针刺联合太阳穴穴位注射治疗外伤性视神经损伤案

外伤性视神经损伤,中医诊断为撞击伤目,瘀血阻络证。本案运用针刺联合太阳穴复方樟柳碱注射液穴位注射的方式对其进行治疗,最大限度地发挥针刺与药物的双重刺激作用,从而达到振奋目系阳气,疏经通络,活血化瘀,补益气血的目的。     

中西医结合诊治环孢素A慢性肾毒性的思路与方法

环孢素A长期使用所致慢性肾毒性限制其临床应用。环孢素A慢性肾毒性发病机制涉及内质网和氧化应激、炎症反应、自噬、细胞凋亡、肾素-血管紧张素系统等方面，中医病机以气虚为本，湿、热、浊毒、血瘀等病理实邪为标。现代西医传统治疗手段难以有效抑制其进展，中医药防治多以益气、活血、清泄为治则，多靶点抑制炎症、凋亡、自噬、抗氧化、改善血流动力学等。通过对近年来在益气活血清泄治则指导下中医药治疗环孢素A慢性肾毒性的研究综述，结合西医病理及相关通路，深入探讨不同病理阶段的病因病机及中西医结合遣方用药的思路与方法，更好地发挥中西医结合优势，为环孢素A安全有效地应用于临床提供理论依据。     

庄礼兴教授调神针法治疗舌咽神经痛思路探微

文章通过详细剖析庄礼兴教授运用调神针法治疗舌咽神经痛验案1例,介绍庄教授治疗舌咽神经痛从调神入手,于合谷穴行导气同精法,以达通经活络,气畅神和的独到思路.其能在减少西药服用量的同时,镇痛效果明显,最大程度缓解患者痛苦,对于舌咽神经痛的针刺治疗具有较好的临床意义.     

火针围刺联合夹脊电针治疗急性期带状疱疹:随机对照试验（英文）

目的:比较火针围刺联合夹脊电针治疗急性期带状疱疹的临床疗效,并通过血清炎性因子和疼痛介质水平的变化探讨其改善疼痛症状的可能机制。方法:将60例急性期带状疱疹患者随机分为针药组和西药组,西药组患者均给予甲钴胺和更昔洛韦治疗,连续治疗14天。针药组在西药组的基础上加用火针围刺(以皮损部位为中心运用火针方法向中心快速刺入)联合夹脊电针(取皮损部位一致的神经节段及上、下各一节段的夹脊穴连取连续波通电治疗)的方法,每日1次,共治疗14天。观察两组患者从出现疱疹到结痂脱落的疱疹症状改善情况,比较两组患者治疗前后疼痛视觉模拟量表(VAS)评分及血清炎性细胞因子(IL-1 β、IL-6、TNT-a)和疼痛介质水平(CGRP、SP)的变化,比较两组患者治疗前后及随访1个月后匹兹堡睡眠指数量表(PSQI)评分、汉密尔顿抑郁量表(HAMD)评分,评估两组患者临床疗效及随访1个月后遗神经痛的发生率。结果:治疗结束后,针药组疱疹的止疱时间、结痂时间、脱痂时间,明显短于西药组(all P<0.05)。治疗后两组患者VAS评分、PSQI评分、HAMD评分均较同组治疗前明显降低(P<0.05),且针药组与...     

Observation on clinical efficacy of acupuncture combined with direct moxibustion with fine-strip moxa for 62 cases of herpes zoster

ObjectiveTo evaluate the clinical effect of acupuncture combined with direct moxibustion with fine-strip moxa for herpes zoster.MethodsSixty-two patients with herpes zoster were randomly divided into two groups according to attendance number, 32 in acupuncture group and 30 in western medicine group. The patients in the acupuncture group were treated by acupuncture at the nidus-related nerve segments Jiāj

(

EX-B2) in combination with direct moxibustion with fine-strip moxa, while the patients in the western medicine group were treated by oral valaciclovir hydrochloride, vitamin B₁, vitamin B₁₂. The times of response, incrustation and decrustation were observed respectively, and pain relief degree of the two groups were compared.ResultsThe response time, incrustation time and decrustation time of the acupuncture group were all less than those of the western medicine group [(1.74±0.43) days vs (3.86±0.58) days, (2.03±0.52) days vs (5.46±0.65) days, (5.14±0.33) days vs (8.34±0.59) days, all P<0.05]. The pain relief degree (VAS score), and pain duration in the acupuncture group were all higher obviously than those of the western medicine group [(10.41±12.1) vs (15.63±11.39), (4.78±0.45) days vs (8.12±0.63) days, all P<0.05]. The total effective rate of the acupuncture group was 96.9% (31/32) and that of the western medicine group was 90% (27/30), thus the therapeutic effect of acupuncture group was better than that of western medicine group (P<0.05).ConclusionThe therapeutic effect of acupuncture combined with direct moxibustion with fine-strip moxa is remarkable. It can effectively control the development of herpes zoster, alleviate pain and shorten therapy periods. It is worthy to be promoted and applied.     

A Study on the Classification and the ‘Catching’ of the ‘Arrived Qi’ in Acupuncture

This essay studies the phenomenon of ‘obtaining of qi’ in acupuncture. Combined with clinical practice, the authors think that it was a habitual misunderstanding in the past to equate ‘needling sensation’ to ‘obtaining of qi’ in acupuncture practice. The two concepts are different and are related with each other. The authors have also classified the phenomenon of ‘obtaining of qi’ according to its depth in the skin layer. Based on the research achievements in neuroscience, the authors propose the study on ‘catching’ the specific cerebrations, so as to reveal the essence of ‘obtaining of qi’.     

疏利三焦针法合汤药治疗功能性尿潴留经验总结

文章总结了王耀光教授运用疏利三焦针法合汤药治疗功能性尿潴留的临床经验,首先阐述了尿潴留的中西医病因病机及分类,然后介绍了王教授从三焦辨证论治功能性尿潴留的学术思想,重点论述了疏利三焦针法的理论基础及其应用范围,最后分享了王教授运用疏利三焦针法配合汤药治疗功能性尿潴留验案2则。     

Akupunktur und Schmerz – eine Historie in 3 Teilen: Teil 2: Der Weg der Akupunktur in die moderne Schmerztherapie

Background

In modern pain therapy, a more integral view on the patient has become prevalent. Interdisciplinary approaches for diagnosis and treatment have become established, especially regarding patients suffering from chronic pain. Besides the application of conventional pain medicine, alternative therapy options are being implemented. Here, especially acupuncture has become important since it emphasizes the unity of body, mind, and soul.

Aim

The historical evolution of the integration of acupuncture into pain therapy as well as the scientific knowledge regarding this therapeutic approach will be explained.

Methods

Extant literature about the development of pain therapy, acupuncture techniques, as well as results of basic research was interpreted in the context of daily clinical practice.

Results

Considering the changes that pain therapy experienced over the last century, the integration of acupuncture into increasingly important interdisciplinary treatment approaches appears almost as a logical consequence. The bio-psycho-social model representing the basis of modern pain therapy emphasizes the interrelation of pain syndromes and purely physical factors, the patient's life situation, and social background, in the same way as done in acupuncture therapy. In this context, the development of western acupuncture styles besides the traditional Chinese techniques is of special interest.

Discussion

The summary of the historical and scientific background of acupuncture and pain medicine reveals that interdisciplinary therapy and, especially the integral point of view represent relatively new approaches. Thus, further progress in the treatment of chronic pain patients can be expected.     

针灸在阿根廷的发展概况

1948年，针灸首次被介绍到阿根廷，但获得当地患者普遍信赖与接受，则有赖于来自中国大陆与台湾之针灸师们。目前，当地已熟悉针灸的西医欲独领此一医术，正在推动针灸立法，使这能正式纳入其医疗体系，并排斥非西医者学习及使用针灸。而在该国多年来一直推广中医针灸的团体则在积极努力争取使“中医针灸”亦能被未来的“针灸法令”所包容，并能建立一个从教育到临床的独立体系，以期在学术上能与“西医针灸”争鸣较劲，在临床上能与之合作共存，并被相关法令允许合法执业，与西医享有同等的地位。     

Studien zum Lingshu als Beitrag zur Bewertung klinischer Akupunkturstudien: – Punktlokalisation,Stichtiefe, De Qi

Background

Clinical trials on acupuncture use a variety of control methods, such as sham acupuncture, minimal acupuncture, and placebo. Frequently, needle insertion on non-classical acupuncture points (“minimal acupuncture”) is employed for this purpose. The aim of such clinical trials is to evaluate specific effects of acupuncture. There is a controversial discussion regarding the appropriateness of comparing “true” acupuncture to “minimal acupuncture”.Minimal and verum acupuncture are distinguished by various criteria, such as “localisation”, “depth of needle insertion”, and “induction of de qi”.

Aim

This study is dedicated to the question of what information the Huang Di Neijing, specifically the Lingshu-compilation which extensively focuses on needling techniques, has to offer regarding the above mentioned criteria, and their importance for successful acupuncture. In relation to this, it will be discussed if the definition of “minimal acupuncture” as used in the German Acupuncture Trials, is feasible.

Methods

The entire original text of the Huang Di Neijing Lingshu was searched for information regarding “point localisation”, “insertion depth”, and “induction of “de qi”. The paragraphs in question were compiled and probed on statements regarding the efficacy of treatment. These subsequently were compared to the technique of “minimal acupuncture” as in the German Acupuncture Trials (ART, GERAC).

Results

The analysis of the Lingshu shows that neither a specific point localisation, nor a certain insertion depth or the induction of de qi are clearly and in all cases relevant for a successful therapy. Rather, the Lingshu offers specific indications for superficial needling. Sites of acupoint localisation aren't clearly defined and the induction of de qi is not understood as mandatory for a successful therapy.

Conclusion

The criteria distinguishing „verum acupuncture” from „minimal acupuncture” as practiced in many clinical trials don't correspond to the early practice of acupuncture as documented in the Lingshu. This can be a possible explanation for the good clinical results of minimal acupuncture in a number of clinical trials.However, for further discussions of this problem the developments and the clinical evolution present-day acupuncture has undergone since the ancient times have to be held in account.     

王晓燕教授治疗郁病经验

郁病是一种临床常见的情感性精神疾病,相当于现代医学所指的癔症、焦虑性神经症、更年期抑郁、神经官能症等疾病。中医治疗郁病在改善患者症状,提高患者生活质量方面具有独特优势。王晓燕教授认为郁病以肝气郁结为主要病机,但不能以此统诸证,临床兼气虚气陷、阳郁阳虚、气机逆乱者多见,论治不能执泥于肝郁一证。在详辨病机的同时,注重病因施治,强调医患共同参与,临床效果显著。     

中医药治疗糖尿病足的研究进展

糖尿病足是糖尿病最常见的严重慢性并发症之一,较高的发病率与致残率显著降低了患者生活质量,造成巨大的经济与社会负担。糖尿病足的常见病因病机主要为先天禀赋不足、饮食不节、情志内伤、劳逸失度、跌扑损伤,而致气阴两虚、气血瘀滞、脉络瘀阻、湿热毒盛、脾肾阳虚等。其治疗主要涉及内治法、外治法以及其他疗法。其中,内治法通过辨证分期、分型论治,结合传统专方验方、单味药物等进行治疗,取得良好的效果,而富于特色的中医外治法则在辨证基础上,通过敷贴、清创、熏洗、艾灸、针灸等疗法获得显著疗效。但辨证分型不规范、临床与基础研究方案欠科学、临床疗效判定标准不统一等问题仍有待解决与改善。     

Discussion on the treatment of scapulohumeral periarthritis

The severity and location of scapulohumeral periarthritis should be identified for determining its treatment method: when the wei exterior is initially invaded by external pathogens for the first time, the location of disease is shallow, therefore, the shallow needling should be performed, which can contribute to diffusing and discharging pathogens of wei exterior. If pathogens had invaded for a long time, they can enter the ying level from wei level, so the acupuncture on ying level should be conducted to discharge the blood stasis and stagnation, thus removing the pathogenic qi and maintaining the healthy qi. If pathogens had invaded for a long time, the meridians and collaterals will be obstructed, and the penetration moxibustion method should be adopted to make the heat penetrate deeply, thereby achieving the effects of warming the meridians and expelling bi. The therapy should be chosen based on syndromes, so meridians can be dredged, and qi-blood can be harmonized, finally the disease will be cured. The precise determination of the location can ensure the success of manipulations. After the nature of disease is identified, targeted methods of acupuncture, bloodletting and fire needling can be performed for treatment of diseases, as a result, “normal physiological activities can be maintained”.     

中西医结合治疗消化性溃疡研究进展

从五个方面,即:中医辨证与西医辨病相结合、中成药与西药治疗相结合、中药局部治疗与西药联合治疗、应用现代医学理论指导中医组方用药、针灸与埋线疗法等论述中西医结合治疗消化性溃疡的研究进展。指出:中西医结合可以在保持原有单纯西药疗效的基础上,提高溃疡愈合质量,减少西药副作用。     

基于贝叶斯学派的中医药疗法治疗功能性肛门直肠痛的网状Meta分析＊

目的 运用网状Meta方法分析评价中医药疗法治疗功能性肛门直肠痛各项观察指标疗效，为其临床治疗提供循证医学依据。方法 计算机检索中国知网（CNKI）、维普网（VIP）、万方网（Wangfang）、PubMed、Web of science、Cochrane Library、CBM、Embase等数据库，检索临床应用中医药治疗功能性肛门直肠痛的随机对照实验（Randomized controlled trial，RCT），检索时限为建库至2021年7月。采用Cochrane5.1手册推荐的偏倚风险评估工具对纳入RCT进行质量评价。使用Stata、Winbugs及Revman软件进行数据分析及可视化。结果 最终纳入10项RCT，总样本量725例，共涉及11种干预措施。网状Meta分析结果表明，在总有效率方面，排名前3的干预措施为：止痛如神汤灌肠+长强穴封闭>止痛如神汤口服+外用>当归芍药散口服；在改善VAS评分方面，排名前3的干预措施为：止痛如神汤口服结合外用>止痛如神汤灌肠+长强穴封闭>中药坐浴联合针刺；在改善肛管静息压方面，排名前3的干预措施为：电针八髎穴>中药坐浴联合针刺>穴位注射下髎穴；在改善肛管收缩压方面，排名前3的干预措施为：穴位注射下髎穴>电针八髎穴>中药坐浴联合针刺；在安全性评价方面，排名前3的干预措施为：电针八髎穴>止痛如神汤灌肠+长强穴封闭>止痛如神汤口服+外用。结论 本研究所纳入的RCT中，中医药疗法治疗功能性肛门直肠痛对于各项观察指标的疗效均优于西医疗法，但此结论尚需进一步深入验证。     

益气活血方防治慢性肾脏病的研究进展

慢性肾脏病（chronic kidney disease,CKD）不仅能够导致肾衰竭，还会提高心血管事件的风险，是危害人类生命健康的常见疾病之一。现代研究认为，肾素-血管紧张素-醛固酮系统的激活、血管内皮功能障碍、氧化应激、炎症反应和蛋白尿等是CKD主要的发病机制，而肾脏纤维化是其主要病理学特征。中医认为，气虚血瘀是CKD的基本病机，益气活血是其主要治法。大量临床证据和基础研究证实，益气活血方联合化学药可通过抑制氧化应激、炎症反应，改善血管内皮功能障碍，抑制蛋白尿和肾脏纤维化等作用提高肾功能，从而起到肾脏保护作用。通过系统论述益气活血方在临床和基础研究的新发现，为益气活血方在临床治疗CKD提供坚实的理论基础，为益气活血方在肾脏病方面的研究方向提供参考。     

Effect of acupuncture on the endoplasmic reticulum stress IRE1-CHOP pathway and the expression levels of Bax and Bcl-2 protein as well as genes in pancreatic tissue of rats with diabetes mellitus

Objective

To explore the effect of acupuncture on the endoplasmic reticulum stress IRE 1-CHOP signal pathway and the expression levels of related apoptosis genes in pancreatic tissue of rats with STZ-induced diabetes mellitus.

疏肝活血汤合针灸早期干预对卒中后抑郁患者预后的影响

观察疏肝活血汤配合针刺疗法早期干预对卒中后抑郁患者神经功能、抑郁症状、生活质量的影响,并与盐酸氟西汀相对照,比较2组疗效差异。将63例卒中后抑郁症患者随机分成中药针灸组31例和氟西汀组32例,在常规治疗原发病的基础上,中药针灸组给予疏肝活血汤配合针刺治疗,氟西汀组给予盐酸氟西汀口服,疗程均为4周。观察治疗前后及随访6个月时汉密尔顿抑郁量表(HAMD)、神经功能缺损评分(NIHSS)及脑卒中专用生活质量量表(SS-QOL)的评分情况。结果2组患者经治疗后HAMD及NIHSS评分均显著下降(P<0.01),而SS-QOL评分明显升高,与治疗前相比有明显差异(P<0.01),且中药针灸组优于氟西汀组(P<0.05)。研究表明疏肝活血汤配合针刺疗法早期干预能减轻PSD患者的抑郁症状和神经功能损伤症状,从而提高患者的生活质量,改善患者的预后。     

国外针灸治病作用机制研究概况

对国外近年来针灸效应机制和针灸治疗疼痛、恶心和呕吐、神经退行性疾病以及心脑血管疾病等病的机制实验研究进展进行了概述,对比国内同类研究现状,为国内同行提供借鉴.     

基于血浊理论针药结合治疗气滞血瘀型脂肪肝经验

脂肪肝目前为中国第一大慢性肝脏疾病,气滞血瘀型为其临床常见证型。文章在血浊理论指导下,结合临床实践,总结了气滞血瘀型脂肪肝的临床治疗经验。采用行气化浊汤以化浊行气,支沟-阳陵泉以疏通经络,太冲-合谷以调理脏腑,天枢-膈俞以通调气血,针药结合,取得了较好的临床疗效,并附病案1则。