针刺联合高压氧治疗小儿格林-巴利综合征27例

目的:观察高压氧联合针刺治疗小儿格林-巴利综合征(GBS)的临床疗效。方法:将54例GBS患儿随机分为治疗组与对照组各27例,对照组给予常规内科治疗,治疗组加用高压氧、针刺治疗,连续治疗10 d为1个疗程,2个疗程后比较两组患者治疗效果。结果:治疗2个疗程后,治疗组愈显率(96.3%)明显高于对照组(74.1%)(P0.05);治疗组患儿呼吸肌麻痹、四肢肌力、肌张力、腱反射、感觉障碍恢复时间均明显短于对照组(P0.01)。结论:高压氧联合针刺治疗小儿格林-巴利综合征可明显提高临床治愈率、缩短病程、促进症状恢复,疗效显著。     

仲景治血痹用针遣药探析

血痹为体虚受风,卫阳不足,血行不畅所致。若病情属较轻,麻木不甚,脉见微涩,寸、关部微紧,脉微主阳气虚弱,脉涩为血行不畅,紧则是外受风寒之寒闭之脉。用针方面,治疗只需针引阳气令阳气通行,对于血分凝滞之病,不独治血分,可用针刺法引动阳气,亦即"气行则血行"之意。针能导引经络去诸痹,故宜针引气血,以泻其邪,而"用针之类,在于调气""调气"不仅是调阳气,调血气,还调一身之气,气被调动了,阳气行则外邪去,气血调和,则寒散痹除。用药方面,张仲景治血痹用黄芪桂枝五物汤以益气通阳,和营行痹,此方即桂枝汤去甘草加黄芪,倍用生姜。为何要去甘草加黄芪,倍用生姜?去甘草之意在于去掉甘草的缓和之性,使药效更快发挥作用;倍用生姜是取其辛温行阳,温振中阳而行卫表,助桂枝走表散邪,阳通血行,血痹自除。     

脑卒中后肩关节半脱位的综合治疗

肩关节半脱位的治疗方法有:针灸疗法、推拿疗法、中药疗法、现代康复疗法等。新的治疗方法也在不断出现,大部分都是采用几种方式结合治疗。现代康复手段是治疗脑卒中后肩关节半脱位最普遍和有效的治疗手段,传统的针灸推拿疗法也有很好的疗效,治疗时要根据患者本身情况结合多种治疗手段对患者进行治疗。另外,对于脑卒中患者应注意早期预防,尽量避免半脱位的发生,一旦发现要及时治疗,以免影响上肢功能的康复。     

针药结合治疗脑梗死后轻度认知障碍疗效观察:随机对照试验

ObjectiveTo observe the clinical effect of acupuncture in combination with medicine in the treatment of mild cognitive impairment after cerebral infarction as well as the impact on patients' daily living ability.MethodsSeventy-two patients, in accordance with random number table, were divided into two groups, acupuncture combined with western medicine group (group A) and western medicine group (group B), each group with 36 patients. In combination with nimodipine tablets, acupuncture which can regulate the mind and reinforce the intelligence [making Băihuì (

GV 20), Sìshéncōng (

EX-HN 1), Sìbái (

ST 2), Fēngchí (

GB 20), Wángŭ (

GB 12), Tiānzhù (

BL 10), Shénmén (

HT 7), Nèiguān (

PC 6), Shu

gōu (

GV 26), Sānyīnjiāo (

SP 6), Tàichōng (

LR 3), Fēnglóng (

ST 40) as the main acupoints] was given in the treatment group (group A) while only nimodipine tablets were given in the control group (group B). The efficacy of these two groups was evaluated by Montreal Cognitive Assessment (MoCA) Scale after the continuous treatment for three months.ResultsThe remarkably effective rate was 69.4% and the total effective rate was 91.7% in the treatment group, while the remarkably effective rate was 55.6% and the total effective rate was 80.6% in the control group; the differences between the two groups were statistically significant (P<0.05). When comparing the MoCA score before and after treatment, which was 20.23±4.67 before treatment and 26.84±3.87 after treatment in group A; 19.82±3.56 before treatment and 23.33±2.78 after treatment in group B, it was found that the score for both groups became higher after treatment than that before treatment. Furthermore, the increase of the score was higher in the treatment group (6.61±0.80) than that in the control group (3.51±0.78) and the differences were statistically significant (P<0.05).ConclusionsAcupuncture, which can regulate the mind and reinforce the intelligence, combined with nimodipine tablets is an effective therapy for the treatment of mild cognitive impairment after cerebral infarction, which is superior to single treatment with nimodipine tablets.     

巨刺法治疗肝阳上亢型偏头痛的临床疗效及其对患者血浆NO含量的影响

ObjectiveTo observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients.MethodsA total of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group (group A) and a routine acupuncture group (group B) by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Tàichōng (

LR 3), Zhōngzhí (

TE 3), Zúlínqì (

GB 41) and Qiūxū (

GB 40) in the uninjured side were selected. After deqi, reducing method was used. Then Tàixī (

Kl 3) in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 min. Patients in group B were treated with routine acupuncture. Local Āshì point, Sishéncōng (

EX-HN1), Yifēng (

TE 17), Fēngchí (

GB 20), Sīzhúkōng (

TE 23), Shuàigŭ (

GB 8), Hégŭ (

LI 4) and Lièquē (

LU 7) were selected. After puncturing, reducing method was used routinely and needles were retained for 30 min. After 2 weeks treatment, migraine specific quality of life questionnaire (MSQ), visual analogue scale (VAS) and nitric oxide (NO) level in plasma of patients in two groups were observed.ResultsAfter treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41 ± 10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ± 8.22 in group A and 75.45 ± 8.34 in group B; score of MSQ emotion was 80.51 ± 10.16 in group A and 75.01 ± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant (all P<0.05). After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17 ± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant (P<0.05). After treatment, blood plasma NO level was (42.15 ± 16.15) μmol/L in group A and (62.76 ± 15.17) μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant (P<0.05). Overall response rate was 86.7% (26/30) in group A and 53.3% (16/30) in group B, and the difference between two groups was statistically significant (P<0.05).ConclusionOpposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yang. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.     

针刀松解术结合脊柱调衡治疗椎动脉型颈椎病

目的观察针刀松解术结合脊柱调衡治疗椎动脉型颈椎病的临床疗效。方法将40例椎动脉型颈椎病患者随机等分为治疗组与对照组。针刀松解术结合脊柱调衡为治疗组,常规电针联合推拿为对照组;观察2组治疗后的临床疗效。结果治疗组治愈率和总有效率为70%、95%,对照组为40%、80%;2组疗效比较差异有统计学意义(P0.05)。结论针刀松解术结合脊柱调衡通过恢复颈椎内外生物力学平衡治疗椎动脉型颈椎病。     

中医药治疗糖尿病周围神经病变

糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)是糖尿病(diabetic mellitus,DM)累及周围神经系统的疾病,是糖尿病患者临床上最为常见的三大慢性并发症之一。现代医学对于DPN的病因及发病机制尚未完全阐明,目前认为主要是与血管神经障碍、代谢障碍和血液成分改变等因素相关,其病理改变主要是周围神经的节段性脱髓鞘和轴突变性或两者兼有。至此,长久以来西医除控制血糖和对症治疗外,尚无切实有效的治疗药物。近年来的研究结果及临床经验表明,中医药治疗DPN疗效确切,具有多靶点、多层面、多途径等优势。     

针刺结合药罐治疗颞颌关节紊乱症临床观察

ObjectiveTo observe the application of acupuncture at distal points combined with medicated cupping on the affected parts in the treatment of temporomandibular disorders (TMD) and to evaluate its effectiveness.MethodsA total of 120 patients with TMD were randomly divided into two groups according to the random number table and random number remainder method. Sixty-two patients in acupuncture combined with cupping group (group A) were treated with acupuncture at Hégŭ (

LI 4) and Tàichōng (

LR 3) combined with medicated cupping on the affected parts with Sānqī (

Radix et Rhizoma Notoginseng) and Báizh

(

Radix Angelicae Dahuricae). Fifty-eight patients in cupping group (group B) were just treated with medicated cupping. Patients were treated for 30 min each time, once daily, and 10 times were considered as one course of treatment. After one course of treatment, the therapeutic effect was evaluated. Before and after treatment, craniomandihular index (CMI), dysfunction index (DI), palpation index(PI) and changes in pain degree (VAS score) were compared.ResultsBefore and after treatment, CMI in group A were 0.27±0.02 and 0.04±0.01, respectively, and in group B were 0.29±0.02 and 0.06±0.01, respectively; PI in group A were 0.19±0.01 and 0.05±0.03, respectively, and in group B were 0.18±0.02 and 0.11±0.02, respectively; DI in group A were 0.33±0.04 and 0.06±0.02, respectively, and in group B were 0.34±0.05 and 0.11±0.04, respectively; VAS in group A were 5.39±0.24 and 2.13±0.47, respectively, and in group B were 5.70±0.31 and 3.97±0.26, respectively. After treatment, CMI, DI, PI and VAS in both groups significantly decreased when compared with those before treatment (all P<0.01), and the indices in group A were significantly lower than that in group B after treatment (all P<0.05), indicating that the difference was significant.ConclusionThe therapeutic effect of acupuncture at distal points combined with cupping at adjacent points in treatment of TMD is superior to that of single medicated cupping therapy.     

针刺对脑缺血后细胞凋亡相关基因Bcl-2Bax调节作用的研究

目的总结针刺对脑缺血后细胞凋亡相关基因Bcl-2、Bax的调节作用,探讨其效应特点。方法基于近10年的现代实验研究文献,简述Bcl-2、Bax基因与脑缺血后细胞凋亡的相关性,着重从整体特征、时效特点及不同针刺治疗方案的作用比较等三方面,就针刺对脑缺血后细胞凋亡相关基因Bcl-2、Bax的调节作用进行总结评述。结果针刺对Bcl-2、Bax基因的作用具有整体、双向性的调衡特征,能促进抗细胞凋亡基因Bcl-2蛋白的表达,抑制促细胞凋亡基因Bax蛋白的表达,增大Bcl-2/Bax比值,达到抗细胞凋亡的作用。结论针刺对Bcl-2、Bax基因的调节作用具有一定的时效特点,起效快,维持时间较长,介入治疗的最佳时机应在脑缺血早期。在总体效应基本趋同的基础上,不同的选穴组方或针刺方法,其调节作用又存在优劣程度的区别。