肝胃百合汤联合氟西汀片治疗围绝经期功能性消化不良肝气犯胃证临床研究

目的观察肝胃百合汤联合氟西汀片治疗围绝经期功能性消化不良(MPFD)的临床疗效。方法采用随机数字表法将60例MPFD患者分为观察组和对照组各30例。观察组予肝胃百合汤,每日1剂,分2次口服;氟西汀片20 mg/次,1次/d。对照组予莫沙必利片5 mg/次、3次/d,氟西汀片20 mg/次、1次/d,口服。2组均连续治疗4周。观察2组治疗前后尼平消化不良症状指数(NDSI)评分、尼平消化不良生活质量指数(NDLQI)评分、汉密顿焦虑量表(HAMA)评分及汉密顿抑郁量表(HAMD)评分,检测血清胃泌素(GAS)、胃动素(MTL)水平,评价中医临床疗效。结果观察组总有效率为93.33%(28/30),对照组为80.00%(24/30),观察组明显优于对照组(P0.05)。与本组治疗前比较,2组治疗后中医症状积分、NDSI评分、HAMA评分及HAMD评分明显下降(P0.05,P0.01),NDLQI评分明显升高(P0.05);2组治疗后比较,观察组上述评分改善较对照组明显(P0.05)。与本组治疗前比较,2组治疗后血清GAS、MTL水平明显升高(P0.05);2组治疗后比较,观察组治疗后血清GAS、MTL水平明显高于对照组(P0.05)。结论肝胃百合汤联合氟西汀片治疗MPFD疗效显著,可缓解患者临床症状,改善其精神状态,升高血清GAS、MTL水平。     

不同施灸时间对脾胃虚寒型浅表性胃炎临床疗效的观察

目的:观察不同艾灸时间温和灸治疗浅表性胃炎(脾胃虚寒型)患者的临床疗效。方法:将84例脾胃虚寒型浅表性胃炎患者随机分为温和灸20min组、温和灸40min组和药物组,每组28例,温和灸组选择足三里、中脘、脾俞、胃俞温和灸20、40min,对各组治疗前后、随访的临床症状评分进行比较。结果:治疗后3组均有疗效,组间比较差异无统计学意义(P>0.05),治疗结束后1个月,温和灸20min、40min组与药物组疗效比较差异均有统计学意义(P<0.01,P<0.05);治疗后及治疗结束后1个月,3组浅表性胃炎症状积分与治疗前比较差异有统计学意义(P<0.01);治疗后与药物组比较,温和灸40min组上腹部胀满症状差异有统计学意义(P<0.05),温和灸20min组纳呆症状差异有统计学意义(P<0.05);治疗结束后1个月与药物组比较,温和灸20min组胃脘疼痛、纳呆症状差异有统计学意义(P<0.01,P<0.05),温和灸40min组上腹部胀满、纳呆症状差异有统计学意义(P<0.05,P<0.01)。结论:在远期疗效上,灸法组明显优于雷尼替丁组;改善患者症状方面,灸法组在近期疗效和远期疗效方面都明显高于雷尼替丁组。     

背俞穴隔药饼灸治疗慢性疲劳综合征疗效观察

目的观察背俞穴隔药饼灸治疗慢性疲劳综合征(CFS)的临床疗效及对患者疲劳症状和睡眠质量的影响。方法选取符合纳入标准的70例CFS患者,随机分为观察组和对照组,每组35例。对照组予谷维素、维生素B1和维生素B6治疗,观察组在对照组基础上予背俞穴隔药饼灸治疗,两组疗程均为4周。观察治疗前后疲劳量表-14(FS-14)评分及匹兹堡睡眠质量指数(PSQI)评分,并评价临床疗效。结果观察组总有效率为91.4%,高于对照组的77.1%,差异有统计学意义(P0.05);两组治疗后FS-14评分及PSQI评分均下降(P0.05);组间治疗后比较,观察组FS-14评分及PSQI评分下降更明显,差异有统计学意义(P0.05)。结论背俞穴隔药饼灸治疗CFS疗效确切,并能改善患者的疲劳症状及睡眠质量。     

不同灸量隔姜灸对脾虚证大鼠胃组织丝裂原细胞外激酶和细胞外调节蛋白激酶表达的影响

目的观察不同灸量隔姜灸对脾虚证大鼠胃组织丝裂原细胞外激酶(MEK)1/2和细胞外调节蛋白激酶(ERK)1/2表达的影响,探讨隔姜灸治疗脾虚证的可能作用机制及量效特征。方法将75只SD大鼠按随机数字表法分为空白对照组、模型组、隔姜灸3壮组、隔姜灸6壮组、隔姜灸9壮组,每组15只。200%大黄浓缩液4℃灌胃制作脾虚证大鼠模型。造模成功后,隔姜灸组选取"足三里""中脘"予不同灸量治疗,连续8 d。HE染色镜下观察大鼠胃组织病理学改变,免疫组化检测大鼠胃组织MEK1/2及ERK1/2的蛋白表达。结果与空白对照组比较,模型组大鼠胃黏膜损伤明显,可见较大的破损、脱落;与模型组比较,隔姜灸3壮组大鼠胃黏膜表面有部分脱落、破损情况改善,隔姜灸6壮组和隔姜灸9壮组大鼠胃黏膜表面较完整、脱落及破损明显改善。与空白对照组比较,模型组胃组织MEK1/2及ERK1/2蛋白表达明显升高(P0.01);与模型组比较,隔姜灸各组胃组织MEK1/2及ERK1/2蛋白明显表达升高(P0.01);与隔姜灸3壮组比较,隔姜灸6壮组和隔姜灸9壮组胃组织MEK1/2及ERK1/2蛋白表达明显升高(P0.01),但二者作用效果相当,差异无统计学意义(P0.05)。结论隔姜灸通过提高胃组织MEK1/2及ERK1/2的蛋白表达,激活MEK/ERK信号转导通路,进而促进脾虚证大鼠胃黏膜的修复。     

耳穴治疗戒断综合征的临床概况

戒断综合征是指长期吸烟、饮酒、上网、使用镇静安眠药或吸毒之人,在成瘾产生依赖性后,突然中断而出现的烦躁不安、呵欠连作、流泪流涎、全身疲乏、昏昏欲眠、感觉迟钝等一系列戒断现象,轻者性格改变,情绪不稳,重者出现精神症状甚或有杀人之念头等。严重影响到家庭甚至社会的安定,因此,戒断综合征已日趋受到医学界的重视。目前,     

温和灸不同灸治时间对浅表性胃炎脾胃虚寒证患者临床疗效及胃肠激素的影响

目的:通过观察不同灸治时间治疗浅表性胃炎脾胃虚寒证患者的临床疗效和胃肠激素的变化,探讨艾灸温补效应的量效规律及对患者血清胃肠激素的调整作用。方法:将84例浅表性胃炎脾胃虚寒证患者随机分到温和灸20min组28例、温和灸40min组28例、药物组28例。观察3组治疗前后的前列腺素E2(PGE2)、生长抑素(SS)和表皮生长因子(EGF)含量的变化及不同时点的临床疗效。结果:①3组治疗后比较,其疗效没有显著性差异(P>0.05);②治疗后及治疗结束后1个月随访时,3组的浅表性胃炎症状积分分别与治疗前比较均有非常显著性差异(P<0.01);治疗后3组间的浅表性胃炎症状积分比较无显著性差异(P>0.05);治疗结束后1个月随访3组间的浅表性胃炎症状积分有非常显著性差异(P<0.01),温和灸20 min组与药物组比较,差异有非常显著性差异(P<0.01);3.3组治疗后,血清PGE2含量明显升高,与各组治疗前比较都具有显著性差异(P<0.05);温和灸40min后,血清EGF含量明显升高,与治疗前比较具有显著性差异(P<0.05)。结论:①3种治疗方法均具有明显疗效,且3组间疗效没有明显差异,但在远期疗效上,灸法组明显优于药物组;②灸法对浅表性胃炎脾胃虚寒证患者胃肠激素具有一定的调整作用,并提示胃肠激素可能参与其发病及病理生理过程。     

不同灸治时间对脾胃虚寒型浅表性胃炎胃肠激素的影响

目的 通过观察不同灸治时间治疗脾胃虚寒型浅表性胃炎患者的临床疗效和胃肠激素的变化,探讨艾灸温补效应的量效规律及对血清胃肠激素的调整作用.方法 将84例脾胃虚寒型浅表性胃炎患者通过中心随机方法(由湖南中医药大学承担中心随机,通过手机短信申请获得随机分组信息)分为温和灸20 min组、温和灸40 min组、药物组各28例....     

隔药饼灸配合针刺治疗腰椎间盘突出症

目的 探讨隔药饼灸配合针刺治疗腰椎间盘突出症(LDH)的临床疗效.方法 将80例患者按随机数字表法分为2组,每组40例.观察组予针刺配合隔药饼灸夹脊、环跳、委中、昆仑等穴,对照组予针刺配合隔面饼灸相同的穴位.均1次/d,共治疗10 d.观察治疗前后的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分,并评价临床疗效,进行对比分析.结果 观察组和对照组的总有效率分别为97.5%、90.0%,观察组高于对照组(P<0.05);治疗后2组VAS评分、ODI评分较治疗前下降,差异有统计学意义(P<0.05,P<0.01);治疗后观察组VAS评分为(1.32±0.83),ODI评分为(13.18±7.73),均低于对照组(P<0.05).结论 隔药饼灸配合针刺治疗腰椎间盘突出症,能明显减轻疼痛,改善腰椎功能.     

肩三带为主刮痧治疗肩关节周围炎的疗效观察

目的观察肩三带为主刮痧联合塞来昔布胶囊、持续被动运动治疗肩关节周围炎(肩周炎)的临床疗效及对患者疼痛程度和功能活动的影响。方法 96例肩周炎患者随机分为观察组和对照组,每组48例。对照组予塞来昔布胶囊和持续被动运动,观察组在对照组的基础上予肩三带为主刮痧治疗。观察两组治疗前后的疼痛视觉模拟评分(VAS)及Constant-Murley肩关节功能评分(CMS评分)变化,并比较两组临床疗效。结果观察组总有效率为95.8%,高于对照组的81.3%(P0.05)。两组患者治疗后VAS评分均较治疗前下降,CMS评分均较治疗前升高(P0.05);观察组治疗后VAS评分及CMS评分优于对照组(P0.05)。结论肩三带为主刮痧联合塞来昔布胶囊、持续被动运动治疗肩周炎疗效显著,并能减轻患者疼痛症状以及改善患者肩部功能活动。     

Effects of different doses of ginger-partitioned moxibustion on trefoil factor 1, mucin 5AC and epidermal growth factor receptor in rats with spleen deficiency syndrome

Objective

To observe the effects of different doses of ginger-partitioned moxibustion on serum trefoil factor 1 (TFF1) and mucin 5AC (MUC5AC) levels, as well as the expression of epidermal growth factor receptor (EGFR) in gastric mucosa of rats with spleen deficiency syndrome, therefore, to explore the possible mechanism and the dose-effect characteristics of ginger-partitioned moxibustion in spleen deficiency syndrome.

Methods

Seventy-five SPF grade Sprague-Dawley (SD) rats were randomly divided into a blank control group (group A), a model group (group B), a 3 moxa-cone ginger-partitioned moxibustion group (group C1), a 6 moxa-cone ginger-partitioned moxibustion group (group C2) and a 9 moxa-cone ginger-partitioned moxibustion group (group C3) using random number table method, 15 rats in each group. Except group A, rats in the other groups received intragastric administration of 4 °C 200% concentrated Da Huang (Radix et Rhizoma Rhei) to prepare spleen deficiency syndrome model. After successful modeling, rats in group B received no treatment; rats in group C1, C2 and C3 were treated with 3, 6 and 9 moxa-cone ginger-partitioned moxibustion at Zusanli (ST 36) and Zhongwan (CV 12) respectively for 8 continuous days. The general symptom score of rats was observed. The serum levels of TFF1 and MUC5AC were detected by enzyme-linked immunosorbent assay (ELISA). The expression of EGFR protein in gastric mucosa was detected by immunohistochemistry.

Results

After the treatment, compared with group A, the spleen deficiency symptom score was increased in group B, the levels of serum TFF1 and MUC5AC, the EGFR protein expression in gastric tissues of group C1, C2 and C3 were significantly increased (all P<0.01); compared with group B, the spleen deficiency scores were decreased in group C1, C2 and C3, and the serum levels of TFF1 and MUC5AC, as well as EGFR protein expression in gastric tissues were increased (all P<0.01). Compared with group C1, the spleen deficiency scores were decreased in group C2 and C3, the serum levels of TFF1 and MUC5AC, and the expression of EGFR protein in gastric tissues were increased (all P<0.01), however, there was no significant difference between group C2 and C3 (all P>0.05). The mechanism may be related to the increase of serum TFF1 and MUC5AC levels and activation of EGFR protein.

Conclusion

Ginger-partitioned moxibustion can improve the symptoms, as well as promote the proliferation and repair of gastric mucosa in rats with spleen deficiency. The therapeutic efficacy of 6 or 9 moxa-cone ginger-partitioned moxibustion is better than that of 3 moxa-cone ginger-partitioned moxibustion, while the efficacies are equivalent between 6 and 9 moxa-cone ginger-partitioned moxibustion groups.