针刺四白及内庭穴对胃蠕动功能的影响

目的：观察针刺足阳明经上下对应的四白、内庭穴对胃蠕动功能的影响，进一步探讨足阳明经与胃的相关规律。方法：选择１２例正常人及３例胃疾病患者为观察对象，对其四白、内庭及左右旁开对照点进行针刺，并以Ｂ超显像观察针刺前后胃蠕动波频率、电子标尺测蠕动波幅，同时摄片记录。结果：针刺足阳明经的四白、内庭穴对胃蠕动功能有特异性影响。结论：足四明经四白、内庭穴对其相应的内脏有特异性，为临床调整消化系统功能的有效穴。     

B超显象观察针刺足阳明经下肢段穴位对胃窦面积的影响

目的通过B超显象观察针刺足阳明经下肢段穴位对胃窦面积的影响，而探讨足阳明经与胃的相关性．方法选用足阳明经下肢段伏兔、梁丘、足三里、上巨虚、冲阳、内庭6个穴组，每组15例，每例均接受经穴及左右旁开1cm对照点的观察．刺激方法为针刺手捻针，观察记录方法为B超显示屏上直接观察，同步用日产日立录像机记录，观察过程为针前记录3min,针刺中记录3min，将记录的信号输入到计算机中每Zs采样一次，6min共捕获图象180幅，以象素为单位，计算鲁窦的面积、上下径、前后径、统计学处理采用配对t检验，组间比较用方差分析及Q检验（方差不齐时采用秩和检验）结果针刺足三里、上巨虚、冲阳、内庭4个穴位后都能使胃窦面积明显增大，与针前比较P值分别＜0．05和0．01，而针刺穴位左右对照点则作用不明显．针刺足三里、冲阳2穴后能使胃窦上下径明显增大，与针前比较P＜0．05．对胃窦前后径的变化起作用的穴位只有足三里1穴．结论针刺足阳明经下肢段穴位对胃运动功能确有特异性影响     

针刺足阳明经穴对兔胃粘膜损伤前后胃运动功能的影响

目的 :通过针刺足阳明经穴对兔胃粘膜损伤前后胃运动的观察 ,进一步探讨足阳明经与胃的相关规律。方法 :对 40只大耳白兔运用无水乙醇灌胃 ,造成胃粘膜损伤模型 ,然后观察针刺对胃粘膜损伤前后胃运动功能的影响。结果 :胃粘膜损伤造模前后 ,胃运动振幅指数百分率比较差异有显著性意义 ,造模后振幅指数显著下降 ,与造模前比较 P <0 .0 1,针刺四白、足三里穴能增强胃运动 ,针刺后比刺前胃运动振幅指数显著升高 (P <0 .0 1) ,尤以四白穴最为显著 ,且在胃粘膜损伤后 ,同样能增强胃的运动。结论 :胃粘膜损伤后 ,胃运动振幅指数显著下降 ,针刺足阳明经穴后可使胃运动振幅指数上升 ,提示足阳明经与胃具有相关性。     

针刺足阳明经穴对大鼠胃运动及脑肠肽的影响

目的：探讨针刺足阳明经穴对胃运动的调整作用与脑肠肽的关系。方法：以乙醇灌胃造成大鼠胃粘膜损伤模型,气囊法测量胃运动频率和波幅的变化率,采用放免分析法（RIA）检测大鼠胃窦及延髓内P物质（SP）、胃动素（MTL）及胃泌素（GAS）含量。结果：模型组胃运动频率和波幅呈抑制状态,针刺四白、天枢、足三里穴可促进胃运动恢复,与此同时胃窦、延髓内SP、MTL、GAS含量出现相应变化。三穴比较：四白主要影响胃窦MTL含量,天枢主要影响胃窦SP及延髓GAS含量,足三里穴对SP、MTL及GAS均有影响。结论：推测针刺足阳明经对胃运动的调整作用有脑肠肽参与,但上述三穴对胃运动的影响所涉及的脑肠肽不完全一致。     

针刺足阳明经穴对健康人血浆胃动素及胃泌素含量的影响

进一步探讨足阳明经与胃运动内在联系的物质基础。方法对50例健康人针刺前后各采血5ml,采用放射免疫分析法测量血浆胃动素、胃泌素的含量。结果针刺四白、足三里穴后,血浆胃动素的含量明显升高,与针前相比差异有显著性意义(P＜0.05),针刺四白旁对照点后血中胃泌素明显升高,与针刺前相比差异有显著性意义(P＜0.05)。结论针刺足阳明经穴位可使血浆胃动素含量上升,与胃运动增强呈平行关系,提示胃运动增强有胃动素的参与。     

针刺足阳明经穴对健康人血浆胃动素及胃泌素含量的影响

目的：进一步探讨足阳明经与胃运动内在联系的物质基础,方法：对50例健康人针刺前后各采用5ml,采用放射免疫分析法测量血浆胃动素,胃泌素的含量,结果：针刺四白,足三里穴后,血浆胃动素的含量明显升高,与针前相比差异有显著意义（P＜0．05）,针刺四社对照点后血中胃泌素明显升高,与针刺前相比差异有显著性意义（P＜0．05）,结论：针刺足阳明经穴位可使血浆胃动素含量上升,与胃运动增强呈平行关系,提示胃运动增强有胃动素的参与。     

电针足阳明经穴对胃粘膜损伤大鼠胃粘膜血流量及生长抑素的影响

目的 :观察电针足阳明经“四白”、“天枢”、“足三里”穴对胃粘膜损伤大鼠胃窦和延髓内生长抑素(SS)含量的影响及与胃粘膜损伤、胃粘膜血流量的关系 ,以探讨经脉 -脏腑相关的物质基础。方法 :健康 SD大鼠 6 0只 ,随机分为正常对照组 (对照组 ) ,模型组 ,针刺四白组、天枢组及非穴点组共 6组 ,以乙醇灌胃造成胃粘膜损伤大鼠模型 ,观察电针大鼠足三里、天枢、四白穴对胃粘膜血流量 (氢气清除法 )的影响 ,用放免分析法检测大鼠胃窦及延髓 SS含量。结果 :胃粘膜血流量在胃粘膜损伤后明显降低 ,针刺四白、天枢、足三里及非穴点后 ,均有不同程度升高 ,尤以足三里和四白组升高明显 (P<0 .0 1) ;胃窦及延髓 SS模型组较对照组升高 (P<0 .0 5 ,<0 .0 1) ,而针刺四白、足三里组升高不明显 (P>0 .0 5 )。结论 :胃窦、延髓 SS含量变化与胃粘膜血流量的改变有一定关系 ,电针足阳明经四白、足三里穴可能通过对胃窦及延髓 SS含量的改变来影响胃粘膜血流量 ,促进胃粘膜损伤的修复。     

针刺足阳明经特定穴治疗功能性消化不良30例

目的:分析针刺足阳明经特定穴治疗功能性消化不良(FD)的临床疗效,探讨针刺足阳明经特定穴对FD的经穴效应特异性.方法:将60例FD患者随机分到治疗组(A)和对照组(B)各30例.治疗组针刺足阳明经特定穴,对照组针刺非经非穴.两组均每日针刺1次,每次0.5 h,每周5次为1个疗程,治疗4个疗程.分别于治疗前、治疗完成、治疗后1 mo由受试者填写尼平消化不良指数(NDI),包括症状指数(NDSI)和生活质量指数(NDLQI),消化不良症状积分(FDI),健康相关生活质量评分(SF-36).统计与分析所获资料.结果:治疗组各种症状的疗效高于对照组.治疗组各症状上腹饱胀不适、早饱、上腹痛、上腹烧灼感的总有效率分别为85.72%、78.26%、94.11%、60.00%,明显高于对照组(19.23%、20.00%、6.25%、7.69%),差异有统计学意义(P<0.01);治疗完成和1 mo随访时,两组相对治疗前NDSI,FDI均显著降低,NDLQI,SF-36均显著增加(均P<0.01);且同期比较治疗组NDSI,FDI明显低于对照组,NDLQI,SF-36明显高于对照组(均P<0.01).结论:针刺足阳明经特定穴与非经非穴治疗FD都是有效的治疗方法,但前者治疗FD近期疗效(治疗完成)和远期疗效(治疗后1 mo)都明显优于后者.     

针刺少阳经特定穴对偏头痛患者脑动脉血流速度的影响

目的 观察针刺手少阳三焦经和足少阳胆经特定穴对偏头痛患者脑血流速度的影响,并探讨其可能的作用机制.方法 将60例偏头痛患者随机分为两组,少阳经特定穴组30例,非经非穴组30例,均采取同样的针刺治疗方法,进行对照观察.在TCD的显示下,分别记录针刺前后的脑动脉血流速度.结果 针刺少阳经特定穴组的患者脑血流速度明显改善,而非经非穴对照组未见有明显改变,经统计学处理两组有统计学意义(P<0.05).结论 针刺少阳经特定穴对偏头痛患者的脑动脉血流速度有较好双向调节作用.     

基于数据挖掘探讨针刺治疗儿童抽动障碍的选穴规律

目的:基于数据挖掘探讨针刺治疗儿童抽动障碍的选穴规律。方法:检索中国知网、万方医学网、维普数据库、PubMed、EMbase有关针刺治疗儿童抽动障碍的相关文献,检索时限为2002年2月—2022年2月,统计分析针刺治疗儿童抽动障碍的主配穴使用频次、中医证候分布及穴位归经等。结果:最终纳入文献71篇,涉及穴位处方95个,其中主穴94个,配穴99个,主穴总取穴频次为438次,使用频次前10位的依次为百会、太冲、合谷、三阴交、四神聪、风池、印堂、神门、内关、神庭;配穴总取穴频次为427次,使用频次前10位的依次为地仓、迎香、廉泉、太阳、颊车、足三里、丝竹空、攒竹、丰隆、肩井。儿童抽动障碍的中医证型分布频次前5位的依次为肝亢风动证、脾虚肝亢证、阴虚风动证、脾虚痰聚证、风痰扰动证。腧穴归经频次前5位的依次为足阳明胃经、督脉、经外奇穴、足太阳膀胱经、手阳明大肠经。对12个高频主配穴进行聚类分析,共得到6个新组合：百会、风池;太冲、合谷;三阴交、足三里;肝俞;神门、内关;四神聪、神庭、印堂。结论:针刺治疗儿童抽动障碍的选穴规律以调神为主,祛风扶正为辅。     

胃经穴位电针对胃运动的调节及对星形胶质细胞GFAP、小胶质细胞OX42表达的影响

目的探讨电针刺激胃经穴对胃运动的调节作用及其作用机制，明确星形胶质细胞和小胶质细胞在其中的作用。方法采用同步实验，在电针足三里穴、上巨虚穴及非经非穴等穴位的情况下，应用免疫组织化学染色的方法，通过对胶质原纤维酸性蛋白（glial fibrillary acidic protien，GFAP）和OX42的ABC法染色，观察延髓内脏带（medullary visceral zone，MVZ）的迷走复合体（dorsalvagalcomple，DVC）中与疼痛密切相关的神经星形胶质细胞（astrocyte，AS）和小胶质细胞（microglia cells）的变化，同时采用浆膜法检测胃电的变化。结果电针刺激足三里穴，在延髓内脏带中的迷走复合体中神经胶质细胞变化及胃电的变化情况均较明显，与电针刺激胃经其他穴位存在显著差异。结论胃经穴位电针对胃运动具有调节作用。这种调节作用的实现，与疼痛作用密切相关。     

Effects of posture on the physiology of gastric emptying: a magnetic resonance imaging study

OBJECTIVE: Gastric contents empty from the stomach despite frequent changes in body position. The mechanism that maintains gastric emptying independent of position is poorly understood. The aim of this study was to determine the effects of body position on gastric emptying and motor function. MATERIAL AND METHODS: Twelve volunteers were investigated in seated position (SP) and upside-down position (UDP) after ingestion of 300 ml water. Magnetic resonance imaging provided a non-invasive assessment of gastric emptying and volumes, intragastric distribution and peristaltic function. RESULTS: A marked difference in distal/proximal intragastric distribution between UDP and SP was present (7% versus 40%; p < 0.01). Gastric-emptying time was similar but emptying pattern was linear in UDP and exponential in SP. Peristalsis was slower in UDP than SP (2.75 versus 2.96 min-1; p < 0.01), but no correlation was found between peristaltic frequency and the rate of gastric emptying in either position. Postprandial volume response (gastric relaxation) was greater in UDP than SP (280 versus 250 ml; p < 0.05). A correlation was found between gastric relaxation and gastric-emptying time in SP (r2=0.46) but not in UDP. CONCLUSIONS: The stomach maintains the rate of gastric emptying despite radical changes in body position and intragastric distribution of gastric contents. In SP, hydrostatic pressure (modulated by gastric tone) dictates the gastric emptying. In UDP, gastric emptying also appears to be mediated by continuous adaptation of gastric tone. These findings provide support for the hypothesis that the mechanism of gastric emptying resembles a "pressure pump" rather than a "peristaltic pump".     

Electroacupuncture Accelerates Solid Gastric Emptying and Improves Dyspeptic Symptoms in Patients with Functional Dyspepsia

The aims of this study were to investigate the effects of electroacupuncture (EA) at ST36 and PC6 points on solid gastric emptying and dyspeptic symptoms in patients with functional dyspepsia. Nineteen patients with functional dyspepsia (FD) were involved in the study, consisting of two parts: (1) acute effects of EA on solid gastric emptying in FD patients with delayed gastric emptying and (2) short-term (2-week) effects of EA on symptoms in FD patients with normal gastric emptying. Results were as follows. (1) Ten of the19 patients showed delayed gastric emptying of solids, and acute EA significantly improved delayed gastric emptying; the halftime for gastric emptying was reduced from 150.3±48.4 to 118.9±29.6 min (P=0.007). (2) In the nine patients with normal gastric emptying, 2-week EA significantly decreased the symptom score, from 8.2±3.3 at baseline to 1.6±1.1 (P < 0.001) at the end of treatment. We conclude that EA at the ST36 and PC6 points accelerates solid gastric emptying in FD patients with delayed gastric emptying and relieves dyspeptic symptoms in FD patients with normal gastric emptying.     

电针四白穴对神经阻断大鼠胃肌电的影响

目的:探讨电针四白穴,对大鼠胃肌电兴奋途径．方法:大鼠32只,随机分为4组．选用ip抗胆碱能M受体阻断剂阿托品、交感神经节阻断剂六羟季胺和肾上腺素能神经阻断剂利血平,观察电针四白穴对神经阻断大鼠胃肌电的影响．结果:大鼠腹腔注射阿托品、六羟季胺后,慢波高活动相平均振幅、慢波高活动相时程／慢波周期比值以及快波平均峰簇数下降(P<0．01, P<0．05,P<0．01);注射利血平后,以上三种参数分别升高(P<0．01,P>0．05,P<0．01)．针刺四白穴能部分取消阿托品、六羟季胺对大鼠胃肌电的抑制效应(P<0．05或P>0．05)．结论:电针足阳明经四白穴对胃调控作用的外周通路既有胆碱能神经、交感神经系统的参与,又有肾上腺素能神经系统的参与．     

Assessment of gastric motor function by cine magnetic resonance imaging

Background and Aim:  The aim of the present study was to evaluate gastric motor function by magnetic resonance imaging (MRI) and investigate whether this examination is a useful tool for therapeutic efficacy or postoperative gastric motor function.
Methods:  Twenty-five healthy volunteers and 10 gastric cancer patients with pylorus-preserving gastrectomy (PPG) underwent cine-MRI. Gastric volume was determined by 3D-volumetry. Gastric motility was quantified by calculating the gastric motility index (GMI).
Results:  The image acquisition and analysis were successfully carried out for all subjects. In healthy volunteers, mean frequency, amplitude, velocity of gastric peristaltic waves and GMI 30 min after the intake of jelly were 3/min, 8.8 mm, 2.2 mm/s and 19.6 mm²/s, respectively. Mean amplitude (8.8 vs 10.4 mm, P  = 0.027), velocity (2.2 vs 2.6 mm/s, P  < 0.001) of peristaltic waves, and GMI (19.6 vs 26.7 mm²/s, P  < 0.001) significantly increased at 30 min after giving mosapride citrate (MS). Mean gastric volume after MS administration was significantly decreased; 0 min (317.3 vs 272.9 mL, P  = 0.021), 45 min (263.4 vs 206.4 mL, P  = 0.004) and 60 min (228.7 vs 165 mL, P  = 0.001). PPG patients with postprandial symptoms were observed having antiperistalsis-like contraction waves and reflux of gastric contents from the pyloric region into the upper part of the stomach. Mean gastric volume in PPG patients with postprandial symptoms at 30 min after intake of jelly tended to be greater than in those without such symptoms.
Conclusions:  The present study demonstrates that cine-MRI is a sensitive and non-invasive imaging technique for simultaneously measuring gastric motility and emptying.     

Enhanced expression of epidermal growth factor receptor gene in gastric mucosal cells by the serum derived from rats treated with electroacupuncture at stomach meridian acupoints

INTRODUCTION Gastric mucosal damage is a common pathological reaction in the diseases of the digestive system. The acupuncture and moxibustion are very effective cure for this damage[1,2]. Previous experimental studies demonstrated that epidermal growth factor (EGF) and transforming growth factor-α (TGF-α) were the most important peptides for the repair of the gastric mucosal injury[3]. Acupuncture at gastric meridian acupoint could alter gastric motility and secretion and also the co…     

Relationship between the gastric myoelectric and mechanical activity in the genesis of ulcers in indomethacin-insulin-treated rats

We have proposed that gastric contractile activity mechanically induces ulcers in the nonsteroid antiinflammatory drug (NSAID)-treated rat. This study examines first the relationship between number (dose) of peristaltic contractions applied to the mucosa and the ulcer score. Second, it examines the relative roles of: altered gastric myoelectrical activity (MEA) resulting from indomethacin (Indo) pretreatment, insulin-induced gastric peristalsis, and a combination of the two in the generation of mucosal lesions. Third, it examines the effect of exogenous prostaglandin on the Indo-altered MEA and relates it to ulcerogenesis. Indo pretreatment increased gastric tone and MEA. In such animals, the dose of peristaltic contractions applied to the gastric wall was related to the ulcer score in a dose-dependent manner. Exogenous prostaglandin (PG) reversed the MEA effect of Indo and reduced ulceration. It is postulated that an altered smooth muscle state secondary to inhibition of prostaglandin synthesis (PG-S) renders the mucosa vulnerable to injury by peristaltic action.This study was supported by the Fast Foundation.     

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

SUMMARY.  There is controversy in the literature regarding the motor function behavior of the lower esophageal sphincter and esophagus following partial gastrectomy. We studied 26 patients with gastric adenocarcinoma of the distal corpus and/or antrum who underwent radical subtotal gastrectomy with Roux-en-Y reconstruction. There were 15 women (57.69%) and 11 men (42.31%) with a mean age of 57.2 years; 21 were White (80.8%) and five were of African descent (19.2%). Before the surgery and 3 months afterwards, every patient underwent manometric and endoscopic examinations. The lower esophageal sphincter showed reductions in mean respiratory pressure (19.41–15.59 mmHg, P = 0.02) and maximum expiratory pressure (8.13–5.54 mmHg, P = 0.02) without significant alteration in diaphragmatic crura pressure (32.92–30.64 mmHg, P = 0.37). An increase in peristaltic wave amplitude (91.43–124.86 mmHg, P < 0.01) and peristaltic wave conduction velocity (3.29 cm/s to 4.23 cm/s; P = 0.024) were detected in esophageal function. The presence of erosive esophagitis decreased from 10 (38.46%) patients to none ( P = 0.002). We concluded that following surgery the lower esophageal sphincter function was impaired, through decreased pressure in the esophageal component without alteration in diaphragmatic crura pressure. On the other hand, there was significant increase in peristaltic wave amplitude and velocity, and improvement of the erosive esophagitis. The authors suggest that subtotal gastrectomy, with gastroesophageal junction preservation, and Roux-en-Y reconstruction should be the preferred operation for distal gastric cancer to minimize esophageal dysfunction and gastroesophageal reflux disease.     

Effect of Helicobacter pylori eradication on gastroesophageal function

BACKGROUND: To elucidate the cause of possible occurrence of reflux esophagitis after Helicobacter pylori eradication, gastric and esophageal function among H. pylori infected Japanese patients were evaluated both before and after eradication therapy. METHODS: Nine H. pylori-positive patients were studied before and 6 months after successful H. pylori eradication. Studies included gastric emptying, esophageal manometry, gastric and esophageal pH monitoring as well as measuring serum levels of gastrin, pepsinogen I and pepsinogen II. RESULTS: Helicobacter pylori eradication was associated with a significant change in serum gastrin and pepsinogen levels, consistent with the improvement in mucosal inflammation. There was no significant change in gastric emptying, fasting or postprandial lower esophageal sphincter (LES) pressure, esophageal primary peristaltic contractions, frequency of transient LES relaxation, or gastroesophageal reflux, as assessed by 24 h pH monitoring. The percent time of the gastric pH>4 at night decreased significantly. A 41-year-old male developed erosive gastroesophageal reflux disease (GERD) (Los Angeles Classification Grade A) after eradication. Physiological studies showed he had abnormal esophageal motility prior to H. pylori eradication. CONCLUSIONS: With the exception of gastric pH at night, most patients did not experience a significant change in gastric or esophageal function after H. pylori eradication. Development of GERD post H. pylori eradication likely reflects an increase in the acidity of the refluxate superimposed on pre-existing abnormalities in gastroesophageal motility.