A COMPARATIVE STUDY ON THE TREATMENT OF VASCULAR DEMENTIA BY PUNCTURING BAIHUI (GV20), SHUIGOU (GV26) AND SHENMEN (HT7)

Objective: To observe the relative specialty of the therapeutic effect of acupuncture of Baihui (百会 GV 20), Shuigou (水沟 GV 26) a nd Shenmen (神门 HT 7) in the treatment of vascular dementia (VD) patients. Methods: F ifty VD patients were randomly divided into routine treatment group (control gro up), Baihui (GV 20) group (GV 20 group), Shuigou (GV 26) group (GV 26 gr oup), Shenmen (HT 7) group (HT 7 group) a nd GV 20+GV 26+HT 7 group (joint treatment group), with 10 cases in ea ch group. In control group, acupoints used were Jianyu (肩NFDA1 LI 15), Quchi (曲池 L I 11), Waiguan (外关 TE 5), etc. (which were also used in the other four groups) on the paralyzed side. The treatment was conducted once a day except weekends, 20 session s all together. Clinical Dementia Rating Scale (CDR), Mini-Mental State Examin at ion (MMSE) test, Blessed Dementia Rating Scale (BDR) and Clinical Neurological D eficit Rating (CNDR) were used to assess the patients’ intelligence state befor e and after acupuncture treatment. Results: After acupuncture tr eatment, the VD patients’ intelligence in all the five groups was improved at different degrees . Additional acupuncture of each of GV 20, GV 26 and HT 7 had a remarkable e ffec t in improving the VD patients’ fluid intelligence, and could obviously promote their abilities of temporal orientation, spatial orientation and figure drawing ; and additional joint acupuncture of the three acupoints could improve their co gnitive and non-cognitive functions, such as reducing the severity of dementia , raising the temporal orientation, spatial orientation, calculation, short-term m emory and figure drawing abilities, and improving their activities of daily livi ng and personality. Besides, acupuncture of GV 20 could improve the abilities of calculation and short term memory, and correct the personality change of VD pat ients, while acupuncture of GV 26 could improve the abilities of naming and sh or t-term memory. Conclusion: Acupuncture of GV 20, GV 26 and HT 7 all had a certai n therapeutic effect in improving VD; the therapeutic effects of acupuncture of GV 20 and GV 26 were better than that of acupuncture of HT 7; and the effica cy of the three points used in combination was the best.

A Comparative Study on the Acupoints of Specialty of Baihui, Shuigou and Shenmen in Treating Vascular Dementia

Objective： To study the relative specialty of the acupoints of Baihui （DU20）, Shuigou （DU26） and Shenmen （HTT） in treating vascular dementia （VD）. Methods： Fifty patients suffering from VD were divided into 5 groups randomly and treated by conventional acupuncture for hemiplegia, or conventional acupuncture plus needling in DU20, DU26, HT7 respectively or simultaneously. Clinical symptoms were observed, and the scales such as Hasegawa＇s dementia scale-recension （HDS-R）, activities of daily living （ADL） and functional activities questionnaire （FAQ） were used for assessment before and after acupuncture treatment. The scores were processed statistically. Results： DU20 and HT7 could improve the abilities of memory, orientation, reaction and reduce adamancy and trance. Bedsides, DU 20 was helpful in improving the abilities of understanding, calculating and social adapting. While DU26 is helpful in treating retardation, failure in daily activities, trance and poor memory. The combination of the 3 acupoints could improve the intelligence and social adapting ability of VD patients. Conclusion： DU20, DU26 and HT7 had its own effect in treating VD, but the effect of three points used in combination was the best.

Effects of different frequencies of electro-acupuncture at Shuigou(GV 26) on recovery of motor function in rats with focal cerebra ischemic injury

OBJECTIVE:To investigate the effects of different frequencies of electro-acupuncture at Shuigou(GV 26) on the latent period and wave amplitude of motor evoked potentials(MEPs) in rats with focal cerebral infarction.METHODS:Fifty healthy male Wistar rats were randomly divided into five groups:controls,model,2 Hz Shuigou,50 Hz Shuigou and 100 Hz Shuigou.There were 10 rats in each group.Using a modification of a technique for middle cerebral artery occlusion,focal cerebral ischemic injury was induced in all rats except those in the control group.The rats in the control group received no treatment.After behavioral deficit had been evaluated using the Zausinger 6-point neurological function score,therats in the Shuigou groups underwent acupuncture and continuous wave stimulation at a frequency of 2 Hz,50 Hz or 100 Hz(intensity 1 mA) for 10 min twice daily for 3 days.The control and model groups underwent no intervention.Zausinger 6-point neurological function score and MEPs were measured 72 h after the start of treatment.RESULTS:The neurological function scores of the three Shuigou groups were significantly higher than those of the model group(P<0.05).There was no significant difference between sides in the latency and amplitude of MEPs in the model group(P> 0.05).The latency on the affected side in the model group was significantly longer than that in the control group(P<0.05) and the amplitude on affected side was significantly reduced(P<0.01).After 3 days of electro-acupuncture,the latency on the affected side in the 2 Hz Shuigou group was significantly shortened(P<0.05) and the amplitude was significantly increased(P<0.05) compared with the model group.CONCLUSION:Low frequency electro-acupuncture at Shuigou(GV 26) can promote recovery of motor function after focal cerebral ischemic injury in rats.

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.

电针“水沟”与“井穴”对全脑缺血大鼠脑组织钙调素活性影响的对比研究

目的 :观察电针“水沟”与“井穴”对全脑缺血大鼠脑细胞内活性钙调素 (CaM )含量的影响。方法 :采用大鼠全脑缺血再灌注模型 ,用磷酸二脂酶法测定电针后正常对照组、模型对照组、电针“水沟”穴组、电针“井穴”组、假手术对照组脑组织活性CaM的含量。结果 :脑缺血后脑组织活性CaM含量明显升高 ,电针刺激“水沟”和“井穴”均可使大鼠缺血区脑组织活性CaM含量明显降低 ,两组无显著性差异。结论 :电针“水沟”与“井穴”均能明显降低活性CaM的含量 。

“水沟”穴最佳刺激参数的筛选研究

目的:了解针刺参数对针效的影响,探讨"醒脑开窍"针刺法中水沟穴最佳刺激参数。方法:复制大鼠大脑中动脉缺血模型(MCAO),以针刺频率的慢、中、快(1、2、3次/秒)和针刺时间的短、中、长(5 s、60 s、180 s)的两因素三水平针刺参数搭配组合9种针刺方法刺激"水沟"穴,以脑血流量为效应指标,通过正交试验、析因分析、单因素方差分析,综合分析不同针刺手法作用于"水沟"穴对MCAO大鼠脑血流量的影响。结果:针刺效应受针刺频率、时间以及它们两者的交互作用影响,其中,针刺时间影响作用最大。尽可能长时间地应用最快频率针刺,可取得最佳针刺效应。结论:"醒脑开窍"针刺法中"水沟"穴的操作是快频率、足够长时间的针刺(雀啄手法以眼球湿润为度),可取得最佳效应。此法是"水沟"穴最佳刺激参数。

电针水沟穴抗轻、中度休克：多中心随机对照研究

目的:探讨电针水沟穴抗轻、中度休克的作用。方法:采用3中心分层随机对照研究方法,将276例患者随机分为针药组(138例)、西药组(138例)。西药组仅给予西医常规治疗,针药组在给予西医常规治疗的同时,电针水沟穴,观察治疗6小时后的疗效。结果:针药组可即刻升高血压,升压起效时间早于西药组(P<0.001)。针药组显效率为52.9%,高于西药组的18.1%(P<0.001)。结论:在西药基础上电针水沟穴治疗轻、中度休克疗效优于单纯西药。

百会、水沟、神门影响血管性痴呆患者认知功能的比较研究

目的:探讨百会、水沟、神门改善血管性痴呆(VD)患者认知功能的相对特异性。方法:50例VD患者,随机分为5组,分别施以针对偏瘫的常规穴位针刺,常规穴位加用百会穴,加用水沟穴,加用神门穴,加用百会、水沟和神门穴。治疗前后运用老年认知功能量表(SECF)进行测评,评分结果纳入统计学处理。结果:常规穴位加用百会、水沟、神门等穴位治疗后,SECF总分有显著提高;加用百会穴治疗后,VD患者的定向、瞬间记忆、长回忆、动物名、划销和计算、分类与类同等方面评分有明显提高;加用水沟穴治疗后,VD患者的定向、划销和计算、分类与类同等方面评分有明显提高;加用神门穴治疗后,VD患者的数字广度、动物名、分类与类同等方面评分有明显提高。结论:百会、水沟、神门能够改善VD患者认知功能,三穴虽然分别有各自的相对特异性,但联合运用效果最佳。

醒脑开窍针法中水沟穴作用探讨

目的 :探讨水沟穴在醒脑开窍针法中的作用。方法 :根据文献及现代医学机理 ,对针刺水沟穴在中风急性期和恢复期、后遗症期的作用进行分析。结果 :中风急症期可醒脑神、开清窍 ,中风恢复期、后遗症期以调神作用为主 ,其作用机制 ,在于针刺刺激了穴周的面神经、三叉神经分支 ,激活了三叉神经—脑血管系统 ,一方面兴奋脑神经元 ,另一方面 ,改善了脑血流。其刺激的量化标志就是流泪。

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。

针刺与药物结合治疗小儿热性惊厥临床观察

目的:探寻治疗小儿热性惊厥的有效疗法。方法:将70例热性惊厥患儿随机分成两组,针药组(36例)采用针刺醒脑开窍法以水沟穴为主,配合鲁米那肌肉注射、安定静脉推注;药物组(34例)单纯采用肌肉注射鲁米那、安定静脉推注。观察两组疗效、止惊起效时间及复发率。结果:针药组总有效率为86.1%,优于药物组的79.4%;在止惊起效时间上,针药组明显短于药物组(P<0.01),且针药组复发率低于药物组(P<0.05)。结论:针刺配合肌肉注射鲁米那、静脉推注安定治疗热性惊厥是一种快速、有效、安全的方法。

素髎、水沟穴主治机理新释

目的:对素髎、水沟穴的主治机理进行新的阐释。方法:以中医的藏象学说为中心,结合西医解剖学对素、水沟穴的主治机理进行分析。结果:不仅提出五官与五脏之间有相互对应(外形的“复制”)的关系,而且运用这一理论解释了素、水沟穴以及周围(鼻尖、鼻中沟)某些奇穴具有相同主治作用的理由。结论:该思路对发现新的针灸治疗点及确定针刺的角度、方向具有指导意义。

针刺人中穴治疗急性腰扭伤的临床试验研究

目的:针刺人中穴治疗急性腰扭伤,为腧穴主治提供临床依据。方法:对患者240例,按照随机方案选择患者。针刺人中穴(治疗组120例)、针刺委中穴(对照组120例),并对其疗效进行分析。结果:试验组:总有效率95.83%;对照组:总有效率86.67%;两组总疗效比较有统计学意义,试验组好于对照组(P<0.05)。结论:针刺治疗急性腰扭伤效果明显,取穴人中疗效优于委中。

针刺水沟穴干预治疗急诊抽搐休克

目的 :探讨针刺水沟穴治疗急诊抽搐昏迷休克 ,为安全而有效的开展急救针灸治疗提供依据。方法 :使用针刺水沟穴和安定注射两种方法 ,比较镇静止惊抗休克效果。结果 :6 8例即效 ,14例显效 ,2例无效。结论 :通过观察 。

水沟穴古代文献应用分析

目的通过对水沟穴古代文献的整理,总结出水沟穴的应用规律。方法以《中华医典》(第4版)收录的1000部书籍为检索范围,对水沟穴主治病证、腧穴配伍、配伍主治病证、刺灸方法、刺激量等进行系统、规范整理,建立数据库。结果总结出关于水沟穴主治应用条文425条,涉及171部古籍,水沟穴配伍的使用频次为240次,与水沟穴配伍的腧穴共计109个。结论配伍前10位的穴位为合谷、百会、足三里、上星、承浆、气海、颊车、风府、中脘、委中。常用的针刺深度为刺4分,常用的灸量为灸3壮。

针刺百会、人中穴对急性脑缺血大鼠模型葡萄糖转运蛋白1、3的影响

【目的】探讨早期针刺治疗对脑缺血模型大鼠局部葡萄糖代谢的调节作用。【方法】将80只3个月龄的SD大鼠随机分为正常组、模型组、2 h针刺组和24 h针刺组4组,每组20只。采用开颅法复制急性脑缺血模型。针刺治疗取百会、人中穴,采用泻法,针刺行针捻转频率120次/min,每隔4 min行针1次,每次行针1 min,总共针刺治疗30 min。2 h针刺组在造模后2 h即开始针刺治疗,在24 h后再次针刺治疗,一共治疗2次;24 h针刺组在模型制备后24 h针刺1次。针刺治疗结束后,大鼠予以神经功能评分,并取材,行2,3,5-氯化三苯基四氮唑(TTC)染色法测定缺血区域梗死面积,采用免疫组织化学法检测缺血脑组织葡萄糖转运蛋白(GLUT)1、3的表达。【结果】模型组大鼠神经功能评分指数较正常组升高,TTC染色结果显示左侧大脑半球肿胀,梗死体积明显大于对侧,免疫组织化学结果显示缺血脑组织区域GLUT1和GLUT3免疫阳性物较正常组增多(P<0.01)。与模型组比较,2 h针刺组和24 h针刺组均能有效改善脑缺血状况,降低神经功能评分指数,减少TTC染色后的梗死面积,增加缺血脑组织区域GLUT1和GLUT3蛋白表达(P<0.05),而2 h针刺组疗效优于24 h针刺组(P<0.05)。【结论】针刺可以有效改善急性脑缺血大鼠脑缺血损伤。针刺改善缺血性脑组织的能量代谢作用可能是通过上调脑内GLUT1和GLUT3的蛋白表达,提高葡萄糖的血脑屏障转运效率,从而促进葡萄糖代谢,为缺血性脑组织提供能量以延缓供能的相对不足,对抗脑缺血损伤。早期以针刺干预调节脑缺血大鼠能量代谢可以起到积极效果。

Electroacupuncture improves neurovascular unit reconstruction by promoting collateral circulation and angiogenesis

Acupuncture at Shuigou（GV26） shows good clinical efficacy for treating stroke, but its mechanism remains poorly understood. In this study, a cerebral infarction model of ischemia/reperfusion injury received electroacupuncture at GV26（15 Hz and 1 m A, continuous wave [biphasic pulses], for 5 minutes）. Electroacupuncture effectively promoted regional cerebral blood flow on the infarct and non-infarct sides, increased infarct lesions, lectin, and number of blood vessels, upregulated von Willebrand factor and cell proliferation marker Ki67 expression, and diminished neurological severity score. These findings confirm that electroacupuncture at GV26 promotes establishment of collateral circulation and angiogenesis, and improves neurological function.

电针水沟穴对高血压性脑出血模型大鼠神经元保护作用的动态观察

目的:探讨电针水沟穴对急性高血压性脑出血模型大鼠脑组织超微结构的影响。方法:参照胶原酶加肝素脑内尾状核联合注射的方法造模。WKY大鼠分为6h、1d、3d、7d对照组。受试SHR大鼠分为模型6h、1d、3d、7d组;假手术6h、1d、3d、7d组;电针6h、1d、3d、7d治疗组。分别在6h、1d、3d、7d用光镜和电镜观察各组大鼠脑组织结构的变化情况。结果:模型组大鼠6h即出现明显的脑组织超微结构改变,模型1d组超微结构病变进一步加重,模型3d组较1d模型组脑组织超微结构病变有所改善,模型7d组超微结构病变与模型6h组相仿。治疗各组与相应模型组比较,大脑皮层神经细胞细胞器肿胀程度减轻,电针7d组,细胞膜结构完整,大部分细胞器结构完整,个别线粒体还存在肿胀,细胞核双层结构,核仁清晰,部分细胞存在异染色质轻微增多现象。结论:电针水沟穴可明显改善高血压性脑出血大鼠脑组织超微结构的损害,这可能是电针水沟穴促进神经功能修复的机制之一。

针刺水沟穴、百会穴联合足运感区对脑卒中恢复期患者肢体功能、颅内血流动力学的影响

目的:观察针刺水沟穴、百会穴联合足运感区对脑卒中恢复期患者肢体功能、颅内血流动力学的影响。方法:选取163例脑卒中恢复期患者,按随机数字表法分为足运感区组81例及联合针刺组82例。足运感区组针刺足运感区治疗,联合针刺组给予针刺水沟穴、百会联合足运感区进行治疗。比较2组临床疗效,比较2组治疗前后神经营养素-3(NT-3)、神经生长因子(NGF)水平、中医证候评分、颅内血流动力学[收缩峰血流速度(Vs)、舒张末血流速度(Vd)、平均血流速度(Vm)]指标值、美国国立卫生研究院卒中量表(NIHSS)评分的变化。结果:治疗后,2组NT-3、NGF水平均较治疗前上升,联合针刺组NT-3、NGF水平高于足运感区组(P<0.05)。治疗后,2组中医证候主症评分、总分均较治疗前下降(P<0.05),联合针刺组主症评分、总分均低于足运感区组(P<0.05)。治疗后,2组Vs、Vd、Vm指标值均较治疗前上升(P<0.05),联合针刺组Vs、Vd、Vm指标值高于足运感区组(P<0.05)。治疗后,2组NIHSS上肢评分、NIHSS下肢评分均较治疗前下降,联合针刺组NIHSS上肢评分、NIHSS下肢评分均低于足运感区组(P<0.05)。联合针刺组临床疗效为97.56%,足运感区组为91.12%,2组比较,差异有统计学意义(P<0.05)。结论:针刺水沟穴、百会联合针刺足运感区治疗脑卒中恢复期,能恢复患者上下肢肢体功能,改善颅内血流动力学,临床疗效较好。

Electroacupuncture induces acute changes in cerebral cortical mi RNA profile, improves cerebral blood flow and alleviates neurological deficits in a rat model of stroke

Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters mi RNA expression in the cortex. In this study, we examined changes in the cerebral cortical mi RNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong（GV26） and Neiguan（PC6）, with a frequency of 2 Hz, continuous wave, current intensity of 3.0 m A, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. mi RNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-mi R-206-3p, rno-mi R-3473, rno-mi R-6216 and rno-mi R-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated mi RNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke.