Electro-acupuncture at Conception and Governor vessels and transplantation of umbilical cord bloodderived mesenchymal stem cells for treating cerebral ischemia/reperfusion injury

Mesenchymal stem cell transplantation is a novel means of treating cerebral ischemia/reper- fusion, and can promote angiogenesis and neurological functional recovery. Acupuncture at Conception and Governor vessels also has positive effects as a treatment for cerebral ischemia/ reperfusion. Therefore, we hypothesized that electro-acupuncture at Conception and Governor vessels plus mesenchymal stem cell transplantation may have better therapeutic effects on the promotion of angiogenesis and recovery of neurological function than either treatment alone. In the present study, human umbilical cord blood-derived mesenchymal stem cells were isolated, cultured, identified and intracranially transplanted into the striatum and subcortex of rats at 24 hours following cerebral ischemia/reperfusion. Subsequently, rats were electro-acupunctured at Conception and Governor vessels at 24 hours after transplantation. Modified neurological severity scores and immunohistochemistry findings revealed that the combined interventions of electro-acupuncture and mesenchymal stem cell transplantation clearly improved neurological impairment and up-regulated vascular endothelial growth factor expression around the isch- emic focus. The combined intervention provided a better outcome than mesenchymal stem cell transplantation alone. These findings demonstrate that electro-acupuncture at Conception and Governor vessels and mesenchymal stem cell transplantation have synergetic effects on promot- ing neurological function recovery and angiogenesis in rats after cerebral ischemia/reperfusion.

Effects of decompression joint Governor Vessel electro-acupuncture on rats with acute upper cervical spinal cord injury

Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord injury.An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury.Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord.In this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury.The rat models were established by inserting a balloon catheter into the atlanto-occipital space.The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression.Electroacupuncture was conducted at the acupoints Dazhui（GV14） and Baihui（GV 20）（2 Hz,15 minutes） once a day for 14 consecutive days.Compared with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture.However,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours.Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone.These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression（48 hours） is more effective in the treatment of upper cervical spinal cord injury.Governor Vessel electroacupuncture combined with early decompression（12 hours） can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury.Nevertheless,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.

CLINICAL OBSERVATION ON TREATMENT OF 205 CASES OF CERVICAL SPONDYLOPATHY BY ACUPUNCTURE AND MOXIBUSTION ON THE GOVERNOR VESSEL OF THE NECK

This article involves 325 patients suffering from cervical spondylopathy,amongthem 205 cases were treated by acupuncture and moxibustion on the governor vessel of the neck（treatment group）,the other 120 cases were treated by common acupuncture（control group）.Itwas observed that the cure rate,the total effective rate was 91.2％,98.5％ in the treatmentgroup,and 55.8％,87.5％ in the control group.There were statistically significant differences（P【0.01）in the cure rate and total effective rate between the two groups.It is concluded thatacupuncture and moxibustion on the governor vessel of the neck may improve Yang Qi circulationwithin the Dumai and promote the micro-circulation in the diseased areas.Thus it evidently in-creases the therapeutic effects.

Governor Vessel Moxibustion:Ancient Chinese Medical Technology with New Vitality

Moxibustion is an ancient therapeutic technique used in Chinese medicine. Governor Vessel moxibustion（GVM） was developed from long snake moxibustion, a popular technique used in China＇s Jiangsu and Zhejiang Provinces, and is significantly more effective than general moxibustion. We aimed to review GVM, including its theoretical basis, choices of moxibustion points and materials, operation procedures, clinical applications, and contraindications. This information could increase the appropriate use of GVM and support further in-depth research.

Clinical Study on Treatment of Post-apoplectic Limb Spasm by Puncturing Acupoints of Governor Vessel

目的:探讨针刺督脉为主的方法治疗中风后肢体痉挛的临床意义.方法:针刺督脉为主配合关节局部取穴治疗中风后肢体痉挛患者29例,与传统取穴方法治疗的29例作疗效对比.结果:治疗前两组患者肢体Ashoworth张力评分及Fugl-Meyer运动功能评分比较差异无显著性(P＞0.05);治疗后两组张力评分评定差异有显著性(P＜0.05);运动功能评分与治疗前比较均明显升高(P＜0.01),但治疗组与对照组比较,肢体运动功能改善更显著(P＜0.05).结论:针刺督脉为主治疗中风后肢体痉挛较传统的针刺方法可明显提高疗效.

Combinatorial effects of conception and governor vessel electroacu-puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE: To investigate the combinatorial effects of conception and governor vessel electroacupuncture(EA) and human umbilical cord blood-derived mesenchymal stem cells(HUCB-MSCs) on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS: With the HUCB-MSCs isolated, cultured and identified and the models of cerebral ischemia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted and the EA at conception and governor vessels was applied. The pathomorphologic lesion by hematoxylin-eosin staining and the cellular apoptosis by terminal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic focus were observed. RESULTS: The cultured adherent HUCB-MSCs exhibited a spindle shape and expressed MSC-specific markers, with the cell purity and proliferation rate significantly increasing after the primary passage. HE staining showed that there were no pathological changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs transplantation + EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treatment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION: HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs transplantation.

Functional Feature of“Five Yang Acupoints”in Governor Vessel

督脉为奇经八脉之一,又称"阳脉之海",与任脉经共同主司人身之阴阳调节,督脉经穴临床应用十分广泛。本文选取最能反映督脉特性的腰阳关、命门、至阳、大椎、百会五穴,阐述其功用特点,供临床应用参考。

Distribution and Permeability of Capillaries at the Skin of the Conception Vessel and the Governor Vessel in Healthy Rabbits

Objective: To investigate the distribution and permeability of blood vessels on the Conception Vessel and the Governor Vessel in the physiological state. Methods: Evans blue (EB) solution was injected into the marginal ear vein of healthy rabbits. Three hours after injection, the rabbits were sacrificed and the skin on the Conception Vessel and the Governor Vessel and the corresponding bilateral non-channels was collected. EB was extracted with 7:3 acetone: physiological saline, and the absorbance of EB at each skin tissue was measured with a spectrophotometer. Results: The A value of EB absorbance at the Conception Vessel on the abdominal skin was lower than that of the corresponding bilateral non-channels with a statistically significant difference (P<0.01). The A value of EB absorbance at the Governor Vessel on the back was higher than that of the corresponding bilateral non-channels (P<0.05). There was no statistical difference in the A value of EB absorbance between the bilateral non-channels of the abdomen and the back (P>0.05). Conclusion: There were differences in capillary distribution and permeability between the Conception Vessel, the Governor Vessel and the corresponding bilateral non-meridians.

Mechanism of the acupoints of the governor vessel in treatment of post-stroke depression on the base of the specificity of meridian points

Focusing on the effect specificity of meridian points along the running course of meridian,by taking the treatment of post-stroke depression(PSD)with the acupoints of the governor vessel as an example,the correlation between meridian points and disease was explored.The specific regulatory effect of governor vessel,Baihui(百会GV20)and Shenting(神庭GV24)in physiology and pathology in PSD and the material basis of the specificity effect were analyzed.Finally,the specific relationship between the acupoints of the governor vessel and PSD was explained.

艾灸督脉组穴对血管性痴呆大鼠海马p38 MAPK信号通路及细胞凋亡的影响

目的基于p38丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)通路探究艾灸督脉组穴对血管性痴呆(vascular dementia,VD)大鼠的脑保护机制。方法将60只SPF级健康雄性SD大鼠随机分为假手术组(12只)和实验组(48只);实验组大鼠采用双侧颈总动脉永久结扎法复制VD大鼠模型,随后将模型复制成功的大鼠分为模型组、艾灸组、阻滞剂组、艾灸+阻滞剂组,每组12只;艾灸组大鼠取“百会”“大椎”“风府”穴,采用温和灸法治疗,每次30 min,每日1次,治疗6 d,休息1 d,连续治疗4周;阻滞剂组在模型复制前30 min腹腔注射p38 MAPK阻滞剂(10μmol/L SB203580),模型复制成功后隔日注射1次,每次每只大鼠按1 mL/kg注射10μmol/L SB203580,连续注射4周;艾灸+阻滞剂组大鼠在阻滞剂组干预方法基础上进行艾灸治疗。采用Morris水迷宫实验检测大鼠认知功能,TUNEL法检测大鼠海马组织CA1区神经元凋亡率,Western blot法和RT-qPCR法分别检测大鼠海马组织CA1区p38 MAPK、Bcl-2、Caspase-3、Caspase-9蛋白及mRNA表达水平。结果与模型组比较,艾灸组、阻滞剂组、艾灸+阻滞剂组大鼠平均逃避潜伏期均显著缩短(P<0.05),穿越平台次数显著增加(P<0.05),海马组织CA1区神经元凋亡率显著降低(P<0.05),p38 MAPK、Caspase-3、Caspase-9蛋白及mRNA表达水平均显著降低(P<0.05),Bcl-2蛋白及mRNA表达水平均显著升高(P<0.05);艾灸+阻滞剂组大鼠平均逃避潜伏期较艾灸组、阻滞剂组显著缩短(P<0.05),穿越平台次数显著增加(P<0.05),海马组织CA1区神经元凋亡率显著降低(P<0.05),p38 MAPK、Caspase-3、Caspase-9蛋白及mRNA表达水平均显著降低(P<0.05),Bcl-2蛋白及mRNA表达水平均显著升高(P<0.05)。结论艾灸督脉组穴对VD大鼠的认知功能具有一定的改善作用,其作用机制可能与调控p38 MAPK信号通路抑制海马神经元凋亡有关。

督灸配合中药治疗重症肌无力的疗效观察

目的 观察督灸配合益髓健肌颗粒治疗重症肌无力的临床疗效。方法 将94例重症肌无力患者随机分为治疗组和对照组,每组47例。治疗组采用督灸配合益髓健肌颗粒治疗,对照组采用口服甲泼尼龙片治疗。观察两组治疗前后英国医学研究理事会(Medical Research Council, MRC)肌力评测表评分、重症肌无力肌群耐力评分量表(myasthenia gravis muscular endurance scale, MGMES)评分、肌肉含量及各项实验室指标[滤泡辅助性T细胞(T follicular helper cells, Tfh)、滤泡调节性T细胞(T follicular regulatory cells, Tfr)、Tfr/Tfh比值、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白细胞介素-2(interleukin-2, IL-2)、白细胞介素-17(interleukin-17, IL-17)、鸢尾素(irisin)、过氧化物酶体增殖物激活受体-γ共激活因子-1α(peroxisome proliferator-activated receptor-γ coactivator 1-α, PGC-1α)、Ⅲ型纤连蛋白结构域蛋白5(fibronectin typeⅢdomain-containing protein 5, FNDC5)、磷脂酰肌醇-3-激酶(phosphoinositide3-kinase, PI3K)、蛋白激酶B(AKT)、雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)]的变化情况,比较两组临床疗效、不良反应发生率及随访6个月复发率。结果 治疗组总有效率为95.7%,明显高于对照组的81.4%(P<0.05)。两组治疗后MRC肌力评测表评分及肌肉含量均较同组治疗前显著上升,MGMES评分均显著下降,差异均具有统计学意义(P<0.05)。治疗组治疗后Tfr、Tfr/Tfh、irisin水平均较同组治疗前显著上升,Tfh、TNF-α、IL-2、IL-17、PGC-1α、FNDC5、PI3K、AKT、mTOR水平均显著下降,差异均具有统计学意义(P<0.05)。对照组治疗后Tfr、Tfr/Tfh水平均较同组治疗前显著上升,Tfh、TNF-α、IL-2、IL-17水平均显著下降,差异均具有统计学意义(P<0.05)。治疗组治疗后MRC肌力评测表评分、MGMES评分、肌肉含量及各项实验室指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗期间不良反应发生率和随访6个月复发率分别为2.2%和6.8%,明显低于对照组的32.6%和42.9%(均P<0.05)。结论 督灸配合益髓健肌颗粒可增强重症肌无力患者的肌肉张力,调节Tfh、Tfr平衡,拮抗血清促炎因子分泌,改善血清肌肉调节因子和PI3K/AKT/mTOR通路水平,安全性好。

针刺联合督灸治疗强直性脊柱炎的疗效观察

目的 观察针刺联合督灸治疗强直性脊柱炎的临床疗效及对AKT/PI3K/mTOR信号通络的影响。方法将96例强直性脊柱炎患者随机分为两组(观察组和对照组),每组48例。对照组口服美洛昔康治疗,观察组予针刺联合督灸治疗。观察两组治疗前后巴氏强直性脊柱炎病情评测指数(Bath ankylosing spondylitis disease activity index,BASDAI)和巴氏强直性脊柱炎活动能力量表(Bath ankylosing spondylitis functional index,BASFI)评分、血清炎性因子[核因子-κB(nuclear factor-κB,NK-κB)、巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、CC趋化因子受体6(CC chemokine receptor 6,CCR6)和单核细胞趋化蛋白-4(monocyte chemokine protein-4,MCP-4)]水平、骨化相关蛋白[基质金属蛋白酶组织抑制剂-2(matrix metalloproteinase tissue inhibitor-2,TIMP-2)、高迁移率族蛋白B1(high mobility group protein box 1,HMGB1)、Dickkopf相关蛋白-1(dickkopf-related protein-1,DKK-1)和骨硬化蛋白(sclerostin,SOST)]水平以及AKT/PI3K/mTOR信号通路[蛋白激酶B(protein kinase B,AKT)、磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)和雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)]水平的变化。比较两组临床疗效及不良反应发生情况。结果 观察组总有效率为97.9%,高于对照组的81.8%(P<0.05)。观察组治疗后、随访3个月及6个月BASDAI和BASFI评分均低于对照组(P<0.05)。观察组治疗后血清NK-κB、MIF、CCR6、MCP-4、TIMP-2、HMGB1、AKT、PI3K和mTOR水平均低于对照组(P<0.05),DKK-1和SOST水平高于对照组(P<0.05)。结论 针刺联合督灸可明显缓解强直性脊柱炎患者的临床症状,疗效优于口服美洛昔康治疗,并可调节AKT/PI3K/mTOR信号通络的表达。

分期针刺任督经穴治疗早发性卵巢功能不全的临床观察

目的观察分期针刺任督经穴治疗早发性卵巢功能不全(POI)的临床疗效。方法选取2021年6月至2022年12月就诊于上海市静安区中医医院的104例POI患者作为研究对象,按照完全随访化方法分为分期组、任脉组、督脉组、西药组,各26例。比较各组患者治疗前后血清性激素水平、窦卵泡计数(AFC),以及治疗和随访过程中共5个访视点的Kupperman(K)表和月经不调症状分级量化(MDQ)表评分。结果治疗后,四组血清卵泡刺激素(FSH)水平下降,雌二醇(E_(2))水平上升(P<0.05);西药组、督脉组和分期组AFC升高(P<0.01),分期组AFC改善优于任脉组(P<0.05)。西药组K表和MDQ表评分在治疗期间下降(P<0.01);随访期间K表不再下降(P>0.05),MDQ表上升(P<0.01)。任脉组K表评分在1MC和随访期间下降(P<0.05),MDQ表评分在3MC下降(P<0.01)。督脉组K表和MDQ表评分在3MC下降(P<0.01);随访期间MDQ表评分下降(P<0.05)。分期组K表评分在每个访视点均下降(P<0.05),MDQ表评分在3MC和随访期间下降(P<0.01)。结论分期针刺任督经穴治疗POI的临床疗效显著。

基于督脉理论探讨“通督益髓”针法治疗脊髓损伤的研究进展

脊髓损伤是一种严重的神经系统疾病,属于中医“痿证”“体惰”范畴,“督脉受损、肾阳不足”是脊髓损伤的主要病因病机,从督脉论治脊髓损伤是中医治疗的关键。文章基于督脉理论,介绍了中医学对脊髓损伤的认识以及“通督益髓”法理论的形成,简述了“通督益髓”法电针治疗脊髓损伤的临床应用及机制研究,以期为脊髓损伤的中医理论及临床研究提供新思路。

督脉十三针联合五脏俞加膈俞针刺治疗帕金森病临床研究

目的:观察督脉十三针联合五脏俞加膈俞针刺治疗帕金森病患者运动症状的有效性和安全性。方法:将58例帕金森病患者随机分为对照组和治疗组,对照组28例,治疗组30例。治疗组给予督脉十三针联合五脏俞加膈俞针刺治疗,对照组给予常规针刺治疗方案,每周治疗3次,共治疗8周。分别于治疗前后观察两组患者帕金森病综合评价量表(MDS-UPDRS)、10米步行试验(10MWT)、改良Webster症状评分量表、Hoehn-Yahr(H-Y)分级量表的变化情况,并比较临床疗效。结果:治疗后,两组MDS-UPDRS评分、10MWT、改良Webster症状评分均较治疗前下降(P<0.05),且在MDS-UPDRS评分、10MWT的改善方面,治疗组优于对照组(P<0.05),两组改良Webster症状评分变化比较差异无统计学意义(P>0.05),两组治疗前后H-Y分级组内及组间比较差异均无统计学意义(P>0.05)。结论:督脉十三针联合五脏俞加膈俞针刺治疗可改善帕金森病运动症状,提高患者的生活质量。

温督调神针刺法治疗颈源性失眠理论探讨

颈源性失眠是指因颈部疾患造成的失眠。温督调神针刺法是温督之法与调神之法相结合,以温督脉、补阳气、调神志为治疗原则来治疗疾病的一种治法。温督之法有两方面含义,一是指以毫火针点刺腧穴,以火热之气温通经脉;二是指督脉总督一身之阳,刺激督脉阳气隆盛的穴位,以温补阳气。两者共达温督升阳之效。调神之法指根据督脉循行,温通督脉调节脑神与心神,配合选取具有调神作用的腧穴,加强调神的效果,以达安神之功。颈源性失眠归属于中医“项痹”“不寐”范畴,阳气不足是颈源性失眠之本,神失所养是颈源性失眠之根。该文从督脉与颈椎病的关系以及督脉相关脏腑与失眠的关系,探究温督调神针刺法在颈源性失眠治疗中的重要作用,以期为临床治疗本病开拓新的思路。

从督论治儿童注意缺陷多动障碍思路探析

基于上海市名中医秦亮甫教授“病变在脑,首取督脉”理论,分析儿童注意缺陷多动障碍(ADHD)的病因病机。笔者认为,儿童ADHD的病机关键为动静失制、阴阳失调,而肾精不足、髓海空虚导致神机失用是该病的发病基础,治疗上应疏通督脉以调神机。通督调神法从督论治儿童ADHD疗效显著,为中医临床诊治本病拓宽了思路。

长蛇灸调节阳虚体质的体表温度特征

目的探讨长蛇灸调节阳虚体质施灸时体表温度特征。方法将80例阳虚体质受试者以1∶1比例随机分为督脉组和膀胱经组各40例。督脉组取背部督脉为施灸部位,膀胱经组取膀胱经〔据后正中线10 cm(3寸)处〕为施灸部位,进行长蛇灸治疗,1次/w,每次3壮(约45 min),共治疗12次。观察两组治疗前、后阳虚体质评分,评估临床疗效;运用温度测试探头采集施灸时体表温度,对比不同经脉施灸、不同疗效程度受试者的体表温度特征。结果治疗后督脉组总有效率明显高于膀胱经组(P<0.05)。治疗后,督脉组和膀胱经组阳虚体质转化分均明显低于治疗前;且督脉组阳虚体质转化分明显低于膀胱经组(P<0.05)。督脉组总平均体表温度明显高于膀胱经组(P<0.05);不同测量时间对经脉体表温度的影响差异有统计学意义(P<0.05);不同测量时间对体表温度的影响存在经脉之间的显著差异(P<0.05);第3、5、7、12次治疗的督脉组平均温度明显高于膀胱经组(P<0.05)。膀胱经组中治疗有效者的体表温度明显高于治疗无效者(P<0.05);所有受试者中治疗有效者的体表温度显著高于治疗无效者(P<0.05)。结论长蛇灸可有效调节阳虚体质,督脉是优选治疗部位;长蛇灸疗效与体表温度呈现出督脉温度高于膀胱经温度、灸效越好温度更高的特征。

基于因子分析与聚类分析抑郁症中医证候特征研究及督脉火龙灸联合经颅磁刺激对抑郁症患者5-HT水平和抑郁状况影响

目的探讨抑郁症中医证候特征及督脉火龙灸联合经颅磁刺激治疗对患者血清5羟色胺(5-HT)水平和抑郁状况的影响。方法选取2020年5月—2023年7月于内蒙古包钢医院就诊诊断为抑郁症的216例患者。运用因子分析及聚类分析方法对216例患者的四诊信息进行研究以获得抑郁症主要中医证型分类的及分布规律。再根据治疗方法的不同将216例患者分为两组,督脉火龙灸联合经颅磁刺激组(n=90)和经颅磁刺激组(n=126),比较两组的治疗疗效、血清5-HT水平、抑郁自评量表(SDS)评分、焦虑自评表(SAS)评分和生活质量评分等。采用广义评估方程评价两种干预方式对患者SDS、SAS评分和血清5-HT水平的影响。结果抑郁症的中医症状分布频率≥50%,分别为情志抑郁、失眠、头晕、多思多虑、胸闷、善悲易哭、神疲、心神不定、舌质红、舌质淡、舌苔白、舌苔薄和乏力,出现频率最高的是情志抑郁,占比94.44%。通过因子分析对抑郁症患者的四诊信息进行分析,结果提示抑郁症主要病性证素是火热、气郁、气滞、气虚、阳亢、血瘀,主要病位证素是心、肝、脾、肾。聚类分析结果显示抑郁症主要病性证素是火热、气郁、气滞、气虚、血瘀,主要病位证素是心、肝、脾、肾。治疗8周后,与经颅磁刺激组比较,督脉火龙灸联合经颅磁刺激组治疗总有效率(92.22%vs 76.98%),5-HT[(19.75±5.18)ng/mL vs(17.31±5.46)ng/mL]、生活质量评分[情感职能:(89.26±2.78)分vs(79.85±3.45)分、生理职能:(88.75±2.36)分vs(80.85±2.37)分、社会功能:(88.47±3.57)分vs(79.57±2.37)分、活力指数:(86.85±3.58)分vs(78.64±3.09)分]明显升高,而SDS评分[(36.18±5.67)分vs(46.38±5.64)分]、SAS评分[(36.75±6.36)分vs(43.85±5.37)分]明显降低,比较差异具有统计学意义(P<0.05);治疗后与经颅磁刺激组比较,督脉火龙灸联合经颅磁刺激组的血清5-HT水平更高,而SDS、SAS评分更低,组间比较差异具有统计学意义(P<0.05)。结论基于因子分析与聚类分析能够客观地分析出抑郁症的中医证型分类及分布规律。督脉火龙灸联合经颅磁刺激治疗可以改善抑郁症患者的血清5-HT水平和生活质量,疗效明显优于经颅磁刺激治疗,应用价值高。

基于“皮部理论”运用头部浅刺治疗慢性失眠临床观察

目的:基于“皮部理论”观察头部浅刺疗法对慢性失眠患者的临床疗效。方法:将82例慢性失眠患者按随机数字表法分为浅刺组和对照组各41例。浅刺组选取施术部位为头部督脉与足太阳膀胱经皮部区域(前至神庭穴水平,后至百会穴水平,左右以正中线旁开3 cm为界),针刺间隔为10~15 mm,针刺深度约2~5 mm。对照组取双侧照海、申脉、神门、三阴交、安眠及四神聪共14穴行常规针刺治疗。两组均每周治疗3次,共4周。观察两组患者干预前后匹兹堡睡眠质量评分(PSQI)、失眠严重程度指数(ISI)、爱泼沃斯嗜睡量表(ESS)评分、抑郁自评量表(SDS)评分和焦虑自评量表评分(SAS)。结果:两组患者治疗后PSQI、ISI、ESS、SDS与SAS量表评分均较治疗前降低(P<0.05),且浅刺组ESS、SDS、SAS评分低于对照组(P<0.05)。结论:基于“皮部理论”运用头部浅刺治疗慢性失眠可有效改善患者睡眠状况及焦虑、抑郁状态,且在改善焦虑、抑郁状态和日间嗜睡方面较常规针刺更有效。