对穴位-脑功能影像学研究现状的思考——基于功能连接与穴脑相关学说的探讨

目前穴位效应的脑功能影像学研究基本肯定了针刺穴位后脑内相关区域的影像学信号会产生不同程度的变化,然而这些变化中是否存在着某些潜在的规律性联系却是一个值得探讨的问题。利用脑功能影像学研究中"功能连接"的概念分析针刺作用下的穴-脑相关的作用机制,从目前血氧水平依赖的神经活动影像信号分析,过渡到基于神经生物学手段的基因表达分析,对于进一步探讨穴位的脑功能特异性有着较为积极的意义。     

针刺对脑挫伤大鼠脑组织坏死面积及脑细胞凋亡的影响

目的观察针刺对脑挫伤模型大鼠脑组织坏死面积与脑细胞凋亡的影响。方法参照Feeney自由落体撞击造模法建立脑挫伤大鼠模型,将40只大鼠随机分为假手术组、模型组、纳络酮组、针刺组,每组10只。针刺组、纳络酮组分别给予针刺、腹腔注射纳络酮,每天1次,共7天。处理结束后,采用生物医学图像分析系统计算坏死面积、TUNEL法检测脑细胞凋亡。结果模型组大鼠脑组织损伤严重,坏死面积大于损伤面积,出现大量的脑细胞凋亡(P0.01);针刺组、纳络酮组脑组织坏死面积较模型组明显减小,且均小于损伤面积(P0.01);两组大鼠脑细胞凋亡指数较模型组明显减少(P0.01);针刺组脑组织坏死面积与纳络酮组比较无统计学意义(P0.05)。结论针刺可缩小脑挫伤模型大鼠脑织坏死面积、减少脑细胞凋亡,具有确切的抗继发性脑损伤作用。     

白花蛇舌草诱导HSP70表达对H22肝癌细胞移植瘤细胞凋亡的影响

目的 观察白花蛇舌草诱导HSP70表达对H22肝癌细胞移植瘤小鼠瘤组织细胞凋亡的影响.方法 以经过白花蛇舌草和党参处理后的小鼠活体腹水H22肝癌细胞免疫小鼠,用HSP70单抗封闭后分为白花蛇舌草未封闭组与封闭组、党参未封闭组与封闭组以及空白对照组,共5组,每组10只,然后再以培养的H22肝癌细胞攻击小鼠形成移植瘤;采用脱氧核糖核苷酸末端转移酶介导的缺口末端标记法原位检测移植瘤小鼠瘤组织细胞凋亡的情况.结果 白花蛇舌草组移植瘤小鼠瘤组织细胞核中可见较多棕褐色阳性颗粒,与党参组相比,细胞凋亡数及染色强度明显增多、增强;白花蛇舌草及党参组细胞凋亡的情况与空白对照组比较,差异均具有显著性,尤以白花蛇舌草组更为明显.尽管白花蛇舌草和党参未封闭组与封闭组组间细胞凋亡的差异并无显著性,但白花蛇舌草未封闭组较封闭组具有凋亡数增多和染色强度增强的趋势.结论 白花蛇舌草可能通过诱导H22肝癌细胞移植瘤小鼠瘤组织HSP70表达,在一定程度上促进肝癌细胞凋亡而达到抗肿瘤的作用.     

Depressive Neurosis Treated by Acupuncture for Regulating the Liver -A Report of 176 Cases

Objective： To observe therapeutic effect of acupuncture for regulating the liver on depressive neurosis. Methods： In a multi-center randomized controlled trial, 440 patients were divided into 3 groups： Acupuncture group for regulating the liver （Acup., 176 cases） was treated by acupuncture at Siguan Points, i.e. bilateral Hegu （LI 4） and Taichong （LR 3）, Baihui （GV 20） and Yintang （EX-HN3） plus ear-acupuncture, Prozac group （P., 176 cases） by oral administration of Prozac, and Non-acupoint needling group （NAN, 88 cases） by acupuncture at non-acupoints as acupuncture placebo. Self-rating Depression Scale （SDS） was examined before treatment, and one month, two and three months after treatment respectively to evaluate therapeutic effect, and Rating Scale for Side Effects （SERS） was used to evaluate the safety. Results： After one month of treatment, SDS scores in Acup. Group were significantly lower than that in P. Group （P〈0.05） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were lower than that in NAN Group （P〈0.05）, showing the SDS scores in Acup. Group 〈P. Group 〈NAN Group. After 2 months of treatment, SDS scores in Acup. Group were also significantly lower than that in P. Group （P〈0.01） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were also lower than that in NAN Group （P〈0.05）, showing the SDS scores in Acup. Group 〈P. Group 〈NAN Group. After 3 months of treatment, SDS scores in Acup. Group were also significantly lower than that in P. Group （P〈0.01） and than that in NAN Group （P〈0.01）, and SDS scores in P. Group were also lower than that in NAN Group （P〈0.01）, showing the SDS score in Acup. Group 〈P. Group 〈NAN Group. After treatment, SERS scores were 0.16±0.95, 6.51±5.09 and 0.23±1.36 in Acup. Group, P. Group and NAN Group respectively. A significant difference existed between Acup. Group and P. Group （P〈0.05）, but no significant difference between Acup. Group and NAN Group （P〉0.05）, showing the SERS scores in Acup. Group 〈NAN Group 〈P. Group. No side effect was found in Acup. and NAN groups. Conclusion： The therapeutic effect of acupuncture on depressive neurosis is better than or similar to that of Prozac but with less side effect.     

捏脊治疗糖尿病胃轻瘫的临床研究

目的:观察捏脊治疗糖尿病胃轻瘫(DGP)的疗效.方法:将68例DGP患者随机分为捏脊治疗组(A组)、捏脊加药物治疗组(8组)和对照组(C组),分别用捏脊、捏脊加吗丁啉和吗丁啉治疗,观察疗效和血浆胃动素、空腹血糖的变化.结果:在疗效上,A、B组均优于C组(P＜0.05);血浆胃动素三组治疗前后自身比较均有差异(P＜0.05),治疗后A、B纽比较无差异(P＞0.05),与C组比较有差异(P＜0.05);空腹血糖A、B组治疗前后自身比较有差异(P＜0.05),C组无差异(P＞0.05),治疗后A、B组比较无差异(P＞0.05),与C组比较均有差异(P＜0.01).[结论]捏脊是治疗该病的有效手段之一,有必要加强DGP动物模型的实验研究以阐明其作用机制.     

岐黄针疗法治疗中风后下肢痉挛的临床观察

【目的】观察岐黄针疗法治疗中风后下肢痉挛的临床疗效。【方法】将70例中风后下肢痉挛患者随机分为观察组和对照组,每组各35例,2组患者均给予内科常规治疗与康复训练,观察组给予岐黄针疗法治疗,对照组给予常规针刺治疗。治疗6次为1个疗程,共治疗2个疗程。治疗2周后,评价2组临床疗效,观察2组患者治疗前后改良Ashworth痉挛分级量表（MAS）评分的变化情况,以及下肢简化Fugl-Meyer(FMA)评分的变化情况。比较2组患者治疗前后改良Barthel指数评定量表（MBI）评分的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】（1）研究过程中,观察组失访2例,对照组失访2例。最终观察组33例、对照组33例纳入疗效统计。（2）治疗后,2组患者的MAS评分、FMA评分与MBI评分明显改善（P<0.05）,且观察组在改善MAS评分、FMA评分与MBI评分方面明显优于对照组,差异有统计学意义（P<0.05）。2组患者MAS评分、FMA评分与MBI评分治疗前后差值比较,差异有统计学意义（P<0.05）。（3）观察组总有效率为93.94%(31/33),对照组为72.73%...     

电针对血管性痴呆大鼠学习记忆能力及血浆TXB2和6-keto-PGF1α含量的影响

目的观察电针肾俞、脾俞、膈俞、百会四穴对血管性痴呆（VD）大鼠学习记忆能力及血浆中TXB2和6-keto-PGF1α含量的影响,进一步探讨针灸治疗VD的机制,为临床推广针灸治疗VD提供更多的实验依据。方法采取4血-管阻断法制备VD模型,用Morris水迷宫测定大鼠学习记忆能力,并用放射免疫法检测大鼠血浆中TXB2和6-keto-PGF1α含量。结果模型组大鼠表现明显的学习记忆障碍,潜伏期显著延长,血浆TXB2含量明显较假手术组高,血浆中6-keto-PGF1α含量明显较假手术组低。电针组潜伏期较模型组明显缩短,血浆TXB2含量显著低于模型组,而血浆6-keto-PGF1α含量明显高于模型组。结论电针能改善VD大鼠学习记忆能力,具有降低血浆TXB2含量和升高血浆6-keto-PGF1α含量的作用。     

Effect of Electro-acupuncture on Rat Joint Pathomorpnology of Chronic Adjuvant Arthritis Model

Objective:To study the effect of electro-acupuncture (EA) on pathomorphological changes of joints in rat model of chronic adjuvant arthritis. Methods: The rat chronic adjuvant arthritis model was established by subcutaneous injection of 0.1 ml of complete Freund's adjuvant to the left hind sole. Forty Wistar rats were randomly divided into the model group, the low frequency (2 Hz) EA group, the high frequency EA (100 Hz) group and the body acupuncture group. After being modeled except the model group, the other three groups were treated with EA or body acupuncture in Yanglingquan points (bilateral) for 3 weeks, the left ankle joints and metatarsal joints of rats were taken for pathological examination by fixing with 10% formalin and embedding in paraffin, sectioning and staining with HE. Results: Obvious inflammatory cell infiltration, loosened synovial tissue, damage of articular cartilage and proliferation of synovial cells and granulation tissue were observed in the sections of joints in model rats.     

Effects of Electroacupuncture on Learning, Memory and Formation System of Free Radicals in Brain Tissues of Vascular Dementia Model Rats

In order to observe the regulative effect of electro-acupuncture on the formation system of free radicals in the brain tissues and learning and memory in vascular dementia (VD) model rats, the Morris‘s water labyrinth was used for testing the learning ability and memory in VD model rats made by 4-vessel occlusion method, and the activities or contents of nitric oxide (NO), NO synthase (NOS), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) were determined. Results showed that the mean escape latency in the electro-acupuncture group was markedly reduced in place test, and the times swam the place of the plate-form in the original plate-form quadrant were significantly more than those in the rest three quadrants in spatial probe test as compared with the model group. In the electro-acupuncture group and the nimodipine group the contents of NO and MDA and the activity of NOS were decreased, while the activities of SOD and GSH-Px were increased. It is indicated that electro-acupuncture can modulate the production and clearance of free radicals, and improve the ability of learning and memory of the VD model rats.