CLINICAL APPLICATION OF RENYING (ST 9)

Referring to the medical classics of different times and according to the author’s clinical experience, a discussion is made in this article on the location, the indication, the application, the functional mechanism of the point Renying (ST 9). It is discovered that the point Renying (ST 9) has a wide range of indications, among which the pain-relieving effect is especially remarkable. The therapeutic effects of the point Renying (ST 9) is thought to be related to its specific location.

Clinical Study on Puncturing Renying （ST 9） to Treat Poststroke Dysphagia

Objective： To observe the clinical efficacy of puncturing Renying （ST 9） in the treatment of poststroke dysphagia. Methods： Sixty cases of poststroke dysphagia were randomized into two groups, a control group in which 30 cases were given rehabilitation training, and a treatment group in which 30 cases were treated by puncturing Renying （ST 9） and rehabilitation training, with a course of four weeks. Results： The total effective rate for dysphagia was higher in the treatment group than in the control group （P〈0.05）. Conclusion： Puncturing Renying （ST 9） is quite effective for poststroke dysphagia.

Effect of acupuncture at Renying(ST 9) on gene expression profile of hypothalamus in spontaneously hypertensive rats

OBJECTIVE: To investigate changes in gene expression profiles in the hypothalamus related to the effects of acupuncture at the Renying(ST 9) acupoint in spontaneously hypertensive(SH) rats.METHODS: We randomly divided 18 SH rats into Renying(ST 9) group and model control group, 9 body weight-matched Wistar-Kyoto rats were used as blank controls. Acupuncture was performed manually for 20-min daily over 28 d in the Renying(ST 9) group. Rat Gene 2.0 array technology was used for the determination of gene expression profiles and the screened key genes were verified by real-time quantitative polymerase chain reaction(RT-PCR) analyses.RESULTS: The different groups exhibited differential gene expression: compared with the blank control group, 48 genes were up-regulated and 91 genes were down-regulated in the model group;compared with the model group, 79 genes were up-regulated and 80 genes were down-regulated in Renying(ST 9) group. The RT-PCR results of the key genes including Chi3 l1, Ephx2, Klk1, 5-HT1 A and Cbs were consistent with that of gene chip analysis.CONCLUTION: Acupuncture at Renying(ST 9)could significantly lower the blood pressure of SH rats and affect their hypothalamic gene expression profile. Genes associated with the contraction of vascular smooth muscle and the regulation of inflammation, neurotransmitters may be involved in acupuncture's antihypertensive mechanism.

Treatment of peripheral facial paralysis with acupuncture at Rényíng (人迎 ST 9) combined with stellate ganglion block:a randomized controlled trial

Objective To explore the best therapeutic method in the treatment of peripheral facial paralysis. Methods One hundred and twenty cases were randomized into a conventional acupuncture group [Yangbai （阳白 GB 24）, Sibai （四白 ST 2）, Yingxiang （迎香 LI 20）, etc.], a Renying （人迎ST 9） acupuncture group and an operation ＋ acupuncture group [acupuncture at ST 9 as the main acupoint and the stellate ganglion block （SGB）], 40 cases in each one. The treatment was given once a day, 7 treatments made one session. After 3 sessions of treatment, the latency and the amplitude of the direct stimulation evoked potential of the facial nerve （ENoG） were compared before and after treatment in three groups, as well as R2 and R2 values of blink reflex （BR）. The total clinical efficacy was assessed. Results The latency of ENoG was shortened and the amplitude was increased significantly in three groups. After treatment, ENoG latency was lower significantly in the operation ＋ acupuncture group as compared with that in the conventional acupuncture group （P〈0.05）. In the Renying （人迎 ST 9） acupuncture group, the amplitude of ENoG was increased as compared with P〈0.05）. After treatment in three groups, those in the other two groups （all R2 and R2 values were decreased significantly. The differences in R1 and R2 values in the Renying （人迎 ST 9） acupuncture group and the operation ＋ acupuncture group before and after treatment were bigger than those in the conventional acupuncture group （all P〈0.05）, and the difference in R2 value in the operation ＋ acupuncture group was bigger than that in the Renying （人迎 ST 9） acupuncture group （P〈O.05）. The clinical markedly effective and curative rate was 87.5% （35/40） in the operation ＋ acupuncture group, which was superior to 77.5% （32/40） in the Renying （）人迎 ST 9）acupuncture group and higher significantly than 65.0% （26/40） in the conventional acupuncture group （P〈0.05）. Conclusion Compared with the conventional acupuncture, the efficacy on peripheral facial paralysis is much better in the Renying （人迎 ST 9） acupuncture group and the operation ＋ acupuncture group. Moreover, the early reflex function of the damaged facial nerve is much better recovered in the operation ＋ acupuncture group as compared with that in the Renying （人迎 ST 9） acupuncture group.

针刺人迎穴为主治疗原发性高血压疗效的Meta分析

目的:系统评价针刺人迎穴为主治疗原发性高血压的疗效及安全性。方法:计算机检索Pub Med数据库、维普数据库(VIP)、万方数据库、中国期刊全文数据库(CNKI)建库至2015年10月31日有关针刺人迎穴治疗高血压的文献,纳入符合标准的随机对照试验及自身前后对照研究进行Meta分析。结果:共纳入9项研究,Meta分析结果显示,针刺人迎穴对收缩压即刻降压作用较明显,而对舒张压即刻降压作用不明显;针刺组方对即刻血压、24h平均血压、日间血压、夜间平均收缩压、血压负荷、日间收缩压变异性及夜间血压变异性都有明显下降作用,而夜间平均舒张压及日间舒张压变异性与针刺前相比无明显差异。结论:在即刻降压方面,针刺组方优于针刺人迎穴,综合监测血压及波动情况后,针刺组方对收缩压的改善优于对舒张压的改善。

针刺人迎穴为主联合加味牵正汤治疗急性周围性面瘫临床研究

目的观察针刺人迎穴为主联合加味牵正汤治疗急性期周围性面瘫(PFP)的疗效。方法将80例急性期PFP患者随机分为两组,均予西医常规治疗,对照组40例针刺常规取穴联合内服加味牵正汤,观察组40例另增加针刺人迎穴治疗。比较两组治疗前后House-Brackmann(H-B)分级、面部残疾指数(FDI)[(躯体功能(FDIp)和社会功能FDIs)]、症状和体征积分的变化。结果观察组总有效率为95.00%,显著优于对照组的82.51%(P<0.05)。治疗后,观察组患者H-B分级、FDIs评分、症状和体征积分均低于对照组(P<0.05),FDIp评分高于对照组(P<0.05)。结论针刺人迎穴为主联合加味牵正汤能有效改善急性期PFP患者的临床症状,提高生活能力。

“双固一通”温针灸治疗膝骨性关节炎疗效观察及对血清炎性因子表达的影响

目的:探讨"双固一通"温针灸治疗膝骨性关节炎(KOA)的临床疗效及作用机制。方法:选取KOA患者90例,随机分为观察组和对照组各45例,对照组口服双氯芬酸钠缓释片治疗,观察组给予"双固一通"温针灸法治疗,观察并比较两组患者治疗前后膝关节功能、血清炎性因子水平,评定临床疗效。结果:治疗后观察组疼痛评分、关节僵硬评分、日常生活评分及总分均低于对照组(P<0.01);血清转化生长因子β(TGF-β)、胰岛素样生长因子-1(IGF-1)、成纤维细胞生长因子-2(FGF-2)水平均高于对照组(P<0.01),治疗愈显率高于对照组(P<0.05)。结论:"双固一通"温针灸法可有效改善KOA患者膝关节功能,抑制炎症反应,疗效显著。

针刺对自发性高血压大鼠粪便短链脂肪酸及TLR4/MyD88/NF-κB信号通路的影响

目的:观察针刺对自发性高血压大鼠(SHR)血压、粪便短链脂肪酸(SCFAs)及toll样受体4(TLR4)/髓样分化因子88(My D88)/核因子κB(NF-κB)信号通路的影响,探讨针刺降压的作用机制。方法:将24只SPF级雄性SHR随机分为模型组、西药组、针刺组和假针组,每组6只;另设6只Wistar-Kyoto(WKY)大鼠为空白组。西药组予氢氯噻嗪溶液灌胃;针刺组针刺双侧“人迎”“足三里”,每次20 min;假针组针刺双侧“人迎”“足三里”附近的非经非穴点,每次20 min。均每日1次,持续4周。干预前及干预第1、2、3、4周后测量各组大鼠尾动脉收缩压(SBP);HE染色观察大鼠结肠组织形态;气相色谱-质谱联用仪检测大鼠粪便SCFAs含量;ELISA法检测大鼠血清白细胞介素(IL)-6、IL-1β和肿瘤坏死因子-α(TNF-α)含量;Western Blot法检测大鼠肠系膜动脉中TLR4、My D88和NF-κB p65蛋白表达。结果:与空白组比较,模型组大鼠SBP升高(P<0.05),结肠组织有明显病理变化,粪便SCFAs含量降低(P<0.05),血清IL-1β、IL-6和TNF-α含量升高(P<0.05),肠系膜动脉中TLR4、My D88、NF-κB p65蛋白表达升高(P<0.05)。与模型组比较,针刺组和西药组大鼠干预2、3、4周后SBP降低(P<0.05),血清IL-1β、IL-6和TNF-α含量降低(P<0.05);针刺组大鼠结肠组织黏膜上皮完整,肠腺数量丰富,粪便SCFAs含量升高(P<0.05),肠系膜动脉中TLR4、My D88、NF-κBp65蛋白表达降低(P<0.05)。与假针组比较,针刺组干预2、3、4周后SBP降低(P<0.05),粪便SCFAs含量升高(P<0.05),血清IL-1β、IL-6和TNF-α含量降低(P<0.05),肠系膜动脉中TLR4、My D88、NF-κB p65蛋白表达降低(P<0.05)。结论:针刺双侧“人迎”“足三里”可有效降低SHR血压,其机制可能与调节粪便SCFAs含量、抑制TLR4/My D88/NF-κB信号通路有关。

基于《内经》“天牖五部”探究推拿治疗急性咽炎

以《内经》中“天牖五部”为切入点,探讨推拿“天牖五部”治疗急性咽炎的思路及手法。“天牖五部”是一组以阳经穴为主的特定腧穴,多位于颈部。穴如其名,“天牖五部”实为头颈之“窗”,通过调整此处可有“开窗散风之功、调气调血之效”。急性咽炎多由风热外邪侵袭咽喉或肺胃蕴热又复感外邪所致,以风热邪气为主因。基于“天牖五部”,通过点、拨、捋的推拿手法开头面“户牖”,并辅以耳尖放血,使邪有出路,疏风散热,达到通畅气机、舒利咽喉的目的。

Effect of three vertigo-stopping needles on neurohumor of patients with cervical vertigo:a controlled trial

Objective To observe the effect of three vertigo-stopping needles on the contents of neuropeptide Y （NPY）, endothelin （ET） and calcitonin gene-related peptide （CGRP） in plasma of patients with cervical vertigo, and to explore its mechanism of treatment. Methods One hundred and eighty patients with cervical vertigo were divided into group A [acupuncture at R6nyfng （人迎ST 9） and Fengchi （风池 GB 20）, and frontal line], group B [acupuncture at Jing jiaji （颈夹脊）, GB 20 and Baihui （百会 GV 20）] and group C [intravenous infusion with ligustrazine and oral administration with flunarizine] according to simple randomization, with 60 cases in each group. For the patients in group A and group B, the treatment was conducted once a day, and ten times were considered as one course of treatment. Two days were free of treatment between two courses, and two courses were needed. For the patients in group C, the treatment was conducted for fifteen days. The contents of NPY, ET and CGRP in plasma before and after treatment were detected in patients with cervical vertigo. Results The contents of NPY in plasma of patients in the three groups after treatment were markedly lower than that before treatment （all P〈0.01）, and the differences were not statistically significant when compared the descending degrees among three groups （P〉0.05）. The contents of ET in plasma of patients in the three groups after treatment were markedly lower than that before treatment （P〈0.05, P〈0.01）, the descending degree in group A was greater than that in group B and group C, and the difference was statistically significant （P〈0.O1, P〈O.05）; while the difference was not statistically significant when compared the descending degrees between group B and group C （P〉0.05）. The contents of CGRP in plasma of patients in the three groups after treatment were markedly higher than that before treatment （P〈0.05, P〈O.O1）, the increasing degree in group A was greater than that in group B and group C, and the difference was statistically significant （both P〈0.05）; while the difference was not statistically significant when compared the increasing degrees between group B and group C （P〉0.05）. Conclusion Three vertigo-stopping needles, acupuncture and medication can regulate the contents of NPY, ET and CGRP in plasma of patients with cervical vertigo, while three vertigo-stopping needles is significantly superior to acupuncture and medication in reducing ET and increasing CGRP.

Clinical Application of Neck Acupoints in Acupuncture

This paper deals with the regional anatomy of the neck and some common acupoints. Acupoint Renying （ST 9） is taken as an example to elaborate the needling techniques and needling precautions of neck acupoints,

针刺人迎穴为主配合星状神经节阻滞术治疗周围性面瘫：随机对照研究

目的:探寻治疗周围性面瘫的较佳疗法。方法:120例患者随机分为常规针刺组(穴取阳白、四白、迎香为主)、人迎针刺组(人迎穴为主针刺)以及术针组(人迎穴为主针刺配合星状神经节阻滞术),每组40例。每天治疗1次,7次为一疗程,3个疗程后,比较3组治疗前后的面神经直接刺激诱发电位(ENoG)潜伏期和波幅,以及瞬目反射(BR)的R1值、R2值,并评定临床总疗效。结果:3组治疗均能显著缩短ENoG潜伏期,且诱发电位波幅显著升高;治疗后术针组ENoG潜伏期较常规针刺组显著降低(P<0.05),人迎针刺组诱发电位波幅较其他两组升高(均P<0.05);各组治疗后R1、R2值显著缩短,人迎针刺组和术针组治疗前后R1差值、R2差值均显著大于常规针刺组(均P<0.05),且术针组R1差值显著大于人迎针刺组(P<0.05);术针组临床愈显率为87.5%(35/40),优于人迎针刺组的77.5%(31/40),且显著高于常规针刺组的65.0%(26/40)(P<0.05)。结论:与常规针刺比较,人迎针刺组和术针组治疗周围性面瘫疗效更优,且术针组较人迎针刺组能更好地恢复受损面神经的早发反射功能。

石学敏院士“司气海,调血压”针刺技术浅析

石学敏院士从"气海理论"出发,创立了以人迎穴为主穴的"司气海,调血压"针刺技术,在临床应用中取得了良好效果。本文立足于"气海理论",从中医的元气、宗气、营气、卫气以及气、血、脉之间的关系和现代医学中心排血量、交感神经活性、血管等方面阐释对高血压病的认识。二者在对高血压形成的认识中达到了较完美的契合,体现本针刺技术的科学性和实用性。此外,文中还详细介绍了石学敏院士根据《内经》中气海理论和"无风不作眩"等理论提出高血压的主要病机为"气海失司"的思想源流以及本针刺技术的穴位选择——人迎、曲池、合谷、足三里、太冲,重点论述了各个穴位针刺的量学操作规范,并基于中医理论和现代临床研究阐述各个穴位的选穴依据。

针刺“人迎”穴对自发性高血压大鼠下丘脑基因表达的影响

目的探讨针刺人迎穴治疗高血压病的可能作用机制。方法将20只自发性高血压大鼠(SHR)随机分为人迎组和模型组,每组10只。10只WKY大鼠作为空白组。人迎组每天针刺大鼠"人迎"穴20 min,每6天休息1天,共28天;模型组和空白组不做任何干预。于针刺干预第1、5、9、13、17、21、25和28天测量血压,实验结束后取材下丘脑进行基因芯片分析,并采用PCR技术检测关键基因5-羟色胺1A受体(5-HT1A)与胱硫醚β合成酶(CBS)mRNA表达。结果与空白组比较,模型组大鼠收缩压在第1、5、9、13、17、21、25、28天升高(P<0.01);与模型组比较,人迎组在第5,9,13,21,25,28天收缩压降低(P<0.05或P<0.01)。与本组前一观察点比较,模型组第21、25、28天血压均升高,人迎组仅第21天血压升高(P<0.05)。与空白组比较,模型组129个基因上调,243个基因下调(P<0.05);与模型组比较,人迎组167个基因上调,188个基因下调(P<0.05)。与空白组比较,模型组5-HT1A mRNA、CBS mRNA表达下降(P<0.01);与模型组比较,人迎组5-HT1A mRNA、CBS mRNA表达升高(P<0.01)。结论针刺"人迎"穴对于降低SHR血压有效,影响下丘脑的基因表达如促进神经递质和交感神经的兴奋性等可能是其作用机制。

古代凶险要穴人迎新用探析

探讨人迎穴的特异性能、刺激方法和临证应用范围。因人迎穴处于颈部险要之处,刺激时凶险较大,历代多避其凶险而不用。近年来人迎的刺激方式主要有针刺、按压二法,针刺的关键是采用正确的进针术式和把握针刺深度、方向,按压的方法在于掌握施力的轻重和点按时间。人迎穴对头眩心悸、喘息气急、偏枯失语、脏躁癔病、急性疼痛、乳腺增生、呃逆不止、咽喉不利等病功效卓著。只要定位精准,操作细心,掌握正确的刺激方式,不但可以保障安全,而且在临证中可充分发挥它应有的作用。

改良针刺单/双侧人迎穴治疗椎动脉型颈椎病及对患者血浆NPY与UⅡ浓度的影响

目的:观察改良针刺单/双侧人迎穴和常规针刺单/双侧人迎穴对椎动脉型颈椎病(CSA)的临床疗效差异,以及对患者血浆神经肽Y(NPY)、尾加压素Ⅱ(UⅡ)浓度的影响。方法:将160例患者按随机数字表法随机分为改良针刺双侧组、改良针刺单侧组、常规针刺双侧组、常规针刺单侧组,每组40例。改良针刺双侧组采用改良针刺双侧人迎穴方法,改良针刺单侧组采用改良针刺单侧人迎穴方法,常规针刺双侧组采用常规针刺双侧人迎穴方法,常规针刺单侧组采用常规针刺单侧人迎穴方法。每天治疗1次,连续治疗6 d为一疗程,间隔休息1 d,连续治疗2个疗程。观察各组治疗前后椎动脉(VA)、基底动脉(BA)的收缩期峰值血流速度(Vs),颈性眩晕症状与功能评估量表(ESCV)评分和血浆NPY、UⅡ浓度,并比较各组临床疗效。结果:治疗后改良针刺双侧组临床疗效[90.0%(36/40)]优于改良针刺单侧组[80.0%(32/40)]、常规针刺双侧组[77.5%(31/40)]、常规针刺单侧组[65.0%(26/40)均P<0.05];治疗后各组VA、BA的Vs均明显提高(均P<0.01),且改良针刺双侧组高于其他组(均P<0.01);治疗后各组ESCV评分均明显增加(均P<0.01),且改良针刺双侧组ESCV评分及改善指数均高于其他组(P<0.05,P<0.01);治疗后各组血浆NPY、UⅡ浓度均明显下降(均P<0.01),且改良针刺双侧组血浆NPY、UⅡ浓度低于其他组(均P<0.01)。结论:改良针刺双侧人迎穴可有效调节椎基底动脉供血,改善大脑循环,优于单侧人迎穴。

人迎穴体表电刺激联合星状神经节阻滞治疗不定陈诉综合征临床观察

目的:比较人迎穴体表电刺激联合星状神经节阻滞(SGB)与单纯SGB治疗不定陈诉综合征的临床疗效差异。方法:选择符合不定陈诉综合征诊断标准的患者60例,随机分为两组,每组30例。观察组为人迎穴体表电刺激联合SGB,对照组为单纯行SGB。两组患者均每周3次,9次为一疗程,疗程间间隔1周,治疗2个疗程,需时7周。均于治疗前及治疗后1个月、3个月根据自觉症状评分标准进行评分。结果:两组患者治疗前自觉症状评分比较差异无统计学意义(P>0.05);治疗后1个月、3个月两组患者自觉症状评分均低于治疗前(均P<0.01),且观察组自觉症状评分低于对照组(均P<0.01)。结论:人迎穴体表电刺激联合SGB治疗不定陈诉综合征能显著提高临床疗效,对临床症状的控制与改善显著优于单独采用SGB治疗者。

针刺人迎穴对缺血性脑卒中伴原发性高血压患者血压的影响

目的:观察针刺人迎穴对缺血性脑卒中伴原发性高血压患者清晨血压、日间高峰血压及全天血压负荷的影响。方法:将80例患者(3例脱落)随机分为观察组(39例)和对照组(38例)。两组均以醒脑开窍针刺法加口服硝苯地平缓释片为基础治疗,观察组在此基础上加用针刺人迎穴,每日1次,每周6次,共治疗4周。比较两组患者治疗前后清晨血压、日间高峰血压和全天血压负荷的变化。结果:治疗后两组清晨血压、日间高峰血压和全天血压负荷均较治疗前下降(均P<0.05);其中观察组清晨收缩压下降幅度与对照组比较差异无统计学意义(P>0.05),清晨舒张压、日间高峰血压、全天血压负荷下降幅度大于对照组(均P<0.05)。结论:在醒脑开窍针刺法加口服硝苯地平缓释片治疗基础上,针刺人迎穴能有效降低缺血性脑卒中伴原发性高血压患者的清晨血压、日间高峰血压和全天血压负荷。

人迎穴降压的理论依据

探讨人迎穴定位特点及功用和针刺人迎穴降压效应的中医理论依据.人迎穴是足阳明胃经经穴,位于喉结两旁之一寸五分,针刺时应注意避开颈总动脉,人迎穴降压机制主要在于针刺人迎穴可调节血脉.

高血压与“活血散风、疏肝健脾”针刺法

高血压病不仅是导致心脑血管病死亡的主要原因,而且已成为疾病负担的首要危险因素。国医大师中国工程院院士石学敏教授认为在有效控制血压的同时,减少靶器官的损害及其并发症,改善预后尤为重要。"活血散风、疏肝健脾"针刺法是石学敏院士继醒脑开窍针刺法后又一巨大贡献,该针法理论新颖、取穴简便,且明确规范手法量学标准和量效关系,有助于临床应用及推广。该针刺法在临床应用中能有效降低血压,改善血压变异性和调节血压节律,并可使患者逐步减少降压药物,改善血管内皮功能等,从而减轻靶器官的损害。但仍需在基础研究方面进一步开展大样本针刺疗法多中心随机对照试验研究进行验证。