针刺百会、人中穴对急性脑缺血大鼠模型葡萄糖转运蛋白1、3的影响

【目的】探讨早期针刺治疗对脑缺血模型大鼠局部葡萄糖代谢的调节作用。【方法】将80只3个月龄的SD大鼠随机分为正常组、模型组、2 h针刺组和24 h针刺组4组,每组20只。采用开颅法复制急性脑缺血模型。针刺治疗取百会、人中穴,采用泻法,针刺行针捻转频率120次/min,每隔4 min行针1次,每次行针1 min,总共针刺治疗30 min。2 h针刺组在造模后2 h即开始针刺治疗,在24 h后再次针刺治疗,一共治疗2次;24 h针刺组在模型制备后24 h针刺1次。针刺治疗结束后,大鼠予以神经功能评分,并取材,行2,3,5-氯化三苯基四氮唑(TTC)染色法测定缺血区域梗死面积,采用免疫组织化学法检测缺血脑组织葡萄糖转运蛋白(GLUT)1、3的表达。【结果】模型组大鼠神经功能评分指数较正常组升高,TTC染色结果显示左侧大脑半球肿胀,梗死体积明显大于对侧,免疫组织化学结果显示缺血脑组织区域GLUT1和GLUT3免疫阳性物较正常组增多(P<0.01)。与模型组比较,2 h针刺组和24 h针刺组均能有效改善脑缺血状况,降低神经功能评分指数,减少TTC染色后的梗死面积,增加缺血脑组织区域GLUT1和GLUT3蛋白表达(P<0.05),而2 h针刺组疗效优于24 h针刺组(P<0.05)。【结论】针刺可以有效改善急性脑缺血大鼠脑缺血损伤。针刺改善缺血性脑组织的能量代谢作用可能是通过上调脑内GLUT1和GLUT3的蛋白表达,提高葡萄糖的血脑屏障转运效率,从而促进葡萄糖代谢,为缺血性脑组织提供能量以延缓供能的相对不足,对抗脑缺血损伤。早期以针刺干预调节脑缺血大鼠能量代谢可以起到积极效果。

长强、会阴穴封闭治疗肛门周围瘙痒症147例临床观察

用亚甲蓝液，作长强会阴穴封闭，治疗肛门周围瘙痒症１４７例，治愈率为５１．８％，总有效率为９３．２％。其疗效明显优于苯海拉明液作肛周局部封闭治疗的效果（Ｐ＜０．０１）。

9E燃机的IGV控制及常见故障分析

本文主要介绍了格尔木300MW燃气电站燃气轮机进口可调导叶（IGV）系统。从理论的角度分析了该系统的工作原理，说明了在机组中的作用，介绍了该系统容易出现的故障及解决方法。

压灸百会、关元对轻中度阿尔茨海默病患者认知障碍及血清Aβ_(1-42)、tau、P-tau水平的影响

目的:比较压灸百会、关元联合盐酸多奈哌齐片与单纯盐酸多奈哌齐片治疗轻中度阿尔茨海默病(AD)患者认知障碍的临床疗效,从血清β淀粉样蛋白1-42(Aβ_(1-42))、微管相关蛋白tau、磷酸化tau(P-tau)水平探讨压灸治疗轻中度AD的机制。方法:将76例轻中度AD患者随机分为观察组(38例,脱落4例)和对照组(38例,脱落2例)。对照组予口服盐酸多奈哌齐片(每次5 mg,每天1次);观察组在对照组基础上予压灸百会、关元治疗,每次每穴施灸5壮,隔日1次,每周3次。两组均连续治疗8周。比较两组患者治疗前后及治疗结束后4、12周简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分,治疗前后血清Aβ_(1-42)、tau、P-tau水平,并进行安全性评价。结果:治疗后各时间点,两组患者MMSE、MoCA评分均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患者血清Aβ_(1-42)、tau、P-tau水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者安全等级比较差异无统计学意义(P>0.05)。结论:压灸百会、关元联合盐酸多奈哌齐片改善轻中度AD认知障碍的近远期疗效优于单纯盐酸多奈哌齐片,且可降低血清Aβ_(1-42)、tau、P-tau水平,这可能是压灸改善认知障碍的机制之一。

Study on the effect of acupuncture at Sìshéncōng(四神聪EX-HN 1) and Bǎihuì(百会 GV 20) on the serum amino acids neurotransmitters of insomnia patients

Objective To explore the efficacy of acupuncture at Sish4nc6ng （四神聪 EX- HN 1） and Baihui （百会 GV 20） as well as the possible mechanism. Methods Eighty cases of insomnia patients treated in our hospital were selected, and randomly divided into a control group and a treatment group according to the random number table method. Conventional treatment was carried out in the control group by giving cliazepam tablets, and acupuncture at EX-HN 1 and GV 20 was conducted in the treatment group. The sleep time and quality, PSQI score, and the level changes of blood glutamic acid （GLU）, y-aminobutyric acid （GABA）, norepinephrine （NE） and dopamine （DA） were compared in the patients in each group before and after treatment. Results Compared with the results before treatment, the time for falling asleep of the patients in the two groups shortened （both P〈0.05）, the levels of GLU and GABA increased （all P〈0.05）, the sleep time was longer （both P〈0.05）, and the levels of NE and DA, as well as the PSQI score reduced （all P〈0.05）. Compared with the control group, the levels of NE and DA, as well as the PSQI score of patients in the treatment group reduced after treatment （P〈0.05）, the time for falling asleep shortened （P〈0.05）, the levels of GLU and GABA increased （P〈0.05）, and the sleep time was longer （P〈0.05）. Conclusion Acupuncture at EX-HN 1 and GV 20 can prolong the sleep time, improve the sleep quality, and the clinical efficacy is superior to that of western medicine treatment. The mechanism may be related to the synthesis and release of amino acids neurotransmitters.

电针承山、长强穴治疗痔疮疼痛疗效观察

目的:评价承山与长强穴配伍治疗痔疮疼痛的临床疗效。方法:将120例痔疮疼痛患者随机分为电针组与药物组,各60例。电针组取长强、承山穴,用频率为2/100Hz疏密波治疗;药物组使用止痛药曲马多口服和马应龙麝香痔疮栓剂纳肛对症治疗。两组共治疗5天,评价每日排便时疼痛的视觉模拟评分(VAS)变化情况。结果:电针组在治疗前VAS评分为6.64±3.66,从第2天针刺治疗后疼痛就明显减轻(P<0.05),第2天VAS评分为5.65±2.21,第5天VAS评分为1.85±1.24。药物组在治疗前VAS评分为6.58±3.18,从第3天起,疼痛较前明显减轻(P<0.05),VAS评分为4.86±2.04,第5天VAS评分2.24±1.46。两组在治疗第5天结束后,VAS疼痛评分组间差异无统计学意义(P>0.05)。结论:承山与长强穴远近配伍对改善痔疮排便疼痛是有效的。

针刺涌泉、重灸百会对局灶性脑缺血大鼠VEGF表达的影响

目的探讨针刺对缺血性脑卒中的作用机制。方法将雄性Wistar大鼠40只,随机分为模型组和针灸组,每组20只。以线栓法闭塞大脑中动脉(middle cerebral artery occlusion,MCAO)制作局灶脑缺血再灌注损伤模型。采用免疫组织化学染色SABC法检测缺血脑组织血管内皮细胞生长因子(VEGF)蛋白表达,RT-PCR法检测缺血脑组织VEGF mRNA表达,TTC染色测定脑梗死面积。结果脑组织VEGF mRNA表达与模型组相比,针灸组缺血半暗带区VEGF mRNA表达明显增强,差异有统计学意义(P<0.05);脑组织VEGF蛋白表达与模型组相比,针灸组VEGF蛋白表达明显增强,差异有统计学意义(P<0.05);模型大鼠的脑组织出现大面积梗死灶,与正常组比较,差异明显(P<0.01);与模型组比较,针灸组脑梗死面积明显缩小,差异有统计学意义(P<0.01)。结论针刺涌泉、重灸百会能显著增强脑组织VEGF蛋白及VEGF mRNA表达,促进缺血半暗带区血管生成,这可能是针灸治疗脑缺血的作用机制之一。

针刺百会、四神聪对脑缺血再灌注损伤模型大鼠缺血半暗带组织NF-κB信号通路的影响

目的采用针刺百会、四神聪穴位的方法,干预脑缺血再灌注损伤模型大鼠,通过对各组大鼠脑缺血半暗带组织中NF-κB、IκB蛋白表达水平的检测,探讨针刺百会、四神聪治疗缺血性脑病的部分作用机制。方法SPF级SD大鼠45只,将大鼠随机分为2组:假手术组(15只);造模组(30只)。然后采用改良线栓法对造模组30只大鼠进行CIRI模型复制,评价模型成功后,再将成功的动物模型随机分为2组:非穴区对照组和针刺组。最终实验分为3组,即:假手术组、非穴区对照组和针刺组。假手术组大鼠采用相同术式但不予线栓干预。模型复制成功后,针刺组大鼠给予百会、四神聪穴针刺干预,间隔8 h 1次,至再灌注72 h结束;非穴区对照组大鼠分别于百会、四神聪穴区周边5 mm处进行针刺皮肤干预,间隔8 h 1次,至再灌注72 h结束。末次针刺后1 h,过量麻醉法处死大鼠,取脑组织,去除缺血液化区组织后,沿缺血灶走行,剥离缺血灶周边2 mm区域内半暗带组织,用于NF-κB、IκB蛋白表达水平的检测。结果假手术组神经功能缺损评分为0,TTC染色未见梗死灶。非穴区对照组和针刺组神经功能缺损评分和梗死百分比均具有显著的统计学差异。与假手术组比较,非穴区对照组和针刺组大鼠缺血半暗带组织中NF-κB表达水平显著上调(P<0.01),IκB蛋白表达水平显著下降(P<0.01),有统计学差异;针刺干预后,与非穴区对照组比较,针刺组大鼠缺血半暗带组织中NF-κB表达水平显著下调(P<0.01),IκB蛋白表达水平显著上调(P<0.01),有统计学差异。结论针刺百会、四神聪穴可明显降低脑缺血再灌注损伤模型大鼠神经功能缺损评分,减小梗死百分比。其作用机制可能是通过调节NF-κB信号通路实现的。

The mechanism of different diseases treated by the same way of acupuncture at Changqiang(长强 GV 1) for cognitive disorder

The basic rule of traditional Chinese medicine,different diseases treated in the same way,refers to the phenomenon that treating different diseases with the same pathogenesis by adopting the same method,which has considerable guiding significance in acupuncture at Changqiang（长强 GV 1） during clinical practices.In this study,by integrating distal end therapeutic effect of meridians and collaterals and acupoints,and yin-yang of traditional Chinese medicine and signal pathway and biological holographic law of western medicine,the mechanism of acupuncture at GV 1 in treatment of multiple cognitive disorderrelated diseases was analyzed,so as to expand the application of acupuncture at GV 1.

Clinical Applications of Acupoints Baihui （GV 20） and Sishencong （Ex-HN 1）

Through clinical practice over the last decade, , I have been using Baihui （GV 20） and Sishencong （Ex-HN 1） for treating various diseases or symptoms. It is now reported as follows.

Effect of acupuncture at Bǎihuì (百会GV 20) and Zúsānlǐ (足三里ST 36) on the level of serum inflammatory cytokines in patients with depression

Objective To investigate the immunologic mechanism of acupuncture at Bǎihuì（百 会 GV 20） and Zúsānlǐ（足三里 ST 36） for treatment of depression. Methods Eighty-four cases of depression patients were randomly divided into an electroacupuncture observation group（group A）, an electroacupuncture control group（group B） and a medication control group（group C）, 28 cases in each group. Bǎihuì（百会 GV 20） and Zúsānlǐ（足三里 ST 36） were used in the group A; Tàichōng （太冲 LR 3）, Sānyīnjiāo （三阴交 SP 6）, Nèiguān （内关 PC 6） and Shénmén （神门 HT 7） were used in the group B; and the group C was treated with oral administration of Fluoxetine. The scores of Hamilton Depression Scale （HAMD） were tested and the level of serum interleukin 1（IL-1β）, interleukin 6 （IL-6）, and tumor necrosis factor α （TNF-α） were measured by Enzyme Linked Immunosorbent Assay （ELISA）before and after treatment. Results Their scores of HAMD were obviously decreased after treatment in three groups（all P0.01）. In the group A, 2 cases were cured, 19 cases were markedly effective, 5 cases were effective and 2 cases were failed. In the group B, 16 cases were markedly effective, 12 cases were effective. While in the group C, 1 case was cured, 17 cases were markedly effective, 7 cases were effective and 3 cases were failed. The grade distribution of clinical effect showed that the effect of group A was better （P0.05）. The levels of serum IL-1β and IL-6 in the three groups were obviously decreased after treatment （P0.05, P0.01）, while there was no significant difference between the level of serum TNF-α before and after treatment. Conclusion The effect of electroacupuncture observation group is superior to those of electroacupuncture control group and medication control group.All of these three methods can clear the inflammatory cytokines such as IL-1β and IL-6 away and improve the symptoms of depression.

Effect of catgut implantation at acupoints on GABA_B and mGluR1 expressions in brain stem of rats with spasticity after stroke

OBJECTIVE: To investigate the effect of catgut implantation at acupoints on the expressions of γ-amino butyric acid B receptor(GABAB ) and metabotropic glutamate receptor 1(mGluR1) in the brain stem of rats with spasticity after stroke.METHODS: In total, 60 male Sprague-Dawley rats were randomly divided into three groups: a sham group(n=10), a model group(n=25) and a treatment group(n=25). The rats in both the model group and the treatment group were subjected to middle cerebral artery occlusion to establish a model of focal cerebral ischemia. Rats with limb-spasm met the inclusion criteria. Only the left carotid artery was isolated in sham group rats. Three days after modeling, the treatment group was subjected to catgut implantation at Dazhui(GV 14), Guanyuan(CV 4), and Zhongwan(CV 12). Neurological deficit symptoms were assessed with the Zea-Longa neurological deficit score. The Modified Ashworth Scale(MAS), and isolated muscle tone were used to evaluate spasticity before and after treatment. Immunohistochemistry was applied to determine the expression of GABAB and mGluR1 in the rat brain stem after treatment.RESULTS: After treatment, neural impairment symptoms had significantly improved in the treatment group when compared to the model group(P<0.05). Both MAS and isolated muscle tone in the treatment group were significantly decreased when compared with the model group(P<0.05),and were also lower than before treatment. GABAB expression was significantly higher and mGluR1 was lower in the treatment group when compared with the model group(P<0.01 and P<0.05, respectively).CONCLUSION: Catgut implantation at Dazhui(GV 14), Guanyuan(CV 4), and Zhongwan(CV 12), can relieve limb spasticity by increasing the expression of GABAB and reducing the expression of mGluR1 in the brain stem of rats after stroke.

基于眼电生物信号调控的经皮穴位电刺激治疗儿童精神发育迟滞:随机对照试验

目的:观察基于眼电生物信号调控的经皮穴位电刺激长强穴治疗精神发育迟滞(MR)患儿的临床疗效,探讨目标成就量表(GAS)对MR的评价效应。方法:将60例MR患儿随机分为观察组和对照组,各30例。对照组采用常规康复治疗,每周5次;观察组在对照组的基础上,采用基于眼电生物信号调控的经皮穴位电刺激长强穴进行治疗,当采集到的眼电信号与眼电模板的相似度在其眼电阈值范围内时,触发1次20 s的长强穴位电刺激治疗(连续波,频率70~100 Hz,脉宽0.1~0.2 ms),每次治疗30 min,每周2次。两组均4周为一疗程,共治疗3个疗程。分别于治疗前后比较两组患儿婴儿-初中学生社会生活能力量表(S-M)、GAS评分。结果:治疗后,观察组患儿独立生活评分、对照组患儿交往评分较治疗前升高(P<0.01,P<0.05),观察组患儿参加集体活动、运动评分高于对照组(P<0.05)。治疗后,两组患儿GAS评分均较治疗前升高(P<0.001),且观察组高于对照组(P<0.05)。结论:基于眼电生物信号调控的经皮穴位电刺激长强穴有助于提升MR患儿参加集体活动、运动和独立生活能力,并能促进患儿个体化目标的实现;与S-M的标准分相比,GAS评分(T值)更能体现出患儿个体化的细微进步。

针刺“长强”穴对自闭症模型大鼠学习记忆能力和前额叶皮层缝隙连接相关蛋白表达的影响

目的:观察针刺"长强"穴对自闭症模型大鼠学习和记忆能力及对前额叶皮层缝隙连接相关蛋白(CX)表达的影响,探讨针刺"长强"穴改善自闭症大鼠学习记忆能力的可能机制。方法:Wistar孕鼠予以腹腔注射丙戊酸钠后所产子代,经睁眼试验、游泳试验筛选后,确定为自闭症大鼠模型,随机挑选30只,分为长强组、非穴组、模型组,每组10只,正常Wistar大鼠子代随机挑选10只作为空白组。长强组针刺"长强",每次1min,10d为1个疗程,干预3个疗程;非穴组取胁下非经非穴点针刺。采用Morris水迷宫观察大鼠学习记忆能力,免疫组化法检测大鼠前额叶皮层CX 43、CX 32、CX 36蛋白的表达。结果:自闭症模型组幼鼠睁眼时间在出生后14d(PN 14)、PN 15、PN 16较空白组晚(P<0.05),游泳能力在PN 13和PN 15时较空白组低下(P<0.05)。治疗前长强组、非穴组、模型组逃避潜伏期及平均速度与空白组比较,差异均有统计学意义(P<0.05);治疗后长强组较模型组及非穴组明显改善(P<0.05)。与空白组比较,模型组CX 43、CX32、CX 36蛋白的表达显著降低(P<0.05);治疗后,长强组CX 43、CX 32、CX 36蛋白的表达显著高于模型组和非穴组(P<0.05)。结论:针刺"长强"穴能通过提高前额叶皮层CX 43、CX 32、CX 36蛋白的表达来改善自闭症模型大鼠学习和记忆能力。

针刺百会、足三里对抑郁症患者血清炎性细胞因子水平的影响

目的:探讨电针百会、足三里治疗抑郁症的免疫机制。方法:将84例患者随机分为电针观察组、电针对照组、药物对照组,每组28例。电针观察组穴取百会、足三里;电针对照组穴取太冲、三阴交、内关、神门;药物对照组给予百优解口服。在治疗前后分别用汉密尔顿抑郁量表(HAMD)评分,采用酶联免疫分析法(ELISA)检测患者血清中白细胞介素1(IL-1β)、白细胞介素6(IL-6)、肿瘤细胞坏死因子-α(TNF-α)的水平。结果:与治疗前比较,各组患者治疗后HAMD评分均显著降低(均P<0.01)。电针观察组痊愈2例,显效19例,有效5例,无效2例;电针对照组分别为0例、16例、12例、0例;药物对照组分别为1例、17例、7例、3例,临床疗效等级分布提示电针观察组有较好的疗效(P<0.05);3组患者血清IL-1β、IL-6水平均较治疗前显著降低(P<0.05,P<0.01);血清TNF-α有所降低,但无统计学意义。结论:电针观察组疗效优于电针对照组和药物对照组;3种治疗方法都能清除炎性细胞因子IL-1β及IL-6,从而改善抑郁症状。

针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀临床观察

目的:比较针刺下髎、长强穴与口服西药地奥司明片治疗混合痔吻合器痔上黏膜环切术(PPH术)后肛门坠胀的临床疗效差异。方法:将60例行PPH术的混合痔患者随机分为观察组和对照组,每组30例。观察组在术后第1d开始针刺下髎、长强穴,得气后留针30min,每天1次,共治疗7d;对照组在术后第1d开始口服地奥司明片,每次0.9g,每日2次,共治疗7d。比较两组患者术后第1、2、3、7d的肛门坠胀程度、坠胀持续时间及疼痛评分情况,并评定其疗效。结果:在术后第1d,两组肛门坠胀程度、坠胀持续时间评分比较差异无统计学意义(均P>0.05),但观察组肛门疼痛评分低于对照组(P<0.05),且低于治疗前(P<0.05);在术后第2、3、7d,两组肛门坠胀程度、坠胀持续时间及肛门疼痛评分均低于治疗前(均P<0.05),且观察组优于对照组(均P<0.05);疗程结束时(术后第7d),观察组总有效率高于对照组[90.0%(27/30)vs 83.3%(25/30),P<0.05]。结论:针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀疗效优于口服地奥司明片。

电针“印堂”“天枢”穴对肠易激综合征大鼠行为学及结肠辣椒素受体的影响

目的:观察电针"印堂""天枢"穴对肠易激综合征(IBS)大鼠行为学及结肠辣椒素受体(TRPV 1)表达的影响,探讨电针不同主治功能的穴位对身心疾病不同症状疗效的差异及其相关机制。方法:Wistar新生大鼠32只随机分为空白对照组、模型对照组、印堂组、天枢组。除空白对照组外,均采用新生期母子分离加醋酸灌肠并联合结直肠扩张刺激法制备IBS大鼠模型。大鼠9周龄时印堂和天枢组分别给予电针干预,每次20min,隔日1次,共5次。采用腹部回撤反射对大鼠进行内脏敏感性评估,观察第1次收缩波潜伏期及90s内收缩波个数;采用旷场实验评估大鼠情绪心理行为,观察其水平及垂直运动次数;采用免疫组织化学法检测结肠组织TRPV 1的表达。结果:与空白对照组比较,模型对照组第1次收缩波潜伏期明显缩短(P<0.01),收缩波个数明显增多(P<0.01),水平运动次数以及垂直运动次数均明显减少(P<0.01),结肠内TRPV 1免疫反应物阳性表达水平增强(P<0.05)。与模型对照组比较,天枢组及印堂组第1次收缩波潜伏期延长及90s内收缩波个数明显减少(P<0.01,P<0.05),天枢组垂直运动次数增多(P<0.05),印堂组的垂直运动次数及水平运动次数均明显增多(P<0.01),天枢组及印堂组结肠TRPV 1免疫反应物阳性表达显著下降(P<0.01,P<0.05)。与印堂组比较,天枢组TRPV 1免疫反应物阳性表达显著下降(P<0.01)。结论:电针"印堂""天枢"穴均可明显缓解IBS大鼠的腹痛并改善精神情绪的异常,电针"印堂"穴能更好地缓解模型大鼠抑郁样情绪行为,而电针"天枢"穴治疗腹痛效果较佳,二者对结肠内TRPV 1免疫反应物阳性表达的影响存在明显差异。

电针超前干预对混合痔术后疼痛的影响

目的:评价术前30min电针长强、承山穴干预对混合痔术后患者疼痛不适症状的临床疗效。方法:将行"外剥内扎术"治疗的混合痔患者120例随机分为电针干预组、假电针干预组与空白对照组,每组40例。在基础治疗的同时电针干预组于术前30min给予电针长强、承山穴;假电针干预组术前30min给予破皮浅刺长强、承山穴对照点(两穴旁开1cm的非经非穴处)且不输出电流的刺激;空白对照组术前不采取任何干预。主要观察术后24h患者服用止痛药可普芬总量、术中追加麻醉药物例数、术后24h患者最痛时自评疼痛强度评分及术后当晚患者睡眠时间。结果:3组患者在术中因疼痛追加麻醉药物的例数差异不具有统计学意义(均P>0.05),但电针干预组较假电针干预组、空白对照组可减少术后24h内患者服用止痛药物可普芬用量[(2.43±1.08)片vs(3.23±1.33)片、(3.10±1.22)片],并降低患者最痛时的疼痛强度评分(6.65±1.00vs 7.48±0.96、7.25±1.19),同时增加患者手术当晚的睡眠时间[(220.63±85.50)min vs(162.00±92.69)min、(151.50±80.01)min,均P<0.05]。结论:术前30min电针长强、承山穴对混合痔患者术后疼痛具有超前镇痛的治疗意义。