深刺天枢治疗老年性便秘近期观察

目的 :评价深刺天枢治疗老年性便秘近期疗效。方法 :采用随机单盲 (盲患者 )安慰对照前瞻性研究方法 ,对照观察深刺天枢和常规深度针刺天枢治疗老年性便秘的近期疗效 ,并初步评价深刺天枢的安全性。结果 :深刺组总有效率 10 0 0 % ,近期治愈率 5 7 7% ;常规针刺组分别是 38 0 %及 0 ,差异具有非常显著性意义 ,而且深刺天枢穴是安全的。结论 :深刺天枢是治疗老年性功能性便秘的较好方法。

不同穴位电针治疗偏头痛效果及其影响因素的研究

目的:比较电针丘墟穴和天枢穴对偏头痛的疗效,探讨影响疗效的因素。方法:将275例患者随机分为试验组138例,采用电针丘墟穴治疗;对照组137例,采用电针天枢穴治疗。观察两组的疗效,并对影响因素进行分析。结果:试验组即时有效率为70.3%,对照组为58.4%,两组比较,P<0.05,治疗4周、随访3个月和6个月疗效比较均P<0.001,电针丘墟穴的效果优于电针天枢穴;电针治疗偏头痛对从事脑力劳动人群、治疗时疼痛评分高、偏头痛发作次数多的人群即时镇痛效果更好;电针治疗偏头痛的长期疗效丘墟穴优于天枢穴。结论:电针丘墟穴治疗偏头痛的疗效优于天枢穴,患者的职业和病情等是影响疗效的因素。

深刺天枢穴改善结肠慢传输型便秘临床观察

目的评价深刺天枢穴改善结肠慢传输型便秘(STC)临床症状的疗效。方法 STC患者120例,随机分为深刺组、常规组和西药组。评价三组患者首次自主排便时间及治疗前、治疗4星期后患者便秘评分及相关临床症状评分。结果深刺组改善便秘临床症状评分优于常规组和西药组,差异有统计学意义(P<0.01)。深刺组在改善排便不成功次数及腹痛等症状上优于西药组和常规组,且深刺的即刻效应较好。结论深刺天枢穴对STC临床症状的改善优于西药乳果糖和常规针刺治疗。

深刺天枢、腹结穴配合电针治疗功能性便秘的临床研究

目的观察深刺天枢、腹结穴配合电针治疗严重功能性便秘的临床疗效。方法将63例严重功能性便秘患者随机分为治疗组33例和对照组30例。治疗组采用深刺天枢、腹结穴配合电针为主治疗,对照组采用假电针治疗。观察两组治疗前后完全自主排便次数(CSBM)、Bristol粪便性状评分(BBS)和便秘患者生活质量(PAC-QOL)评分变化情况。结果治疗组治疗2、4、8星期后及随访4、12星期CSBM与同组治疗前比较,差异均具有统计学意义(P<0.05)。对照组治疗8星期后CSBM与同组治疗前比较,差异具有统计学意义(P<0.05)。治疗组治疗2、4、8星期后及随访4、12星期CSBM与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗2、4、8星期后BSS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2、4、8星期后BSS评分与对照组比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后PAC-QOL各项评分(躯体不适、心理社会不适、担心和焦虑、满意度及总分)与同组治疗前比较,差异均具有统计学意义(P<0.05)。对照组治疗后PAC-QOL中躯体不适评分、担心和焦虑评分、满意度评分及总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PAC-QOL各项评分与对照组比较,差异具有统计学意义(P<0.05)。结论深刺天枢、腹结穴配合电针是一种治疗严重功能性便秘的有效方法。

独针天枢穴治疗老年顽固性便秘疗效观察

目的观察独针天枢穴治疗老年顽固性便秘的临床疗效。方法将193例老年顽固性便秘患者随机分为A组57例、B组73例和C组63例。A组采用针刺天枢穴治疗,B组采用口服乳果糖口服溶液治疗,C组采用清洁保留灌肠治疗。比较3组临床疗效及疗效维持时间。结果 A组总有效率为89.3%,B组为88.6%,C组为92.1%,3组总有效率比较,差异均无统计学意义(P>0.05)。A组显效及好转患者疗效维持时间与B组和C组比较,差异均具有统计学意义(P<0.01)。结论独针天枢穴是一种治疗老年顽固性便秘的有效方法。

深刺天枢穴治疗结肠慢转运性便秘疗效及安全性评价

目的:评价深刺天枢穴对结肠慢转运性便秘(STC)的近、中期疗效及安全性。方法:STC患者60例,随机分为治疗组和对照组。评价治疗前、治疗2周后和治疗后6个月临床评分及结肠转运时间(CTT),并从临床、检验和影像学角度评价安全性。结果:(1)近期疗效:治疗组临床评分和CTT疗效均优于对照组,差异有显著性(P<0.01)。(2)中期疗效:治疗组治疗后6个月仍有效,疗效明显优于对照组(P<0.01),对照组无效。治疗组患者无不良反应。结论:深刺天枢穴治疗STC近期疗效确切,有一定中期疗效,无不良反应。

天枢超声电导胃肠宁贴片防治混合痔外剥内扎术后排便困难临床研究

目的:观察天枢超声电导胃肠宁贴片防治混合痔外剥内扎术后排便困难的临床疗效。方法:选取90例行混合痔外剥内扎术治疗的患者,随机分为对照组和治疗组各45例。对照组术后予以常规护理,治疗组在对照组基础上给予天枢超声电导胃肠宁贴片治疗,2组干预时间均为7 d。记录并比较2组首次排便时间,以及术后3 d、7 d的排便疼痛程度、排便顺畅情况和排便持续时间。结果:治疗组术后首次排便时间短于对照组,差异有统计学意义(P<0.05)。术后3 d、7 d,治疗组排便疼痛程度、排便顺畅情况均优于对照组,排便持续时间短于对照组,差异均有统计学意义(P<0.05)。结论:天枢超声电导胃肠宁贴片可改善混合痔外剥内扎术后患者的排便质量,缓解术后疼痛。

电针治疗慢性功能性便秘疗效观察

目的观察电针治疗慢性功能性便秘的临床疗效。方法将80例功能性便秘患者随机分为治疗组和对照组,每组40例。治疗组针刺双侧支沟、天枢及足三里穴,同时在天枢及足三里穴给予电针治疗;对照组采用口服聚乙二醇4000散治疗。治疗2星期后,比较两组治疗前后排便次数、粪便性状的变化,并判定临床疗效。结果两组治疗后大便性状恢复正常率比较,差异具有统计学意义(P<0.05)。两组第1、2星期平均每日排便次数比较,差异均无统计学意义(P>0.05)。治疗组总有效率为95.0%,对照组为65.0%,两组比较差异具有统计学意义(P<0.05)。结论电针是一种治疗慢性功能性便秘的有效方法。

Clinical Study on Deep Insertion at Tianshu (ST 25) for Colonic Slow Transit Constipation

Objective：To observe the clinical effect of deep insertion at Tianshu（ST 25）for colonic slow transit constipation（STC）.Methods：120 cases of STC patients were randomly divided,60 cases in a deep insertion group,30 cases in an electroacupuncture group and 30 cases in a medication group by 2：1：1 ratio.The deep insertion group was treated with deep insertion at Tianshu（ST 25）.The electroacupuncture group was treated with routine insertion at Tianshu（ST 25）.The medication group was treated with oral administration of Lactulose oral liquid.The first voluntary defecation time,and constipation scores before the treatment,four weeks after the treatment and relevant scores of clinical symptoms were assessed in the three groups of the patients.Results：The scores of the clinical symptoms in improvement of constipation were better in the deep insertion group than in the electroacupuncture group and medication group,with differences in statistical significance（P〈0.01）.The unsuccessful numbers in the improvement of defecation and abdominal pain were also better in the deep insertion group than in the other two groups,and better in instant effect in the deep insertion.Conclusion：The improvement of STC clinical symptoms was better by deep insertion at Tianshu（ST 25）than by medication and routine acupuncture method at Tianshu（ST 25）.

Assessment of the operation standard and safety on the individualized deep acupuncture at Tiānshū (天枢 ST 25) under CT

Objective To discuss the individualized operation standard and its safety on the deep acupuncture at Tianshu （天枢 ST 25）. Methods Acupuncture was applied to Tianshu （天枢 ST 25）） in 39 patients. The individualized standard depth of insertion at the acupoint was determined as the penetrating the peritoneum with needle by 1 to 2 mm. The regression analysis was adopted to analyze the impacts of abdominal circumference （AC, cm） on the peritoneal position via CT cross-section scanning and image survey. Results The formula of rational needling depth at Tianshu （天枢 ST 25） with individualized deep acupuncture was： depth=-0.562＋0.045. AC. Conclusion The depth of insertion at Tianshu （天枢 ST 25）, determined as penetrating the peritoneum with needle by 1 to 2 mm is safe and feasible, which may be applicable and have the guidance significance for the assessment of clinical operation and safety on the deep acupuncture at the other acupoints on the abdominal region.

天枢、上巨虚作为基础腧穴治疗胃肠疾病的研究进展

分析总结天枢、上巨虚作为基础腧穴治疗胃肠疾病的临床与基础研究进展,探索合募配穴的临床价值,从而为合募配穴的临床应用提供依据。基于现有文献,天枢与上巨虚作为基础腧穴应用广泛,二者共同作为基础腧穴主要应用于功能性肠病与炎症性肠病的治疗,而在慢性胃炎、功能性消化不良等其他常见消化疾病中应用较少。临床常用的治疗方法为针刺、艾灸、中药穴位贴敷。基于动物实验的疗效机制表明,天枢、上巨虚及其他配穴干预,可调节大鼠兴奋性、抑制性神经递质并改善大鼠体内炎症介质水平,改善功能性便秘症状;抑制中枢敏化,从而缓解大鼠肠易激症状;抑制胃内压和胃运动以减轻功能性腹泻症状;通过降低大鼠延髓孤束核内神经元和星形胶质细胞的阳性免疫产物的高表达水平,并抑制Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核因子κB(NF-κB)信号通路并减少炎症介质的释放以保护溃疡性结肠炎大鼠结肠黏膜组织。在不同胃肠疾病治疗中,天枢、上巨虚所配伍的腧穴有所差异,因此应基于现有证据与临床经验选择最佳腧穴配伍,从而提升临床疗效。

电针天枢穴治疗肾绞痛疗效观察

目的 :观察天枢穴治疗肾绞痛的即时止痛作用。方法 :将 97例肾绞痛患者采用半随机方法分成电针组 (5 5例 )和药物组 (42例 )。电针组采用电针天枢穴治疗 ,药物组采用度冷丁 5 0mg肌肉注射治疗。结果 :电针组显效率为 5 2 7%,总有效率为 96 4%;药物组显效率为 2 8 6 %,总有效率为 73 8%。经统计学处理 ,两组显效率和总有效率的差异具有非常显著性意义 (P <0 0 1 )。结论 :对肾绞痛的缓解作用 ,电针组优于药物组。

Clinical Research of Irritable Bowel Syndrome Treated by Electroacupuncture on Tianshu（ST 25）

Objectives： By observing and evaluating the clinical curative effect systematically of electrical acupuncture （EA） on Tianshu （ST 25） on diarrhea-predominant irritable bowel syndrome （D-IBS）, to make it benefit for the application and spread of EA on Tianshu （ST 25） on D-IBS. Methods： 103 D-IBS matched the involved standards were allocated into treatment group （EA on ST 25, n=53） and control group （EA on Daheng, SP 15, n=50） in randomized, controlled and single-blind ways. Curative effect differences were analyzed by Ridit analysis. Results： The incidence of diarrhea, abdominal pain, abdominal distention or abdominal discomfort, borborygmus, defecation urgency and defecation incompletion feeling were 100%, 89.3%, 71.8%, 74.8%, 83.5% and 78.6% respectively in D-IBS. Generally, after treatment, 11 cases got excellent results, 34 cases improved and 8 failed in treatment group, totally effective rate was 84.9%; while in control group, 4 cases got excellent effects, 26 improved and 20 failed, totally the effective rate was 60.0%. Conclusion： Compared with control group, EA on Tianshu （ST 25） has a better curative effect on D-IBS.

Effect of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV 6) for the treatment of diarrhea-dominant irritable bowel syndrome： a patient-blinded pilot trial with orthogonal design

OBJECTIVE: To investigate the effects of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV6) in patients with diarrhea-dominant irritable bowel syndrome(D-IBS) by assessing predominant factors, and determining the best factor combinations and their interactions. To identify the optimal quantity of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV 6) to achieve optimal efficacy.METHODS: An L9(3~4) orthogonal design was applied to 233 confirmed subjects based on the three most influential factors and the three most frequently used levels. Nine programs were designed.Subjects were assigned to four subgroups according to age and gender; each subject underwent one of the nine programs randomly. We selected Tianshu(ST 25, bilateral) and Qihai(CV 6). The scores of symptoms and the IBS Quality of Life(IBS-QOL) were evaluated after the final treatment.RESULTS: After treatment, clinical symptoms of all patients were significantly improved(P = 0.001).Quality of life also improved significantly(P < 0.05).For all the participants, frequency was the dominating factor regarding symptoms(P = 0.01). Duration was the dominating factor for quality of life(P =0.0001). The best combination for improving symptoms in 30-40-year-old male and female patients was two courses of 10 min each once a day, and for41-50-year-old male and female patients it was three courses of 10 min(males) or 30 min(females)twice a day. The best combination for quality of life was three courses of 20 min once a day. No interaction was found between frequency and course, or frequency and duration.CONCLUSION: Warming moxibustion Tianshu(ST25, bilateral) and Qihai(CV 6) is a promising therapy for D-IBS. To acquire optimal efficacy, the three main factors(duration, frequency and treatment course) of the warming moxibustion should reach a specific quantity and be combined appropriately.

Effect of herbal-partitioned moxibustion at Tianshu(ST 25) and Qihai(CV 6) on pain-related behavior and emotion in rats with chronic inflammatory visceral pain

Objective：To observe the effect of herbal-partitioned moxibustion （HPM） on pain-related behavior and emotion in a rat model of chronic inflammatory visceral pain, and to investigate the mechanism. 〈br〉 Methods：Twenty-four male Sprague-Dawley （SD） rats were randomly divided into three groups：a normal group, a model group and an HPM group. Except for the normal group, rats in the other two groups were clystered with mixed liquor of Trinitrobenzene Sulfonic Acid （TNBS） and 50%ethanol to induce the chronic inflammatory visceral pain model. After the models were established successfully, rats in the HPM group were treated with HPM at bilateral Tianshu （ST 25） and Qihai （CV 6）. Rats in the normal group and the model group were only fixed as those in the HPM group without treatment. Abdominal withdrawal reflex （AWR） score, mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL） were adopted to detect the visceral and somatic pain;meanwhile, open field test （OFT） and elevated plus maze test （EPMT） were employed to evaluate pain emotions such as depression and anxiety. 〈br〉 Results：Compared with the normal group, AWR scores of the model group were significantly increased under different stimulus expansion pressure level （P〈0.01）, MWT and TWL were significantly decreased （P〈0.05）;in OFT, the values of horizontal activities and vertical activities were significantly decreased （P〈0.01）;in EPMT, the proportion of the number of entry into the open arms （OE%） and that of residence time in the open arms （OT%） significantly decreased （P〈0.01）, indicating that the model was successful. Compared with the model group, the AWR score of the HPM group was decreased significantly （P〈0.05）, MWT and TWL were significantly increased （P〈0.05）, the values of horizontal activities and vertical activities in the model group were significantly increased （P〈0.01）;in OFT and EPMT, OE%and OT%were significantly increased （P〈0.01）. 〈br〉 Conclusion：HPM has analgesic effect on chronic inflammatory visceral pain. It can reduce the visceral and somatic pain in rats and markedly improve the emotions such as anxiety and depression induced by chronic visceral pain.

基于俞募配穴理论针刺天枢、大肠俞治疗功能性腹泻的临床疗效观察

目的基于俞募配穴理论取天枢、大肠俞治疗功能性腹泻,观察其临床疗效,探讨其作用机理。方法将所招募的患者随机分为针刺组和药物组,针刺组选取双侧天枢、大肠俞,得气后辅以电针治疗;药物组则给予盐酸洛哌丁胺胶囊口服;两组的观测指标均为1周自主排便总次数及粪便性状评分(1周平均分),分别以治疗1周、4周、6周、8周后为观测节点。结果治疗1周后,两组均能使功能性腹泻患者自主排便次数减少(P<0.05),但两组之间比较,差异无统计学意义(P>0.05);治疗4周、6周、8周后,针刺组对患者排便次数的改善仍明显(P<0.01),而药物组对患者排便次数的改善存在反复,两组比较差异有统计学意义(P<0.05,P<0.01)。治疗1周后,两组功能性腹泻患者的粪便性状评分均降低(P<0.05),两组比较疗效未见明显差异(P>0.05);治疗4周、6周、8周后,针刺组对患者粪便性状的改善仍明显(P<0.01),而药物组对患者粪便性状的改善存在反复,两组比较差异有统计学意义(P<0.05,P<0.01)。结论口服盐酸洛哌丁胺胶囊及针刺天枢、大肠俞(配合电针)对治疗功能性腹泻疗效均确切,且近期疗效相当;但与药物组比较,针刺组的疗效更持久、个体差异性较小、安全系数更高。

Therapeutic Effect Observation on Moxibustion at Tianshu (ST 25) for Acne Vulgaris

Objective： To observe the clinical efficacy of moxibustion at Tianshu （ST 25） for acne vulgaris. Methods： Medicinal cake based on pattern identification was used to conduct moxibustion on Tianshu （ST 25）. Results： After three courses of treatment, the recovery and marked effect rates reached 83.9%. The recovery and marked effect rates in those within 1-year duration reached 94.4%, including the recovery rate of 50.0%. This result is significantly better than those with longer than 1-year duration （P〈0.01）. The recovery and marked effect rates of acne vulgaris due to damp-heat in the stomach and intestine were superior to that due to wind-heat in the lung meridian （P〈0.05）. Conclusion： Medicinal cake-partitioned moxibustion can obtain a better effect for acne vulgaris. The earlier the treatment starts, the better the effect gets. In addition, this therapy works better for acne vulgaris due to damp-heat in the stomach and intestine than wind-heat in the lung meridian.

电针对溃疡性结肠炎大鼠肠黏膜维生素D受体表达的影响

目的:观察电针天枢、上巨虚穴对结肠炎大鼠肠黏膜中维生素D受体(VDR)表达的影响,探讨电针治疗溃疡性结肠炎(UC)的可能机制。方法:按照随机数字表法将雄性Wistar大鼠分为对照组、模型组和电针组,每组8只。采用三硝基苯磺酸(TNBS)灌肠的方法来诱导溃疡性结肠炎制备大鼠模型,同时采用大鼠疾病活动指数(DAI)评分和组织学活动度评分(HAI)来评估结肠炎症程度。电针组大鼠经TNBS造模成功后次日取天枢、上巨虚穴进行电针治疗,共14 d。于第15天处死大鼠后收集结肠组织,分别采用免疫组化和实时荧光定量PCR法(qRT-PCR)检测肠黏膜VDR的表达水平,采用分光光度法测定结肠组织髓过氧化物酶(MPO)活性。结果:与模型组比较,电针组HAI明显下降(P=0.005)。与对照组比较,模型组和电针组结肠组织中MPO活性均明显增加。与模型组比较,电针组结肠组织中MPO活性下降(P<0.001)。与对照组比较,模型组、电针组大鼠肠黏膜中VDR mRNA及蛋白表达降低(P<0.01)。与模型组比较,电针组大鼠肠黏膜VDR m RNA及蛋白表达升高(P<0.05)。蛋白免疫组化提示VDR主要在上皮细胞中表达。VDR蛋白表达水平与MPO活性成负相关(P<0.05)。结论:电针天枢、上巨虚两穴可能通过上调肠黏膜VDR表达来缓解大鼠UC症状。

基于数据挖掘探讨穴位埋线治疗肥胖型多囊卵巢综合征的选穴规律

目的:系统收集并整理穴位埋线治疗肥胖型多囊卵巢综合征的文献,采用数据挖掘分析穴位埋线治疗肥胖型多囊卵巢综合征的选穴规律。方法:以"穴位埋线""肥胖型多囊卵巢综合征"为主题词检索中国知网、维普、万方和pubmed数据库,检索时间均为建库至2019年9月4日,初步纳入192篇文献,经剔除后纳入48篇文献。结果:选穴频次依次为:天枢、关元、丰隆、三阴交、脾俞。经脉频次依次为:足阳明胃经、任脉、足太阳膀胱经、足少阳胆经、足太阴脾经。特定穴中以交会穴、募穴、俞穴、五输穴、八会穴居多。取穴部位多集中于胸腹部和下肢。结论:穴位埋线治疗肥胖型多囊卵巢综合征常用穴位为天枢、关元、丰隆、三阴交、脾俞,主要集中在胃经、任脉、膀胱经上,穴位位于胸腹部和下肢。

Observation of Therapeutic Effects of Needle Warming Moxibustion for Chronic Diarrhea

Objective： To observe the therapeutic effects of needle warming moxibustion for chronic diarrhea. Methods： Two-hundred cases with chronic diarrhea were divided randomly into a treatment group and a control group. 100 cases in the treatment group were treated with needle warming moxibustion on specific acupoints. 100 cases in the control group were treated by oral administration of Smecta. Results： The therapeutic results showed cure in 52 cases, remarkable effect in 34 cases, improvement in 14 cases and the total effective rate in 100.0% in the treatment group, and cure in 5 cases, remarkable effect in 23 cases, improvement in 33 cases, failure in 39 cases and the total effective rate in 61.0% in the control group. The comparison of the total effective rate between the two groups was statistically significant （P〈0.05）. Conclusion： The needle warming moxibustion on specific acupoints is better than oral administration of Smecta in the therapeutic effects.