电针干预膝骨关节炎过程中转化生长因子β的调控作用*

背景: 电针治疗膝骨关节炎具有良好的中枢和外周镇痛作用。研究显示转化生长因子β在膝骨关节炎发生中具有重要作用。 目的：从转化生长因子β调控角度,认识电针治疗膝骨关节炎的可能作用机制。 方法：健康3月龄雄性SD大鼠,随机分为正常组、模型组、电针组和药物组。通过结扎大鼠股静脉并强迫运动的方法,建立膝骨关节炎动物模型。造模1个月后,电针组刺激内膝眼(EX-LE4)和犊鼻(ST 35)穴位,深0.1寸,脉冲2 Hz刺激20 min,1次/d,药物组为关节腔内注射药物透明质酸钠,0.1 mL/次,1次/周。治疗2周后,采集各组动物膝关节滑膜组织,观察转化生长因子β1、转化生长因子β1受体Ⅰ、转化生长因子β受体Ⅱ的表达。 结果与结论：膝关节骨关节炎动物膝关节滑膜中转化生长因子β1水平增加(P < 0.05),经电针或透明质酸钠治疗后,膝关节滑膜中转化生长因子β1水平降低(P < 0.05),且转化生长因子β1受体Ⅰ,Ⅱ含量出现显著降低(P < 0.05)。提示电针治疗膝骨关节炎是通过下调转化生长因子β1的含量来改善骨关节炎症状的,受体含量的减少有助于膝骨关节炎的恢复。     

温针腰神经根受压大鼠前列腺素E2的水平

背景:研究表明温针对降低大鼠腰神经根受压模型中前列腺素E2表达有重要意义。目的:探讨温针对大鼠腰神经根受压模型中前列腺素E2的调节作用,并与针刺和美洛昔康作对比。方法:60只SD大鼠随机等分为正常组、模型组、美洛昔康组、针刺组和温针组,后4组通过放置硅胶片建立大鼠腰神经根受压模型。美洛昔康组、针刺组、温针组大鼠分别在造模后予以3.75mg/kg美洛昔康灌胃、针刺和温针腰L5夹脊穴治疗14d。结果与结论:美洛昔康、针刺和温针都可以降低大鼠受压腰神经根组织中前列腺素E2的水平(P<0.01),温针较美洛昔康和针刺能更明显地降低前列腺素E2水平(P<0.01),提示温针可以有效地降低大鼠腰神经根受压模型中的前列腺素E2。     

温针对大鼠腰神经根受压模型中PLA2的影响

目的观察温针对大鼠腰神经根受压模型中PLA。的调节作用。方法将60只sD大鼠随机分为正常组、模型组、莫比可组、针刺组和温针组,每组12例。除了正常组外,其他各组通过放置硅胶片建立大鼠腰神经根受压模型。正常组不造模不治疗,模型组造模后不治疗,莫比克组、针刺组、温针组的大鼠分别在造模后予以莫比克灌胃、针刺、温针治疗14d,14d后所有大鼠麻醉处死取材,运用生化酶标板微孔检测法对每组大鼠受压神经根组织中PLAz进行测定。结果莫比可、针刺、温针都可以降低大鼠受压腰神经根组织中磷酯酶A：（PLA。）的含量（P（O．01,P〈O．05）,温针较莫比可和针刺能更明显地降低PLA：含量（P〉O．01,P〉O．05）。结论温针可以有效地降低大鼠腰神经根受压模型中的PLA：。     

穴位注射配合牵引治疗腰椎间盘突出症60例疗效观察

目的：观察穴位注射配合牵引治疗腰椎间盘突出症的临床疗效。方法：将120例腰椎间盘突出症患者随机分为治疗组与对照组各60例。对照组予腰椎牵引治疗,治疗组在腰椎牵引的基础上加用穴位注射鼠神经生长因子。治疗8周后比较两组间疗效差异。结果：治疗组VAs评分优于对照组,差异有统计学意义（P〈0．05）。总有效率治疗组为91．6％,对照组为78.3％．治疗组优于对照组,差异有统计学意义（P〈0．05）。结论：穴位注射配合牵引治疗腰椎间盘突出症有较好临床疗效。     

Community promotion of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint

Objective

To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint.

Methods

A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed.

Results

There were no between-group statistical differences before the treatment (all P>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (all P<0.01). In addition, no adverse events were reported by participants in the observation group.

Conclusion

Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

     

几丁糖关节腔注射结合手法治疗退行性膝骨关节炎临床研究

目的观察几丁糖关节腔注射结合手法治疗退行性膝骨关节炎的临床疗效。方法将120例患者随机分为对照组和治疗组,每组60例。对照组予单纯膝关节腔几丁糖注射疗法,治疗组同时加用手法治疗。两组疗程均为5周,观察临床疗效及膝关节WOMAC评分变化情况。结果治疗组、对照组总有效率分别为95.0%、88.3%,治疗组临床疗效优于对照组(P0.05)。两组治疗后膝关节疼痛、僵硬、关节功能积分均明显降低(P0.05),其中治疗组僵硬、关节功能积分降低幅度大于对照组(P0.05)。结论几丁糖关节腔注射结合手法治疗退行性膝骨关节炎的临床疗效良好,且安全可靠,相对于单纯膝关节腔注射疗法,能够更好地改善患者的膝关节僵硬及关节功能。     

耳穴揿针联合石膏外敷治疗肺胃湿热型寻常型痤疮疗效观察

目的 观察揿针联合石膏外敷治疗肺胃湿热型寻常型痤疮的临床疗效。方法 将100例肺胃湿热型寻常型痤疮患者随机分为治疗组和对照组,每组50例。对照组采用夫西地酸乳膏外用治疗,治疗组在此基础上联合耳穴揿针和石膏外敷治疗。观察两组治疗前后Pillsbury分级、痤疮特异性生活质量量表(acne-specific quality of life questionnaire, acne-QOL)评分和皮损症状评分变化,并比较两组临床疗效和不良反应情况。结果 治疗组总有效率为88.0%,对照组为64.0%,两组比较差异无统计学意义(P>0.05)。两组治疗后皮损症状评分低于治疗前(P<0.05);两组治疗后皮损症状评分及治疗前后皮损症状评分的差值比较有统计学意义(P<0.05)。两组治疗后Pillsbury分级和Acne-QOL评分优于治疗前(P<0.05),且治疗组优于对照组(P<0.05)。治疗组不良反应发生率为4%(2/50),与对照组的0%(0/50)比较差异无统计学意义(P>0.05)。结论 在常规药物治疗的基础上,揿针联合石膏外敷治疗肺胃湿热型寻常型痤...     

芒针恢刺治疗髂胫束摩擦综合征-随机临床试验（英文）

Objective:to observe the clinical effect of acupuncture by mángzhen huid(relaxing needling with sharp long needle) on iliotibial band friction syndrome(ITBS).Design:this was a two-arm randomized controlled trial with blinding of participants,outcome assessment and statistician.Setting:acupuncture-Moxibustion,Tuina and Orthopedics Department and the Orthopedics Department of Shanghai the Sixth People’s Hospital,June 2018 to January 2021.Participants:a total of 64 patients with iliotibial band fri...