ASSOCIATION BETWEEN ACUPUNCTURE NEEDLING SENSATION(DE-QI) AND LOCAL SKIN BLOOD FLOW IN HEALTHY SUBJECTS:A SINGLE-BLIND,RANDOMIZED CONTROLLED TRIAL

Objective: De-qi refers to sensations generated by needle insertion into an acupuncture point.De-qi sensation is believed to be associated with treatment effects of acupuncture with the increase of local blood flow, although some patients may feel these sensations uncomfortable.This study aimed to assess the association between the strength of de-qi sensation and local skin blood flow in healthy subjects.Methods: Forty-five healthy subjects were randomized into real acupuncture(RA) group(n=15), Park-sham acupuncture(SA) group(n=15) and non-needling control(CO) group(n=15).A single acupuncture session was conducted on the right LI4 point with manual stimulation and 10-minute needle retention.De-qi sensation was assessed immediately after the removal of needling by the Southampton needle sensation questionnaire.Local skin blood flow recording within 2 cm in diameter of ipsilateral LI4 area was performed intermittently from just before the intervention to the end of the trial by the laser Doppler blood perfusion imager.Correlation between the change of skin blood flow and strength of De-qi was assessed.Results: Median change of local skin blood flow from baseline to post-treatment was 48.85, 48.20 and 0.59 arbitrary unit(AU) in RA, SA and CO groups, respectively.Median total sensation score was 10, 3 and 0 of 51 points, respectively.No significant correl ation between total sensation score and change of skin blood flow in the RA and SA groups was observed(0.105 9 of Spearman's rho, P=0.57).Conclusion: The data suggest that there is no association between De-qi sensation and local skin blood flow after acupuncture in healthy adults.The role of De-qi sensation for physiological changes and clinical outcomes should be further investigated in future acupuncture trials.     

OBSERVATION ON THE THERAPEUTIC EFFECT OF CT—AIDED SURROUNDING NEEDLING IN THE TREATMENT OF ISCHEMIC STROKE AND CHANGES OF PLASMA CATECHOLAMINE LEVEL

Ｓｔｒｏｋｅｉｓａｃｏｍｍｏｎｌｙｍｅｔａｎｄｆｒｅｑｕｅｎｔｌｙｏｃｃｕｒｒｉｎｇｄｉｓｅａｓｅｉｎｃｌｉｎｉｃ ,ａｎｄｉｓｏｎｅｏｆｔｈｅｄｉｓ ｅａｓｅｓｗｉｔｈｈｉｇｈｅｒｍｏｒｂｉｄｉｔｙ ,ｈｉｇｈｅｒｍａｉｍｒａｔｅａｎｄｈｉｇｈｅｒｄｅａｔｈｒａｔｅｉｎｔｈｅｗｏｒｌｄ .Ｉｎｏｒｄｅｒｔｏｓｅａｒｃｈｆｏｒｍｏｒｅｅｆｆｅｃｔｉｖｅａｃｕｐｕｎｃｔｕｒｅｔｈｅｒａｐｙｆｏｒｔｒｅａｔｍｅｎｔｏｆｉｓｃｈｅｍｉｃｓｔｒｏｋｅ ,ｔｈｉｓｐａｐｅｒｓｕｍｓｕｐｒｅｓｕｌｔｓｏｆＣＴ ａｉｄ…     

CLINICAL OBSERVATION ON TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH DIFFERENT NEEDLING METHODS

ＦｒｏｍＤｅｃｅｍｂｅｒｏｆ 1 992ｔｏＤｅｃｅｍｂｅｒｏｆ2 0 0 1 ,ｔｈｅａｕｔｈｏｒｓｏｆｔｈｅｐｒｅｓｅｎｔｐａｐｅｒｏｂｓｅｒｖｅｔｈｅｔｈｅｒａｐｅｕｔｉｃｅｆｆｅｃｔｓｏｆｐｅｎｅｔｒａｔｉｏｎｎｅｅｄｌｉｎｇｍｅｔｈｏｄａｎｄｔｒａｄｉｔｉｏｎａｌａｃｕｐｕｎｃｔｕｒｅｍｅｔｈｏｄｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆ 1 58ｃａｓｅｓｏｆｐｅｒｉｐｈｅｒａｌｆａｃｉａｌｐａｒａｌｙｓｉｓ.Ｔｈｅｒｅｓｕｌｔｓａｒｅｉｎｔｒｏｄｕｃｅｄａｓｔｈｅｆｏｌ ｌｏｗｉｎｇ .1　ＣＬＩＮＩＣＡＬＤＡＴＡ1…     

CLINICAL OBSERVATION ON TREATMENT OF CHILD CEREBRAL PALSY WITH PENETRATION NEEDLING FROM SISHENCONG TO BAIHUI POINT

Childcerebralpalsy(CCP)isanon-pro-gressivecerebralinjury-inducedsyndromeoccur-ringwithinamonthfrompre-birthtopoSt-birth,manifestedmainlybycentralneurogenicdyskinesiaandabnormalPosture,disturbanceofvision,audition,speechandintelligence,andepilepticattack.Itseriouslyendangerschildren'smentalandphysicalhealthandoftenresultsinpermanentdisability.Uptonow,therehavenoyetbeenanyspecialtherapeuticapproaches.Inrecentyears,theauthorsadoptedpenetrationneedlingandmoxibustiontotreatCCPandachievedsatisfac…     

CLINICAL OBSERVATION ON PENETRATION NEEDLING TREATMENT OF 65 CASES OF HYPERTENSION

The present paper reports the results of 65 hypertension patients treated with pene-tration needling（point through point method in acupuncture）.For comparison,other ps cases ofhypertension were treated with routine needling method.Changes of blood pressure were ob-served before,during and after treatment.Results showed that the hypotensive effect of the pen-etration needling was significantly superior to that of the routine acupuncture（P<0.05）.Thefollowing-up survey 3 months after treatment showed significant differences between two groupsand between post-treatment and pre-treatment in each group in the mean vahes of systolic and di-astolic pressure（P<0.05）.It reveals that acupuncture has a good hypotensive action,and thepenetration needling is of a certain long-term therapeutic effect.     

极泉穴不同操作对神经根型颈椎病疗效的影响

目的:观察极泉穴不同手法操作对神经根型颈椎病引起的上肢感觉异常的改善程度.方法:将107例患者随机分为3组.提插组37例采用极泉穴提插手法操作;捻转组36例采用极泉穴捻转手法操作;常规针刺组34例,穴取C4-T1夹脊、曲池等.结果:提插组总有效率达91.9%,显著优于捻转组的58.3%(P<0.005)和常规针刺组的76.5%(P<0.05),而捻转组和常规针刺组临床疗效接近(P>0.05).结论:极泉穴配合提插手法量学操作可显著改善神经根型颈椎病引起的上肢感觉异常.     

RESEARCH ON SEQUELAE OF CEREBROVASCULAR ACCIDENT TREATED BY THREE DIFFERENT NEEDLING TECHNIQUES

One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture group(BG), 50 cases. It was shown that after 30 treat-ments the curative effects were significantly different (P<0. 01) among the three groups. The effectin TG was better than those in SG and BG. There was no difference in curative effects between SGand BG. It is indicated that all the three needling techniques can improve encephalic blood flow in pa-tients. It seems that the effects of the three needling techniques are as follows: TG>SG>BG.     

OBSERVATION ON CLINICAL THERAPEUTIC EFFECT OF MRI-AIDED ENCLOSURE NEEDLING IN THE TREATMENT OF STROKE AND ITS INFLUENCE ON BLOOD RHEOLOGY

Objective: To observe clinical therapeutic effect of magnetic resonance imaging (MRl)-aided enclosure needling in the treatment of stroke patients and changes of the related blood rheology. Methods: A total of 61stroke patients were randomized into MR I-aided enclosure needling group (MRI-aided acupuncture group) (n = 31 ) and conventional acupuncture group (n= 30). For patients of MRl-aided acupuncture group, acupuncture needles were inserted into the subcutaneous tissues around the focus-projection scalp area displayed by MRI, with the needle tips toward the center of the projection region and with two needles being about 2 crn apart, combined with other acupoints according to the concrete syndromes or symptoms. For patients of conventional acupuncture group, Motor Area (MS 6)and Sensory Area (MS 7) on the contralateral side of the focus were punctured. The treatment was conducted once daily, continuously for 30 days. Results: After treatment, of the 31 cases in MRl-aided acupuncture group, 20 werecured basically, 10 responded with significant improvement of symptoms and signs, one case had some improvement.While in conventional acupuncture group, of the 30 cases, 11 were cured basically, 15 responded with striking amelioration of symptoms and signs and 4 had some amelioration. Ridit analysis showed that the therapeutic effect of MRI-aided acupuncture group was significantly superior to that of conventional acupuncture group (P ＜ 0.05). After treatment,the whole blood viscosity, plasma viscosity, hematocrit, whole blood reduction viscosity, hemagglutination index, and the total score of the two groups all decreased significantly in comparison with those of pre-treatment of each group,while whole blood viscosity, hematocrit, vascular sclerosis index and the total score of MRl-aided acupuncture group were obviously lower than those of conventional acupuncture group ( P＜ 0.05- 0.01 ), suggesting that the effect of theformer group in bettering blood rheology was pronouncedly superior to that of conventional acupuncture group. Conclusion: MRl-aided acupuncture group is obviously superior to that of conventional acupuncture group in improving clinicalsymptoms and signs and blood rheology in stroke patients.     

不同穴位针刺对暂时性局部脑缺血大鼠皮层体感诱发电位和脑梗塞体积的影响

观察不同穴位针刺对暂时性局部脑缺血的作用，采用皮层体感诱发电位测定和ＴＴＣ染色法，结果表明，电针能促进皮层体感诱发电位的恢复，可使脑缺血后脑梗塞体积减小，且督脉穴位针刺在促使脑缺血后皮层体感诱发电位恢复上可能具有相对较强的作用。     

CONTROL OBSERVATION OF THERAPEUTIC EFFECTS ON SYNDROME OF THE 3~(rd) LUMBAR TRANSVERSE PROCESS WITH THICK SILVER WARMING NEEDLING AND ELECTRIC ACUPUNCTURE

Objective: To compare the clinical therapeutic effects on the syndrome of L3 transverse process between thick silver warming needling and electric acupuncture. Methods: One hundred and twenty cases of the syndrome of L3 transverse process were randomized into observation group and the control, 60 cases for each one. Thick silver warming needling was applied in observation group and electric acupuncture in the control. Results: The curative rate was 81.7% In observation group and 58.3% in the control, indicating significant difference (P＜0.01). The significant difference in the therapeutic effects between two groups had not been discovered yet for the cases within 3 months of sickness ( P＞0.05), but, the therapeutic effect in observation group was superior to that in the control for the cases over 3 months of sickness ( P＜0.01).Conclusion: The therapeutic effects of thick silver warming needling and electric acupuncture were quite advantageous on the syndrome of L3 transverse process, but that of thick silver warming needling was superior to electric acupuncture.     

针刺手法对感受器发放的影响

本工作利用在猫的脊神经背根分离神经纤维细束的方法记录单位型关节深部感受器的传入发放,试验了提插并捻转、单纯提插及单纯捻转这三种基本的传统针刺手法对19个感受器的作用。每次运针所引发的感受器放电平均数分别是6.98个,4.60个和1.83个。前两者之间无明显差异。而前两者与后者相比则显著高于后者。提示针刺手法和传入信息量之间有着明显的相互关系。从发放的瞬间频率图初步分析了针刺引起的传入信息编码形式。提示了不同针刺手法产生不同临床效果的初级机理。     

镇痛药、针刺镇痛对佐剂性关节炎大鼠血浆 cAMP 含量的影响

<正> 针刺对慢性炎症局部的镇痛作用,已为大量的临床和实验观察所证明。我们也以佐剂性关节炎大鼠的炎症性疼痛为模型,证实了针刺对炎症局部具有明显的镇痛效果。针后,实验动物的中枢神经系统组织内的脑啡肽含量明显增加,说明针刺可能是通过提高体内的内源性吗啡样物质(MLS)含量,兴奋相应的受体而发生镇痛作用的。但针刺与某些兴奋吗啡样受体的镇痛药物不同,它可能是一种多元性自我调节的过程,除提高     

OBSERVATION ON THE THERAPEUTIC EFFECT OF CT—AIDED SURROUNDING NEEDLING TREATMENT OF ISCHEMIC STROKE

121 cases of ischemic stroke were randomly divided into CT-aided surrounding needling group (CTASN, 61 cases) and scalp Acupuncture group (SA, 60 cases). After 30 sessions of treatment the therapeutic results of the two groups are significantly different (P<0.05), the therapeutic effect of CTASN group is better than that of SA group. The plasma contents of TXB2 and 6-keto-PGF1a of the two groups change considerably after acupuncture treatment, the change in CTASN group is more obvious.     

针灸治疗坐骨神经痛30例临床观察

目的　观察痛阈改变与针灸治疗坐骨神经痛患者临床疗效的关系，探索将痛阈值作为判断坐骨神经痛疗效的量化标准的可行性。方法　将90例患者随机分为3组，每组30例；温针灸组施以温针灸，西药组口服尼美舒利片，穴位注射组用654—2行穴位注射，分别测定患者治疗前与治疗第1、2、3疗程后的痛阈值。结果　根据临床疗效、治疗前后痛阈值和临床症状、体征检测进行综合评定。除喷嚏时疼痛加剧、排便时疼痛加剧及西药组咳嗽时疼痛加剧外，温针灸组与西药组、穴位注射组疗效比较差异有显著性意义（P〈0．01）。结论　针灸治疗坐骨神经痛能使痛阈值升高，改善临床症状。     

针灸治疗仪结合电火针在神经阻滞定位中的应用

目的观察针灸治疗仪结合电火针在腋路臂丛阻滞神经定位中的应用效果。方法随机选取本院60例拟行前臂、腕部和手部的择期手术患者,被随机分入异感定位组（B组）和针灸治疗仪与电火针结合定位组（A组）,每组30例。观察两组臂丛阻滞的操作时间,麻醉起效时间及阻滞后的麻醉效果。结果A组的臂丛阻滞的操作时间明显长于B组（P〈0.05）,但麻醉起效时间明显短于B组（P〈0.05）,阻滞后的麻醉效果优良率明显好于B组（P〈0.01）。结论用针灸治疗仪与电火针结合用于臂丛阻滞的神经定位,其输出功率、电流强度可调性好,引起肌颤的反应完全能达到神经刺激器同样的效果,经济性及适用性都较好,有一定的临床使用价值。     

EIGHTY CASES of SOFT TISSUE INJURY TREATED WITH LOCAL CONTRALATERAL NEEDLING METHOD

Contralateral needling method is a common and effective one of acupuncture analgesicmethods.It is used to treat a local pain in the limbs and trunk with a short course of disease,pain and swelling will disappear or be relieved immediately for one or two treatments.Really,there isan effect of relieving pain as soon as the needle is inserted.When the local contralateral needlingmethod is used,the key to improving the effectiveness lies in determining the pain position and its correspondingpoint correctly,the more correct the pain position and its corresponding point are determined,the better the effectiveness will be.In this group,80 cases soft tissue injury were treatedwith local contralateral needling method,the cure rate was 82％,and the total effective rate was100％.     

PAIN AND SENSORY DETECTION THRESHOLD CAN BE MODULATED BY THE ASSOCIATION BETWEEN COPING STRATEGY AND ACUPUNCTURE SENSATION IN ACUPUNCTURE STIMULATION

Introduction: Although acupuncture reduces pain and is important in its effect, the role of coping strategy on acupuncture modulation of pain and sensory thresholds, and the association between acupuncture sensation and these modulatory effects, is currently unknown.Methods: Electroacupuncture(EA) was applied at acupoints ST36 and GB39 in 61 healthy adults.Two coping conditions were experimentally designed to form an active coping strategy group(AC group), who thought they could control EA stimulation intensity, and a passive coping strategy group(PC group), who did not think they had such control.However, the EA intensity was not changed.Quantitative sensory testing was performed before and after EA, and vibration(VDT), mechanical(MDT),warm(WDT), and cold(CDT) detection thresholds, and pressure(PPT), mechanical(MPT), heat(HPT) and cold(CPT) pain thresholds were measured.Autonomic measures, skin conductance response(SCR), were also acquired to quantify physiological response to EA under different coping conditions.Results: The AC group showed greater SCR to EA than the PC.Acupuncture sensation did not differ between the AC and PC groups.Increased pain/sensory threshold and acupuncture sensation were positively correlated in the AC group(VDT change vs.MI: r=0.58; CDT change vs.tingling: r=0.53; CPT change vs.tingling: r=0.55; CPT change vs.dull: r=0.55), and were negatively correlated in the PC group(CDT change vs.intensity: r=-0.52; WDT change vs.fullness: r=-0.57).Additionally, subjects in the AC group demonstrated reduced PPT following EA.Conclusion: Active coping strategy increased pain and sensory detection threshold when acupuncture sensation was high, while passive coping strategy produced an opposite association.Theassociation of descending cortical(psychological coping strategies) and ascending sensory afference(acupuncture sensation) might affect periaqueductal grey to modulate pain and sensory processing.Clinically, our findings suggest that acupuncture analgesia can be maximized by matching physical stimulation intensity with the psychological coping strategy inherent to different naturalistic subject-specific acupuncture contexts.     

毫钝针疗法治疗腰肌筋膜疼痛综合征的临床研究

目的探讨毫钝针针刺治疗在腰肌筋膜疼痛综合征中的应用效果。方法选取60例腰肌筋膜疼痛综合征(MPS)患者进行研究,按照1∶1比例随机分组,毫钝针刺组采用毫钝针针刺激痛点治疗,普通针刺组采用普通针刺常规穴位治疗。每2天治疗1次,每个疗程治疗6次,连续治疗2个疗程,治疗完毕采用视觉模拟疼痛量表(VAS)和Roland-Morri功能障碍调查问卷表(RMDQ)评价疗效。结果与治疗前VAS评分相比,毫钝针刺组经过治疗降低(4.17±1.53)分,普通针刺组经过治疗降低(3.33±1.40)分,差异均具有统计学意义(P <0.05)。毫钝针刺组治疗后VAS评分较普通针刺组低,而VAS差值较普通针刺组高,差异具有统计学意义(P <0.05)。与治疗前RMDQ评分相比,毫钝针刺组经过治疗降低(10.80±2.34)分,普通针刺组经过治疗降低(8.63±2.91)分,差异均具有统计学意义(P <0.05)。毫钝针刺组治疗后RMDQ评分较普通针刺组低,而RMDQ差值较普通针刺组高,差异具有统计学意义(P <0.05)。毫钝针刺组总有效率为93.33%,普通针刺组总有效率为80.00...     

针刺得气感与感传及针效关系的初步观察

<正> 针刺时要有得气感才能产生疗效。但是针刺受针者将出现什么样的得气感是十分复杂的问题。而得气感与针效是否有关?它与感传的出现有何关系?对探讨针刺机理和经络实质都十分重要,但未见这方面的报导。本文对300例冠心病患者,由专人施针,采用相同手法,单独针刺左侧内关,以心电图ST段、T波和心输出量SV、CO为客观指标,观察受针者的得气感与感传及针效的关系。     

灸刺足三里治疗难治性面瘫临床观察

目的:观察采用灸刺足三里激发“循经感传”治疗难治性面瘫的临床疗效。方法:60例患者随机分为灸刺足三里组(试验组)、常规治疗组(对照组)各30例,对照组取合谷、太冲、头维等穴,试验组在对照组取穴基础上加灸刺足三里,以患者自觉有温热感沿针体传入穴位深层为度。结果:试验组总有效率为93·3%,明显优于对照组的76·7%(P<0·05);试验组中,有循经感传者的总有效率为100·0%,明显优于无循经感传者的80·0%(P<0·05)。结论:灸刺足三里激发“循经感传”治疗难治性面瘫具有较好疗效,值得推广应用。