石门穴临床应用举隅

介绍石门穴的局部解剖、针灸方法、主治功效及其对尿路感染、小儿遗尿、妇女避孕等验案四则。     

A precise and accurate acupoint location obtained on the face using consistency matrix pointwise fusion method

OBJECTIVE: To develop a more precise and accurate method, and identified a procedure to measure whether an acupoint had been correctly located.METHODS: On the face, we used an acupoint location from different acupuncture experts and obtained the most precise and accurate values of acupoint location based on the consistency information fusion algorithm, through a virtual simulation of the facial orientation coordinate system.RESULTS: Because of inconsistencies in each acupuncture expert’s original data, the system error could not be modified using the characteristics ofthe general weight calculation. First, we corrected each expert of acupoint location system error itself,to obtain a rational quantification for each expert of acupuncture and moxibustion acupoint location consistent support degree, to obtain pointwise variable precision fusion results, to put every expert’s acupuncture acupoint location fusion error enhanced to pointwise variable precision. Then, we more effectively used the measured characteristics of different acupuncture expert’s acupoint location, to improve the measurement information utilization efficiency and acupuncture acupoint location precision and accuracy.CONCLUSION: Based on using the consistency matrix pointwise fusion method on the acupuncture experts’ acupoint location values, each expert’s acupoint location information could be calculated, and the most precise and accurate values of each expert’s acupoint location could be obtained.     

艾灸预处理对大鼠应激性胃黏膜损伤增殖修复相关因子的影响

目的:观察艾灸预处理对应激性胃黏膜损伤大鼠血清和胃黏膜表皮生长因子(EGF)、转化生长因子-α(TGF-α)、胃黏膜三叶因子家族-1(TFF1)、增殖细胞核抗原(PCNA)的影响,探讨艾灸预处理促进胃黏膜损伤增殖修复的作用机制.方法:将48只健康SD大鼠随机分为4组,即空白组、模型组、艾灸穴位组、艾灸非穴组.束缚冷应激法制作大鼠应激性胃黏膜损伤模型.造模之前,艾灸组选取足三里、中脘、脾俞和胃俞等穴位行艾灸预处理8d,艾灸非穴组选取非穴对照点进行预处理.以Guth法计算胃黏膜损伤指数,光镜下观察大鼠胃黏膜组织学改变,放射免疫法测定血清EGF与TGF-α的含量,酶免法检测胃黏膜组织中EGF、TGF-α、TFF1和PCNA的含量.结果:与模型组和艾灸非穴组比较,艾灸足三里、中脘等穴位可使应激性胃黏膜损伤大鼠胃黏膜损伤指数明显下降(14.667±5.710vs27.250±7.448,24.750±7.300,P<0.01),血清EGF、TGF-α含量升高(2.167±0.756vs1.147±0.983,1.358±0.962,P<0.05;11.170±1.315vs4.585±0.720vs5.118±0.659,P<0.01),胃黏膜EGF、TGF-α和PCNA含量升高(343.560±27.644vs269.610±45.119,279.590±58.890,P<0.05;147.470±17.784vs115.530±24.319,116.620±14.908,P<0.01;191.910±37.262vs154.580±18.910,152.450±20.333,P<0.05);与模型组比较,艾灸穴位组胃黏膜TFF1含量明显升高(4.573±0.121vs3.654±0.507,P<0.05).结论:艾灸足三里、中脘等穴位预处理可减轻束缚水浸应激所造成大鼠胃黏膜损伤、促进胃黏膜损伤组织增殖修复,可能是通过上调胃黏膜损伤增殖修复相关因子(EGF、TGF-α、TFF1和PCNA)而达到其促胃黏膜损伤修复的作用.     

孤束核、脊髓损毁后艾灸预处理对急性胃黏膜损伤大鼠PGE2与EGF含量的影响

目的:损毁大鼠中枢神经通路中的孤束核和脊髓,观察艾灸预处理对胃黏膜内源性保护物质前列腺素E2(prostaglandin E2,PGE2)和表皮生长因子(epidermal growth factor,EGF)含量的影响,进而探讨艾灸启动内源性保护信息与中枢神经通路的关系.方法:50只SD大鼠随机分5组,即A:空白对照组;B:模型对照组;C:温和灸+模型组;D:温和灸+模型组+孤束核损毁组;E:温和灸+模型组+脊髓损毁组.预先按要求对D、E组大鼠分别实施孤束核、脊髓的损毁手术,再对相应组别进行艾灸处理,最后用无水酒精灌胃造成急性胃黏膜损伤模型.运用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)法检测胃黏膜组织中PGE2和EGF的含量.结果:艾灸预处理有上调胃黏膜中PGE2、E G F含量的作用(338.82g/L±19.87g/Lvs279.52g/L±16.53g/L,P<0.01;4037.12g/L±300.20g/L vs2923.73g/L±251.23g/L,P<0.05),孤束核和脊髓被损毁的2组大鼠胃黏膜PGE2和EGF的含量明显低于神经通路未损伤的温和灸组(298.65g/L±12.89g/L,317.56g/L±16.60g/Lvs338.82g/L±19.87g/L;3176.21g/L±242.35g/L,3337.43g/L±249.86g/L vs4037.12g/L±300.20g/L,均P<0.01),且孤束核损毁的大鼠胃黏膜中PGE2的含量较脊髓损毁的低(P<0.05).结论:损毁大鼠中枢神经通路中的孤束核和脊髓对艾灸预处理提高胃黏膜组织中PGE2、EGF含量有影响,提示孤束核和脊髓均参与了艾灸保护胃黏膜信号的传导.其中,艾灸诱导胃黏膜PGE2的产生可能主要受控于孤束核,而其对胃黏膜EGF表达调控则与孤束核和脊髓均有关.     

不同针法镇痛后效应与下丘脑β-内啡呔机制研究

目的探求不同针法镇痛后效应的下丘脑作用机制.方法以急性佐剂性关节炎(AA)大鼠为疼痛模型,比较手针组、水针组、电针组和刺血组AA大鼠下丘脑β-内啡呔(β-EP)的含量.结果不同针法治疗后,在0.5小时内,都使β-EP的含量进一步升高,其中电针和手针组的效应还持续到30min.结论不同针法的镇痛后效应与其调节中枢镇痛物质β-EP的含量有关.     

Clinical effects of innovative tuina manipulations on treating cervical spondylosis of vertebral artery type and changes in cerebral blood flow

OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.     

康复推拿对脑卒中痉挛期患者生活能力与肢体运动功能作用的评价

目的:评价康复推拿疗法对脑卒中偏瘫痉挛患者的康复治疗效果。方法:将缺血性脑卒中偏瘫痉挛60例随机分为治疗组和对照组各30例,治疗组在住院常规治疗的基础上采用康复推拿治疗,对照组只进行常规住院治疗。对两组患者在入组时、治疗1月后进行上下肢Fugl-Meyer运动功能评价与改良Barthel指数日常生活活动能力评价。并对组间疗效进行比较。结果:经治疗1月后,上肢Fugl-Meyer运动功能评分仅表现出较对照组增高的趋势,差异无显著性(P>0.05),下肢Fugl-Meyer运动功能评分与改良Barthel指数评分差异有显著性(P<0.05),总体上治疗组效果优于对照组。结论:康复推拿有助于促进脑卒中痉挛状态患者的运动功能恢复,对提高下肢运动能力与日常生活能力效果良好。     

电针对青少年肾功能的影响

目的观察电针对肾脏泌尿功能的影响。方法以青少年为对象,观察电针肾俞、中极、三阴交和悬钟穴在无负荷、盐水负荷、水负荷以及盐水负荷加利尿剂的情况下对肾脏泌尿功能的影响。结果在前两种情况下,各穴位对肾泌尿功能都有促进作用,以肾俞、中极有显著意义（Ｐ＜０．０５）,而在后两种情况下,各穴位对肾泌尿功能都有抑制作用,亦以肾俞、中极明显（Ｐ＜０．０５）。结论肾俞、中极是电针治疗水肿的主要穴位,但是要注意时机和机体反应。     

有烟艾灸、无烟艾灸对急性胃黏膜损伤大鼠血清中SOD、MDA的影响

目的:观测有烟艾灸、无烟灸对急性胃黏膜损伤修复作用的差异.方法:40只SPF级SD大鼠随机分为4组,即正常对照组、模型组、有烟艾灸组、无烟灸组,每组10例,采用无水乙醇灌胃制备急性胃黏膜损伤模型.采用比色法检测体内超氧化物歧化酶(super oxide dismutase,SOD)的活性、丙二醛(malondialdehyde,MDA)的含量,HE染色光镜下观察胃黏膜组织形态学变化.结果:(1)胃黏膜组织炎症病理学评分比较:与正常对照组比较(0.75±0.46),模型组病理组织学评分明显升高(7.75±1.67vs0.75±0.46,P<0.01);有烟艾灸组、无烟灸组明显低于模型组(4.63±0.52vs7.75±1.67、4.75±0.46vs7.75±1.67,P<0.01);有烟艾灸组与无烟灸组比较无显著差异(4.63±0.52vs4.75±0.46);(2)血清中SOD、MDA值比较:与正常对照组比较(301.48±16.675、6.77±0.529),模型组SOD值明显降低(260.07±15.481vs301.48±16.675,P<0.01)、MDA值明显升高(9.73±0.704vs6.77±0.529,P<0.01);与模型组比较,有烟艾灸组、无烟灸组SOD值明显升高,且有显著性差异(281.03±17.713vs260.07±15.481、278.61±17.550vs260.07±15.481,P<0.05)、MDA值降低,有显著性差异(7.52±0.361vs9.73±0.704、7.78±0.387vs9.73±0.704,P<0.01);有烟艾灸组较无烟灸组SOD值稍高(281.03±17.713vs278.61±17.550)、MDA值稍低(7.52±0.361vs7.78±0.387),但两组无显著性差异.结论:(1)有烟艾灸、无烟灸对急性胃黏膜损伤具有修复作用,且两者之间抗氧化比较没有明显差异;(2)有烟艾灸、无烟灸通过上调SOD活性、降低MDA含量,调节氧化/还原的动态平衡,使胃黏膜达到抗氧化损伤的作用.     

艾灸预处理对应激性胃黏膜损伤大鼠血清IL-1β、TNF-α和IL-10的影响

目的观察艾灸预处理对应激性胃黏膜损伤大鼠白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）的影响,探讨艾灸预处理抗胃黏膜炎症损伤的作用机制。方法将SD大鼠随机分为空白组、模型组、艾灸穴位组、艾灸非穴点对照组。束缚冷应激法制作应激性胃黏膜损伤模型,按Guth法计算胃黏膜损伤指数（UI）,放射免疫法测定血清IL-1β、TNF-α和IL-10的含量。结果与模型组和艾灸非穴点对照组比较,艾灸足三里、中脘等穴可使应激性胃黏膜损伤UI明显下降、血清IL-1β含量降低、TNF-α含量降低、IL-10含量升高。结论艾灸足三里、中脘等穴预处理可促进大鼠胃黏膜损伤的修复、减轻急性炎症反应,可能是通过抑制细胞炎症反应的免疫促炎因子IL-1β、TNF-α和促进抗炎因子IL-10而达到其抗胃黏膜损伤作用。