Comparative Study on the Effect of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） on Cognition of Patients with Vascular Dementia

Objective： To study the relative specificity of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） in improving the cognitive function of patients with vascular dementia （VD）. Method： Fifty VD cases were randomized into 5 groups, which were treated with routine points, routine points plus Baihui （GV 20）, routine points plus Shuigou （GV 26）, routine points plus Shenmen （HT 7）, and routine points plus the above-mentioned three points together respectively. The scale of elderly cognitive function （SECF） was measured before and after the treatment for statistical management. Results： The total score of SECF was markedly increased after Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） were added to the routine points, more specifically, with addition of Baihui （GV 20）, the patients with VD got increased scores in such aspects as orientation, instant memory, long-term anamnesis, animal names, cancellation and calculation, and classification and analogy; with addition of Shuigou （GV 26）, the patients with VD got increased scores in such aspects as orientation, cancellation and calculation, and classification and analogy; with addition of Shenmen （HT 7）, the patients with VD got increased scores in such aspects as digital scope, animal names, and classification and analogy. Conclusion： Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） could improve the cognitive function of patients with VD, and the combination of the three points got the best result despite their respective specificity.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

Effect of long-time needle retaining at Baihui(GV 20) on cognitive impairment in post-stroke patients

Objective： To observe the clinical efficacy of long-time needle retaining at Baihui（GV 20） in treating post-stroke cognitive impairment. Methods： A total of 60 eligible patients with post-stroke cognitive impairment were randomized into a treatment group and a control group by random digital table, 30 cases in each group. The control group was intervened by basic treatment including routine therapy in Neurology department and Western medicine rehabilitation therapy, while the treatment group was intervened by same treatment in the control group combined with long-time needle retaining at Baihui（GV 20）. Mental state of patients was evaluated by National Institute of Health stroke scale（NIHSS） and mini-mental state examination（MMSE） after 4 weeks of treatment. Results： After 4-week treatment, the NIHSS score dropped in both groups, and intra-group comparisons showed statistical significances（both P〈0.05）, and the score in the treatment group was statistically lower than that in the control group（P〈0.01）; the MMSE score in the treatment group was significantly higher than that in the control group, there was a statistical inter-group difference（P〈0.01）; the total effective rate was 93.3%, and the marked effective rate was 50.0% in the treatment group, versus 76.7% and 20.0% in the control group, there were significant differences in the total effective rate and the marked effective rate between the two groups（all P〈0.05）. Conclusion： Long-time needle retaining at Baihui（GV 20） can produce a safe valid therapeutic efficacy in treating post-stroke cognitive impairment.

Clinical Observation on Suspended Moxibustion at Baihui （GV 20） for Insomnia

Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients＇ daily life, work and study, so it should be treated as early as possible. A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs. The author treated insomnia with suspended moxibustion at Baihui （GV 20）, the report is as follows.

Clinical observation on moxibustion at Baihui(GV20)plus Tuina for children with postnasal drip syndrome

Objective:To observe the clinical efficacy of moxibustion at Baihui(GV20)plus Tuina(Chinese therapeutic massage)for children with postnasal drip syndrome(PNDS).Methods:A total of 60 cases were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9%normal saline.Cases in the observation group received additional moxibustion at Baihui(GV20)plus Tuina at the head and face.All the cases were treated for four consecutive weeks.The clinical efficacy and traditional Chinese medicine(TCM)symptoms score were compared between the two groups.Results:The total effective rate of the observation group was 93.3%while that of the control group was 70.0%.The difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups declined significantly,showing a statistical difference from that before treatment(P<0.05),and the score of the observation group was notably lower than that of the control group(P<0.05).Conclusion:The clinical efficacy of moxibustion at Baihui(GV20)plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

Therapeutic observation on improving efficacy of moxibustion at Bǎihuì(百会 GV 20) for insomnia

Objective To compare the therapeutic effect between needling combined with moxibustion at Baihui （百会 GV 20） and conventional needling for treatment of insomnia, and to verify the synergy of moxibustion at Baihui （百会 GV 20） on insomnia. Methods Two hundreds and seven cases of insomnia patients were randomly divided into observation group and control group. The conventional needling combined with moxibustion at Baihui （百会 GV 20） was applied in observation group, and the conventional needling was employed in control group, once a day, and for 5 consecutive days per week, 4 weeks as a course, and 1 course in total. Pittsburgh Sleep Quality Index （PSQI） Scale was adopted before and after the treatment, and the therapeutic effects of two groups as well as of asthenia and sthenia syndromes and among syndromes were observed and compared in observation group. Results After treatment, PSQI scores of both groups significantly improved （both P〈0.05）, and the score of observation group was superior to that of control group （P〈0.05）; after 1 course, the total effective rate in observation group was 88.0% （88/100）, superior to 74.5% （73/98） in control group （P〈0.05）; in observation group, the total effective rate was 92.4% （61/66） of asthenia syndrome, superior to that of 79.4% （27/34） of sthenia syndrome （P〈0.05）. Conclusion Needling combined with moxibustion at Baihui （百会 GV 20） has marked therapeutic effect on insomnia, with better effect on prolonging the time of sleep, improving the sleep quality than that of single needling. And the therapeutic effect on asthenia syndrome was superior to that of sthenia syndrome.

“水沟”穴最佳刺激参数的筛选研究

目的:了解针刺参数对针效的影响,探讨"醒脑开窍"针刺法中水沟穴最佳刺激参数。方法:复制大鼠大脑中动脉缺血模型(MCAO),以针刺频率的慢、中、快(1、2、3次/秒)和针刺时间的短、中、长(5 s、60 s、180 s)的两因素三水平针刺参数搭配组合9种针刺方法刺激"水沟"穴,以脑血流量为效应指标,通过正交试验、析因分析、单因素方差分析,综合分析不同针刺手法作用于"水沟"穴对MCAO大鼠脑血流量的影响。结果:针刺效应受针刺频率、时间以及它们两者的交互作用影响,其中,针刺时间影响作用最大。尽可能长时间地应用最快频率针刺,可取得最佳针刺效应。结论:"醒脑开窍"针刺法中"水沟"穴的操作是快频率、足够长时间的针刺(雀啄手法以眼球湿润为度),可取得最佳效应。此法是"水沟"穴最佳刺激参数。

电针水沟穴抗轻、中度休克：多中心随机对照研究

目的:探讨电针水沟穴抗轻、中度休克的作用。方法:采用3中心分层随机对照研究方法,将276例患者随机分为针药组(138例)、西药组(138例)。西药组仅给予西医常规治疗,针药组在给予西医常规治疗的同时,电针水沟穴,观察治疗6小时后的疗效。结果:针药组可即刻升高血压,升压起效时间早于西药组(P<0.001)。针药组显效率为52.9%,高于西药组的18.1%(P<0.001)。结论:在西药基础上电针水沟穴治疗轻、中度休克疗效优于单纯西药。

艾灸健康人百会穴对大脑中动脉血流速度的影响

目的 :探讨艾灸百会穴治疗缺血性脑血管病的机理。方法 :选择本校健康男性学员 30名 ,应用美国AcusonSequoia 51 2型超声诊断仪 ,分别于艾灸百会穴前后测试双侧大脑中动脉最大血流速度(Vmax)、最小血流速度 (Vmin)、搏动指数 (PI)、阻力指数 (RI)等血流动力学有关参数。结果 :艾灸百会穴 5天后 ,左侧大脑中动脉Vmax、PI、RI及右侧大脑中动脉Vmax、Vmin增加非常显著 (P <0 0 1 ) ,其余各项指标虽有不同程度的改变 ,但无统计学意义。结论 :艾灸百会穴可使大脑中动脉血流速度明显加快 ,血管搏动指数增加 ,脑血流量增加 。

电针百会印堂穴在精神科的应用

目的 :将我国近年来电针百会穴对精神疾病的临床治疗及研究进行综述。方法 :从抑郁症、精神分裂症、神经症、其他精神障碍及电针治疗机理的实验室研究等 5个方面综述。结果 :电针治疗抑郁症已被众多的临床和基础研究所证实。治疗神经症、精神分裂症及其他精神障碍也取得了一定的疗效。结论 :电针治疗是一种疗效好、无副作用、安全、经济、操作简便、受病人及家属欢迎的治疗精神疾病的新疗法。

针刺配合艾灸百会穴治疗中风后失眠疗效观察

目的观察针刺配合艾灸百会穴治疗中风后失眠的临床疗效。方法将65例中风后失眠患者随机分为治疗组33例和对照组32例。治疗组采用针刺配合艾灸百会穴治疗,对照组采用常规针刺治疗。观察两组治疗前后SPIEGEL量表评分及脑卒中专用生活质量量表(SS-QOL)评分变化情况,并比较两组临床疗效。结果两组治疗后SPIEGEL量表评分和SS-QOL评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后SPIEGEL量表评分和SS-QOL评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为93.9%,对照组为68.8%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合艾灸百会穴是一种治疗中风后失眠的有效方法。

百会、水沟、神门治疗血管性痴呆的比较研究

目的比较百会、水沟、神门治疗血管性痴呆(VD)的相对特异性。方法50例血管性痴呆患者,随机分为5组,A组治以常规穴位针刺,在A组基础上B组加用百会、C组加用水沟,D组加用神门,E组加用百会、水沟和神门3穴。治疗前后均观察临床症状的变化,并运用修订长谷川痴呆量表、日常生活活动量表、社会功能活动调查等量表进行测评,评分结果进行统计学处理。结果百会、神门能够改善VD患者记忆、定向、反应、固执、恍惚等方面的症状,百会长于帮助患者理解、计算、适应社会;水沟则偏重于针对VD患者喜睡嗜卧、反应迟钝、神思恍惚、记忆等症状的改善;百会、水沟、神门3穴联合运用,对于VD患者的智力水平、社会适应能力有着较为全面的改善。结论百会、水沟、神门3穴在改善VD患者临床症状和智力水平方面各有其相对特异性,3穴联合运用疗效最佳。

醒脑开窍针法中水沟穴作用探讨

目的 :探讨水沟穴在醒脑开窍针法中的作用。方法 :根据文献及现代医学机理 ,对针刺水沟穴在中风急性期和恢复期、后遗症期的作用进行分析。结果 :中风急症期可醒脑神、开清窍 ,中风恢复期、后遗症期以调神作用为主 ,其作用机制 ,在于针刺刺激了穴周的面神经、三叉神经分支 ,激活了三叉神经—脑血管系统 ,一方面兴奋脑神经元 ,另一方面 ,改善了脑血流。其刺激的量化标志就是流泪。

电针百会穴对脑梗死后认知障碍患者听觉P300的影响

目的观察电针百会穴对脑梗死后认知障碍患者听觉事件相关电位P300的影响。方法将59例脑梗死患者随机分为治疗组30例和对照组29例。治疗组采用电针配合认知功能训练治疗,对照组采用单纯认知功能训练治疗。比较两组治疗前后蒙特利尔认知评价量表(MoCA)评分及P300检测情况。结果两组患者治疗后MoCA量表各项评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。除言语项目外,治疗组患者治疗后MoCA量表各项评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后P300潜伏期、波幅与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后P300潜伏期、波幅与对照组比较,差异均具有统计学意义(P<0.05)。P300潜伏期与MoCA评分呈负相关性,P300波幅与MoCA评分呈正相关性。结论电针百会能改善脑梗死后认知障碍患者的认知功能。

百会、水沟、神门影响血管性痴呆患者认知功能的比较研究

目的:探讨百会、水沟、神门改善血管性痴呆(VD)患者认知功能的相对特异性。方法:50例VD患者,随机分为5组,分别施以针对偏瘫的常规穴位针刺,常规穴位加用百会穴,加用水沟穴,加用神门穴,加用百会、水沟和神门穴。治疗前后运用老年认知功能量表(SECF)进行测评,评分结果纳入统计学处理。结果:常规穴位加用百会、水沟、神门等穴位治疗后,SECF总分有显著提高;加用百会穴治疗后,VD患者的定向、瞬间记忆、长回忆、动物名、划销和计算、分类与类同等方面评分有明显提高;加用水沟穴治疗后,VD患者的定向、划销和计算、分类与类同等方面评分有明显提高;加用神门穴治疗后,VD患者的数字广度、动物名、分类与类同等方面评分有明显提高。结论:百会、水沟、神门能够改善VD患者认知功能,三穴虽然分别有各自的相对特异性,但联合运用效果最佳。

针刺百会、神庭穴治疗脑卒中后认知功能障碍效果的系统评价

目的系统评价针刺百会、神庭穴治疗脑卒中后认知功能障碍(PSCI)的临床疗效。方法采用计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、中文科技期刊数据库、Pub Med、康健临床决策循证数据库、the Cochrane Library,手动检索《中国针灸》《上海针灸杂志》两本杂志,检索时限至2013年12月31日止已发表中、英文文献。纳入针刺取穴含百会、神庭穴治疗脑卒中后认知功能障碍的随机对照试验。根据资料提取表提取数据,用Cochrane系统评价手册中的文献质量评价标准对纳入文献进行评价,用Rev Man5.0软件进行Meta分析。结果最终纳入22个临床试验共1637例受试者,Meta分析结果显示,针刺取穴含百会穴和神庭穴干预组的康复效果优于单纯认知康复训练或药物,且差异有统计学意义,MMSE评分[WMD=3.37,95%CI(1.70,5.05),P<0.00001],P300潜伏期[WMD=-17.31,95%CI(-19.70,-14.93),P<0.00001],P300振幅[WMD=1.22,95%CI(0.84,1.59),P<0.00001]。未发现严重不良反应。结论针刺取百会、神庭穴可有效改善PSCI患者的认知功能,然而对于PSCI的诊断标准和评价指标有待进一步规范、统一,且针刺干预PSCI的临床研究的方法学有待进一步提高。

针刺百会穴对急性脑血肿大鼠局部脑血流量的影响

目的 观测急性脑血肿大鼠局部脑血流量的改变及头穴针刺后局部脑血流量和神经功能症状的变化。方法 应用L S-III型组织血流测定仪 ,选用临床上治疗脑出血常用的“百会”穴。结果 实验大鼠造模组与正常组及假手术组对比不同时刻局部脑血流量均明显下降 ( P<0 .0 1) ,而造模组与针刺组对比即刻局部脑血流量无显著性差异 ,而在 1h,4h局部脑血流量有显著性差异 ( P<0 .0 1)。另外造模组与针刺组对比神经功能症状在 1h有显著性差异 ( P<0 .0 1) ,经相关分析可见 1h局部脑血流量与神经功能症状存在负相关关系。结论 急性脑血肿大鼠局部脑血流量明显下降 ,经百会针刺后局部脑血流量的下降得到有效的改善 。

脑缺血损伤大鼠海马区钙结合蛋白Calbindin-D28k蛋白表达的变化及针刺对其影响

【目的】观察针刺对脑缺血损伤大鼠大脑海马区钙结合蛋白Calbindin-D28k蛋白表达及神经行为学的影响。【方法】选用雄性SD大鼠,随机分为空白对照组、脑缺血模型组、针刺治疗组,每组10只,采用化学刺激诱导血栓性闭塞大脑中动脉手术复制大鼠局灶性脑缺血模型;针刺组采用针刺百会、水沟穴,每天1次,治疗7d;治疗结束后,采用免疫组化方法观察针刺前后大鼠海马区Calbindin-D28k蛋白表达的变化,造模后1～2h及治疗结束后分别对各组大鼠进行神经行为学评分。【结果】大鼠局灶性脑缺血后Calbindin-D28k阳性细胞表达显著减少(与空白对照组比较,P<0.05),针刺后大鼠大脑海马区Calbindin-D28k阳性细胞表达显著增加(与脑缺血模型组比较,P<0.01)。大鼠在造模后1～2h的神经症状行为评分均有阳性反应,与空白对照组比较差异均有显著性意义(P<0.01),针刺治疗组大鼠在治疗前后的神经症状行为评分差异也有显著性意义(P<0.01)。【结论】针刺可上调Calbindin-D28k蛋白的表达,减轻细胞内Ca2+超载,可能是针刺保护脑缺血损伤的机制之一。

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。

针刺与药物结合治疗小儿热性惊厥临床观察

目的:探寻治疗小儿热性惊厥的有效疗法。方法:将70例热性惊厥患儿随机分成两组,针药组(36例)采用针刺醒脑开窍法以水沟穴为主,配合鲁米那肌肉注射、安定静脉推注;药物组(34例)单纯采用肌肉注射鲁米那、安定静脉推注。观察两组疗效、止惊起效时间及复发率。结果:针药组总有效率为86.1%,优于药物组的79.4%;在止惊起效时间上,针药组明显短于药物组(P<0.01),且针药组复发率低于药物组(P<0.05)。结论:针刺配合肌肉注射鲁米那、静脉推注安定治疗热性惊厥是一种快速、有效、安全的方法。