基于粪便代谢组学探讨长蛇灸治疗强直性脊柱炎的作用机制

目的:通过代谢组学研究长蛇灸对强直性脊柱炎患者粪便代谢物的影响,进而探讨长蛇灸治疗强直性脊柱炎的可能作用机制。方法:招募强直性脊柱炎患者30例,健康志愿者30例,予强直性脊柱炎患者长蛇灸治疗,每周1次,治疗12周。检测强直性脊柱炎患者治疗前后的血清红细胞沉降率、超敏C反应蛋白水平;采用超高效液相色谱四极杆-飞行时间质谱联用检测技术,对强直性脊柱炎患者治疗前后及健康志愿者的粪便样本进行分析,再用主成分分析法和正交偏最小二乘法判别分析(Orthogonal Partial Least Squares-Discriminant Analysis,OPLS-DA)筛选差异性代谢物,并使用MetaboAnalyst网站分析相关的代谢通路。结果:经长蛇灸治疗,强直性脊柱炎患者血清红细胞沉降率、超敏C反应蛋白水平较治疗前降低,差异具有统计学意义(P <0.05);健康志愿者与强直性脊柱炎患者治疗前、强直性脊柱炎患者治疗前与治疗后的粪便代谢物有明显区分,共鉴定出36个差异性代谢物,其代谢通路涉及核黄素代谢、鞘脂代谢、组氨酸代谢、β-丙氨酸代谢、柠檬酸循环、丙酮酸代谢。结论:长蛇灸可减轻强直性脊柱炎患者体内炎症反应,其治疗作用与改善肠道代谢物水平有关,机制涉及核黄素代谢、鞘脂代谢、氨基酸代谢、柠檬酸循环等多个方面。

不同频次镇静安神针法治疗慢性失眠临床观察

目的探索不同频次的“镇静安神”针法对慢性失眠患者的影响。方法选取90例慢性失眠患者,随机分成高频次组、低频次组及对照组,以“镇静安神”针法的四神聪、神门、三阴交作为主穴,观察患者PSQI、HAMA、SF-36量表以及GABA、5-HT的变化。结果治疗后及随访期,各组PSQI、HAMA评分较治疗前降低,SF-36评分升高(P<0.05),高频次组和低频次组均优于对照组,高频次组优于低频次组(P<0.05);与对照组比较,高频次组及低频次组患者GABA、5-HT含量均显著增加(P<0.05),且高频次组优于低频次组(P<0.05)。结论“镇静安神”针法能改善失眠症状、提高生活质量,调节血清GABA、5-HT含量,且高频次的针刺频率临床疗效更佳。

长蛇灸对阳虚质人群Th1/Th2免疫功能影响的临床研究

目的:探索长蛇灸对阳虚质人群Th1/Th2免疫功能的影响。方法:依照纳入、排除标准,筛选90例阳虚质患者,随机分成空白对照组、膀胱经长蛇灸组以及督脉长蛇灸组,各30例。空白对照组不予任何治疗,长蛇灸组在膀胱经或督脉区域施行灸法,每周1次,共12次。以阳虚体质量表、SF-36量表以及IFN-γ、IL-4作为疗效评价指标,观察3组患者治疗后阳虚评分、SF-36指数以及Th1/Th2平衡作用的改变。结果:治疗后督脉长蛇灸组、膀胱经长蛇灸组阳虚质评分均较治疗前显著降低,SF-36评分显著上升(P<0.05),且与同时间点空白对照组比较差异均有统计学意义(P<0.05);治疗后督脉长蛇灸组、膀胱经长蛇灸组均较空白对照组IFN-γ升高、IL-4下降,差异均有统计学意义(P<0.05)。结论:长蛇灸可以改善阳虚质人群体质评分,提高生活质量水平,同时纠正Th1/Th2失衡,调节机体免疫功能。

滋水涵木针法治疗绝经综合征的效果及对性激素水平的影响

目的:探讨滋水涵木针法治疗绝经综合征的效果及对血清性激素水平的影响。方法:选择2019年8月—2021年8月收治的绝经综合征患者90例,随机分为针刺组和激素组,每组45例。针刺组采用滋水涵木针法,激素组只服用替勃龙片。疗程8周,疗程结束后第4周随访。比较两组患者的Kupperman评分、血清性激素[雌二醇(E2)、促黄体生成素(LH)、性激素促卵泡激素(FSH)]水平、临床疗效及不良反应。结果:治疗4周、8周后,两组Kupperman评分比治疗前均有所下降,但针刺组下降得更明显,差异有统计学意义(P<0.05);疗程结束后第4周与治疗8周后比较,针刺组差异有统计学意义(P<0.05),而激素组差异无统计学意义(P>0.05)。治疗后,针刺组E2水平显著高于激素组,差异有统计学意义(P<0.05);两组FSH和LH比较,差异无统计学意义(P>0.05)。针刺组临床总有效率为88.89%(40/45),激素组为91.11%(41/45),差异无统计学意义(P>0.05)。针刺组不良反应发生率为6.67%(3/45),低于激素组的24.44%(11/45),差异有统计学意义(P<0.05)。结论:滋水涵木针法可有效改善绝经综合征患者雌激素水平和临床症状,不良反应少,远期疗效更理想。

浅谈“司气海,调血压”针刺技术防治高血压前期

从“司气海,调血压”针刺技术的理论内涵、临床应用及中医未病先防的理念入手,论述对高血压前期患者进行针刺干预在高血压防治工作中的意义,并探讨该针刺技术对高血压前期防治的可行性。结果表明,重视高血压前期的干预能够在防治高血压工作中起到事半功倍的效果;同时,“司气海,调血压”针刺技术防治高血压前期疗效可信,具有进一步研究的意义。

慢性盆腔炎热敏腧穴应用规律的文献计量研究

目的:以文献计量为基础研究方式,对热敏灸治疗慢性盆腔炎(CPID)的文献进行归纳,探索其热敏高发区域及选穴规律。方法:按照文献检索策略,对四大医学文献库进行高级检索,筛选出契合热敏灸治疗CPID要求的文献,应用Note Express2.9软件管理数据,总结出热敏腧穴应用规律。结果:27篇文献符合要求,应用穴位前三位的分别是关元(24,88.9%)、子宫(20,74.4%)、三阴交(19,70.4%);涉及经脉频率前三位的分别是足太阳膀胱经(6,23.1%)、任脉(5,19.2%)、足太阴脾经(4,15.4%),经过盆腔的经脉有7条。结论:2013—2015年文献数量最多,使用频次最高的腧穴是关元穴,经脉为足太阳膀胱经,选穴以关元和子宫穴为主,以局部探穴为主,募穴是CIPD热敏点的高发穴位。

长蛇灸对肾阳虚大鼠HPA轴及肝脏11β-HSD1的影响

Objective:To observe the effects of long-snake moxibustion on the hypothalamic-pituitary-adrenocortical(HPA)axis and hepatic 11β-hydroxy steroid dehydrogenase type 1(11β-HSD1)expression in rats with kidney yang deficiency to provide a basis for later in-depth exploration of the action mechanism of longsnakemoxibustion on suchrats.Methods:Fifteen SPF-grade,male,SD rats were randomly divided into a blank control group,a model group,and a long-snake moxibustion treatment group,with five rats in each group.Hydrocortisone powder(30 mg/kg)was administered by gavage at a volume of 10 mL/kg to prepare the rat model of kidney yang deficiency.After successful modeling,the rats in the long-snake moxibustion treatment group underwent long-snake moxibustion treatment every other day along the governor vessel from Dazhui(GV14)to Shenshu(BL23),for a period of 14 days.The remaining two groups were secured in the same way as the long-snake moxibustion treatment group,although they did not receive any treatment.The body weight,rectal temperature,and spontaneous activity count of the rats,as well as serum levels of corticotropin releasing hormone(CRH)and corticosterone(CORT)were detected by ELISA before modeling,after modeling,and after treatment.The amount of 11β-HSD1 protein in rat liver was determined by immunohistochemistry and Western blot analysis.Results:Compared with the rats in the blank control group,those in the model group exhibited a significant decrease in the trend of body weight growth and in rectal temperature(P<0.05),as well as a slight yet non-significant decrease in spontaneous activity count(P>0.05);compared with the rats in the model group,the rats in the treatment group exhibited a significant increase in rectal temperature(P<0.05)and in spontaneous activity count(P<0.05).Moreover,after 14 days of treatment,compared with the rats in the blank,the rats in the model group exhibited a significant decrease in serum cORT content(P<0.05)and in the expression of 11β-HSD1 in the liver(P<0.05),as well as a slight yet non-significant decrease in serum CRH content(P>0.05);compared with the rats in the model group,the rats in the treatment group exhibited a significant increase in serum CRH content(P<0.05)and in the expression of 11β-HSD1 in the liver(P<0.05),as well as a slight yet non-significant increase in serum CORT content(P>0.05).Conclusion:Long-snake moxibustion can increase the rectal temperature and spontaneous activity count of rats with kidney yang deficiency,improve the function of the HPA axis,and increase the expression of 11β-HSD1 in the liver.