探究电针廉泉穴对脑卒中后吞咽困难大鼠神经功能缺损的影响

目的探讨电针廉泉穴对脑卒中后吞咽困难(PSD)大鼠神经功能缺损的影响及潜在对瞬时受体电位香草酸亚型1(TRPV1)信号通路的调节机制作用。方法选用SPF级SD雄性大鼠60只,随机分为正常组12只(仅浅插栓线,未导致脑内动脉闭塞),余48只制作PSD模型,将造模成功的36只大鼠随机分为模型组、治疗组和治疗+咖啡酸组,每组12只。记录大鼠吞咽潜伏期和吞咽次数,生物信号采集器检测舌下神经放电、舌肌阈强度和收缩幅度,酶联免疫吸附测定血清P物质含量,甲苯胺蓝染色检测舌下神经核尼氏体数目,免疫组织化学检测舌下神经核TRPV1、五羟色胺(5-HT)、磷酸化p38、神经元型一氧化氮合酶(nNOS)蛋白表达水平。结果与正常组比较,模型组大鼠吞咽潜伏期、吞咽次数、舌下神经放电积分面积、舌肌收缩幅度、血清P物质含量、舌下神经核尼氏体数目、TRPV1及5-HT蛋白表达水平下降,舌肌阈强度和舌下神经核磷酸化p38、nNOS蛋白表达水平增加(P<0.05);与模型组比较,治疗组大鼠舌肌单收缩幅度、舌肌强直收缩幅度、血清P物质含量、舌下神经核尼氏体数目、TRPV1及5-HT蛋白表达水平增加[2.36±0.26 vs 1.77±0.22、3.46±0.36 vs 2.15±0.18、(3.92±0.38)ng/ml vs(1.69±0.17)ng/ml、(33.60±3.65)个vs(24.60±2.34)个、(19.85±2.11)%vs(9.79±1.07)%、(22.43±2.34)%vs(10.85±1.13)%,P<0.05]。结论电针廉泉穴可能通过激活TRPV1信号通路改善PSD大鼠神经功能缺损。

王祖红主任治疗中风后失语症经验撷菁

中风后失语症发病率高,严重影响患者的生活质量,目前采用针灸治疗中风后失语优势显著。本文重点介绍王祖红教授以肾-脾-心经络诊察,结合管氏舌针及廉泉齐刺法整体治疗中风后失语症经验。

廉泉穴齐刺治疗脑梗死后运动性失语疗效观察

目的观察齐刺廉泉穴治疗脑梗死后运动性失语的临床疗效。方法将70例诊断明确的脑梗死后运动性失语患者随机分为治疗组和对照组,每组35例。治疗组采用廉泉穴齐刺为主治疗,对照组采用常规针刺治疗,10次为1个疗程,治疗2个疗程后观察患者汉语失语成套测试(ABC)评分和临床疗效情况。结果两组治疗后ABC评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后ABC评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组显效率和总有效率分别为42.9%和85.7%,对照组分别为17.1%和62.9%,两组比较差异均具有统计学意义(P<0.05)。结论廉泉穴齐刺是一种治疗脑梗死后运动性失语的有效方法。

针刺与nCPAP治疗OSAHS患者疗效差异对比研究

目的:比较针刺治疗与经鼻持续气道内正压通气(nCPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者疗效的差异,分析针刺治疗对该病的疗效特点和优势。方法:将66例OSAHS患者按比例随机分为针刺组(44例,穴取廉泉、天容等)和nCPAP组(22例)进行治疗,并监测治疗前、中、后各项呼吸、血氧及睡眠指标。结果:与治疗前相比,针刺组在治疗进行中,各指标无明显差异(P>0.05),治疗结束后,对低通气指数(HI)、呼吸暂停低通气指数(AHI)、最长呼吸暂停时间、最长呼吸低通气时间、血氧饱和度低于90%的时间(SaO2<90%T)和微觉醒指数有明显改善作用,差异有显著性或非常显著性意义(P<0.05或P<0.01);而nCPAP组在治疗进行中,各指标均发生显著改善(P<0.01),治疗结束后,疗效未能维持,与治疗前差异无显著性意义(P>0.05)。2组比较,nCPAP组在治疗过程中疗效优于针刺组(P<0.05或P<0.01),治疗结束后疗效并无优势(P>0.05)。结论:nCPAP治疗对OSAHS患者的疗效发生在治疗过程中,针刺的疗效发生在治疗结束后,两者疗效体现方式的不同,可能与其作用机制的不同有关。

基于DTI技术探讨廉泉、天容可视化齐刺治疗环咽肌功能障碍所致吞咽困难的中枢效应机制

目的:观察廉泉、天容可视化齐刺治疗环咽肌功能障碍(CD)所致吞咽困难的临床疗效,并基于弥散张量成像(DTI)技术从脑白质纤维束结构与密度的改变探讨其可能的作用机制。方法:选取168例CD所致吞咽困难患者,按随机数字表法分为观察组和对照组,每组84例。观察组给予廉泉、天容可视化齐刺治疗,并在每侧的夹廉泉及天容旁连接电针;对照组给予常规针刺治疗。2组均治疗4周。比较2组治疗前后吞咽造影检查(VFSS)评分、舌骨喉复合体动度及患侧脑区各向异性分数(FA),比较2组临床疗效。结果:治疗后,2组VFSS评分均较治疗前升高(P<0.01),观察组VFSS评分高于对照组(P<0.01)。治疗后,2组舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移距离均较治疗前增大(P<0.05);观察组舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移距离均大于对照组(P<0.05)。治疗后,2组患侧小脑下脚、小脑中脚、小脑上脚、大脑脚、脑桥束、皮质核束FA值均较治疗前增大(P<0.05),观察组患侧脑区上述6项FA值均大于对照组(P<0.05)。观察组总有效率为97.6%,高于对照组的89.3%,差异有统计学意义(P<0.05)。结论:廉泉、天容可视化齐刺可改善CD所致吞咽困难患者的临床症状,其作用机制可能是相关脑区白质纤维束的结构及密度改变增强了其神经可塑性。

Analysis of points selection pattern in acupuncture treatment of sleep apnea syndrome based on data mining

To explore the points selection pattern of acupuncture for sleep apnea syndromes by data mining technique. Methods： Clinical literature about acupuncture therapy for sleep apnea syndromes was derived from China National Knowledge Infrastructure （CNKI）, Wanfang Academic Journal Full-text Database （Wanfang）, Chongqing VIP Database （CQVIP）, PubMed and Science Direct between the time that databases were created and March 25th,2017. Relevant excel database was established and descriptive studies and association rules were analyzed. Results： The most frequently used point was Lianquan （CV 23） and the most frequently used meridian was the Stomach Meridian. The analysis of association rules showed that the clinical choice of acupuncture points was highly correlated, among which the combination of the highest degree of confidence and the highest degree of support was Shenmen （HT 7） and Sishencong （EX-HN 1）; Lieque （LU 7）, lianquan （CV 23） and Zhaohai （KI 6）. Conclusion： Acupuncture treatment of sleep apnea syndromes has specific selection rules of points, providing certain references for clinical and scientific research.

Acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome from 2007 to 2016

Objective： To discuss the acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome（PMS） from 2007 to 2016. Methods： Clinical literatures related to PMS treated with acupuncture-moxibustion published from 2007 to 2016 were collected from Chinese Biomedical Literature Database（CBM）, Chongqing VIP Database（CQVIP）, China National Knowledge Infrastructure（CNKI）, and Wanfang Academic Journal Full-text Database（Wanfang）. The retrieved data underwent descriptive analysis, cluster analysis and association pattern analysis to determine the acupoints selection principle in acupuncture-moxibustion treatment of PMS. Results： The top five acupoints used in acupuncture-moxibustion treatment of PMS were Sanyinjiao（SP 6）, Shenshu（BL 23）, Guanyuan（CV 4）, Baihui（GV 20）, and Shenmen（HT 7）. The leading 4 meridians were Bladder Meridian, Conception Vessel, Spleen Meridian, and Governor Vessel. The clustering analysis showed that the 5 core acupoint groups were：（1） Sanyinjiao（SP 6）;（2） Shenshu（BL 23） and Guanyuan（CV 4）;（3） Baihui（GV 20）, Shenmen（HT 7）, Zusanli（ST 36）, Ganshu（BL 18） and Taichong（LR 3）;（4） Taixi（KI 3）, Pishu（BL 20）, Xinshu（BL 15）, Qihai（CV 6） and Neiguan（PC 6）;（5） Sishencong（EX-HN 1）, Zhongwan（CV 12）, Hegu（LI 4）, Yintang（GV 29）, Fengchi（GB 20）, Zhongji（CV 3） and Feishu（BL 13）. The three most significant acupoints were Sanyinjiao（SP 6）, Shenshu（BL 23） and Guanyuan（CV 4）. Acupoint groups based on syndrome differentiation included：（1） Hegu（LI 4）, Zhongwan（CV 12） and Sishencong（EX-HN 1）;（2） Feishu（BL 13）, Zhongji（CV 3）, Fengchi（GB 20） and Yintang（GV 29）;（3） Xinshu（BL 15）, Pishu（BL 20）, Qihai（CV 6）, Neiguan（PC 6） and Taixi（KI 3）;（4） Ganshu（BL 18）, Zusanli（ST 36）, Shenmen（HT 7）, Taichong（LR 3） and Baihui（GV 20）. The analysis of association pattern elaborated that Shenshu（BL 23） and Sanyinjiao（SP 6） won the highest support rate in the paired groups; Ganshu（BL 18）, Shenshu（BL 23） and Sanyinjiao（SP 6） had the highest support rate among the acupoint groups. Conclusion： The data mining results of acupuncture-moxibustion treatment of PMS substantially conform to the general principle in traditional acupuncture-moxibustion theories, able to reflect the acupoints selection and grouping pattern and provide references for acupuncture-moxibustion treatment of PMS.

Regulatory effects of herbal cake-partitioned moxibustion on the expressions of IL-17,IL-23 and their mR NAs in the colon of rats with Crohn's disease

Objective： To observe the regulatory effects of herbal cake-partitioned moxibustion on Crohn＇s disease （CD） rat＇s colon inflammatory cytokine interleukin-17 （IL-17）, IL-23 and their mRNAs, and to investigate the action mechanism of moxibustion in treating CD. Methods： Forty SPF grade Sprague-Dauley （SD） male rats were randomly divided into a normal group, a model group, an herbal cake-partitioned moxibustion group and a Western medicine group, with 20 rats in each group. Except the normal group, rats in the other three groups were used to make CD model by giving an enema in colon with Trinitro-benzene-sulfonic acid （TNBS）. When the models were successful made, rats in the model group had no therapeutic intervention; rats in the herbal cake-partitioned moxibustion group were subjected to herbal cake-partitioned moxibustion treatment at bilateral Tianshu （ST 25） plus O.ihai （CV 6）; and rats in the Western medicine group were given oral Mesalazine. After treatment, the histopathological changes and inflammatory cytokines IL-17, IL-23 and their mRNAs expressions were observed in descending colon by hematoxylin-eosin （HE） staining, immunohistochemistry （IHC） and real-time polymerase chain reaction （RT-PCR） methods. Results： Colon tissues of TNBS enema rat models showed cracks-like ulcers accompanied by mucous layer inflammation, granulomas, and inflammatory cytokines IL-27, IL-23 and their mRNAs expressions were all higher than those in the normal group （P〈O.01）; after intervention, colon tissue cracks-like ulcers and inflammation degree reduced, inflammatory cytokines IL-17, IL-23 and their mRNAs expressions were all significantly decreased （P〈0.01） in the herbal cake-partitioned moxibustion group and the Western medicine group. Conclusion： Herbal cake-partitioned moxibustion may improve colon tissue ulcers and relieve intestinal inflammation by down-regulation of IL-17, IL-23 and their mRNAs expressions in CD model rats＇ colonic mucosa.

Study on the differences between moxibustion at different points in the effects on the anti-fatigue ability of rats undergoing one-time exhaustive swimming

Objective:To observe the effects of moxibustion at Shenshu(BL 23),Zusanli(ST 36)and Shenque(CV 8)on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming,and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue.Methods:Forty-eight male SPF rats were randomly divided into a blank group,a model group,a non-meridian and non-acupoint group,a Shenshu(BL 23)group,a Zusanli(ST 36)group,and a Shenque(CV 8)group using random number table method,with eight rats in each group.Except for the blank group,rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment.Except for the model group,the other model rats received mild moxibustion immediately after swimming.Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points,those in the Shenshu(BL 23)group received mild moxibustion at bilateral Shenshu(BL 23),those in the Zusanli(ST 36)group received mild moxibustion at bilateral Zusanli(ST 36),and those in the Shenque(CV 8)group received mild moxibustion at Shenque(CV 8)for 15 min.Four hours after the exhaustive swimming,femoral artery blood was collected to detect blood lactate(BLA),lactate dehydrogenase(LDH),creatine kinase(CK),creatinine(CRE),blood urea nitrogen(BUN),cortisol(C)and testosterone(T)levels,and calculate the T/C ratio.Results:Compared with the blank group,rat's serum levels of BLA,LDH,CK,BUN and C in the model group and the non-meridian and non-acupoint group were increased,and serum levels of CRE and T,and T/C ratios were decreased(P<0.01 or P<0.05);compared with the model group and the non-meridian and non-acupoint group,the serum levels of BLA,LDH,CK,BUN and C in the Shenshu(BL 23)group,Zusanli(ST 36)group and Shenque(CV 8)group were decreased,and the serum CRE and T levels,and the T/C ratios were increased(all P<0.01);compared with the Shenshu(BL 23)group,the serum CK level was decreased in the Shenque(CV 8)group(P<0.01),the serum levels of T and C were decreased in the Zusanli(ST 36)group and Shenque(CV 8)group(P<0.01 or P<0.05),and the T/C ratio was increased in the Shenque(CV 8)group(P<0.01);compared with the Zusanli(ST 36)group,the serum CK and BUN levels were decreased(P<0.01,P<0.05),and the T/C ratio was increased in the Shenque(CV 8)group(P<0.05).Conclusion:Moxibustion at Shenshu(BL 23),Zusanli(ST 36)and Shenque(CV 8)shows different anti-fatigue effects by regulating the energy metabolism and endocrine metabolism in rats undergoing one-time exhaustive swimming.Moxibustion at Shenshu(BL 23)is better in promoting energy synthesis.Moxibustion at Shenque(CV 8)is more effective in regulating synthesis and decomposition of the skeletal muscle proteins.

廉泉穴针刺深度对中风后吞咽障碍的疗效影响:随机对照研究

目的：探讨针刺廉泉穴不同深度对中风后吞咽障碍的临床疗效差异。方法：采用随机对照原则,将251例中风后吞咽障碍患者随机分为廉泉深刺组（85例）、廉泉浅刺组（83例）和舌咽针刺组（83例）。在常规治疗的基础上,3组均行舌咽针刺法,穴取舌面、患侧咽后壁、金津、玉液,快速点刺不留针,廉泉深刺组、廉泉浅刺组均先行舌咽针刺法后取廉泉穴,廉泉深刺组针刺60~70mm,廉泉浅刺组针刺30~40mm,均留针30min。每天治疗1次,3组均治疗30天。观察3组治疗前后洼田饮水试验评价量表评分,并评定3组疗效。结果：廉泉深刺组总有效率为95.3%（81/85）,优于廉泉浅刺组的85.5%（71/83）及舌咽针刺组的83.1%（69/83,均P〈0.05）。各组治疗后洼田饮水试验评分分值均下降明显（均P〈0.01）,廉泉深刺组较其他两组中下降更明显（P〈0.01）,且廉泉深刺组在治疗2周后分值下降均明显高于廉泉浅刺组和舌咽针刺组（P〈0.05）。结论：针刺廉泉穴能有效改善中风后吞咽功能障碍,针刺深度对疗效有影响,深刺效果更佳。

针刺廉泉穴治疗卒中后吞咽困难疗效观察

目的:验证针刺廉泉穴对卒中后吞咽困难患者的临床疗效。方法:将180例患者随机分为针刺A组、针刺B组和康复组,每组60例。在常规药物治疗的基础上,针刺A组采用针刺廉泉穴治疗;针刺B组采用针刺合谷、内关穴治疗;康复组采用吞咽康复训练治疗,均每日1次,每周5次,治疗4周。采用美国国立卫生研究院卒中量表(NIHSS)、电视X线透视吞咽功能检查(VFSS)对各组患者治疗前后神经功能缺损及吞咽功能进行评分,比较各组肺炎发生率及临床疗效。结果:3组患者治疗后NIHSS评分、VFSS评分均明显改善(均P<0.05),且针刺A组优于其他两组(均P<0.05);针刺A组肺炎发生率低于针刺B组、康复组[3.3%(2/60)vs 6.7%(4/60)、8.3%(5/60),均P<0.05];针刺A组有效率优于其他两组[95.0%(57/60)vs 81.7%(49/60)、75.0%(45/60),均P<0.05]。结论:在常规药物治疗的基础上,针刺廉泉穴能有效改善卒中后吞咽困难患者的吞咽功能,改善神经功能缺损,降低肺炎发生率。

艾灸对脑瘫患儿免疫功能的影响

目的:比较艾灸关元、肾俞、足三里与西药对脑瘫患儿免疫功能的影响。方法:230例脑瘫患儿随机分为观察组和对照组,每组115例。观察组于关元、肾俞、足三里穴行温和灸;对照组口服匹多莫德口服液,每次10 mL。两组均每日1次,30天为一疗程,共治疗90天。分别于治疗30天、60天、90天比较两组T淋巴细胞亚群、血清免疫球蛋白及发育商的变化,并于治疗后6、12个月随访患儿疾病发生率。结果:两组治疗30、60、90天后均较治疗前明显提高T淋巴细胞亚群(CD_3^+、CD_4^+、CD_4^+/CD_8^+)、血清免疫球蛋白(IgG、IgA)及发育商(P<0.01,P<0.05);在CD_3^+、CD_4^+、CD_4^+、CD_8^+及IgG、IgA、发育商方面,治疗30天后对照组优于观察组(均P<0.05),治疗60天后两组差异无统计学意义(均P>0.05),治疗90天后观察组优于对照组(均P<0.05);CD_8^+、IgM两组治疗前后比较差异无统计学意义(均P>0.05)。观察组不良反应发生率为7.0%(8/115)低于对照组的23.5%(27/115,P<0.01);观察组治疗后6、12个月随访患儿疾病发生率明显低于对照组(P<0.05)。结论:艾灸关元、肾俞、足三里可改善脑瘫患儿的免疫功能,疗效优于西药匹多莫德。

艾灸对运动员红细胞免疫功能与T细胞亚群的影响

目的:观察艾灸肾俞、关元穴对运动员红细胞免疫功能及T细胞亚群的影响。方法:在训24名乒乓球队队员按配对设计分为试验组和对照组各12例,两组队员训练内容相同,试验组于训练后3h接受艾灸肾俞、关元穴治疗15min,每日1次,连续5周;对照组不做艾灸处理。于试验前后分别采用功率自行车在20min内完成定量负荷运动,运动后抽取静脉血测定红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)和T细胞亚群CD3、CD4、CD8及CD4/CD8。结果:(1)试验组试验后比试验前及对照组RBC-C3bRR明显升高(均P<0.01),RBC-ICR显著下降(均P<0.01),CD3、CD4比对照组升高(均P<0.05),CD8和CD4/CD8与试验前及对照组比较差异无统计学意义(均P>0.05);(2)对照组试验后较试验前RBC-C3bRR降低(P<0.05),CD3、CD4、CD8及CD4/CD8均降低(均P<0.05)。结论:大负荷训练使运动员红细胞免疫和T细胞亚群功能低下,免疫力下降;艾灸肾俞、关元穴治疗可改善运动员红细胞免疫功能和T细胞亚群功能异常,提高免疫力。

廉泉穴临床应用规律古代文献研究

目的:通过对廉泉穴相关古代文献的整理分析,归纳总结古代廉泉穴应用规律。方法:以《中华医典》(第5版)收录的1 156部中医古籍为检索范围,对廉泉穴主治病症、腧穴配伍、配伍主治病症以及刺灸法的相关条文进行归纳整理,并建立数据库。结果:本研究最终纳入符合要求条文共计196条,涵盖60本古籍,与廉泉穴主治相关条文共155条,包括35种病症,涉及内科、儿科及五官科等多门学科。其中单穴及配伍主治病症频次最高的均为五官科疾病,配穴频次最高的为少商穴。廉泉穴刺灸法条文共计78条,使用治疗方法共4种。结论:廉泉穴主治规律以局部病症为主,其中关于舌咽疾病的选穴体现辨证分经的规律,并以循经主治病症为辅;相对穴、五输穴等配穴应用主要起到协同增效的作用;廉泉穴刺灸方法主要以灸法为主,刺激量以灸3壮为多,针刺深度多为针3分。

不同频率电针廉泉、风府穴治疗中风吞咽障碍临床研究

目的:在西医内科治疗及常规康复训练基础上,观察不同频率电针治疗中风吞咽障碍的临床疗效差异。方法:将符合纳入标准的60例中风吞咽障碍患者随机分为低频(2 Hz)组与高频(100 Hz)组,每组30例。两组均行基础治疗,穴取风府、廉泉,电针采用连续波,频率分别为2、100 Hz,刺激强度以患者可耐受为度,每日1次,每次留针30 min,连续治疗14 d。主要评定指标为电视X线透视吞咽功能(VFSS),检查口腔期通过时间、咽期延迟时间、咽期通过时间,次要评定指标为洼田饮水试验评级、标准吞咽功能评定量表(SSA)评分,并评价临床疗效。结果:电针后,两组患者口腔期通过时间、咽期延迟时间、咽期通过时间均较治疗前减少(均P<0.05),且低频组均少于高频组(均P<0.05),两组患者洼田饮水试验分级均较本组电针治疗前改善(均P<0.05),且低频组优于高频组(P<0.05),两组治疗后SSA评分均较治疗前下降(均P<0.05),低频组治疗后SSA评分改善情况优于高频组(P<0.05),电针治疗后,低频组与高频组的总有效率分别为93.3%(28/30)、66.7%(20/30),差异有统计学意义(P<0.05),结论:低频电针改善中风后吞咽功能的疗效优于高频电针。

恢刺廉泉穴治疗脑卒中后吞咽障碍:随机对照试验

目的:观察恢刺廉泉穴对脑卒中后吞咽障碍的影响,探讨其作用机制。方法:将64例脑卒中后吞咽障碍患者随机分为观察组和对照组,每组32例。两组均给予常规基础治疗,观察组穴取廉泉,采用恢刺手法不留针,每日1次;对照组采用吞咽康复训练治疗,每日1次。两组均每周治疗5 d,休息2 d,1周为一疗程,共4个疗程。比较两组患者治疗前后洼田饮水试验分级、标准吞咽功能评价量表(SSA)评分,采用视频吞咽造影检查(VFSS)测量观察组患者治疗前后舌骨运动位移、咽期运送时间。结果:治疗后,两组患者洼田饮水试验分级均较治疗前改善(P<0.05),且观察组优于对照组(P<0.05);两组患者SSA评分均较治疗前降低(P<0.05),观察组低于对照组(P<0.05)。与治疗前比较,观察组患者治疗后舌骨运动位移增加、咽期运送时间缩短(P<0.05)。结论:恢刺廉泉穴可改善脑卒中后吞咽障碍患者吞咽障碍症状,可能与增加舌骨运动位移、缩短咽期运送时间有关。

针刺配合吞咽训练治疗脑卒中后吞咽障碍:随机对照研究

目的:观察深刺廉泉、翳风为主配合吞咽康复训练治疗脑卒中后吞咽障碍的临床疗效。方法:将60例脑卒中后吞咽障碍患者随机分为观察组和对照组,每组30例。观察组在常规针刺基础上深刺廉泉、翳风穴,每日1次,每次30min,并配合康复吞咽训练,每日2次,每次20min;对照组予以单纯康复吞咽训练,两组均配合脑卒中常规治疗。6天为一疗程,疗程间休息1天,连续3个疗程。治疗前后分别进行VFSS(电视荧光吞咽检查)吞咽困难评价量表和洼田饮水试验评定,并比较两组的临床疗效及治愈所需时间。结果:治疗后,观察组VFSS评分明显优于对照组,两组比较差异具有统计学意义(P<0.01);洼田饮水试验明显优于对照组,两组比较差异具有统计学意义(P<0.01)。观察组与对照组的痊愈率分别为70.0%(21/30)和43.3%(13/30),总有效率分别为86.7%(26/30)和66.7%(20/30),组间治愈率与总有效率差异均有统计学意义(均P<0.01)。两组临床治愈时间观察组明显短于对照组(P<0.01)。结论:深刺廉泉、翳风穴为主配合康复吞咽训练能有效改善脑卒中后吞咽功能。

Effect of acupuncture on rabbit bladder with urodynamic indexes

OBJECTIVE： To study the effect of acupuncture on rabbit bladder with urodynamic indexes. METHODS： New Zealand male rabbits were divid ed into control group, model group, treatment group 1 treated by acupuncture at Shenshu （BL 23） and treatment group 2 treated by acupuncture at Zhongji （CV 3）. The urine dynamic parameters through the urethral catheter were detected in each group in order： fluctuation of pressure at fill ing phase of urinary bladder and flow rate in urina tion phase, which were used as quantification in dexes of urinary bladder function. The urinary blad der abnormal model was prepared by administra tion of cholinergic stimulant; Regulatory effects of acupuncture at Shenshu （BL 23） and Zhongji （CV 3） on the abnormal state of the urinary bladder were respectively observed. RESULTS： 1） In the filling phase of urinary bladder and in the urination phase, the intravesical pres sure wave in infilling （IPWI） and intravesical dis charge rate （IDR） could be respectively recorded. 2） IPWI and IDR could become abnormality by neo stigmine methyl sulfate [stability type IPWh the con trol group （n=20, 80%） vs the model group （n=15, 14.3%）, P〈0.01; IDR and time regression equation： the control group （n=20, y=24.3 0.878x） vs the model group （n=15, y=40.0 5.15x）, P〈0.01]. 3） Ab normal IPWI＇s could be normalized respectively by acupuncture at Shenshu （BL 23） and Zhongji （CV 3） [the stability type IPWl wave： the model group （n= 2, 14.3%） vs the treatment group 1 （n=3, 30%）, P〉 0.05; the instability type IPWl wave： the model group （n=13, 85.7%） in vs the treatment group 2 （n=6, 60%）, P〉0.05]; 4） Abnormal IDR also could be turned to normality by acupuncture at Shenshu （BL 23） and Zhongji （CV 3）, respectively [IDR and the time regression equation： the model group （n=15, y=40.0 5.15x） vs the treatment group 1 （n=10, y= 18.9 0.499x）, P〈0.01; the model group （n=15, y= 40.0 5.15x） vs the treatment group 2 （n=10, y= 17.5 0.251x）, P〈0.01]. CONCLUSION： 1） Urodynamic indexes can be used for study of mechanism of acupuncture effects; 2） The effect of acupuncture in the bladder filling phase is smaller than that in the urination phase; 3） Acupuncture has a very obvious effect on intravesi cal discharge rate.