针刺合谷与太冲fMRI脑功能成像的比较研究

目的 :探讨针刺不同穴位对脑组织fMRI功能成像的影响。方法 :将健康受试者随机分为针刺合谷组、太冲组、合谷配伍太冲组各 7人 ,分别观察fMRI脑功能成像。结果 :针刺合谷穴诱导额叶和枕叶脑组织血流量和血流容积的增加 ;针刺太冲穴仅诱导颞叶脑组织血流量和血流容积的增加 ;针刺合谷配太冲穴诱导额叶和颞叶脑组织血流量和血流容积的增加。 结论 :针刺不同穴位激发不同脑区的脑组织变化 ,而两个穴位配伍并不是两个穴位引起脑组织fMRI功能改变作用的叠加 ,而是引起脑组织fMRI功能重新分布。

论四关穴在慢性疲劳综合征治疗中的作用

目的探讨四关穴在慢性疲劳综合征针刺治疗中的作用。方法以慢性疲劳综合征在中医学中的诊断归属以及病因病机分析作为切入点,通过对近10年来四关穴的相关文献分析,从3个方面对四关穴在慢性疲劳综合征针刺治疗中的作用进行了归纳。结论对于涉及身心两方面众多纷繁复杂症状的慢性疲劳综合征,以四关穴为主进行针刺治疗可以收到较好的疗效。

针刺治疗抑郁性神经症：多中心随机对照研究

目的:观察针刺对于抑郁性神经症的临床疗效。方法:采用多中心随机对照研究,将440例患者分为针刺组、百忧解组、非穴位针刺组。针刺组采用四关穴(合谷、太冲)为主的穴位,百忧解组服用药物百忧解20 mg/d,非穴位针刺组患者接受针刺治疗,但取穴偏离真正的穴位。在治疗前、后进行汉密尔顿抑郁量表(HAMD)计分,按HAMD减分率进行疗效评价,以Asberg氏抗抑郁药副反应量表(SERS)结合严重不良反应记录进行安全性评估,对数据进行意向性分析(ITT分析)。结果:针刺组的总有效率为86.4%,优于非穴位针刺组的59.1%及百忧解组的72.7%;针刺组的HAMD计分与百忧解组相当,而且2组均优于非穴位针刺组;针刺组及非穴位针刺组的SERS计分均明显低于百忧解组,未见晕针等严重针刺不良反应记录。结论:针刺对于抑郁性神经症是一种有效、安全的疗法;针刺治疗抑郁性神经症的疗效可能优于百忧解或与百忧解相当,但副作用远低于百忧解。

针四关穴为主治疗原发性痛经临床观察

目的:观察青龙摆尾法针刺四关穴为主治疗原发性痛经(PD)的临床疗效,并探讨其作用机制。方法:将180例PD患者随机分为针四关穴组( A组)60例、常规取穴组(B组)60例、月月舒组(C组)60例。A组以青龙摆尾法针刺四关穴(合谷、太冲);B组常规取穴,穴取三阴交、次醪为主;C组口服月月舒冲剂。治疗3个月后统计疗效,并观察治疗前后患者血液流变学及前列腺素等指标的改变。结果:A组治愈率为75.0%,总有效率为100.0%;B组分别为60.0%、95.O%;C组分别为25.0%、90.0%。A、B组疗效优于C组(P<0.01);而治疗30分钟内止痛疗效比较,A、B两组优于C组(P<0.01),A组优于B组(P<0.01)。结论:青龙摆尾法针刺四关穴为主治疗原发性痛经疗效显著,其作用机制可能是通过改善患者的血液循环状态、抑制前列腺素而达到缓解疼痛的目的。

光明、太冲穴与中枢神经相关效应的观察

目的观察针刺光明、太冲穴时,中枢不同区域的相关反应。方法将19名正常志愿者随机分为1组(视觉刺激加单侧针刺组)7人,2组(视觉刺激加双侧针刺组)6人和3组(单纯针刺双侧穴组)6人。用功能性磁共振(f MRI)观察各组在针刺光明、太冲穴时视觉皮质区与相关脑区的反应。结果发现视觉刺激及针刺进针时,视觉皮质的血氧饱和水平(BOLD)无明显变化(P>0.25),但在进行单侧和双侧持续刺激时,发现大脑相关区域有BOLD变化。结论针刺对单侧和双侧穴位的刺激均能改善大脑相关区域的BOLD,但与进行手法和视觉刺激无关。

针刺太冲穴对自发性高血压大鼠小脑差异蛋白表达的影响

目的探讨针刺太冲穴对自发性高血压(SHR)大鼠小脑差异蛋白表达的影响。方法选用SHR大鼠55只,随机分为模型组、非穴组、曲泉组、太冲组、冲阳组5组,每组11只;另取Wistar大鼠8只,作为正常组。模型组和正常组只抓取不针刺,其余4组相应针刺曲泉穴、太冲穴、非穴和冲阳穴,1次/d,共7 d,记录实验前后各组小鼠的血压变化,后将小鼠处死取材,获得小脑组织,通过双向电泳和质谱检测观察蛋白表达结果。结果治疗前后血压对比模型组的血压有显著升高(P<0.05),太冲组舒张压呈下降趋势,其他针刺组的收缩压和舒张压有略微升高,但均无统计学意义(P>0.05);双向电泳和质谱结果显示太冲穴组针刺后小脑区蛋白表达点上调明显多于曲泉组、冲阳组及非穴组。结论针刺太冲穴后促使小脑组织蛋白表达发生差异性变化,其差异蛋白点功能包括促进代谢产物如过氧化物的消除、加快遗传信息转化、促进神经再生等,为神经-内分泌-免疫网络假说提供佐证。

Effect of electroacupuncture at Qūchí (曲池 LI 11) and Tàichōng (太冲 LR 3) on blood pressure variability in young patients with hypertension

Objective To compare therapeutic effects of electroacupuncture and western medicine on blood pressure variability in young patients with hypertension. Methods Sixty cases of young patients of hypertension were randomly divided into an electroacupuncture group and a western medicine group, 30 cases in each group. In the electroacupuncture group, electroacupuncture was applied at Quchi （曲池LI 11） and Taichong （太冲LR 3）. In the western medicine group, Captopril was taken orally. Twenty-four hour dynamic blood pressure, and blood pressure variability and circadian rhythms were observed after treatment for 14 days in the two groups. Results Electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） significantly decreased systolic pressure and diastolic pressure at different time phases in the young patients with hypertension （all P〈0.01）, with no significant difference as compared with the western medicine group （all P〉0.05）; electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） significantly reduced the standard deviations of systolic pressure and diastolic pressure at different time phases in the young patients with hypertension as compared with those before the treatment （P〈0.01, P〈0.05）. There were statistically significant differences between the two groups in 24 h systolic standard deviation （24 h SSD）, 24 h diastolic standard deviation （24 h DSD）, daytime SSD （dSSD）, nighttime SSD （nSSD） and nighttime DSD （nDSD） （P〈0.01, P〈0.05）; and there was significant difference between the two groups in numbers of the Dipper and the non-Dipper after treatment （P〈0.05）. Conclusion Electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） has a better long-term effect of decreasing blood pressure and improves effectively changes of circadian rhythms in young patients with hypertension, which are an effective point pair for hypertension.

灸肺俞刺四关治疗阴暑症临床疗效观察

目的观察灸肺俞刺四关治疗阴暑症的临床疗效。方法将100例阴暑症患者随机分为治疗组和对照组,各50例;治疗组采用灸肺俞刺四关治疗,对照组采用常规针灸治疗,疗程3天。结果治疗组和对照组的治愈率分别为100%、52%,两者比较有显著性差异(P<0.05)。结论灸肺俞刺四关治疗阴暑症的临床疗效确切。

针刺安神六穴配合四关穴治疗偏头痛的临床研究

目的观察针刺安神六穴配合四关穴治疗偏头痛的临床疗效。方法将128例符合纳入标准的偏头痛患者随机分为治疗组和对照组,每组64例。治疗组采用针刺安神六穴配合四关穴治疗,对照组采用常规针刺治疗。观察并比较两组治疗前后及随访时疼痛数字评分法(NRS)评分、头痛发作次数、头痛持续时间、头痛程度、伴随症状、国际抑郁自评量表(SDS)评分及国际焦虑自评量表(SAS)评分的变化情况。结果两组治疗2、4星期后及随访时NRS评分及各项头痛症状及功能评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗4星期后及随访时NRS评分、头痛持续时间及头痛程度与对照组比较,差异均具有统计学意义(P<0.05,P<0.01)。治疗组治疗2、4星期后及随访时SDS评分与SAS评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。对照组治疗4星期后SDS评分和SAS评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。两组治疗2、4星期后及随访时SDS评分和SAS评分比较,差异均具有统计学意义(P<0.05,P<0.01)。治疗组随访时SDS评分和SAS评分与同组治疗2星期后比较,差异均具有统计学意义(P<0.01)。结论针刺安神六穴配合四关穴是一种治疗偏头痛的有效方法,能减轻患者头痛程度,改善焦虑和抑郁情况。

Effects of Hegu (LI 4) and Taichong (LR 3) on Vascular Dilation and Constriction in Migraine Patients

Hegu （LI 4） and Taichong （LR 3） are the Yuan- Primary acupoints of the Large Intestine and Liver Meridian, and are collectively named as Si Guan （four gates） point. Combined use of these two acupoints can harmonize yin and yang, regulate qi and blood, and balance ascending or descending. This paper attempts to study the effects of Si Guan point on the vascular dilation and constriction in migraine patients from the perspective of its feature.

Effect of Taichong(LR 3) acupuncture in spontaneously hypertensive rats

OBJECTIVE: To evaluate the effects of Taichong(LR3) acupuncture points(acupoints) on the expression of glucose transporter protein 1(GLUT1) in the hypothalamus of spontaneously hypertensive rats(SHRs) as measured by combined positron emission tomography and computed tomography(PETCT).METHODS: Spontaneously hypertensive rats(SHR)were divided into model, Taichong(LR 3) acupuncture, and sham groups. Additionally, Tokyo Wistar rats were used as the control group. Changes in blood pressure were recorded in different groups of rats before and after the corresponding treatment. Hematoxylin and eosin(HE) staining was used to study basic morphological changes, and immunohistochemistry was used to determine GLUT1 expression in the hypothalamus. Further,PET-CT was utilized to elucidate the antihypertensive mechanism after acupuncture at the Taichong(LR 3) acupoints.RESULTS: PET-CT indicated activation of the hypothalamus. Measurement of blood pressure showed that acupuncture at the Taichong(LR 3) acupoints lowered blood pressure. HE staining did not show any significant pathological changes, although differences in cell number were observed. Immunohistochemical analysis indicated a GLUT1 downregulation in the SHRs of the Taichong(LR 3) acupuncture group after the treatment.CONCLUSION: Acupuncture at Taichong(LR 3) acupoints lowered blood pressure in SHRs, with possible mechanisms being changes in cell number and GLUT1 expression in the hypothalamus.

太冲穴主治偏头痛的机理探讨及临床应用

太冲穴主治黄疸、少腹肿痛、头痛等病症。在现今临床中,太冲穴用于偏头痛的治疗,疗效可靠,但目前对该穴治疗偏头痛的机理尚不明确。通过检索文献、综合分析,认为太冲穴主治偏头痛的机理包含:经脉交会,主治所及;四根三结,上病下取;从肝论治,顺降经气;调达木气,冲和气血;暗和全息,清利头目。该法取穴方便,操作简单,可重复性强,对于针灸治疗偏头痛具有指导意义,应进一步深入挖掘。

Treatment of Toothache by Needling Taichong (LR 3): A Report of 20 Cases

Purpose To explore the feasibility of treating toothache with the acupoints in Liver Meridian. Method According to syndrome differentiation, toothache was divided into pathogenic wind-fire type and deficiency-fire type. Twenty patients were treated by needling Tai-chong (LR 3) o! the affected side. Reducing manipulation was performed for toothache due to pathogenic windfire while early-reducing-late-tonifying was performed for toothache due to deficiency-fire type. Results The pain disappearance occurred in 14 cases, improved in 5 cases and no effect in one case. Conclusion Needling Tai-chong( LR 3) was effective for toothache.

Influence of Electroacupuncture at Taichong(LR 3) and Ququan(LR 8) on Hepatic Hemodynamics

Objective： To observe the influence Taichong （LR 3） and Ququan （LR 8） on patients with chronic hepatic diseases. of electroacupuncture hepatic hemodynamics （EA） at in the Methods： Sixty cases with chronic hepatic diseases were randomly divided into a Taichong （LR 3） group and a Ququan （LR 8） group, 30 cases in each group, and were respectively treated with electroacupuncture at Taichong （LR 3） and Ququan （LR 8）. The blood flow results of the hepatic artery and portal vein by color ultrasonic test were used as the objective indexes, to compare and observe the hemodynamics changes of the hepatic artery and portal vein in the patients before and after EA. Results： After EA, in Taichong （LR 3） group, the average velocity, the lowest velocity, resistance indexes and the highest velocity of blood flow of the hepatic artery, and the highest velocity, average velocity of blood flow of the portal vein, blood flow volume of the portal vein （PVBF）, total blood flow volume of the liver （TLBF）, and Doppler blood perfusion indexes of the hepatic artery （DPI） were all statistically different from those before intervention （all P^O,O5）, In Ququan （LR 81 group, the highest velocity, average velocity, lowest velocity and resistance indexes of blood flow of the hepatic artery, and the highest velocity and average velocity of blood flow of the portal vein, and PVBF were significantly different from those before intervention （P〈0.05）. The TLBF and DPI were significantly different from those before intervention （P〈0.01）. All various indexes were not statistically different between the two groups. Conclusion： EA at Taichong （LR 3） and Ququan （LR 8） can speed up blood flow velocity of the portal vein, increase PVBF, increase the TLBF, increase the resistance indexes of the hepatic artery, decrease the blood flow velocity of the hepatic artery, and decrease DPI in the liver.

Effects of acupuncture on neuro-electrophysiological activities in hippocampal CAI and CA3 areas of rats with post-traumatic stress disorder

Objective: To observe the effects of acupuncture on the characteristics of neuro-electrophysiological activity in hippocampal CAI and CA3 areas of rats with post-traumatic stress disorder (PTSD). Methods: Fifty Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a grasping group, a Western medicine group and an acupuncture group, with 10 rats in each group. Except for the blank group, rats in the other 4 groups all received the combined stress modeling method. Rats in the Western medicine group were intragastrically administrated with paroxetine hydrochloride, those in the acupuncture group received acupuncture intervention, those in the grasping group received grasping fixation, and those in the model group and the blank group did not receive any in terve ntions. After 14 d of in terve ntion, the interspike in terval (ISI) and power spectral den sities (PSD) were an a lyzed and mapped by in vivo multiple channels to record the neuron clusters discharge in the hippocampal CAI and CA3 areas. Results: Compared with the blank group, ISI was proIonged in the CAI and CA3 areas of the model group and the grasping group, and the concentrated PSD distribution area moved down (Pv0.05 or P<0.01). Compared with the grasping group, the ISI of the CAI and CA3 areas in the Western medicine group and the acupuncture group was shortened, and the concentrated PSD distribution area moved up (P<0.05 or P<0.01). The ISI and PSD distributions in the CAI and CA3 areas of the acupuncture group were not statistically different from those in the Western medicine group (both P>0.05). Conclusion: Both acupuncture and paroxetine hydrochloride can significantly regulate the neuro-electrophysiology activity of hippocampal CAI and CA3 areas in PTSD rats, which may be one of the mechanisms of acupuncture intervention to promote PTSD recovery.

Comparative study on skin temperature response to menstruation at acupuncture points in healthy volunteers and primary dysmenorrhea patients

OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P < 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P < 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P < 0.05).No significant differences of skin temperature were detected at other points(P > 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.

Data mining for points-selection rules in acupuncture treatment of mammary gland hyperplasia

Objective： To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia （MGH） by data mining and statistical method. Methods： Clinical literatures about the treatment of MGH with acupuncture published in the recent 16 years were retrieved from Chinese Journal Full-text Database （CJFD） and established into a database by Excel. The SPSS 20 version software and Clementine 12.0 version software were adopted to analyze the frequency and association rules of points-selection in the treatment of MGH with acupuncture. Results： The top 3 points used most frequently in acupuncture treatment of MGH were Danzhon8 （CV 17）, Taichong （LR 3） and Zusanli （ST 36）; points from the Stomach Meridian of Foot Yangming and Liver Meridian of Foot Jueyin were most commonly used; the commonly selected points were predominantly distributed in thoracic and abdominal regions and lower limbs; emphasis on the combination use of local and distal points; of the specific points, the five Shu-Transmitting points were mostly used; association analysis showed that the associations among Taichong （LR 3）, Danzhong （CV 27） and Zusanli （ST 36） were the most significant. Conclusion： The data mining results substantially accord with the general rules of acupuncture-moxibustion theories in traditional Chinese medicine, able to reflect the points-selection principles and features in acupuncture treatment of MGH and provide evidence for the points selection in the treatment of MGH in acupuncture clinic.

电针曲池、太冲对青年高血压患者血压变异的影响

目的:观察电针及西药治疗对青年高血压患者血压变异的疗效差异。方法:选择60例青年高血压患者随机分为电针组和西药组各30例。电针组电针曲池、太冲;西药组口服卡托普利。两组均治疗14天后观察24h动态血压、血压变异性及昼夜节律。结果:电针曲池、太冲能降低青年高血压患者各时段收缩压和舒张压水平(均P<0.01),与西药组比较差异无统计学意义(均P>0.05);电针曲池、太冲可明显降低青年高血压患者各时段的收缩压和舒张压的标准差,与治疗前相比差异有统计学意义(P<0.01,P<0.05),与西药组比较24h收缩压标准差(24hSSD)、24h舒张压标准差(24hDSD)、白天收缩压标准差(dSSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)差异均有统计学意义(P<0.01,P<0.05);两组患者中杓型与非杓型者人数进行比较,治疗后两组差异有统计学意义(P<0.05)。结论:电针曲池、太冲具有较好的长时降压效果,可有效改善青年高血压患者的血压昼夜节律变化,是针灸降压的有效穴对组方。

捻针及假针刺刺激太冲穴对原发性高血压患者的脑功能磁共振成像研究

目的:运用脑功能磁共振成像技术(fMRI),观察针刺和假针刺太冲穴对原发性高血压患者的脑功能成像特点,分析太冲穴治疗原发性高血压的中枢机制。方法:将18例原发性高血压患者分为捻针组(10例)和假针刺组(8例),分别采用手法捻针和假针刺刺激右侧太冲穴,均每捻转30s,间歇30s,共操作5min,同时针刺过程中观察fMRI扫描原发性高血压病人静息态脑功能成像特点,所获得数据通过Matlab软件SPM2模块分析。结果:针刺原发性高血压患者太冲穴主要引起对侧脑区耗氧量增高,主要激活区域为左侧前扣带回(BA32)、左侧顶下小叶(BA40)、左侧颞下回(BA19)、左侧颞中回(BA37)、右额叶中央前回(BA6),激活区域与运动区、视觉、情感认知有关。假针刺太冲穴激活的脑区是右侧前扣带回(BA24)、左侧顶下小叶(BA40)、左侧额下回(BA7)。结论:太冲穴对原发性高血压患者降压作用和改善相关症状的中枢效应并非在激活传统控制血压的丘脑、延髓区域。太冲穴能激活前扣带回调节副交感神经降低血压,并且通过前扣带回加强与其他脑区的功能连接来改善长期高血压带来的认知损害。

太冲穴对椎-基底动脉供血不足患者血流速度的影响

目的：观察针刺太冲对椎一基底动脉供血不足（VBI）患者椎动脉血流速度紊乱的干预作用，为穴位特异性研究提供li盘床依据。方法：100例VBI患者用经颅多普勒超声（TCD）检测分出低流速型血管（43条）、高流速型血管（79条）；对照组为正常人群50例，计椎动脉100条，观察针刺太冲穴前后椎动脉收缩期血流速度（Vs）的变化。结果：针刺太冲后低流速型椎动脉Vs明显增高，针刺5～10min、出针后半小时与针刺前比较差异均有统计学意义（均P〈0．01）；高流速型椎动脉Vs明显降低，针刺5～10min、出针后半小时与针刺前比较差异具有统计学意义（均P〈0．01）i对照组针刺前后比较差异无统计学意义（P〉0．05）。结论：针刺太冲穴以双相调节的方式有效地改善椎动脉的供血，纠正椎动脉血流动力学的紊乱。