The study on the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of nerve root sciatica: A protocol for systematic review and meta-analysis of randomized controlled trials

Background:Nerve root sciatica (NRS) is a common orthopedic disease, which usually occurs between 20 and 40 years of age, and the incidence rate is increasing year by year and is being younger. The disease has no special effect of treatment, clinically generally taking the symptomatic treatment, such as taking short-term glucocorticoids, sedatives, analgesics, and so on. Long-term use of drugs will adversely affect the patient''s gastrointestinal tract, liver, and kidney function. The surgical treatment has a high risk of surgery, high cost, side effects, and other problems, so the choice of treatment method has always been a difficult problem in clinical and scientific research. The study shows that 90% of patients with sciatica can be cured by non-surgical treatment, so conservative therapy is often used in the treatment of sciatica, traditional Chinese medicine treatment methods in the treatment of NRS has been widely used, which has achieved good results, but there is no evidence of evidence-based medicine. Therefore, this study uses systematic evaluation to conduct the scientific evaluation of the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS, and provide evidence-based medical evidence support for the treatment of NRS.Methods:Using the computer to retrieve the PubMed, ScienceDirect, Web of Science, Embase, Cochrane Library, CNKI, VIP, WANFANG Database, and CBM. Using the subject words and terminology words to retrieve the Chinese-English database and retrieve a randomized controlled study on the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS, and the range of search time is January 1990 to January 2021. The searched literature is screened and evaluated by two researchers respectively according to the inclusion and exclusion criteria. If there is disagreement, discussing it with the third researcher to determine the final inclusion of the literature. Using the RevMan 5.3 software to conduct the meta-analysis.Results:This study will compare the effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of NRS.Conclusion:The results of this study will be published in internationally influential academic journals to provide evidence-based medical evidence for the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding in the treatment of NRS.Ethics and dissemination:This study does not involve specific patients, and all research data comes from publicly available professional literature, so an ethics committee is not required to conduct an ethical review and approval of the study.OSF registration number:DOI 10.17605/OSF.IO/Q492E.     

电针结合穴位敷贴治疗肛肠手术后便秘临床观察

目的观察电针结合穴位敷贴治疗肛肠手术后便秘的临床疗效。方法 100例肛肠手术后便秘患者随机分为两组。治疗组采用针刺双侧天枢、足三里、上巨虚,同时在两侧天枢及上巨虚采取电针治疗,治疗30min后,将中药敷贴贴于神阙穴上;对照组采用开塞露灌肠治疗。2个疗程后比较两组治疗效果,及治疗前后排便次数、排便困难程度的变化。结果治疗组总有效率与对照组比较有明显差异(P0.05);治疗后两组排便次数较治疗前有明显变化(P0.05);治疗组治疗后排便困难程度积分较治疗前比较有明显差异(P0.05),对照组无明显变化。结论电针结合穴位敷贴是一种治疗肛肠手术后便秘的有效方法。     

本经取穴调控无先兆偏头痛患者基因表达谱的研究

【目的】研究针刺少阳经穴与针刺非经非穴治疗无先兆偏头痛患者前后的基因表达谱。【方法】采用基因芯片技术,分析比较采用经穴（经穴组）和非经非穴（非经非穴组）治疗无先兆偏头痛患者（各10例）后基因表达谱的差异;选取部分基因进行Real-time聚合酶链反应（RT－PCR）,验证基因芯片结果的准确性。【结果】经穴组治疗前后筛选出72个差异基因;非经非穴组治疗前后筛选出110个差异基因。经穴组差异基因涉及的功能包括脑内啡肽酶、 ATP合酶等,与治疗该病的关联性大。但非经非穴组涉及的基因功能广泛且分散,与治疗该病关联性较小,如细胞凋亡、 DNA修复等。 RT－PCR检测了经穴组的ATPAF2、 PTGS2、 TOR3A基因,非经非穴组的ACP2、 AURKA、 ARHGEF11、 CASP8基因,验证了基因芯片数据的可靠性。【结论】本经取穴治疗无先兆偏头痛的经穴效应在分子水平是多基因作用的综合结果,而非经非穴产生的安慰效应并未找到与之对应的与治疗无先兆偏头痛相关的靶基因,进一步证明了经穴效应的存在。     

表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及JNK信号通路的影响

【目的】观察表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及c－jun氨基末端激酶（JNK）信号通路的影响,探讨其对脑缺血再灌注损伤保护作用的可能机制。【方法】将120只SD大鼠随机分为假手术组、模型组、表里经配穴电针组、抑制剂组;参照Longa法复制局灶脑缺血再灌注模型,表里经配穴电针组取表里经配穴的足三里、三阴交和尺泽、合谷行电针治疗,每日1次。采用神经行为学评定各组大鼠不同时段神经行为, TUNEL法检测海马细胞凋亡指数,免疫组织化学法检测p－JNK表达。【结果】表里经配穴电针组、抑制剂组神经功能缺损评分均显著低于模型组（P＜0．05）;模型组凋亡指数显著高于假手术组（P＜0．01）,表里经配穴电针组和抑制剂组凋亡指数均显著低于模型组（P＜0．05）;模型组各时段p－JNK表达较假手术组显著增加（P＜0．01）,表里经配穴电针组、抑制剂组p－JNK表达较模型组显著降低（P＜0．05）。【结论】表里经配穴法可不同程度地减轻缺血再灌注后大鼠的神经功能缺损,减少细胞凋亡,其机制可能与抑制JNK信号通路有关。     

加味赤石脂禹余粮汤联合热敏灸治疗肝硬化腹水并顽固性腹泻疗效观察

【目的】观察加味赤石脂禹余粮汤联合热敏灸对肝硬化腹水并顽固性腹泻的临床疗效。【方法】选择肝硬化腹水并顽固性腹泻患者60例,随机分为治疗组与对照组各30例,对照组采用西医常规疗法加中药加味赤石脂禹余粮汤治疗,治疗组在对照组治疗基础上加用热敏灸疗法,观察2组患者腹泻、腹水及肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、前白蛋白(PA)]改善情况。【结果】(1)腹泻疗效:治疗组总有效率为100.00%,优于对照组的86.67%(P<0.05)。(2)腹水疗效:经彩超检查,治疗后2组的肝硬化腹水均有显著改善(P<0.05),且治疗组疗效优于对照组(P<0.05)。(3)肝功能作用:治疗后,2组TBIL、ALT、AST、ALB、PA指标均显著改善(P<0.05),且治疗组的改善作用均优于对照组(P<0.05)。(4)不良反应及随访情况:治疗过程中,治疗组与对照组均未发生明显不良反应。3个月后随访,对照组腹泻治愈患者中复发5例,治疗组无复发病例。【结论】加味赤石脂禹余粮汤联合热敏灸对肝硬化腹水并顽固性腹泻患者疗效显著,具有止泻迅速、应用方便、安全可靠等优点,并且有加速腹水消退、促进肝功能恢复的作用。     

针灸治疗干眼症

目的 总结近5年针灸治疗干眼症的临床研究进展,并提出存在问题与研究展望.方法 检索2008年1月-2013年6月发表的针灸治疗干眼症的临床研究文献,从临床疗效、临床操作、诊疗标准及作用机制角度进行探讨.结果 针灸治疗干眼症以眼周局部取穴为主,常用穴位有睛明、攒竹、太阳等,配穴以局部和远端取穴相结合为主,但诊疗标准缺乏统一,机制研究较少,有待进一步完善.结论 针灸通过刺激神经兴奋,促进泪腺、睑板腺主动分泌泪液,双向调节性激素水平等环节起到缓解眼部症状的功效.     

神门、三阴交穴位配伍改善失眠症患者焦虑、抑郁状态：随机对照研究

目的:观察电针神门、三阴交对失眠症患者焦虑、抑郁状态的影响,并探索其配伍效应的作用机制。方法:将90例失眠症患者随机分为配伍组、神门组和三阴交组,每组30例,并进一步筛选出37例焦虑状态患者(配伍组12例、神门组13例、三阴交组12例)和42例抑郁状态患者(配伍组14例、神门组14例、三阴交组14例)。配伍组、神门组、三阴交组分别予电针神门-三阴交、神门单穴及三阴交单穴,疏密波,频率5 Hz/25 Hz,治疗每次30 min,每天1次,连续治疗5 d为一疗程,共治疗2个疗程。分别于治疗前后评定各组患者失眠严重程度指数(ISI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分,检测血清多巴胺(DA)和去甲肾上腺素(NE)含量。结果:与治疗前比较,治疗后3组患者ISI、SAS、SDS评分均降低(P<0.05),配伍组ISI评分低于神门组(P<0.05)。治疗后,3组失眠症焦虑状态患者ISI、SAS评分及血清DA含量均较治疗前下降(P<0.05),配伍组、神门组患者血清NE较治疗前下降(P<0.05);配伍组、神门组患者SAS评分、血清NE含量及配伍组ISI评分低...     

Direct inhibition of rat leydig cell function by tamoxifen

The effects of tamoxifen on rat testicular steroidogenesis were studied using dispersed interstitial cells. Tamoxifen significantly inhibited LH-, and 8-bromo-adenosine 3′,5′-monophosphate (8-bromo-cyclic AMP)-stimulated testosterone synthesis in a dose-dependent manner. Tamoxifen (10^?5M) also reduced LH-stimulated cyclic AMP formation. The addition of equimolar concentrations of 17β-estradiol or tamoxifen separately to interstitial cells resulted in similar inhibition of LH-stimulated testosterone synthesis. When equimolar concentrations of 17β-estradiol and tamoxifen were added concomitantly to interstitial cells, the inhibition was additive. Present studies demonstrate that tamoxifen has direct inhibitory effects on testicular steroidogenesis: both at the plasma membrane resulting in decreased cyclic AMP formation and also at steps subsequent to cyclic AMP.     

穴位按摩结合“U”形枕干预在老年视网膜脱离术后病人中的应用

目的:探讨穴位按摩结合“U”形枕干预在老年视网膜脱离术后病人中的应用效果。方法:按随机数字表法将2017年9月—2019年9月收治的118例老年视网膜脱离术后病人分为观察组和对照组各59例,对照组行常规干预,观察组行穴位按摩结合“U”形枕干预。采用Kolcaba舒适状况量表对两组病人干预前、干预3 d、7 d、14 d的体位舒适度进行评价,采用匹兹堡睡眠质量指数量表(PSQI)对两组干预前、干预14 d后睡眠质量进行评价。结果:观察组病人干预3 d、7 d、14 d体位舒适度评分均高于对照组(P<0.05);观察组病人干预14 d后睡眠质量、睡眠时间、睡眠紊乱、睡眠效率、入睡时间、催眠药物、日间功能障碍、总分均低于对照组(P<0.05)。结论:对老年视网膜脱离术后病人实施穴位按摩结合“U”形枕干预可有效提升病人的舒适度,改善病人睡眠质量。     

经皮穴位电刺激不同时间对雷公藤甲素致大鼠急性肝损伤的影响

目的 观察经皮穴位电刺激（transcutanclus electrical acupoint stimulation,TEAS）不同刺激时间对雷公藤甲素致大鼠急性肝损伤的保护作用。方法 将50只SD大鼠随机分为空白组、模型组、TEAS Ⅰ组（刺激20 min）,TEAS Ⅱ组（刺激30 min）、TEAS Ⅲ组（刺激40 min）,以雷公藤甲素灌胃法复制急性肝损伤模型。TEAS各组刺激“足三里”穴,每日1次,连续5 d。观察肝脏组织形态学变化,检测血清天冬氨酸氨基转移酶（aspartate aminotransferase,AST）、丙氨酸氨基转移酶（alanine aminotransferase,ALT）及肝组织丙二醛（malondialdehyde,MDA）、肿瘤坏死因子- α（tumor necrosis factor- α,TNF- α）、白介素- 10（interleukin- 10,IL- 10）、硫化氢的含量。结果 模型组大鼠肝索排列紊乱,肝窦扩张,肝细胞水肿、脂肪变性、坏死;各TEAS组肝脏病理变化较模型组减轻。与空白组比较,模型组大鼠血清ALT、AST及肝组织MDA、TNF- α含量明显升高（P＜0.05）,硫化氢含量明显降低（P＜0.05）,肝组织IL- 10含量无明显变化（P＞0.05）。与模型组比较,TEAS Ⅰ、Ⅱ、Ⅲ组大鼠血清AST、ALT含量和肝组织MDA、TNF- α含量明显降低（P<0.05）或呈降低趋势（P>0.05）,硫化氢含量明显升高（P<0.05）。其中TEAS Ⅲ组与TEAS Ⅰ、Ⅱ组各指标比较,差异均具有统计学意义（P＜0.05）。结论 TEAS能减轻雷公藤甲素对肝组织的损伤,且较长时间（40 min）刺激的保护作用更为明显。