Effect of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors

OBJECTIVE:To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors,and to explore an efficient and noninvasive method for postoperative recovery of bowel functions.METHODS:Forty patients were randomly and evenly assigned into a regular nursing care group(RNC) and an acupoint electric stimulation group(AES).Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation of acupoints.The serum levels of gastrin(GAS),motilin(MOT),and cholecystokinin(CCK),and an electrogastrogram(EGG) of all the patients were evaluated on the first,third,and fifth day after surgery.The time to first flatus after surgery and the number of patients with side effects such as abdominal pain,abdominal distention,and diarrhea were recorded.RESULTS:There were significant differences between the two groups in GAS,MOT,EGG,time to first flatus,abdominal pain,abdominal distention,and diarrhea(P < 0.05).CONCLUSION:Electric stimulation on acupoints could increase levels of GAS and MOT,promote the recovery of gastrointestinal functions,and decrease complications among postoperative senile patients with gastrointestinal tumors.

Differences in thermal effects of moxibustion at Zusanli(ST 36) and Hegu(LI 4) on various facial areas in healthy people

OBJECTIVE:To study the effects of temperature on different facial areas by suspended moxibustion at two points,Zusanli(ST 36) and Hegu(LI 4),and probe the phenomena underlying self-regulation in the human body after thermal stimulation.METHODS:Thirty healthy volunteers accepted moxibustion over Zusanli(ST 36) and Hegu(LI 4),and the order of moxibustion points was randomly determined.Moxibustion method:suspension of moxibustion over Zusanli(ST 36) and Hegu(LI 4) on both sides was performed using an ignited moxa stick stuck in a support for 20 min.Observation method:An infrared thermal image of the face was taken before and after suspended moxibustion using a CK350 medical infrared thermal imaging instrument.Data analysis:A thermal microscopic section view system(TMTSys) was used to analyze the change in temperature in special facial areas.Statistical analysis was carried out using SPSS 14.0 software.RESULTS:Before moxibustion was suspended,the facial thermal image showed a T-shaped thermal area related to the vascular distribution with even temperature and good symmetry on both sides.Suspended moxibustion over Zusanli(ST 36) have a very significant increase in temperature at the forehead,around the nose,at the corners of the mouth,and at the cheeks and lips(P<0.01).Suspended moxibustion over Hegu(LI 4) also have a significant(P<0.05) increase in temperature around the nose,the corners of the mouth,the cheeks,and lips,where has a new high temperature area was formed(P<0.01).Suspended moxibustion over Hegu(LI 4) raised the temperature at the middle point of the lips more obviously than did Zusanli(ST 36) in the same person,(P<0.05).After 10 min of moxibustion over Zusanli(ST 36) and Hegu(LI 4),the change in temperature in the facial area reached its peak value.CONCLUSIONS:Facial infrared thermography of healthy people revealed a T-shaped thermal area reflecting a physiological thermal area.Moxibustion over Zusanli(ST 36) or Hegu(LI 4) raised the temperature in this facial T-shaped thermal area.Hegu(LI 4) led to the formation of a new thermal area in the lips.The time required for moxibustion to regulate human body temperature was 10 min.

电针足三里与内关公孙不同配伍对胃黏膜损伤大鼠NO EGF的影响

目的:观察电针足三里与内关、公孙不同配伍对胃黏膜损伤大鼠表皮生长因子(EGF)、一氧化氮(NO)的影响以了解不同配伍其效应有何差异。方法:60只大鼠随机分为6组,即足三里组、足三里配内关组、足三里配公孙组、足三里配内关公孙组、模型组、空白对照组,每组10只。用无水乙醇按0.6mL/100g灌胃,造成胃黏膜损伤模型。各组检测胃黏膜EGF、血清和胃黏膜N0含量。结果:各电针组胃黏膜EGF含量明显高于模型组(P<0.01),血清和胃黏膜NO含量高于模型组(P<0.05);足三里组、足三里内关组、足三里公孙组之间没有显著差异,而足三里内关公孙组对比这三组均有显著差异。结论:电针足三里与内关、公孙不同配伍能提高胃黏膜EGF含量,促进NO的合成与释放,起到对胃黏膜的保护作用。内关、公孙与足三里单独配伍没有明显地增效作用,而两穴合用时可有明显增效作用。

针刺合谷穴与足三里穴对脑功能的动态观察

目的探讨针刺合谷穴与足三里穴对中枢神经系统的即时效应。方法对9例健康志愿者采用针刺合谷、足三里及非经非穴,实时观察受试者脑磁图的动态变化。结果针刺合谷、足三里和非经非穴对照点脑磁图变化有差异。结论脑磁图检测对合谷穴与足三里穴的循经感传研究具有一定的特异性,两穴针刺对脑部影响区域有差异。

Clinical observation on the correlation between moxibustion sensation and distance of moxa stick

Objective： To explore the correlation between moxibustion sensation and distance of moxa stick and provide reference for clinical practice.Methods： A total of 16 healthy volunteers aged 18-35 years old in college were recruited and given mild moxibustion at Shousanli（LI 10）, Zusanli（ST 36）, Shenshu（BL 23） and Tianshu（ST 25） with moxa stick, and the occurrence and frequency of moxibustion sensation were recorded at distances of 5 cm, 4 cm, 3 cm and 2 cm. Mild moxibustion scale was used to count the score.Results： Warm was the main moxibustion sensation, burning pain and soreness decreased with the rise of distance; for the same acupoint, score of mild moxibustion scale increased with the decrease of distance; score ranged between 5.5 and 6.5at distance 3 cm, which was the most comfortable distance for volunteers.Conclusion： The distance of 3 cm is the most comfortable distance in mild moxibustion.

Therapeutic efficacy observation on needling Yangming method for facial palsy

Objective： To observe the clinical efficacy of Prof. Gao Yu-chun＇s needling Yangming method for facial palsy, as well as to inherit and further develop the academic idea.Methods： A total of 70 cases were randomly allocated into a treatment group（n=35） and a control group（n=35）. Cases in the treatment group were treated with needling Yangming method, whereas cases in the control group were treated with traditional acupuncture method. The treatment was done once a day in both groups（6 times a week） for a total of 6 weeks. Then the therapeutic efficacies were evaluated before and after treatment using the House-Brackmann（H-B） scale and scores of signs and symptoms. Results： After 2 weeks of treatment, patients in the treatment group obtained a better H-B score and recovery rate than those in the control group（P〈0.05）. After 4 weeks of treatment, the H-B score, scores of signs and symptoms and recovery rate in the treatment group were better than those in the control group（P〈0.05, P0.01, P〈0.05）. After 6 weeks of treatment, there were no between-group statistical differences in the above aspects（P〉0.05）. Conclusion： Needling Yangming method can obtain a faster effect, a higher early-stage recovery rate and shorter course of treatment than traditional acupuncture method.

浅谈“肚腹三里留”

对"肚腹三里留"中"肚腹"与"三里"的含义进行探讨,为"肚腹三里留"的临床应用提供理论依据。以古代文献为基础,结合《黄帝内经》相关理论,通过对足三里与胃腑的关系、足三里对肚腹疾病的主治范围及作用机制、足三里与手三里穴的对比研究进行深入探讨,认为"肚"当音睹,指胃,说明足三里在治疗肚腹疾病时与脾胃关系密切;"腹"则泛指腹部,应包括肝胆、脾脏、胃肠、肾脏、胞宫、三焦等所有脏腑,"三里"当独指足三里。

经皮穴位电刺激对腹腔镜肠道手术围术期炎性反应和肠黏膜通透性的影响

目的:观察经皮穴位电刺激(TEAS)对腹腔镜结直肠癌根治手术患者术后炎性反应和肠黏膜通透性的影响,探讨TEAS在围术期脏器保护方面的作用机制。方法:将60例择期行腹腔镜直肠癌根治手术患者随机分为观察组和对照组,每组30例。观察组在手术当天及术后3 d内每天给予足三里、内关、合谷经皮穴位电刺激治疗1次,频率2 Hz,刺激强度选择患者能耐受的最适宜强度(不超过2 m A)。对照组操作同观察组,但不开启电源。检测术前(TEAS前)及术后12、24、48、72 h各时间点血浆炎性反应指标肿瘤坏死因子(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6);肠黏膜屏障反应指标内毒素(LPS)含量及D-乳酸水平。结果:与对照组相比,观察组术后24、48、72 h炎性因子IL-1、IL-6及TNF-α含量降低(均P<0.05);D-乳酸、LPS水平组间比较差异无统计学意义(均P>0.05)。结论:经皮穴位电刺激可以减轻腹腔镜直肠癌患者术后炎性反应,但对肠道黏膜通透性无影响。

经皮穴位电刺激对腹腔镜胆囊切除术患者术后早期恢复质量的影响

目的:观察经皮穴位电刺激对腹腔镜胆囊切除术患者麻药和镇痛药用量及术后早期恢复质量的影响。方法:选择择期拟行腹腔镜胆囊切除手术患者100例,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级。采用随机数字表法分为观察组和对照组,每组50例。两组均采用常规气管插管全身麻醉,麻醉诱导、术中维持用药相同。观察组麻醉诱导前30 min于双侧合谷与内关、足三里与其外侧2寸的非穴位行经皮穴位电刺激(2 Hz/100 Hz的疏密波、电流强度介于8~12 mA),直至手术结束。对照组在相应的穴位上贴刺激电极,不进行相应的电刺激。统计术中瑞芬太尼的用量,术后补救镇痛药地佐辛用量,记录苏醒时间和拔管时间以及拔管时心率(HR)和平均动脉压(MAP)变化。分别于术前1 d(T_0),术后4 h(T_1)、8 h(T_2)、24 h(T_3)、48 h(T_4)采用40项恢复质量评分量表(QoR-40)综合评价患者术后恢复质量、简易智能状态(MMSE)量表评价患者术后认知功能,并记录T_1~T_4时点患者恶心呕吐的发生情况。结果:观察组瑞芬太尼用量及地佐辛用量均少于对照组,苏醒时间及拔管时间均短于对照组,拔管时HR显著低于对照组(均P<0.05);两组MAP比较差异无统计意义(P>0.05)。与T_0比较,T_1、T_2、T_3时,两组患者QoR-40量表总评分均降低(均P<0.05),且观察组总评分均高于相应时间点对照组总评分(均P<0.05);观察组在T_1时、对照组在T_1、T_2、T_3时情绪状态、身体舒适度、心理支持、自理能力、疼痛评分均较T_0时降低(均P<0.05);观察组在T_1、T_2、T_3时,情绪状态、身体舒适度、心理支持、自理能力、疼痛评分均高于对照组(均P<0.05)。与T_0比较,T_1、T_2时两组患者MMSE评分均降低;T_1、T_2、T_3时观察组MMSE评分均显著高于相应时间点对照组MMSE评分(均P<0.05)。T_1、T_2时,观察组恶心呕吐发生率分别为22.0%(11/50)、12.0%(6/50),对照组恶心呕吐发生率分别为32.0%(16/50)、24.0%(12/50),观察组明显低于对照组(均P<0.05);T_3、T_4时,观察组恶心呕吐发生率分别为6.0%(3/50)、2.0%(1/50),对照组恶心呕吐发生率分别为8.0%(4/50)、4.0%(2/50),差异均无统计学意义(均P>0.05)。结论:经皮穴位电刺激可改善腹腔镜胆囊切除术患者术后早期恢复质量,减少术中麻醉药和术后镇痛用药量。

ERK信号通路在电针刺激足三里穴和阳陵泉穴减轻大鼠神经病理性痛中的作用

目的探讨细胞外信号调节激酶（ERK）信号通路在电针刺激足三里穴和阳陵泉穴减轻大鼠神经病理性痛中的作用。方法健康成年雄性SD大鼠50只，体重180—220g，鞘内置管成功后，采用随机数字表法，将其随机分为5组（n=10）：假手术组（S组）、CCI组、电针刺激穴位组（EA组）、电针刺激非穴位组（NA．EA组）和ERK抑制剂U0126组（U0126组）。CCI组、EA组、NA-EA组和U0126组采用坐骨神经慢性结扎的方法制备神经病理性痛模型。EA组于术后4d开始电针刺激术侧足三里穴和阳陵泉穴，连续波，频率2Hz，刺激强度≤1．5mA，1次，d，30min／次，连续6d；NA．EA组电针刺激术侧足三里穴旁开5mm和阳陵泉穴旁开5mm处非穴位点。U0126组术后4d开始鞘内注射U0126，5μg／次，2次，d，连续6d。分别于CCI术前1d（To，基础状态）和术后3、5、7、9d（T。）时测定机械刺激缩足反应阈值（MWT）和热刺激缩足潜伏期（TWL）。于术后10d处死大鼠，取术侧脊髓L4-6节段，检测脊髓背角P2X3受体蛋白及其mRNA表达，测定脊髓背角ERK1／2和磷酸化ERK1／2（p-ERKl／2）表达。结果与S组比较，其余4组MWT降低，TWL缩短，脊髓背角P2K受体蛋白及其mRNAp．ERK1／2表达上调（P〈0．01）；与CCI组比较，EA组和U0126组MWT升高，TWL延长，脊髓背角P2X，受体蛋白及其mRNA表达和p-ERKl／2表达下调（P〈0．01），NA—EA组上述指标差异无统计学意义（P〉0．05）；与EA组比较，U0126组MWT升高，TWL延长，脊髓背角P2X受体蛋白及其mRNA表达和p-ERK1／2表达下调（P〈0．01）。结论电针刺激足三里穴和阳陵泉穴可减轻大鼠神经病理性痛，其机制与抑制脊髓ERK信号通路有关。

针刺腧穴“降压方”对自发性高血压大鼠血管重构的影响

目的:探讨针刺腧穴“降压方”降压及改善血管重构的可能机制。方法:将30只10~11周龄的雄性自发性高血压大鼠(SHR)按随机数表分为模型组、针刺组和药物组,每组10只。10只同周龄的雄性WKY大鼠作为空白组。针刺组通过针刺人迎、曲池、足三里穴(腧穴“降压方”)进行干预;药物组予以氯沙坦进行灌胃治疗,共治疗8周。光镜下观察主动脉病理形态学变化;Masson染色观察主动脉形态变化;透射电镜下观察主动脉管壁超微结构的变化;ELISA法检测血清中炎症因子基质金属蛋白酶9(MMP-9)及基质金属蛋白酶抑制剂-1(TIMP-1)的变化;用免疫组化法检测主动脉组织中Profilin-l表达含量。结果:与模型组比较,药物组和针刺组大鼠主动脉管腔内径(LD)增大(P<0.05),中膜厚度(MT)及MT/LD比值显著减小(P<0.01,P<0.05)。与模型组比较,药物组和针刺组主动脉弹性纤维排列整齐,分布均匀,胶原蛋白纤维没有明显增生;主动脉组织Profilin-1表达显著降低(P<0.01)。主动脉电镜超微结构显示,与模型组比较,针刺组、药物组内皮损伤均明显改善,其中药物组内皮细胞轻度变性,内皮细胞下层的胶原纤维和弹性纤维结构基本完整;针刺组内皮部分肿胀,平滑肌细胞轻微肥大增生,胶原纤维增多,粗细不一。与模型组比较,药物组和针刺组血清MMP-9含量显著降低(P<0.05),针刺组TIMP-1含量显著升高(P<0.05)。结论:针刺腧穴“降压方”可改善SHR内皮肿胀、胶原纤维与弹力纤维分布,进而影响血管舒缩及血压调节。