FUNCTIONAL MAPPING OF THE HUMAN BRAIN DURING ACUPUNCTURE WITH MAGNETIC RESONANCE IMAGING SOMATOSENSORY CORTEX ACTIVATION

1NTRODUCTIONHegu(Ll4)isoneofthemosteffectiveandmostfrequentlyusedacupointsintraditionalChineseacupuncture.ItisindicatedfOrpaininmanypartsofthebody,butisparticularlyeffec-tiveforheadache,migraine,toothache,sorethroatandotherd1sordersoftheheadandface.Manyanimalexperimentsindicatethathighercentersinthenervoussystemareinvolvedinacupunctureanalgesia["2]butdirectevidenceforhumansubjectsisdifficulttoobtainuntilthere-centadventofpowerfu1andn0n-invasivemeth-odsforneuroimaginginthe9O's.Werecentlya…     

BRAIN FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY OF DIARRHEA TYPE OF IRRITABLE BOWEL SYNDROME TREATED WITH MOXIBUSTION AND PLACEBO MOXIBUSTION

Objective: Moxibustion treatment for diarrhea type of irritable bowel syndrome(D-IBS) has exact clinical effects.D-IBS patients show intestinal hypersensitivity.The efficacy mechanism of moxibustion treatment for D-IBS may be implicated during brain functional magnetic resonance imaging(fMRI).Methods: fMRI was performed in 6 female and 9 male patients with D-IBS in moxibustion treatment group and 6 female and 7 male patients in placebo moxibustion group during rectal balloondistension before and after the treatments.Rectal pain was scored before and after the treatments.Results: The first sensation threshold had no difference between 2 groups.Defecation urge threshold increased significantly in moxibustion group after treatment(P0.01) while no changes occurred in placebo moxibustion group after treatment.Pain detection threshold increased significantly in moxibustion group after treatment(P0.01) and increased in placebo moxibustion group but without statistical significance.The rectal pain score beneath 50 mL rectal balloon distention in both groups had no changes before and after the treatments.100 mL distention in moxibustion group decreased after treatment while no changes occurred in placebo moxibusition group.There was no definite area activated beneath 50 mL rectal balloon in both groups before treatment.After treatment, prefrontal cortex(PFC) was affected in moxibustion group, and prefrontal cortex and cingulated cortex(CC) were affected in placebo moxibustion group.Beneath 100 mL rectal balloon distention, activated area(PFC and CC) decreased in moxibustion group after treatment but didn't decrease in placebo moxibusiton group.Conclusion: The rectal sensitivity of D-IBS decreased after moxibustion treatment.The mechanism of the effect of the moxibustion on D-IBS may relate with the decreased sensitivity of the rectum.     

A BRAIN FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY ON NEEDLING IN HEGU(LI4) AND HOUXI(SI3) IN ADULT HEALTHY VOLUNTEERS

Objective: To explore the neurophysiological mechanisms of acupuncture needling in Hegu(LI4) and Houxi(SI3) and the functional specificity of them based on the technique of brain functional magnetic resonance imaging(fMRI).Methods: Forty healthy right-handed volunteers were divided into LI4 point group and SI3 point group, with 20 cases in each group.All healthy volunteers were stimulated at left LI4 or SI3, and fMRI data were acquired with the same scanning sequences.All fMRI data were analyzed by analysis of functional neuroimage program and the results were corrected with Monte Carlo method(P=0.002, α≤0.05).Results:(1) Many brain areas were activated with increased signal by stimulating at left LI4 which included: bilateral cerebellum, right thalamus and subthalamic nucleus, bilateral lentiform nucleus and putamen, right caudate, right cingulate gyrus, bilateral precentral gyrus, right posterior central gyrus, bilateral superior parietal lobule, right inferior parietal lobule, left inferior frontal gyrus, right middle frontal gyrus, right middle temporal gyrus, bilateral superior temporal gyrus, right supramarginal gyrus, left middle occipital gyrus, and left insula;(2) many brain areas were activated with increased signal by stimulating at left SI3 which included: bilateral cerebellum, left thalamus and ventral posterior medial, right caudate, right precentral gyrus, right middle frontal gyrus, left cingulate gyrus, and bilateral insula;(3) it showed significant differences of the intergroup analysis results of stimulating at LI4 vs SI3: increased signal in left cingulate and precentral gyrus and decreased signal in right middle frontal gyrus and inferior frontal gyrus.Conclusion: The present study directly illustrated the link of LI4 with the face and mouth, as well as SI3 with the neck and torso at the levels of central nervous system.It also offered objective neurophysiological evidence to the traditional Chinese medical theory that face and hand are controlled by Hegu and Houxi is associated with the governor vessel.In addition, it explained the mechanism of Hegu treatment to hyperhidrosis, Houxi treatment to neck lumbar diseases, and the analgesic function of both acupoints in some degree.Nevertheless, it provided objective basis of functional specificity of the acupoints which were close in location.     

WHITE MATTER MICROSTRUCTURE CHANGES IN ACUPUNCTURE FOR PATIENTS WITH STABLE SOMATOSENSORY STROKE:A DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING STUDY

Objective: Acupuncture has been proved to have beneficial effects in the motor recovery process for stroke patients.In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive.The aim of the study was to characterize acupuncture efficacy-related white matter microstructural changes in patients with stable somatosensory stroke.Methods: Twenty-four patients with right hemispheric striatocapsular infarction and stable ischemic stroke were assigned randomly to receive acupuncture or sham treatment for 4 weeks.Twelve age-matched and gender-matched normal subjects were also included.Fractional anisotropy(FA) and mean diffusivity(MD) maps from diffusion tensor imaging(DTI) were obtained for each stroke group before and after acupuncture treatments and for normal subject once.Moreover, mean FA and MD in regions with detected difference after acupuncture treatment were compared in each stroke group and correlations between diffusion quantities and severity of stroke were analyzed.Results: White matter microstructure differences were found between patients and normal subjects primarily in the contralesional primary motor cortex(M1) and insula.The clinical data demonstrated that after 4 weeks of treatment the motricity index(MI) was increased significantly in the acupuncture group but there was no difference between the acupuncture and the sham groups.Only the acupuncture group showed greater activity in the contralesional M1 and non-primary motor cortex(the insula and cingulate cortex) compared with the sham group.The changes were also related significantly with the MI.In the sham group,the activity of the parahippocampus tended to be associated with the increase in the Barthel Index of activities in daily life.Conclusion: Acupuncture and sham intervention have relatively different clinical efficacy and white matter microstructure changes.Acupuncture treatment, which better improves the symptoms and quality of life of stroke patients significantly, enhances the white integrity of both motor network and non-primary motor network.     

EVOKED PRESSURE PAIN FUNCTIONAL MAGNETIC RESONANCE IMAGING(fMRI) PREDICTS CLINICAL RESPONSE TO SHAM BUT NOT VERUM ACUPUNCTURE IN FIBROMYALGIA

Objective: Previously, we showed that patients with fibromyalgia(FM) display enhanced sensitivity to experimental pressure-pain which predicts clinical response to sham acupuncture(SA) treatment.In this study, we investigated whether fMRI blood oxygen-leveldependent(BOLD) response to experimental pressure-pain predicts increased clinical pain reductions after SA as opposed to verum acupuncture(VA) treatment.Methods: Thirty-nine female patients satisfying American College of Rheumatology 1990 criteria for FM were randomized to receive either VA(n=18) or non-skin penetrating SA(n=21) with 9 treatments over the course of 4 weeks.Before treatment, patients underwent an fMRI evoked pressure-pain scan, during which 2 kg of pressure was presented to volunteers' left thumbs.Clinical pain was assessed both before and after treatment with the Short Form McGill Pain Questionnaire(SF-MPQ).Preprocessing and regression analyses of baseline BOLD signal(2 kg vs.touch) as a predictor for change in clinical pain were performed separately for each group in SPM8.The BOLD signal was extracted from significant clusters, and used in a General Linear Model(SPSS v21) for group*BOLD interactions.Significance was assigned at P0.05 corrected for multiple comparisons.Results: Baseline BOLD responses in the left posterior insula(r=-0.80, P=0.001), right posterior insula/putamen(r=-0.70, P=0.007), and the anterior cingulate cortex(r=-0.657, P=0.018) were all negatively correlated with change in clinical pain(SFMPQ affective scores; post-pre); posterior cingulated(r=-0.69, P=0.001) was correlated with change in clinical pain(SF-MPQ total scores; post-pre).No significant clusters were found for the VA group alone.However when the SA regions were used to extract BOLD signals from the VA group, significant group*BOLD interactions were obtained for the previously mentioned regions(P0.001, P=0.008, P=0.004, P=0.001, respectively).Conclusion: Results suggest that evoked pressure-pain fMRI BOLD response in pain responsive regions may be a factor in determining subsequent responsiveness to SA but not VA.     

EFFECTS OF LOW-FREQUENCY ELECTROACUPUNCTURE ON THE IMMUNOLOGIC FUNCTION IN MORPHINE DEPENDENCE RATS

InGoodmanandGilmans’bookPharmaco logicalBasisofTherapeutics[1 ] ,acupuncturetherapyhasbeenregardedasthethirdtypeofremediesforheroinomania .However,uptonow ,majorityoftheresearchesfocusonhowtotreatwithdrawalsymptoms,feweronthereha bilitationofthepatient’simmunefunction .Inthepresentpaper,theeffectoflow frequencyelectroacupuncture (EA)onthecontentofTlymphocytesubgroupsintheperipheralbloodisobservedforrevealingmechanismsofacupunc tureinraisingimmunologicfunction .1　MATERIALSANDMETHOD…     

佃氏舒筋精药酒抗炎、消肿作用的实验研究

通过测定小鼠不同炎症肿胀膜型的变化,探讨佃氏舒筋精的抗炎消肿作用。分别以二四苯诱发小鼠耳廓肿胀模型、甲醛致小鼠足肿模型、自由坠落物击打致肌肉组织损伤模型为观察对象,分别设立佃氏舒筋精高剂量组、低剂量组,相应的空白对照组、阳性药物对照组、模型对照组等不同组别进行对照观察。结果显示,佃氏舒筋精对二甲苯诱发的小鼠耳廓肿胀有明显的抑制作用(P<0.05),对甲醛所致的小鼠足肿有明显的抑制作用(P<0.05),对坠落物击打所致的肌肉组织的肿胀与炎症病理变化有明显的抗炎消肿效果,但对醋酸所致的小鼠腹腔毛细血管通透性增高无降低作用(P>0.05)。研究表明,佃氏舒筋精有良好的抗炎消肿作用,不同的剂量在病理表现中有一些差异。     

经络中气血运行特征的放射性核素显像研究

在放射性高锝酸钠注入穴位后,用r-闪烁照像方法的研究证实:1.按子午流注理论,于“开穴”注入示踪剂后,其清除率明显降低而平均通过时明显延长;2.压力可以阻断沿经的清除过程;3.普鲁卡因或生理盐水皮下注射均可阻断示踪剂的迁移,但仅持续约10分钟左右;4.温和的热刺激可以促进迁移过程,但较激烈的刺激则抑制这一过程;5.针刺可以加速迁移过程。     

中药艾灸神阙穴对腹膜透析患者腹膜超滤功能的影响

目的:观察中药艾灸神阙穴对高腹膜转运CAPD患者腹膜超滤功能的影响。方法:高腹膜转运CAPD患者26例随机分为两组,治疗组(中药艾灸)与对照组各13例,观察治疗后透析超滤量(UF)、腹膜溶质清除指数(KT/V、CCr)及腹透液中CA125、透明质酸的变化。结果:治疗组治疗后24小时总超滤量明显增加,腹透液中CA125、透明质酸量明显增加,优于对照组(P<0.05)。结论:中药艾灸神阙穴可有效地提高透析超滤量,对高腹膜转运CAPD患者腹膜的超滤功能具有较好的保护作用。     

针刺对痛经大鼠下丘脑-垂体-卵巢轴的影响

目的：观察针刺对病经大鼠下丘脑-垂体-卵巢轴（HPOA）的影响,并初步探讨其作用机制。方法：观察了针刺对痛经大鼠β-内啡肽（β-EP）、下丘脑激素（促性腺激素释放激素GnRH）、垂体激素（促性腺激素释放激素受体GnRH-R、卵泡刺激素FSH、黄体生成素LH）和卵巢激素（雌激素E2、雌激素受体ER、孕激素P及孕激素受体（PR）的影响。结果：针刺治疗后,β-EP、GnRH、GnRH—R、FSH、LH、E2、ER、P和PR的水平改变,因此针刺对痛经大鼠HPOA的有调节作用。结论：针刺对痛经大鼠HPOA的作用机制可能与针刺调节HPOA的性激素及其受体的表达有关。     

THE EFFECTS OF ACUPUNCTURE ON COGNITIVE FUNCTION AND SERUM sCD40L IN PATIENTS WITH SUBCORTICAL ISCHEMIC VASCULAR DISEASE

Objective: To observe the influence of acupuncture on the cognitive function and serum sCD40 L of patients with subcortical ischemic vascular disease(SIVD), to explore the relationship between cognitive function and the level of serum sCD40 L of patients with SIVD and to provide new ideas for clinical treatment.Methods: Sixty cases of SIVD were randomly divided into acupuncture treatment group and nimodipine group, 30 cases of each group.The acupuncture treatment group took the acupoints of Baihui(DU20), Renzhong(DU26), Fengfu(DU16), Fengchi(GB20), Neiguan(PC6), Shenmen(HT7), Hegu(LI4) and Taichong(LR3), and the needles were kept 30 min each time.The matched group took oral nimodipine 30 mg for three times per day.Both of the groups were treated for 4 weeks as a course and it was 2 courses totally.Cognitive function(MoCA score) and serum sCD40 L level of patients before and after the treatment were observed.Results: After four weeks' treatment, the patients in the treatment group got a significant decreasing in serum sCD40L(P0.01), no obvious changes were observed in the control group(P0.05).Cognitive function in patients was improved notably.After 8 weeks' treatment, the serum sCD40 L levels of patients in the two groups were significantly decreased(P0.01), and the curative effect of the treatment group was better than the control's.Cognitive function in patients was improved notably(P0.05).Conclusion: Acupuncture can significantly reduce the content of serum sCD40 L of patients with SIVD and improve their cognitive function.     

针刺特定穴治疗功能性消化不良的研究现状与思考

Acupuncture plays a dominant role in treating functional dyspepsia （FD）. By reviewing and e- valuating clinical ROT and fundamental research with high quality in the past 17 years, it is found that specific acupoints are the chief in the treatment of FD; additionally, there are differences between specific acupoints and non-specific acupoints in therapeutic effect, explaining that the specificity of meridian points plays an im- portant role in treatment. However, because of inadequate high-quality researches in clinics, the specificity of acupoints can＇t be proved until the researches of clinical effect and mechanism of therapeutic difference are intensified.     

RESEARCH OF ACUPUNCTURE EFFECTS ON THE FUNCTION OF SMOOTH MUSCLE CONTRACTION IN TREATING ASTHMATIC RATS

To explore the role of acupuncture in treating asthma disease, on the basis of airway smooth muscle cytoskeleton protein function,we observed the effects of acupuncture on smooth muscle contraction function of a rat model of asthma.In vivo, rats were exposed to ovalbumin sensitization to establish the rat model of chronic asthma and they were treated with manual acupuncture on Feishu(BL13), Shenshu(BL23) and Dingchuan(EXB1) acupoints(incidental and fundamental acupoints), once a day and 30 min each time for 3 months.We used pulmonary pathology HE staining and Sirius red staining to observe the airway structure and epithelial fibrosis for each group, and computer image analysis system for evaluation of airway remodeling.Force transduction device was applied to observe bronchial smooth muscle contraction curve.Contents of IL-6, IL-1β, TNF-α and NF-κB in bronchoalveolar lavage fluid were detected by ELISA.Simultaneously,the expression of α-SMA in lung and bronchial smooth muscle cells was observed by Western-blot and immunostaining methods.Furthermore, actin polymerization was detected as evidence of the immunoblot analysis.The airway remodeling structures were changed, such as incensing of inflammatory cell infiltration, losing of epithelial cells, epithelium of fibrosis, and increasing thickness of smooth muscle cell layer under the epithelium.Manual acupuncture alleviated the pathological changes.We found that smooth muscle cell contractility was improved significantly after acupuncture treatment.Contents of IL-6, IL-1β, TNF-α and NF-κB in bronchoalveolar lavage fluid were significantly decreased after acupuncture treatment.Acupuncture also reversed the increase of α-SMA protein expression in the lung and bronchus,and decreased the F/G actin ratio.In conclusion, acupuncture treatment can effectively regulate the airway smooth muscle contractility function of the asthmatic rats, and effectively restrain the airway remodeling and inflammatory reaction of asthma.     

CLINICAL OBSERVATION ON EFFECTS OF EYE-ACUPUNCTURE ON LEFT-VENTRICULAR FUNCTION IN PATIENTS OF HYPERTENSION

Hypertensioninmodernsciencesisinclud-edinthecateg0ry0fdizzinessintraditionalChi-nesemedicineanditisanindependentdisease,mainlymanifestinganincreaseofarterialbloodpressure,andeasi1yinjuringtheheart,kidney,brainandotherorgans.Inthepresentstudy,18Ocasesofhyper-tensionweretreatedrespectivelywitheye-acupuncture,body-acupunctureand0ra1adminis-trationofhypotensor,andheartfuncti0n,includ-ingUCGandSTIandotherobjectiveindexeswereusedtoobserveeffectsofeye-acupunctureonLVFandbloodpressureathypertesion…     

气街理论指导针刺对癫痫患者内分泌功能的影响

目的：以针灸“气街”理论为指导,观察针刺对癫痫患者内分泌指标的影响。方法：将60例癫痫患者随机分为针药组和药物组,各30例。药物组常规服用抗癫痫药物丙戊酸钠,针药组在常规药治疗基础上,加用针刺治疗,主穴取人迎、风府、天柱。观察治疗前后癫痫计分及检测血浆总皮质醇（CORT）、雌二醇（E2）、孕酮（Prog）、垂体泌乳素（PRL）水平。结果：2组总有效率均为96．7％,两者差异无显著性意义（P〉0．05）;针药组治疗前癫痫计分（13．58±4．01）分,治疗后（8．30±4．52）分,药物组治疗前癫痫计分（12．97±3．91）分,治疗后（7．86±4．90）分,2组治疗后计分较治疗前有明显改善（P〈0．05）;与药物组治疗后相比,针药组的CORT升高具有显著性意义（P=0．046）,E2、PRL和Prog的差异则无显著性意义（P〉0．05）,说明针药组在有效控制癫痫发作的同时,能更好的改善患者内分泌功能。结论：气街理论指导针刺是改善癫痫患者内分泌状况的有效方法。     

OBSERVATION OF THE CLINICAL EFFECTS OF ELECTROACUPUNCTURE COMPOSITE REHABILITATION TRAINING ON THE MOTION FUNCTION OF PATIENTS WITH INCOMPLETE SPINAL CORD INJURY

Objective: To testify the effectiveness of electroacupuncture treatment by observing the improved situation of motion function in patients with incomplete spinal cord injury treated by elec troacupuncture composite rehabilitation training, and to provide a new method for the patients with incomplete spinal cord injury Methods: Randomized, double-blind and blank-contro method was used.Thirty-two patients with incomplete spina cord injury were assigned into the observation group, in which acupuncture with the electric pulse stimulation was applied to the motor points of the key muscles of the lower extremities, and the control group, in which electroacupuncture was applied a Biguan, Yinshi, Futu, Liangqiu, Fenglong, Chongyang, and Jiexie In each group, treatment was given once a day; one-month treat ment made a session.Three sessions were required totally with two-day rest between each session.Before and after each session the American Spinal Injury Association(ASIA) impairmen scale, ASIA motor score, modified Barthel index(MBI), and integrated electromyography tests were adapted to the subjects.The differences in the efficacy on the motion function were compared with the results before and after treatment.Results: The changes of ASIA impairment scale were not statisti cally different(P0.05) at 1 h, 2 and 3 months after treatment While the changes of ASIA motor score, MBI, and integrated electromyography were statistically different when tested afte treatment for 1, 2 and 3 months.That meant the motion function of the subjects was improved in both groups.The ASIA motoscore, MBI, and integrated electromyography changes were of no statistical significance(P0.05) at 1 and 2 months after treatment, while were of statistical difference at 3 months.The effect of the treatment group was better.Conclusion: Both the electroacupuncture and traditional body acupuncture could improve the motion function of patients with incomplete spinal cord injury.However, concerning in the long term, the electroacupuncture composite rehabilitation training achieves better result, and is more safe and effective.     

THE STUDY ON EFFECTS OF ELECTROACUPUNCTURE AT OUCH POINT ON THE MUSCLE REGENERATION IN RABBITS WITH CONTUSION BASED ON THE INHIBITION OF ERK SIGNAL PATHWAY BY U0126

Objective: To observe the effects of electroacupuncture at ouch point on basic fibroblast growth factor(bFGF), proliferating cell nuclear antigen(PCNA) and extracellular signal-regulated kinase(ERK1/2) expression of U0126 inhibitor-injected rabbits with acute lumbar muscle contusion.Methods: Forty male New Zealand rabbits were randomly divided into blank group(BG), model group(MG), model with inhibitor group(MI), electroacupuncture group(EA) and electroacupuncture with inhibitor group(EI), eight rabbits in each group.Blunt trauma methods were used to forming lumbar muscle injury.CK level in serum was detected one day after modeling.HE staining, and PCNA and bFGF immunohistochemical staining were used for lumbar muscles of each rat 14 d after modeling.Western-blot was used to detect the expression of ERK1/2 protein.Results: In myofiber average cross-sectional area, PCNA and ERK1/2 protein expressions of EA group were higher than MG group(P0.05, or P0.01) and EI group(P0.05, or P0.01); bFGF expression of EA group was significantly higher than MG group(P0.01).Conclusion: ERK inhibitor U0126 can partly inhibit the proliferating effect of electroacupuncture at ouch point on muscle satellite cells.bFGF/ERK signal pathway may be one of the main pathways through which electroacupuncture at ouch point promotes muscle regeneration.     

中医医院膝关节骨关节炎住院患者的治疗情况--附892份病历分析

为了解中医医院膝关节骨关节炎住院患者的治疗现状,对湖南省12家中医医院5年膝关节骨关节炎住院患者治疗情况进行调查,摘录其相关治疗资料,并进行统计学分析处理.结果显示892例中,78.8%者内服中药汤剂,19.4%外用中药,所用中药性味多为辛温,内服药以祛风湿、补虚类药物居多,外用药以祛风湿、活血化瘀类药物为主.25.1%采用针灸治疗,常用穴位有膝眼、足三里、阳陵泉、阴陵泉、血海、梁丘等.13.1%接受推拿按摩治疗,但大多数病案未记载具体手法.46.2%内服NSAIDs,19.5%使用抗生素,15.4%使用激素类药物.表明中医医院对膝关节骨关节炎住院患者常采用中西医结合方法治疗,中医治疗多为各种方法组合的综合疗法,中药多选择性味辛温之品,祛风湿药、补虚药和活血化瘀类药物为临床常用中药.     

宫内节育器作用机制的研究现状

宫内节育器(IUD)在临床上推广应用已有30余年，我国是世界上使用IUD最多的国家，约有6000多万人。IUD作为一种可逆节育措施，其安全、有效、简便已为广大育龄妇女所共识。但其作用机制尚不甚明了，学者们从不同的角度对其进行了研究。本文将近10年的研究综述如下。1惰性IUD(第一代IUD)惰性IUD是最早出现的IUD，由惰性原料如金属、硅胶、塑料或尼龙等制成。国内主要为不锈钢圆环及其改良品。由于此类IUD妊娠率较高，目前已基本淘汰。但可作为载体，加入活性物质成为活性IUD供临床应用。大量研究表明[1、2]，使用IUD对妇女身体健…