Treatment of 60 Cases of Acute Lumbar Sprain by Puncturing Yintang(Ex-HN 3) toward Shenting(GV 24)

Sixty cases of acute lumbar sprain were treated by puncturing Yintang（Ex-HN 3） toward Shenting（GV 24）, among which, 50 cases were cured, 9 were improved and only one failed, and the total effective rate was 98.3%.

Mechanism of the acupoints of the governor vessel in treatment of post-stroke depression on the base of the specificity of meridian points

Focusing on the effect specificity of meridian points along the running course of meridian,by taking the treatment of post-stroke depression(PSD)with the acupoints of the governor vessel as an example,the correlation between meridian points and disease was explored.The specific regulatory effect of governor vessel,Baihui(百会GV20)and Shenting(神庭GV24)in physiology and pathology in PSD and the material basis of the specificity effect were analyzed.Finally,the specific relationship between the acupoints of the governor vessel and PSD was explained.

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。

“调神四穴”的理论探索与临床应用

"神"的异常会影响气血运行而诱发各种疾患,王丽平善于使用百会、神庭、印堂、承浆四穴先调患者的"神",通过安神定志的方法,对治疗起到极大的作用。操作方法:取1寸针,百会、神庭逆经斜刺,印堂顺经斜刺,承浆直刺,进针深度透皮即可,为了减轻患者疼痛感,无需手法补泻,留针20 min。王丽平将"调神四穴"运用于临床,治疗多动症、中风、不寐、癫痫、痴呆、头痛及郁证,可以得到事半功倍的效果。

电针百会穴、神庭穴对血管性认知功能障碍的临床研究

目的:观察针刺百会穴、神庭穴对非痴呆型血管性认知功能障碍(VCIND)的临床疗效。方法:选取2011年1月至2017年1月福建中医药大学附属康复医院收治的VCIND患者60例纳入研究,按照随机数字表法随机法分为对照组和观察组,每组30例。2组患者均接受内科常规治疗,如控制血压、调节血糖、改善循环、营养神经、改善脑代谢等。同时接受肢体运动功能康复训练及认知训练,观察组在上述治疗方案基础上加电针百会穴及神庭穴,1次/d,45 min/次,5次/周。2组均连续治疗8周。比较2组患者治疗前后欧洲五维健康量表(EQ-5D-5L)评分量表、简易精神状态量表中文版(MMSE)、蒙特利尔认知评估量表北京版(MoCA)、Barthel指数(MBI)以及时间相关电位(P300)中潜伏期及波幅的变化。结果:1)经过为期8周的治疗,2组患者(EQ-5D-5L)评分均有所升高,与治疗前比较差异有统计学意义(P <0. 05)。2)治疗后2组MMSE评分以及MBI评分均较治疗前有所提升,其中观察组改善的幅度较对照组明显,差异有统计学意义(P <0. 05)。3)治疗后2组Mo CA总评分有明显提升,视空间与执行能力、注意力、命名能力、语言能力、抽象、延迟记忆力及定向力的各项评估中亦发现有明显提升,其中观察组改善的幅度较对照组明显,差异有统计学意义(P <0. 05); 4)治疗后2组P300潜伏期均有所缩短,波幅均有所增加,与治疗前比较差异有有统计学意义(P <0. 05),其中观察组改善的趋势较对照组明显,差异有有统计学意义(P <0. 05)。结论:电针百会穴及神庭穴可明显改善VCIND认知能力,提升患者的生命质量。

电针后留针联合认知训练治疗脑卒中后认知功能障碍:多中心随机对照试验

目的:比较电针后留针联合认知训练与电针联合认知训练治疗脑卒中后认知功能障碍(PSCI)的临床疗效。方法:将206例PSCI患者随机分为留针组(103例,脱落9例)和电针组(103例,脱落6例)。两组患者均接受常规内科基础治疗及康复治疗,留针组予神庭、百会电针治疗(前15 min连续波,频率50 Hz,后15 min疏密波,频率2 Hz/50 Hz)后继续留针1 h,留针期间行认知训练;电针组予相同电针治疗30 min后(不留针)行认知训练。两组均每天1次,每周5次,共治疗8周。分别于治疗前及治疗8周后观察两组患者中医证候积分;于治疗前及治疗4、8周后观察两组患者简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力评分;并于治疗8周后评定两组临床疗效。结果:治疗8周后,两组患者中医证候积分高于治疗前(P<0.05);留针组患者中医证候积分高于电针组(P<0.05)。治疗4、8周后,两组患者MMSE、MoCA、日常生活能力评分均高于治疗前(P<0.05);留针组患者治疗4、8周后MMSE、MoCA评分及治疗8周后日常生活能力评分高于电针组(P<0.05)。留针组总有效率为90.4%(85/94),高于电针组的82.5%(80/97,P<0.05)。结论:电针后留针联合认知训练和电针联合认知训练均可有效治疗PSCI,改善患者临床症状、认知功能和日常生活能力,电针后留针联合认知训练疗效更优。

针刺百会、神庭联合基础治疗和常规康复训练治疗脑卒中后认知障碍:随机对照研究

目的:观察针刺百会、神庭联合康复训练治疗脑卒中后认知障碍(post-stroke cognitive impairment,PSCI)的临床疗效。方法:将50例PSCI患者随机分为观察组与对照组,每组25例。对照组给予基础治疗和常规康复训练,观察组在对照组治疗的基础上加用针刺百会、神庭治疗,每天1次,每周5次,连续治疗4周。观察两组治疗前后简易精神状态检查量表(mini-mental state examination,MMSE)积分和蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)积分的变化。结果:两组治疗后MMSE积分、MoCA积分较治疗前均有显著改善(均P<0.05),且观察组改善程度均优于对照组(均P<0.05)。结论:针刺百会、神庭联合基础治疗和常规康复训练能明显改善PSCI患者的认知功能,且疗效优于基础治疗和常规康复训练。

Moxibustion therapy improving delayed memory deficits via promoting neurogenesis and angiogenesis of hippocampus in a vascular dementia rat model

Objective:To investigate the alteration of delayed memory and its relationship with neurogenesis and angiogenesis in vascular dementia(VD)rats after moxibustion therapy.Methods:Two hundred adult male SPF Wistar rats were chosen for the experiment.Thirty-six rats were randomly selected as the sham operation group.Except for rats in the sham operation group(n=36),the others were made into VD models by bilateral comm on carotid arteries occlusi on(BCCAo).After modeli ng,the 108 survived rats were ran domly divided into 3 groups:a model group,a neural stem cells(NSCs)plus endothelial progenitor cells(EPCs)moxibustion group and a NSCs moxibustion group.Co-transplanted implant was transplanted into the rats in the NSCs plus EPCs moxibustion group,and the rats in the NSCs moxibustion group were transplanted by NSCs only.The NSCs plus EPCs moxibustion group and the NSCs moxibustion group received suspended moxibustion therapy at Baihui(GV 20),Dazhui(GV 14)and Shenting(GV 24),(each group was divided into 3 subgroups by the treatment course as 1,2 and 3 courses).Every group was measured by Morris water maze to evaluate its delayed memory after 3 treatment courses and the rat's brain was taken out after perfusion of 4%paraformaldehyde one day after 1,2 and 3 treatment courses,respectively.Marker protein expression was detected by laser con focal microscope to an a lyze the effect on neuroge nesis and an gioge nesis.Results:VD rats showed delayed memory in Morris water maze test 3 d after ischemic injury.After 3 courses of moxibustion therapy,VD-induced delayed memory deficits were improved in the NSCs plus EPCs moxibustion group and the NSCs moxibustion group.The expressions of nestin,doublecortin(DCX)and CD34 increased significantly in the two moxibusiton groups after every treatment course(all P<0.05),which might contribute to the neurogenesis and angiogenesis in hippocampus.In addition,compared with the rats in the NSCs moxibustion group,the expressions of nestin,DCX and CD34 increased significantly in the NSCs plus EPCs moxibustion group(P<0.05).Conclusion:Moxibustion can reverse VD-induced delayed memory deficits,which may be related to the promotion of neurogenesis and angiogenesis.