新型纳米非病毒基因转运系统治疗软骨缺损的实验研究

Objective To develop a clinically applicable approach to enhance repair of cartilage defects by constructing an in vivo non-viral gene transfer system targeting chondrocytes. Methods High molecular weight chitosan (HMWC) was degraded to produce low molecular weight chitosan (LM-WC) that was combined with transforming growth factor-β1 (TGF-β1) plasmid to form stable nano-sizc complexes. After being tested in vitro firstly, these nano-size complexes were injected into the knee joint of New Zealand white rabbit models with full-thickness cartilage defects to detect their feasibility of delive-ring the growth factor gent in vivo. Results The results showed that LMWC/DNA nano-sizc comple-xes could deliver the gone into the cultured chondroeytes and cartilage tissue efficiently in vitro. When used in vivo, LMWC/TGF-β1 gene nano-size complexes could enhance the transfection efficiency and prolong the expression of TGF-β1 gone. In the animal models of articular osteechondral defect of rabbits, better healing and gentler degeneration could be observed in comparison with the control. Conclusion In vivo transfection of LMWC/TGF-β1 nano-size complexe is a safe and effective method to early promote the repair of osteochondral defects.     

新型纳米非病毒基因转运系统治疗软骨缺损的实验研究

Objective To develop a clinically applicable approach to enhance repair of cartilage defects by constructing an in vivo non-viral gene transfer system targeting chondrocytes. Methods High molecular weight chitosan (HMWC) was degraded to produce low molecular weight chitosan (LM-WC) that was combined with transforming growth factor-β1 (TGF-β1) plasmid to form stable nano-sizc complexes. After being tested in vitro firstly, these nano-size complexes were injected into the knee joint of New Zealand white rabbit models with full-thickness cartilage defects to detect their feasibility of delive-ring the growth factor gent in vivo. Results The results showed that LMWC/DNA nano-sizc comple-xes could deliver the gone into the cultured chondroeytes and cartilage tissue efficiently in vitro. When used in vivo, LMWC/TGF-β1 gene nano-size complexes could enhance the transfection efficiency and prolong the expression of TGF-β1 gone. In the animal models of articular osteechondral defect of rabbits, better healing and gentler degeneration could be observed in comparison with the control. Conclusion In vivo transfection of LMWC/TGF-β1 nano-size complexe is a safe and effective method to early promote the repair of osteochondral defects.     

电针治疗腰椎间盘突出症术后下肢麻木172例及肌电图变化

[目的]研究电针治疗腰椎间盘突出症术后下肢麻木的疗效。[方法]将172例腰椎间盘突出症术后出现下肢麻木的患者分为两组,治疗组采用电针治疗,每日1次,10次1疗程,治疗两疗程,对照组使用甲钴胺口服治疗,连续服用25天,进行疗效比较,同时对两组患者进行治疗前后肌电图F波传导速度和频率进行检查对比。[结果]电针组总有效率为87.21%,药物组总有效率为74.42%,治疗组疗效明显优于对照组(P<0.05)。两组治疗前后F波传导速度和发生频率均较治疗前有明显改善(P<0.001),电针组明显优于药物组((P<0.001))。[结论]电针治疗可有效治疗腰椎间盘突出症患者术后下肢麻木症状,改善F波传导速度和发生频率。     

关刺结合温通针法治疗膝骨关节炎临床研究

目的观察关刺结合温通针法治疗膝骨关节炎的临床疗效。方法将320例膝骨关节炎患者随机分为治疗组(关刺结合温通针法组)161例、对照组(单纯针刺组)159例,并进行两组间的疗效评估。结果治疗组总有效率为90.7%,对照组总有效率为79.9%。两组疗效比较差异有统计学意义(P0.05)。结论关刺结合温通针法治疗膝骨关节炎的疗效优于单纯针刺治疗。     

电针对于腰神经根压迫兔子肌肉状态及电生理变化的作用

Objective

To observe the effects of electroacupuncture on force-displacement value (FDV) of muscle state and electrophysiology of the muscle in rabbits with lumbar nerve root compression.

Methods

Thirty New Zealand white rabbits were randomly divided into a control, a model, an electro-acupuncture acupoints (EAA), a medication, and an electro-acupuncture un-acupoints (EAU) group. All rabbits except those in the control group were subject to modeling (surgical lumbar nerve root compression). The control group was sham-operated without nerve root compression. The EAA group received electro-acupuncture at bilateral Shenshu (BL23) and Dachangshu (BL25) that were located 1.5 cun lateral to the posterior midline on the lower border of the spinous process of the 2nd and 4th lumbar vertebra, respectively. The EA was 15 mm deep and the frequency was 2 Hz. Each session lasted for 20 min per day for a total of 14 times. The medication group was treated with Loxoprofen sodium by gastrogavage at 4 mg/kg per day for 14 days. The EAU group received electro-acupuncture identical to the EAA group with regard to the treatment frequency and duration except a different acupoint at the tip of rabbit tail. Muscle states were determined by measuring FDVs of the bilateral biceps femoris using the Myotonometer® fast muscle state detector. Meanwhile, the prolonged and non-prolonged insertion potentials were measured by electromyography before and after modeling and after treatment. Latency, amplitude (Amp) of evoked potential, motor nerve conduction velocity (MNCV) were also determined after treatment.

Results

(1) After modeling, FDVs of right side activation (RSA, P=0.003) and right side relaxation (RSR) in the model group (P=0.000) were significantly decreased in comparison to the control group. The number of rabbits with non-prolonged insertion potentials in the model group was also significantly decreased (P=0.015) in comparison to the control group. (2) After treatment, FDVs of RSR were significantly increased in the EAA (P=0.000) and medication groups (P=0.018) in comparison to the model group. The increase in FDVs of RSR in the EAA group was significantly higher than that in EAU (P=0.000) and medication groups (P=0.002). MNCV in the model group was reduced compared with the control group (P=0.000). The reduction in MNCV after modeling was reversed in the EAA group (P=0.000) and medication group (P=0.008) after treatment and the increases were significant in both treatment groups in comparison to the model group. The EAA group had a greater MNCV recovery than the medication group (P=0.022).

Conclusion

Electro-acupuncture could improve the rehabilitation and regeneration of FDVs and the electrophysiology index of the muscle with nerve control impairment.     

Clinical Study on Treatment of Frozen Shoulder by Penetrating Needling with Manipulation

目的：观察透刺结合手法治疗肩关节周围炎的临床疗效。方法：采用随机分组方法，将336例符合纳入标准的肩关节周围炎患者分为治疗组（透刺＋手法）和对照组（单用透刺），分别采用肩髃透刺肩前穴结合手法以及单用透刺的方法治疗并进行比较研究，同时观察两组治疗前后肩关节功能活动分值以及红外热像图的改变。结果：治疗组疗效明显优于对照组，差异有统计学意义（P〈0．05）。结论：透刺结合手法是治疗肩关节周围炎的有效方法。     

Clinical Study on Treatment of Myofascial Pain Syndrome with Ashi Points

目的：探讨阿是穴治疗肌筋膜疼痛综合征的临床疗效。方法：将150例患者按就诊顺序随机分为治疗组和对照组，治疗组应用阿是穴“滞针法”针刺，配合“一指禅”推拿手法治疗；对照组应用扶他林乳剂局部涂擦治疗。两组均每日治疗1次，10次为1个疗程。结果治疗组90例，临床痊愈18例，显效34例，有效34例，显效率57．8％，总有效率94．4％；对照组60例，其中临床治愈1例，显效18例，有效15例，显效率31．7％，总有效率73．3％。，两组疗效经统计学处理，P〈0．01，有非常显著性差异，说明治疗组疗效明显优于对照组。同时本疗法可以有效改善本病引起的局部疼痛、压痛、肌肉痉挛、关节活动度等症状，对于肌肉痉挛、关节活动度的改善明显优于对照组。结论本疗法具有良好的临床疗效，且安全可靠，值得临床推广应用。     

一指禅推“筋会”阳陵泉治疗肝肾亏虚型腰椎间盘突出症

目的:观察一指禅推阳陵泉治疗肝肾亏虚型腰椎间盘突出症的临床疗效。方法:将100例腰椎间盘突出症患者随机分为观察组和对照组各50例。对照组采用中药离子导入疗法,观察组在对照组基础上给予一指禅推"筋会"阳陵泉穴疗法。两组治疗前后均进行腰部功能评估、中医证候量化积分功能进级评价、Myotonometer肌张力测试。结果:治疗前两组患者腰部功能评估、中医证候量化积分功能进级评价、Myotonometer肌张力测试差异均无统计学意义(P0.05)。Oswestry功能障碍指数(Oswestry disability index,ODI)结果,组内比较,两组治疗后的ODI总评分均低于治疗前,且具有显著性差异(P0.01);组间比较,两组治疗后,观察组的ODI指数明显低于对照组(P0.01)。中医证候量化积分功能进级评价结果,两组治疗后,观察组明显优于对照组,具有统计学差异(P0.05)。肌肉的压力-位移下面积比较结果,组内比较,两组治疗后患侧的腰方肌和胫前肌压力-位移下面积均高于治疗前,且均具有显著性差异(P0.01),说明两组患者治疗后腰部和腿部的肌肉顺应性均明显上升。组间比较,治疗后患侧腰方肌的压力-位移下面积,观察组稍高于对照组,但无统计学差异(P0.05);患侧胫前肌的压力-位移下面积,观察组明显高于对照组,且具有显著统计学差异(P0.01)。结论:一指禅推阳陵泉穴治疗肝肾亏虚型腰椎间盘突出症有确切的治疗作用,且安全可靠。     

坐位斜扳法治疗颈椎病的临床疗效

目的探讨坐位斜扳法治疗颈椎病的临床疗效。方法将84例颈椎病患者随机分为两组,分别采用坐位斜扳法和针刺治疗20 d,并观察疗效和起效时间。结果推拿治疗组总有效率为97.6%,针刺治疗组总有效率为95.2%,两组总有效率比较无统计学差异。推拿治疗组起效时间在1~2周之间,占42.9%;而针刺治疗组起效时间在2周~1个月之间,占45.2%,说明推拿的起效时间比针刺的早。结论坐位斜扳法治疗颈椎病起效快,疗程短,治疗方便安全,临床有一定的推广意义。     

麦粒灸配合三棱针挑刺治疗扁平疣的疗效观察

目的观察麦粒灸配合三棱针挑刺治疗扁平疣的临床疗效。方法将104例扁平疣患者随机分为治疗组53例与对照组51例。治疗组采用麦粒灸配合三棱针挑刺治疗,对照组采用外涂维A酸乳膏治疗。比较两组近期(治疗后)和远期(治疗后3个月)的疗效。结果治疗组治疗后总有效率和痊愈率分别为90.2%和62.7%,对照组分别为86.0%和48.0%,两组比较差异具有统计学意义(P0.05)。治疗组治疗后3个月总有效率和痊愈率分别为92.2%和64.7%,对照组分别为86.0%和48.0%,两组比较差异具有统计学意义(P0.05)。结论麦粒灸配合三棱针挑刺是一种治疗扁平疣的有效方法。