循经针刺对偏头痛的即刻疗效及其机制探讨

目的:观察循经针刺治疗偏头痛患者的即可疗效,并通过检测降钙素基因相关肽(CGRP)、血浆内皮素(ET)和五羟色胺(5-HT)的表达情况探讨其机制。方法:选取2017年2月至2018年2月天津中医药大学附属武清中医院收治的偏头痛患者85例作为研究对象,根据随机数字表法将患者分为观察组(n=43)和对照组(n=40),排除不良反应的5例,2组均为40例,观察组予以循经针刺法针刺少阳经的角孙、风池、外关、阳陵泉和丘墟穴,对照组予以非经非穴治疗。于治疗前及治疗后0. 5、1、2和4 h进行偏头痛积分和VAS(视觉模拟量表评分)评估;采用放射免疫法检测降钙素基因相关肽(CGRP)和血浆内皮素(ET),利用ELISA(酶联免疫吸附剂测定)检测五羟色胺(5-HT),观察2组患者治疗前和治疗后4 h的表达情况,探讨循经针刺的疗效机制。记录研究过程中存在的不良反应。结果:1)观察组循经针刺对偏头痛的临床有效率是90. 00%,对照组是67. 50%,观察组的临床有效率优于对照组,2组比较差异有统计学意义(P 0. 05)。2) 2组治疗后0. 5、1、2和4 h的偏头痛积分和VAS评分均较治疗前下降(P 0. 05),仅治疗后2 h及治疗后4 h的偏头痛积分和VAS评分较对照组低(P 0. 05)。3) 2组治疗前CGRP和ET的表达差异无统计学意义(P 0. 05);与治疗前比较,2组治疗4 h后均可下调CGRP和ET的表达水平(P 0. 05);观察组治疗后CGRP和ET的下调水平优于对照组(P 0. 05)。4) 2组治疗前5-HT的表达无比较,差异统计学异议(P 0. 05);与治疗前比较,2组治疗4 h后均上调5-HT的表达水平(P 0. 05),其中观察组优于对照组(P 0. 05)。5)研究过程中5例患者出现不良反应,其中观察组出现3例(晕针2例+局部出血1例),对照组2例(晕针1例+局部出血1例)。晕针患者平卧取针后即可恢复,局部出血则以局部按压进行止血处理。整个研究过程中均未出现严重不良反应。结论:循经针刺治疗偏头痛患者的即刻疗效于治疗后0. 5 h症状开始缓解,于治疗后4 h疗效最佳,其即刻疗效可能与上调CGRP和5-HT表达水平和下调ET表达水平有关。     

Do humor styles predict clinical response to the MINDSET (MINDfulneSs & EducaTion) program? A pilot study in patients with fibromyalgia

Background and aimHumor has been described as an effective coping strategy for dealing with chronic pain conditions; likewise, coping strategies predict some clinical outcomes after cognitive-behavioral therapy and mindfulness-based interventions. The present study aims to preliminarily explore the role of humor styles in predicting clinical changes after the multicomponent intervention (MINDSET) that combines mindfulness and psychoeducation for fibromyalgia (FM) patients.Material and methodsA subsample of 35 patients with FM of the EUDAIMON study, a randomized controlled trial, was used for the present study; linear regressions and Spearman's correlations were computed.ResultsAffiliative humor and positive/negative ratio humor styles had a unique predictive effect on self-reported clinical changes. Significant correlations between humor styles with functional impact and mindfulness facets were observed.ConclusionsSome humor styles may imply a better disposition in patients to learn and implement the concepts and resources that the intervention offered.     

Five-year follow-up of clinical and radiological outcomes of LP-ESP elastomeric lumbar total disc replacement in active patients

Background context

The surgical treatment of degenerative disc disease at the lumbar spine may involve fusion. Total disc replacement (TDR) is an alternative treatment to avoid fusion-related adverse events, specifically adjacent segment disease. New generation of elastomeric non-articulating devices has been developed to more effectively replicate the shock absorption and flexural stiffness of native disc.

从“五脏相关”论治小儿慢性荨麻疹

"五脏相关"是岭南医家邓铁涛教授基于传统中医五行学说提出的概念。小儿慢性荨麻疹病因复杂,以风、火、湿邪多见,导致心火过亢、肝气郁滞、脾虚湿蕴、肺卫不固、阴阳两虚。治疗该病多从五脏着手,以清泄心火、疏肝理气、健脾祛湿、调和营卫、调和阴阳为法,标本同治、消补兼施。     

Preiser’s disease in a five-fingered hand

Preiser’s disease, also known as idiopathic avascular necrosis of the scaphoid, and five-fingered hand are rare hand conditions. In this report, we present a case of a 25 year old female patient who had avascular necrosis of the scaphoid and five-fingered hand.     

Agreeableness modulates mental state decoding: Electrophysiological evidence

Agreeableness is one of the five personality traits which is associated with theory of mind (ToM) abilities. One of the critical processes involved in ToM is the decoding of emotional cues. In the present study, we investigated whether this process is modulated by agreeableness using electroencephalography (EEG) while taking into account task complexity and sex differences that are expected to moderate the relationship between emotional decoding and agreeableness. This approach allowed us to identify at which stage of the neural processing agreeableness kicks in, in order to distinguish the impact on early, perceptual processes from slower, inferential processing. Two tasks were employed and submitted to 62 participants during EEG recording: the reading the mind in the eyes (RME) task, requiring the decoding of complex mental states from eye expressions, and the biological (e)motion task, involving the perception of basic emotional actions through point-light body stimuli. Event-related potential (ERP) results showed a significant correlation between agreeableness and the contrast for emotional and non-emotional trials in a late time window only during the RME task. Specifically, higher levels of agreeableness were associated with a deeper neural processing of emotional versus non-emotional trials within the whole and male samples. In contrast, the modulation in females was negligible. The source analysis highlighted that this ERP-agreeableness association engages the ventromedial prefrontal cortex. Our findings expand previous research on personality and social processing and confirm that sex modulates this relationship.     

家兔前肢太阴经五腧穴解剖

目的研究家兔前肢太阴经五腧穴：少商、鱼际、经渠、太渊和尺泽的层次结构。方法先对腧穴定位标识,逐一对腧穴层次解剖。结果五腧穴浅层穴树多以头静脉、桡神经浅支为基础,深层穴树以桡动脉及分支和正中神经为基础。结论家兔前肢太阴经五腧穴与头静脉、桡动脉及分支、桡神经、正中神经有密切的关系,这也许是针刺五腧穴治病的形态学基础。     

健康人胃经五输穴体表阻抗的年龄特征

目的了解五输穴体表阻抗的年龄特性。方法采用自行研制的人体穴位表面电阻测仪对2281名健康人的胃经五输穴体表阻抗进行测收,测试分别于中、青、老年组和其他条件一致的情况下测得。结果发现青年、中年之间各对应体表穴位阻抗值差异不大P〉0．05,老年组各体表穴位阻抗值明显高于青、中年组,有显著差异P〈0．05。各体表穴位问的阻抗值的差异也较明显,其体表穴位阻抗值按足三里、解溪、陷谷、内庭、厉兑顺序规律降低。统计学分析具有明显年龄差异。结论不同年龄组健康人胃经五输穴体表阻抗值有显著性差异。     

浅谈五行点穴疗法在临床中的应用

本文对五行点穴疗法在临床中的应用进行了浅谈。     

基于“脾应长夏”的胃肠激素季节变化与松果腺褪黑素的相关性研究

目的：观察大鼠血清褪黑素（MT）、胃泌素（GAS）及胃动素（MTL）五季中的含量变化,探讨胃肠动力的季节变化与松果腺褪黑素的相关性,揭示“脾应长夏”内涵。方法：在春、夏、长夏、秋及冬季分批饲养SD雄性大鼠,每一季节中的大鼠随机分为对照组（不做任何处理）和模型组（行松果腺摘除术）。饲养至节气点时间春分、夏至、立秋前1 d、秋分及冬至取材,酶联免疫吸附测定法（ELISA法检测血清中MT、GAS和MTL含量。结果：春、夏、长夏、秋、冬五季中对照组血清MT、GAS及MTL分泌存在季节性变化节律,均在长夏季节含量最低。松果腺摘除后,模型组中五季血清MT、GAS及MTL分泌的季节性变化节律发生改变,但各指标含量仍在长夏季节最低。长夏季节GAS及MTL分泌与褪黑素具有一致性。结论：胃肠消化系统的功能与中医脾藏象理论密切相关,松果腺褪黑素调节下的胃肠动力的季节变化为中医“脾应长夏”理论生理机制的研究提供了依据。