效较好.     

不同时辰针刺对金黄地鼠自发活动及体温昼夜节律的影响

目的:研究针刺调整生物昼夜节律的时间规律性.方法:在子、午、卯、酉不同时辰电针金黄地鼠"肾俞"穴,运用时间生物学研究方法观察分析不同时辰针刺对动物自发活动及体温昼夜节律的不同影响.结果:对于自发活动昼夜节律,午时针刺使其节律振幅降低(P<0.05),卯时针刺使其节律峰相位迟后(P<0.05),酉时针刺使其节律峰相位超前(P<0.05);对于体温昼夜节律,卯、酉时针刺对节律峰相位有一定程度的影响,卯时针刺使峰相位迟后22.36度,酉时针刺使峰相位超前39.32度.     

银杏叶提取物对华法林人体内抗凝血功能和血药浓度的影响

目的:研究银杏叶提取物对华法林在人体内药动学和药效学的影响.方法:采用随机、单盲、双周期交叉、安慰荆对照试验设计.12名健康志愿者(男女各半)随机分为2组,连续5周每日分别服用银杏叶片(EGB,每片含总黄酮醇苷9.6mg,萜类内酯2.4 mg)或安慰剂2粒,1日3次;29 d口服单剂量华法林5 mg;第2周期2组交叉服用安慰剂或银杏叶片,其余给药方案不变.按要求收集志愿者血样,分别以半自动血凝仪测定常见凝血指标,以HPLC测定华法林的血药浓度.结果:单独服用银杏叶提取物4周后,华法林凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)无显著变化.华法林药动学参数Cmax,AUC0-144,AUC0-∞,t1/2显著增加(P＜0.05);CL(F)显著减小(P＜0.05),tmax和Vd(F)没有显著变化.结论:银杏叶提取物可影响华法林的药动学指标,但不影响华法林的药效学;单独服用银杏叶提取物4周对凝血功能无明显影响.     

膝骨关节炎患者膝关节区域局部皮温与临床症状及炎症因子的相关性研究

目的研究膝骨关节炎患者膝关节区域局部皮温与临床症状及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)]水平的相关性。方法随机选择膝骨关节炎患者104例,以近红外成像拍照技术采集患者膝关节区域局部温度,运用WOMAC评分评定患者临床症状,同时采用ELISA法测定患者血浆TNF-α、IL-6、IL-1β水平,利用Spareman相关和偏相关性分析膝关节各区域皮温与WOMAC评分、炎性因子水平的相关性。结果校正相关协变量后,膝关节内侧胫骨平台区温度与WOMAC功能评分及总体评分均具有相关性(r=0.203,P=0.043;r=0.205,P=0.041);膝关节内侧胫骨平台区、外侧胫骨平台区、股骨内侧髁区、股骨外侧髁区、髌上区及整个膝关节的皮温与血浆IL-1β水平均呈正相关(r=0.263,P=0.013;r=0.224,P=0.036;r=0.236,P=0.027;r=0.269,P=0.011;r=0.246,P=0.021;r=0.269,P=0.011)。结论膝骨关节炎患者膝关节区域局部皮温不仅可以反映患者膝关节临床症状的严重程度,而且还能体现患者体内的炎症水平。