CLINICAL OBSERVATION ON 32 CASES OF FUNCTIONAL ENURESIS TREATED WITH ACUPUNCTURE AT BAIHUI(GV 20)

Acupuncture at Baihui（GV 20）was employed in treating 32 cases of functionalenuresis.As a result,the curative rate reached 81.25％,but that in control group of 32 cases withoutneedling Baihui point was 56.25％.There was a significant difference in statistics（P【0.05）.It indi- cates that Baihui can enhance the therapeutic effect of acupuncture on treating enuresis.

针刺百会、曲鬓穴对急性期脑出血大鼠的影响及其作用机制研究

目的 观察针刺百会、曲鬓穴对急性期脑出血(ICH)大鼠白细胞分化抗原36(CD36)、Toll样受体4(TLR4)表达的影响,探讨针刺治疗脑出血的作用机制。方法 选择144只Wistar雄性大鼠,采用随机数字表法分为假手术组、模型组、针刺组、抑制剂组4组,每组36只,每组按1、3、7 d时间点再分为3个亚组,每组12只。采用立体定位自体血注入法建立ICH大鼠模型。模型组仅接受ICH模型制备,不进行任何治疗;假手术组接受类似模型组各项手术操作,但不进行注血制作;抑制剂组造模后6 h,腹腔注射TLR4抑制剂TAK242,3 mg/kg,1次/d,连续5 d;造模12 h后,针刺组各亚组开始接受针刺治疗,穴位选择百会穴(顶骨正中)、右侧曲鬓穴,采用透刺方法,进针深度20 mm,以100 r/min小幅度捻转,持续捻转2 min,每间隔5 min捻针1次,共留针30 min,期间捻转3次,1次/d,针刺组各亚组分别治疗1、3、7 d。分别于治疗后第1、3、7天,采用改良神经功能缺损评分(mNSS)评估大鼠神经功能;检测脑组织血肿体积;采用Western blot法检测脑组织CD36、TLR4蛋白表达水平;采用免疫荧光法观察CD36、TLR4在星形胶质细胞中的表达。结果 (1) mNSS评分:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1 d mNSS评分明显降低(P<0.05)。(2)血肿体积:与模型组同一时间点比较,针刺组、抑制剂组治疗后3、7 d脑血肿体积均明显降低,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05)。(3) CD36、TLR4蛋白表达水平:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d CD36、TLR4蛋白表达水平均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高(P<0.05),针刺组、抑制剂组治疗后3、7 d TLR4蛋白表达水平均明显降低(P<0.05);与针刺组比较,抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高,TLR4蛋白表达水平均明显降低(P<0.05)。(4) CD36、TLR4在GFAP中的表达水平:假手术组大鼠脑组织内可见少量CD36、TLR4表达。与假手术组同一时间点比较,模型组治疗后1、3、7 d CD36、TLR4在GFAP表达均明显增加(P<0.05);与模型组同一时间点比较,抑制剂组、针刺组治疗后1、3、7 d CD36在GFAP表达明显增加,TLR4在GFAP表达明显降低(P<0.05)。结论 针刺百会、曲鬓穴可以改善急性期ICH大鼠神经功能,减轻脑出血血肿体积,可能与促进CD36蛋白表达、抑制TLR4蛋白表达有关。

Clinical Applications of Acupoints Baihui （GV 20） and Sishencong （Ex-HN 1）

Through clinical practice over the last decade, , I have been using Baihui （GV 20） and Sishencong （Ex-HN 1） for treating various diseases or symptoms. It is now reported as follows.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

《史记·扁鹊仓公列传》“外三阳五会”新考

在既往研究基础之上,结合《素问·缪刺论篇》《针灸甲乙经·缪刺》及出土汉代医简等现有证据,并基于胡天雄、黄龙祥的学术观点,考证《史记·扁鹊仓公列传》中“外三阳五会”具体指代何经、何穴。认为《素问·缪刺论篇》尸厥一条与《史记·扁鹊仓公列传》关系密切,应采录自扁鹊医书,但因传世本《素问·缪刺论篇》对扁鹊医书原文抄录有误,具体为心主之误、阴阳之误、穴位之误,造成了“外三阳五会”解读上的错误。经考证与校订,认为“外三阳五会”所指应为关冲、足窍阴、少泽、至阴、厉兑五穴。

Forty Cases of Insomnia Treated by Suspended Moxibustion at Baihui (GV 20)

Objective： To observe the therapeutic effect of suspended moxibustion at Baihui （GV 20） for insomnia. Methods： 75 cases were divided randomly into two groups, with 40 cases in the treatment group treated by suspended moxibustion over Baihui （GV 20） and 35 cases in the control group treated by oral administration of Estazolam. Results： The difference in therapeutic effect between the two groups was not statistically significant （P〉0.1）. Conelusion： It was concluded that suspended moxibustion at Baihui （GV 20） is as effective as Estazolam for insomnia.

Effect of long-time needle retaining at Baihui(GV 20) on cognitive impairment in post-stroke patients

Objective： To observe the clinical efficacy of long-time needle retaining at Baihui（GV 20） in treating post-stroke cognitive impairment. Methods： A total of 60 eligible patients with post-stroke cognitive impairment were randomized into a treatment group and a control group by random digital table, 30 cases in each group. The control group was intervened by basic treatment including routine therapy in Neurology department and Western medicine rehabilitation therapy, while the treatment group was intervened by same treatment in the control group combined with long-time needle retaining at Baihui（GV 20）. Mental state of patients was evaluated by National Institute of Health stroke scale（NIHSS） and mini-mental state examination（MMSE） after 4 weeks of treatment. Results： After 4-week treatment, the NIHSS score dropped in both groups, and intra-group comparisons showed statistical significances（both P〈0.05）, and the score in the treatment group was statistically lower than that in the control group（P〈0.01）; the MMSE score in the treatment group was significantly higher than that in the control group, there was a statistical inter-group difference（P〈0.01）; the total effective rate was 93.3%, and the marked effective rate was 50.0% in the treatment group, versus 76.7% and 20.0% in the control group, there were significant differences in the total effective rate and the marked effective rate between the two groups（all P〈0.05）. Conclusion： Long-time needle retaining at Baihui（GV 20） can produce a safe valid therapeutic efficacy in treating post-stroke cognitive impairment.

Comparative Study on the Effect of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） on Cognition of Patients with Vascular Dementia

Objective： To study the relative specificity of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） in improving the cognitive function of patients with vascular dementia （VD）. Method： Fifty VD cases were randomized into 5 groups, which were treated with routine points, routine points plus Baihui （GV 20）, routine points plus Shuigou （GV 26）, routine points plus Shenmen （HT 7）, and routine points plus the above-mentioned three points together respectively. The scale of elderly cognitive function （SECF） was measured before and after the treatment for statistical management. Results： The total score of SECF was markedly increased after Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） were added to the routine points, more specifically, with addition of Baihui （GV 20）, the patients with VD got increased scores in such aspects as orientation, instant memory, long-term anamnesis, animal names, cancellation and calculation, and classification and analogy; with addition of Shuigou （GV 26）, the patients with VD got increased scores in such aspects as orientation, cancellation and calculation, and classification and analogy; with addition of Shenmen （HT 7）, the patients with VD got increased scores in such aspects as digital scope, animal names, and classification and analogy. Conclusion： Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） could improve the cognitive function of patients with VD, and the combination of the three points got the best result despite their respective specificity.

Clinical Observation on Suspended Moxibustion at Baihui （GV 20） for Insomnia

Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients＇ daily life, work and study, so it should be treated as early as possible. A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs. The author treated insomnia with suspended moxibustion at Baihui （GV 20）, the report is as follows.

Clinical observation on moxibustion at Baihui(GV20)plus Tuina for children with postnasal drip syndrome

Objective:To observe the clinical efficacy of moxibustion at Baihui(GV20)plus Tuina(Chinese therapeutic massage)for children with postnasal drip syndrome(PNDS).Methods:A total of 60 cases were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9%normal saline.Cases in the observation group received additional moxibustion at Baihui(GV20)plus Tuina at the head and face.All the cases were treated for four consecutive weeks.The clinical efficacy and traditional Chinese medicine(TCM)symptoms score were compared between the two groups.Results:The total effective rate of the observation group was 93.3%while that of the control group was 70.0%.The difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups declined significantly,showing a statistical difference from that before treatment(P<0.05),and the score of the observation group was notably lower than that of the control group(P<0.05).Conclusion:The clinical efficacy of moxibustion at Baihui(GV20)plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

艾灸健康人百会穴对大脑中动脉血流速度的影响

目的 :探讨艾灸百会穴治疗缺血性脑血管病的机理。方法 :选择本校健康男性学员 30名 ,应用美国AcusonSequoia 51 2型超声诊断仪 ,分别于艾灸百会穴前后测试双侧大脑中动脉最大血流速度(Vmax)、最小血流速度 (Vmin)、搏动指数 (PI)、阻力指数 (RI)等血流动力学有关参数。结果 :艾灸百会穴 5天后 ,左侧大脑中动脉Vmax、PI、RI及右侧大脑中动脉Vmax、Vmin增加非常显著 (P <0 0 1 ) ,其余各项指标虽有不同程度的改变 ,但无统计学意义。结论 :艾灸百会穴可使大脑中动脉血流速度明显加快 ,血管搏动指数增加 ,脑血流量增加 。

电针百会印堂穴在精神科的应用

目的 :将我国近年来电针百会穴对精神疾病的临床治疗及研究进行综述。方法 :从抑郁症、精神分裂症、神经症、其他精神障碍及电针治疗机理的实验室研究等 5个方面综述。结果 :电针治疗抑郁症已被众多的临床和基础研究所证实。治疗神经症、精神分裂症及其他精神障碍也取得了一定的疗效。结论 :电针治疗是一种疗效好、无副作用、安全、经济、操作简便、受病人及家属欢迎的治疗精神疾病的新疗法。

针刺配合艾灸百会穴治疗中风后失眠疗效观察

目的观察针刺配合艾灸百会穴治疗中风后失眠的临床疗效。方法将65例中风后失眠患者随机分为治疗组33例和对照组32例。治疗组采用针刺配合艾灸百会穴治疗,对照组采用常规针刺治疗。观察两组治疗前后SPIEGEL量表评分及脑卒中专用生活质量量表(SS-QOL)评分变化情况,并比较两组临床疗效。结果两组治疗后SPIEGEL量表评分和SS-QOL评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SPIEGEL量表评分和SS-QOL评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为93.9%,对照组为68.8%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合艾灸百会穴是一种治疗中风后失眠的有效方法。

百会、水沟、神门治疗血管性痴呆的比较研究

目的比较百会、水沟、神门治疗血管性痴呆(VD)的相对特异性。方法50例血管性痴呆患者,随机分为5组,A组治以常规穴位针刺,在A组基础上B组加用百会、C组加用水沟,D组加用神门,E组加用百会、水沟和神门3穴。治疗前后均观察临床症状的变化,并运用修订长谷川痴呆量表、日常生活活动量表、社会功能活动调查等量表进行测评,评分结果进行统计学处理。结果百会、神门能够改善VD患者记忆、定向、反应、固执、恍惚等方面的症状,百会长于帮助患者理解、计算、适应社会;水沟则偏重于针对VD患者喜睡嗜卧、反应迟钝、神思恍惚、记忆等症状的改善;百会、水沟、神门3穴联合运用,对于VD患者的智力水平、社会适应能力有着较为全面的改善。结论百会、水沟、神门3穴在改善VD患者临床症状和智力水平方面各有其相对特异性,3穴联合运用疗效最佳。

针刺百会穴对急性脑血肿大鼠局部脑血流量的影响

目的 观测急性脑血肿大鼠局部脑血流量的改变及头穴针刺后局部脑血流量和神经功能症状的变化。方法 应用L S-III型组织血流测定仪 ,选用临床上治疗脑出血常用的“百会”穴。结果 实验大鼠造模组与正常组及假手术组对比不同时刻局部脑血流量均明显下降 ( P<0 .0 1) ,而造模组与针刺组对比即刻局部脑血流量无显著性差异 ,而在 1h,4h局部脑血流量有显著性差异 ( P<0 .0 1)。另外造模组与针刺组对比神经功能症状在 1h有显著性差异 ( P<0 .0 1) ,经相关分析可见 1h局部脑血流量与神经功能症状存在负相关关系。结论 急性脑血肿大鼠局部脑血流量明显下降 ,经百会针刺后局部脑血流量的下降得到有效的改善 。

电针百会穴对脑梗死后认知障碍患者听觉P300的影响

目的观察电针百会穴对脑梗死后认知障碍患者听觉事件相关电位P300的影响。方法将59例脑梗死患者随机分为治疗组30例和对照组29例。治疗组采用电针配合认知功能训练治疗,对照组采用单纯认知功能训练治疗。比较两组治疗前后蒙特利尔认知评价量表(MoCA)评分及P300检测情况。结果两组患者治疗后MoCA量表各项评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。除言语项目外,治疗组患者治疗后MoCA量表各项评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后P300潜伏期、波幅与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后P300潜伏期、波幅与对照组比较,差异均具有统计学意义(P<0.05)。P300潜伏期与MoCA评分呈负相关性,P300波幅与MoCA评分呈正相关性。结论电针百会能改善脑梗死后认知障碍患者的认知功能。

百会穴久留针治疗椎动脉型颈椎病疗效观察

目的:观察百会穴久留针与常规留针治疗椎动脉型颈椎病的疗效差异。方法:将120例椎动脉型颈椎病患者随机分为治疗组和对照组各60例。治疗组采用百会穴久留针8小时和局部穴位电针疗法;对照组采用百会穴留针时间30分钟和局部穴位电针疗法。结果:治疗组治愈率为70.0%,总有效率为98.3%;对照组治愈率为45.0%,总有效率为86.7%,两组比较,治愈率和总有效率差异有非常显著或显著性意义(P<0.01,P<0.05)。结论:百会穴久留针治疗椎动脉型颈椎病有较好疗效。

针刺涌泉、重灸百会对局灶性脑缺血大鼠VEGF表达的影响

目的探讨针刺对缺血性脑卒中的作用机制。方法将雄性Wistar大鼠40只,随机分为模型组和针灸组,每组20只。以线栓法闭塞大脑中动脉(middle cerebral artery occlusion,MCAO)制作局灶脑缺血再灌注损伤模型。采用免疫组织化学染色SABC法检测缺血脑组织血管内皮细胞生长因子(VEGF)蛋白表达,RT-PCR法检测缺血脑组织VEGF mRNA表达,TTC染色测定脑梗死面积。结果脑组织VEGF mRNA表达与模型组相比,针灸组缺血半暗带区VEGF mRNA表达明显增强,差异有统计学意义(P<0.05);脑组织VEGF蛋白表达与模型组相比,针灸组VEGF蛋白表达明显增强,差异有统计学意义(P<0.05);模型大鼠的脑组织出现大面积梗死灶,与正常组比较,差异明显(P<0.01);与模型组比较,针灸组脑梗死面积明显缩小,差异有统计学意义(P<0.01)。结论针刺涌泉、重灸百会能显著增强脑组织VEGF蛋白及VEGF mRNA表达,促进缺血半暗带区血管生成,这可能是针灸治疗脑缺血的作用机制之一。

艾灸健康人百会穴对右侧大脑中、后动脉血流动力学影响的研究

目的 :探讨艾灸百会穴治疗缺血性脑血管病的机理。方法 :选择本校健康男性学员 3 0名 ,年龄 2 0～ 2 2岁之间 ,应用美国AcusonSequoia51 2型超声诊断仪 ,探头频率 4 0MHz,由固定专人操作 ,分别于艾灸前及艾灸后 ,测试右侧大脑中、后动脉Vmax(最大血流速度 )、Vmin(最小血流速度 )、PI (搏动指数 )、RI (阻力指数 )等血流动力学有关参数。结果 :艾灸百会穴 5天后 ,右侧大脑后动脉Vmin增加显著 (P <0 0 5) ,右侧大脑中动脉Vmax、Vmin及右侧大脑后动脉Vmax、PI、RI增加非常显著 (P <0 0 1 ) ,右侧大脑中动脉PI、RI各指标虽有不同程度的改变 ,但无统计学意义。结论 :艾灸百会穴可使右侧大脑中、后动脉血流速度明显加快 ,脑血流量增加 ,脑部血液循环明显改善。这对揭示艾灸百会穴治疗缺血性脑血管病的机理具有重要意义。

艾灸健康人百会穴对脑血管血液动力学的影响

目的：探讨艾灸百会穴治疗脑血管病的可能机制。方法：选择本校健康男性学员30名,年龄20-22岁。取百会穴,悬起温和灸,每次5-10 min,每日1次,共5次。应用上海麦登电子设备有限公司生产的脑血管血液动力学分析仪（CBA CV-300型）,探头频率5 MHz,由固定专人操作,分别于艾灸治疗前及艾灸治疗后测试脑血管血液动力学各项指标。结果：艾灸百会穴5 d后,受试者收缩压、舒张压及心率虽有不同程度的变化,但与艾灸前比较无统计学差异（P〉0.05）;左右两侧颈总动脉血液Qmean（平均流量）、Vmean（平均流速）及Vmin（最小流速）增加显著（P〈0.01）,脑血管Rv（外周阻力）、DR（动态阻力）明显降低（P〈0.05）。结论：艾灸健康人百会穴可使颈总动脉血流速度明显加快,脑部外周血管阻力明显降低,脑部血液供应明显改善。这对揭示艾灸百会穴治疗缺血性脑血管病的机制具有一定的意义。