针刺膈俞穴的活血化瘀作用(英文)

Effect of acupuncture at Geshu on activating blood circulation and resolving stasis

背景:膈俞穴为八会穴之一的血会,具有补血养血,活血化瘀的功能。目的:通过针刺膈俞穴治疗血瘀证,探讨其对血瘀证的活血化瘀功能。设计:随机对照,正常对照观察。单位:华中科技大学同济医学院附属协和医院。对象:选择2001-01/2002-12在华中科技大学同济医学院附属协和医院针灸科住院的血瘀证患者65例。方法:将65例患者随机分治疗组33例和对照组32例。对照组:口服活血化瘀中成药龙血竭,4片/次,3次/d,15d为1个疗程。治疗组:取双侧膈俞穴,穴位常规消毒,用25mm毫针进针得气后,采用平补平泻手法行针5min,留针10min,再行平补平泻手法5min,留针10min,然后出针,1次/d。采用放射免疫分析法检测血浆6-酮-前列腺素后F10、血浆血栓素B2含量。临床疗效标准(治愈为舌淡红,脉和缓有力,肢体疼痛、皮肤黏膜瘀斑消失,痛经消失,偏瘫肢体基本恢复正常功能,麻木消失。有效为舌暗红,脉微涩,肢体疼痛减轻,皮肤黏膜瘀斑减少,痛经减轻,偏瘫肢体部分恢复功能,麻木减轻。无效为治疗前后临床症状无变化)。主要观察指标:①观察两组患者的疗效。②观察血浆6-K-P、TXB2含量及6-K-P/TXB2值。结果:65例患者均进入结果分析。①两组患者疗效比较:治疗组明显高于对照组[治愈:(15,10);有效:(13,11)]。②血浆6-K-P含量比较:治疗组治疗后明显高于治疗前[(159.28±16.48),(117.25±16.47)μg/L,P<0.05];对照组治疗后明显高于治疗前[(133.51±13.97),(114.64±16.39)μg/L,P<0.05]。③血浆TXB2含量比较:治疗组治疗后明显低于治疗前[(98.21±11.38),(110.45±1067)μg/L,P<0.05];对照组治疗后明显低于治疗前[(101.15±12.14),(109.21±11.58)μg/L,P<0.05)。④血浆6-K-P/TXB2值:治疗组治疗后明显高于治疗前(1.621±0.203,1.101±0.316,P<0.05);对照组治疗后明显高于治疗前(1.322±0.216,1.234±0.305,P<0.05)。结论:针刺膈俞穴可提高血浆6-K-P含量和6-K-P/TXB2值。降低TXB2含量,说明针刺膈俞穴通常调节血瘀证患者失衡的PGI2-TXA2系统,从而达到活血化瘀的作用。

BACKGROUND： Geshu （BL 17） is one of eight influential points of blood, acting on tonifying blood, nourishing blood, activating blood circulation and resolving stasis. OBJECTIVE： To explore the effect of Geshu （BL 17） on activating blood circulation and resolving stasis in blood stagnation syndrome with acupuncture. DESIGN： Randomized controlled and normal controlled observations were designed. SETTING： Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. PARTICIPANTS： Totally 65 cases of blood stagnation syndrome were selected from inpatients in Department of Acupuncture and Moxibustion in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. METHODS： Totally 65 cases were randomized into experiment group （33 cases） and the control （32 cases）. In the control, the patent Chinese drug, longxuejie was administrated orally for activating blood circulation and resolving stasis, 4 tablets/time, 3 times/day, 15 days made 1 course of treatment. In experiment group, Geshu （BL 17） was localized bilaterally; after routine sterilization on the points, a filiform needle, 25 mm in length was inserted and manipulated with even technique after arrival of qi for 5 minutes. In 15 minutes of needle retaining, the needle was manipulated for another 5 minutes and retained for 10 minutes, and then, the needle was withdrawn. The treatment was given once a day. Radioimmunoassay （RIA） was applied to determine the levels of 6-K-P and thromboxane B2 （TXB2） in plasma. Criteria on clinical therapeutic effects： Being cured is determined by slight red tongue, retarded and forceful pulse, disappearance of limb pain, skin and mucosal ecchymosis and dysmenorrhea, basic recovery of motor function in hemiplegia and disappearance of numbness. Being effective is by dark red tongue, slightly hesitant pulse, alleviation of limb pain, reducing of skin and mucosal ecchymosis, alleviation of dysmenorrhea, partial recovery of motor function in hemiplegia and alleviation of numbness. No effect is by none of any change of clinical symptoms in comparison before and after treatment. MAIN OUTCOME MEASURES：① Observation of therapeutic effects between two groups.② Observation of plasma 6-K-P and TXB2 levels and 6-K-P/TXB2. RESULTS： Totally 65 cases were all in the result analysis. ①Observation of therapeutic effects between two groups： The therapeutic effect in experiment group was higher remarkably than that in the control [be cured： （15,10）; be effective： （13,11）]. ②Comparison of plasma 6-K-P levels： In experiment group, it was higher remarkably after treatment compared with that before treatment [（159.28±16.48）, （117.25±16.47） μg/L, P 〈 0.05]. In the control, it was higher remarkably after treatment compared with that before treatment [（133.51±13.97）, （114.64±16.39） μg/L, P 〈 0.05]. ③ Comparison of plasma TXB2 level： In experiment group, it was lower remarkably after treatment compared with that before treatment [（98.21 ±11.38）, （110.45±1067） μg/L, P 〈 0.05]. In the control, it was lower remarkably after treatment compared with that before treatment [（101.15 ±12.14）, （109.21±11.58） μg/L, P 〈 0.05]. ④ Plasma 6-K-P/TXB2： In experiment group, it was higher remarkably after treatment compared with that before treatment （1.621±0.203; 1,101±0.316, P 〈 0.05）. In the control, it was higher remarkably after treatment compared with that before treatment （1.322±0.216, 1.234±0.305, P 〈 0.05）. CONCLUSION： Acupuncture on Geshu （BL 17） increases 6-K-P level and 6-K-P/TXB2 and reduces TXB2 level. It is explained that acupuncture on Geshu （BL 17） regulates imbalance of PGI2-TXA2 system in blood stagnation syndrome so that the blood circulation is activated and stasis is resolved.