基于数据挖掘探究经皮经颅电刺激治疗卒中后运动障碍刺激参数应用规律

目的 基于数据挖掘探究经皮穴位电刺激(TEAS)及经颅直流电刺激(tDCS)治疗卒中后运动障碍的刺激参数应用规律。方法 检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献数据库、PubMed、Web of Science 2000年1月-2023年5月发表的相关临床研究文献,进行质量评价后建立数据库。采用频次分析、关联规则及复杂网络分析探究核心腧穴及电刺激参数应用规律。结果 共纳入文献79篇,提取128组数据。TEAS核心腧穴主要包括外关、手三里、足三里、合谷、内关、阳陵泉等,上下肢最常用配伍为手三里-外关、阳陵泉-足三里;电刺激参数中频率选择多样,100 Hz最常用,刺激弛缓型偏瘫上肢腧穴时亦多选用2 Hz;其他电刺激参数应用较一致,多选用脉宽200~250μs的双向对称方波,刺激强度以患者耐受为度。t DCS刺激电极多置于脑部M1运动区在头皮的投影,安全刺激强度为1~2 mA。结论 采用TEAS治疗卒中后运动障碍应根据卒中后不同康复阶段患者肌肉状态选择刺激腧穴及电刺激参数,尤需关注刺激频率的选择。

从“动筋调气”探析痉挛性运动障碍的针刺治疗

痉挛性运动障碍是因大脑或脊髓损伤导致的以肢体痉挛、关节挛缩为主要表现的运动功能障碍。本研究总结梳理了针灸临床治疗痉挛性运动障碍的几种特色针法,以期为优化针刺临床方案及抗痉挛刺法的研究提供依据及思路。通过归纳比较头针运动针法、动气针法、浮针疗法、筋针疗法、滞动针疗法、动筋针疗法以及恢刺法等常用有效的抗痉挛方法,发现其共性特点是动态留针与带针运动,即针刺调理经脉气血与运动拘急经筋的结合。基于“动筋调气”理念的运动类针刺法有助于缓解中枢损伤所致的肢体痉挛、促进运动功能恢复,值得进一步开展临床及机制研究。

基于关联规则与复杂网络探讨针灸治疗痉挛型脑瘫的处方规律

目的基于关联规则与复杂网络探讨针灸治疗痉挛型脑瘫的处方规律。方法检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Web of Science建库至2022年5月针灸治疗痉挛型脑瘫的临床文献。运用Apriori算法进行关联规则分析核心穴位配伍,Gephi 0.9.6软件进行复杂网络分析核心穴位群及刺灸特点。结果共纳入293篇文献,提取639条针灸处方。关联性最高的传统腧穴为足三里-三阴交,靳三针为四神针-手三针,焦氏头针中足运感区、平衡区、运动区与运用区关联性一致。复杂网络3类处方核心穴位群主要包括百会、足三里、三阴交、合谷、曲池、运动区、平衡区、足运感区、阳陵泉、颞三针等,刺灸方式多样。结论针灸治疗痉挛型脑瘫注重传统腧穴与头针、靳三针的配合,以针对病变根源的头部穴位为主,配合瘫痪肢体局部选穴,达到形神同调的目的。

应用复杂网络及数据挖掘探讨常见内脏痛针灸处方特点

目的探讨针灸治疗常见内脏痛的处方特点,为临床选择腧穴及刺灸法提供依据。方法检索中国知识资源总库(CNKI)、万方数据知识服务平台(万方数据)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)、PubMed、Embase 2001年1月1日-2021年10月31日收录的针灸治疗内脏痛的临床研究文献,筛选后建立针灸处方数据库。采用SPSS Modeler 18.0及Gephi0.9.2进行关联规则及复杂网络分析。结果共纳入文献386篇,包括心绞痛(AP)、肠易激综合征(IBS)和原发性痛经(PD),提取386条处方,共涉及17种针灸术式、115个腧穴,总使用频次为2463次。治疗AP、IBS、PD使用频次最高的腧穴分别是内关、天枢、三阴交。治疗消化道兼症最常用腧穴为足三里、天枢、上巨虚、内关。支持度最高的腧穴配伍分别是膻中-内关(AP)、足三里-天枢(IBS)、关元-三阴交(PD)。核心腧穴的刺灸方式多为针、灸并用,其术式及补泻手法均多样。结论常见内脏痛针灸处方选穴多以疼痛内脏局部躯干腧穴及循经远部特定穴为主,具有核心腧穴刺灸术式多样及兼治内脏痛消化道兼症的特点,体现了针灸治疗应与病症相适应的原则。

针刺足三里得气对脑功能活动影响的系统评价

目的:评价针刺足三里后得气状态相较于静息状态激活的脑区。方法:检索国内外10个医学文献数据库以及5个临床试验注册平台,系统收集以fMRI为观察指标,比较针刺足三里后得气状态相较于静息状态的不同脑活动临床试验文献。采用SDM软件进行体素Meta分析。结果:最终纳入10篇文献,共185名受试者。均值分析的结果显示,针刺足三里后有5个脑区的活动较静息状态更为活跃,包括右额下回、眶部、右中值扣带/扣带旁回、右缘上回以及右脑桥。结论:初步认为,针刺足三里后得气状态相较于静息状态有更多更强烈的脑区激活,且针刺足三里得气后激活的脑部区域与足三里的主治功能有一定关联。

针刺治疗脑卒中后肢体痉挛的机制研究探讨

卒中后肢体痉挛是阻碍患者肢体运动功能恢复的主要原因,严重影响了脑卒中患者的身心健康。针刺对卒中后肢体痉挛疗效肯定,但机制尚不完全明确。本文通过梳理针刺对痉挛相关神经递质及受体、运动神经元兴奋性、炎性细胞因子、细胞信号传导相关物质及离子通道的影响,探讨针刺抗痉挛的可能靶点和有效途径,为针刺抗痉挛的机制研究提供方向。

针刺角度、方向、深度与针效关系探讨

本研究总结分析毫针刺法与针效关系的研究现状,为优化临床针刺方案及毫针刺法与针效关系研究提供可能的思路。检索毫针刺法影响针效的相关文献,重点对针刺角度、方向、深度影响针效的作用环节及规律进行总结分析。针刺的角度、方向、深度对针效的影响各不相同,选择与病证相适应的刺法是提高针效的关键。毫针刺法与针效的关系研究逐渐受到重视,但尚缺乏临床试验与机理研究相结合的系统性研究,有待进一步完善。

恢刺“阳陵泉”穴对脑卒中大鼠肌痉挛状态和脑梗死体积的影响

目的:观察恢刺“阳陵泉”穴对卒中后痉挛大鼠脑梗死体积和运动相关行为学的影响,为恢刺法在针灸临床治疗卒中后肢体痉挛提供依据。方法:45只SD大鼠随机分为假手术组(n=9)、模型组(n=18)和恢刺组(n=18)。采用改进的线栓法制作卒中后痉挛模型。术后第3天,恢刺组恢刺“阳陵泉”穴,留针30 min,1次/d,连续7 d。于造模前、后各时间点分别行Zea Longa神经功能损伤评分、改良Ashworth肌张力评分(MAS)和网屏实验运动功能评分。治疗后进行2,3,5-氯化三苯基四氮唑(TTC)脑切片染色观察脑梗死体积变化。结果:与假手术组比较,模型组大鼠造模后Zea Longa评分和MAS评分均显著升高(P<0.01),网屏实验评分显著降低(P<0.01),脑梗死体积比显著升高(P<0.01)。与模型组比较,恢刺组大鼠治疗后Zea Longa评分及MAS评分均显著降低(P<0.01),网屏实验评分显著升高(P<0.01),脑梗死体积比显著降低(P<0.01)。结论:恢刺法可缓解卒中后痉挛大鼠的肌痉挛,提高其运动功能,改善其脑缺血状态,发挥一定的神经功能保护作用。

不同时机电针对寒湿凝滞证原发性痛经镇痛效应的影响

目的探讨不同时机电针对寒湿凝滞证原发性痛经(PD)镇痛效应的影响。方法选取2018年12月至2020年12月首都医科大学电力教学医院门诊纳入的72例寒湿凝滞证PD患者为研究对象,采用随机数字表法将其分为经前组和经期组,各36例。两组均取三阴交、地机和悬钟,电针30 min,连续治疗3个月经周期,随访2个月经周期。采用疼痛视觉模拟评分法(VAS)和伴随症状严重程度评分(RSS-COX2)评价临床症状。结果整体分析发现:组间比较及交互作用的VAS评分比较,差异均无统计学意义(P>0.05);时间点VAS评分比较,差异有统计学意义(P<0.05)。第1~5周期的VAS评分与治疗前比较均降低,第2~5周期VAS评分与第1周期比较均降低,第3~5周期VAS评分较第2周期降低,第4~5周期的VAS评分较第3周期降低,第5周期VAS评分较第4周期降低,差异有统计学意义(P<0.05)。整体分析:组间比较、时间点比较及交互作用RSS-COX2评分差异均有统计学意义(P<0.05)。组内比较:第1~5周期RSS-COX2评分较治疗前降低,第2~5周期RSS-COX2评分较第1周期降低,第3~5周期的RSS-COX2评分较第2周期降低,第4~5周期RSS-COX2评分较第3周期降低,第5周期RSS-COX2较第4周期降低,差异均有统计学意义(P<0.05)。组间比较:从第2~5周期,经期组RSS-COX2评分高于经前组(P<0.05)。结论经前及经期电针对寒湿凝滞证PD均能显著缓解疼痛及伴随症状,经前治疗改善伴随症状优于经期。

试述浅刺法在疼痛治疗中的意义

本研究总结分析了浅刺法治疗疼痛的理论基础、历史源流及临床应用,以期为多元化针刺治痛方案及浅刺法治痛的研究提供依据及思路。通过对各类浅刺法治痛的特点、针具使用和适应痛证类型等方面的比较分析,发现不同浅刺法治痛特色鲜明,镇痛效果突出,操作便利,针刺安全性有保障,患者依从性高,可用于多种痛证,值得进一步推广。根据不同痛症的特点、病因病机及患者情况选择适宜的浅刺法是提高治痛疗效的关键,关注针刺深度与角度的结合,开展浅刺法治痛的临床及机制研究,对揭示经典刺法理论的科学内涵具有重要意义。

基于古今文献的运动障碍选穴规律探析

目的通过古今文献共检,分析总结运动障碍的取穴规律,为给运动障碍人群制定安全有效、规范系统的选穴方案提供参考。方法采用文献计量学的方法,对《中华医典》(第五版)及2011-2021年中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据资源系统(WF)中运动障碍选穴治疗的相关文献进行检索和整理,分析归纳选穴规律。结果古籍条文纳入443条,共涉及121个腧穴;现代文献纳入249篇,共涉及152个腧穴。使用频率最高的经脉为足少阳胆经和手阳明大肠经;四肢部和头面部取穴较多,躯干部取穴较少;使用频次最高的特定穴为五输穴、下合穴和原穴;曲池、阳陵泉、悬钟、肩髃、手三里、合谷、足三里、环跳、百会、尺泽为古今常用的腧穴。结论古今治疗运动障碍的选穴以运动障碍肢体局部腧穴为主以调形,配合百会穴以调神,体现了"形神共调"的原则。

融合复杂网络与数据挖掘探析炎性痛的针灸处方特点

目的 通过复杂网络与数据挖掘分析针灸治疗炎性痛相关病症的处方特点,为临床治疗炎性痛选穴及针灸治疗方法提供依据与思路。方法 检索近10年中国知网(CNKI)、维普(VIP)、万方(WF)、中国生物医学文献数据库(SinoMed)、PubMed、EMbase数据库中针灸治疗炎性痛的临床文献,建立数据库,运用Apriori算法进行关联规则分析,利用Gephi 0.9.2软件进行复杂网络分析。结果 共纳入213篇文献,涉及5种炎性痛病症,提取213条针灸处方,涉及145个腧穴,33种针灸术式。关联性最高的穴位配伍分别是内膝眼-犊鼻(膝骨关节炎),肾俞-委中(腰椎间盘突出症),肩髃-肩贞(肩周炎),三阴交-足三里(盆腔炎),足三里-阳陵泉(术后炎性痛)。5种炎性痛处方中通用核心腧穴为足三里、阿是穴、阳陵泉、血海、三阴交,其刺灸方式呈现多样性的特点。结论 针灸治疗炎性痛处方选穴体现了辨证选穴与近部选穴相结合的特点;配穴以循经远部选取特定穴为主;核心腧穴刺灸方式多样。以痛为腧的阿是穴以及具有全身性抗炎镇痛效应的足三里穴可作为多种炎性痛的主穴。

基于复杂网络探析针灸治疗高血压合并失眠的临床规律

目的:基于复杂网络探析针灸治疗高血压合并失眠的临床规律,为临床治疗取穴及刺激方式提供参考。方法:检索近20年中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science数据库中针灸治疗高血压合并失眠的相关临床文献,筛选后建立数据库。运用SPSS25.0,SPSS Modeler18.0及Gephi0.9.2分别进行疗效指标、关联规则及复杂网络分析。结果:纳入46篇文献,共提取49条针灸处方,涉及64个腧穴、12种针灸治疗方法。针灸疗法结合降压药应用频数最高,各疗法治疗后均可有效降低PSQI评分及血压水平(P<0.05)。使用频数最高的腧穴为百会,经脉为督脉,支持度最高的腧穴组合是三阴交-内关和百会-内关。针灸处方包含百会、四神聪、风池、安眠、完骨等16个核心腧穴。社团分析显示针灸处方具有按照穴位功效、所属部位及经脉属性进行配伍的3个主要规律。结论:针灸疗法结合降压药是临床治疗高血压合并失眠的一种安全而有效的方法。百会、四神聪是其主要核心腧穴,腧穴配伍以调和阴阳为原则,远近配穴和辨证配穴相结合。

VOCs在线分析仪表的应用研究

本文分析了我国VOCs在线监测的监管状况,介绍VOCs在线分析仪表系统结构及流程;重点阐述了BF-2000色谱分析仪技术特点及实施过程,为企业VOCs分析仪表选型提供可靠依据。

Influence of the quickness and duration of De Qi on the analgesic effect of acupuncture in primary dysmenorrhea patients with a cold and dampness stagnation pattern

OBJECTIVE: To investigate the influence of the quickness and duration of De Qi(or Qi arrival) on the analgesic effect of acupuncture in primary dysmenorrhea patients with a cold and dampness stagnation pattern.METHODS: Sixty-eight patients were randomly assigned to the De Qi group(deep needling with thick needles and manipulation, n = 17) or the non-De Qi group(shallow needling with thin needles and no manipulation, n = 51). Both groups underwent needling at Sanyinjiao(SP 6) for 30 min.The visual analogue scale was used to measure the degree of menstrual pain, and the Acupuncture De Qi Clinical Assessment Scale was used to assess De Qi. Only data from patients who experienced actual De Qi were included in the analysis.RESULTS: Thirty-nine patients experienced actual De Qi. Patients who experienced actual De Qi in the De Qi group(n = 14) felt De Qi more rapidly(P =0.028) and for a longer duration(P = 0.04) than patients who experienced actual De Qi in the non-De Qi group(n = 25). Both groups showed a reduction in the visual analogue scale score for pain after treatment. The analgesic effect did not significantly differ between the two groups. The occurrence time of De Qi showed a significant negative correlation with pain reduction at 20 and 30 min after needle removal(P < 0.05). There was no correlation between the duration of De Qi and the therapeutic effect.CONCLUSION: In primary dysmenorrhea patients with a cold and dampness stagnation pattern,quicker onset of De Qi when needling Sanyinjiao(SP 6) achieves a better analgesic outcome. However, a longer duration of De Qi does not affect the degree of analgesia. Compared with minimal acupuncture, active acupuncture stimulation achieves a more rapid onset and longer duration of De Qi.

Comparative study on skin temperature response to menstruation at acupuncture points in healthy volunteers and primary dysmenorrhea patients

OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P < 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P < 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P < 0.05).No significant differences of skin temperature were detected at other points(P > 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.

Immediate analgesic effect of needling acupoints(bilateral De Qi vs unilateral De Qi)on primary dysmenorrhea:a multi-center,randomized,controlled trail

OBJECTIVE: To analyze the effect of needling acupoints(bilateral vs unilateral) with De Qi using data collected from 501 primary dysmenorrhea(PD) patients participating in multi-center, randomized,controlled trail.METHODS: De Qi was defined as at least one of the feelings in soreness, numbness, fullness or heaviness at the acupoints when stimulated with needles. The 501 patients were grouped in 3 groups in terms of De Qi or not De Qi in one side(unilateral)or both sides(bilateral) of the body: bilateral De Qi group, unilateral De Qi group, and non-De Qi group. The abdominal pains were measured using visual analog scale(VAS).RESULTS: In 501 patients, 472 acquired De Qi at unilateral acupoints, 24 De Qi at bilateral acupoint,and 5 had no De Qi at any acupoint. The data of non-De Qi group was excluded as the sample was less than 5% of that in the bilateral De Qi group.There was significant difference in the VAS before and after treatment between unilateral and bilateral De Qi group(P < 0.01). After stratified by acupoints, for the patients needled at Sanyinjiao(SP 6)and Xuanzhong(GB 39), VAS scores in the bilateral De Qi group were larger than those in the unilateral De Qi group(P < 0.05).CONCLUSION: Bilateral De Qi was possibly superior to unilateral De Qi in enhancing the immediate analgesic effect of needling the acupoints, but no statistical significance was observed on the pa-tients of needling at non acupoint, which preliminarily suggested this immediate analgesic effect was perhaps along meridians.

Applications of pain-related evoked potentials and short-latency somatosensory evoked potentials in acupuncture research:a narrative review

OBJECTIVE:To review and discuss the Chinese and English literature on the use of pain-related evoked potentials(PREP) and short-latency somatosensory EP(SLSEP) in acupuncture research.METHODS:China National Knowledge Infrastructure Database and MEDLINE were searched for the following key words:acupuncture and PREP or SLSEP.RESULTS:Thirty-seven articles were included in the review.Researchers usually use PREPs to study the analgesic effect of acupuncture,observe influential factors,or for mechanistic exploration.In the SLSEP studies,researchers focused on response characteristics of acupuncture,acupoint specificity,and influential factors of the treatment.There were some problems with the study design and conclusions.CONCLUSION:Researchers could use PREP and SLSEP to objectively validate the effects of acupuncture and explore its mechanisms using nerve electrophysiology.Further studies can benefit from observing more acupoints' effects using PREPs or SLSEPs and investigating the placebo effect of acupuncture.

Waggle needling Yanglingquan(GB34) enhances cerebral blood flow and ameliorates condition of spastic paresis in rats with middle cerebral artery occlusion induced by surgical nylon suture

OBJECTIVE:To evaluate the therapeutic efficacy and the influence on cerebral blood supply of waggle needling Yanglingquan(GB34) on spastic paresis(SP) rats after middle cerebral artery occlusion(MCAO) induced and investigate its mechanism of relieving neurobehavior deficiency.METHODS:SP rat model was produced by permanent MCAO.Rats were divided into five groups:blank control group(Control),sham operation group(Sham),model group(Model),waggle needling group(WN) and perpendicular needling group(PN).SP rats were treated with acupuncture from day 3 after MCAO,once a day for 6 d.The modified neurological severity score(m NSS) and modified Ashworth scale(MAS) were conducted on days 0,1,3,5,7 and 9.Cerebral blood flow(CBF) in ischemic cortex was measured by laser speckle imaging 5 min pre ischemia,5 min post ischemia,and after intervention on day 9.All rats were sacrificed at day 9 and the protein and m RNA expressions of γ2 subunit of the γ-aminobutyric acid receptor A(GABAAγ2) and K+-Cl-cotransporter 2(KCC2) in the ischemic cortex and lumber enlargement was measured by Western blotting and real-time quantitative polymerase chain reaction.RESULTS:Both Control and Sham groups showed no changes in m NSS and MAS scores and in the regional CBF.Compared with Model group,both WN and PN treatments significantly ameliorated neurological deficit(P < 0.01),decreased muscle tone(P < 0.05),and enhanced CBF(P < 0.001) in SP rats;moreover,WN showed superior effects than PN(P < 0.001).In line with the improvement in neurobehavior,acupuncture interventions up-regulated the expressions of GABAAγ2 and KCC2 in the ischemic cortex as well as lumber enlargement(P < 0.01) in SP rats,and those changes were more obvious in WN(P < 0.05).CONCLUSIONS:Acupuncture at Yanglingquan(GB34) enhanced cerebral blood flow and ameliorated SP in permanent MCAO rats,while waggle needling was superior to regular perpendicular needling.Waggle needling Yanglingquan(GB34) would be a potential complementary therapy for SP.

Application of Traditional Chinese Medicine Four-diagnostic auxilia-ry apparatus in evaluation of health status and clinical treatment

OBJECTIVE: To evaluate the application of Traditional Chinese Medicine(TCM) Four-diagnostic Auxiliary Apparatus in disease diagnosis.METHODS: The liver cancer patients and healthy controls were recruited from Shanghai Integrated Chinese and Western Medicine Hospital and Beijing University of Traditional Chinese Medicine, respectively. Then, the included subjects were diagnosed by the Four-diagnostic auxiliary apparatus.RESULTS: Thirty liver cancer patients and 30 paired healthy controls were enrolled in this study. Based on the apparatus, the pulse wave velocity was significantly higher in patients compared with controls(P < 0.05). The number of patients with purple tongue and ecchymosis were more than controls(P < 0.05). The number of patients(10%) with yellow tongue coating were higher than the controls(0%). Patients were inclined to be with water type and fire type constitution.CONCLUSION: TCM Four-diagnostic auxiliary apparatus can be applied in clinical diagnosis of body constitution and health status of subjects. It promotes the accuracy and speed for disease diagnosis and TCM standardization.