湘西刘氏小儿推拿学术流派“理-法-方(穴)-术”理论体系刍议

湘西刘氏小儿推拿学术流派是我国小儿推拿主要流派之一,源于湘西地区,在独特的历史、人文、自然环境中形成了具有浓郁民族性、地域性的理论体系。其理论内涵深厚,涵盖了小儿疾病的分类方法、证治规律、治疗策略、穴部及配伍,其操作体系丰富多样、灵活多变,倡导了开关气口、操作有序、注重整体、远近相配。对其理论体系的整理,对小儿推拿的进一步发展有着重要的参考价值。

中药细辛对兔膝骨性关节炎局部不同组织炎症因子的影响

目的探讨单味中药细辛对膝骨性关节炎(KOA)模型膝周不同组织炎症因子的影响。方法将36只健康雄性新西兰大白兔采用随机数字表分为6组,即:空白组(A)、模型组(B)、对照组(C)、低剂量细辛组(D)、中剂量细辛组(E)、高剂量细辛组(F),每组6只。除A组外,均采用本课题组改良方法复制KOA模型,即造模开始第1、4、7天向右后肢关节腔内注射木瓜蛋白酶水溶液。第8天开始,麻醉、绑定、固定造模肢足底,调节改良装置转速为120次/min,行程15cm,牵拉足部,使其造模肢被动屈伸,牵拉肌肉。每天1次,每次2 h,共7天。造模14天后,于第15天进行干预,D、E、F组分别灌服不同浓度的细辛水溶液(根据药典剂量换算低、中、高剂量分别为0.14、0.28、0.7 g/kg),1次/天,共5天。C组给予吲哚美辛片水溶液(根据药典换算单次剂量为0.03g/kg)灌胃,1次/天,共5天。A、B组给予生理盐水灌胃。观察各组兔行为学变化及膝关节肿胀程度,HE染色观察各组图不同组织的病理改变,检测各组关节腔积液、滑膜、软骨、肌肉的IL-1β、肿瘤坏死因子(TNF-α)含量及肝、肾功能。结果B组各组织中炎症因子IL-1β、TNF-α水平显著高于A组(P<0.05,P<0.01);与B组比较,D、E、F组滑膜、软骨、肌肉组织中IL-1β、TNF-α水平均显著降低(P<0.05,P<0.01)。结论细辛有着很强的抗炎作用,其抗炎作用在肌肉、软骨、滑膜中无明显差异。

Manipulation parameter optimization in Liu's back tuina therapy for kids'cough variant asthma in remission stage

Objective:To determine the optimal manipulation parameters in Liu's back tuina therapy for remission-stage cough variant asthma(CVA)in kids.Methods:A 5-factor 3-level L18(37)orthogonal design was adopted.The experimental factors and levels were selected:A,the number of times of Rou-kneading Feishu(BL 13);B,the frequency of Rou-kneading Feishu(BL 13);C,the number of times of Tui-pushing in a'介'-like pattern;D,the frequency of Tui-pushing in a'介'-like pattern;E,the intensity of red color after Ca-scrubbing Feishu(BL 13)with salt.A1,A2 and A3 stood for 10 times,20 times and 30 times,respectively;B1,B2 and B3 stood for 200 times/min,240 times/min and 280 times/min,respectively;C1,C2 and C3 stood for 50 times,75 times and 100 times,respectively;D1,D2 and D3 stood for 150 times/min,175 times/min and 200 times/min,respectively;E1,E2 and E3 stood for pinkish,bright red and dark red,respectively.A total of 108 kids with CVA in remission stage were divided into 18 groups using the random number table method,with 6 cases in each group.Changes in the cough score and fractional exhaled nitric oxide(FENO)level were observed after 15-day treatment.Results:The cough score and FENO level changed significantly in every group after treatment(all P<0.01).By the effect in improving cough score,the factors were listed as D,B,A,C and E in descending order;the most optimal manipulation parameter combination was group 17(A3B2C1D3E1);the second optimal parameter combinations were group 7(A3B1C2D1E3),group 13(A2B1C2D3E1)and group 14(A2B2C3D1E2).Regarding the effect in down-regulating the level of FENO,the factors were listed as C,A,E,B and D in descending order;the most optimal manipulation parameter combination was group 13(A2B1C2D3E1);the second optimal parameter combinations were group 18(A3B3C2D1E2),group 16(A3B1C3D2E3)and group 14(A2B2C3D1E2).Conclusion:Two most effective manipulation parameter combinations were selected out of 18 different parameter combinations in Liu's back tuina therapy for remission-stage CVA in kids.Doctors can choose an appropriate manipulation based on the symptom features of the disease.