EFFECT OF ACUPUNCTURE STIMULATION AT SANYINJIAO (SP 6) ON CEREBRAL GLUCOSE METABOLISM IN DYSMENORRHEA PATIENTS

To study the central mechanism of acupuncture stimulation of Sanyinjiao （三阴交 SP 6） in relieving dysmenorrhea. Methods： A total of 6 dysmenorrhea volunteer patients were subjected into this study. On the first positron emission tomography （PET） scan examination, they were assigned to pseudoacupuncture group by using the acupuncture needle just to prick the skin of Sanyinjiao （SP 6） ; while on the second PET scans, they were assigned to acupuncture group by inserting the needle into the same acupoint. 18F fluorodeoxyglucose （;SF-FDG） PET of the whole brain was performed during pseudo-acupuncture and real acupuncture of Sanyinjiao （SP 6）. The acquired PET data were analyzed by using statistical parametric mapping （SPM） software to determine changes of glucose metabolism in different cerebral regions. The patient＇s pain intensity was rated by using 0-10 numerical pain intensity scale. Results： After pseudo-acupuncture stimulation of Sanyinjiao （SP 6）, no significant changes were found in the pain intensity （ P 〉0.05）, while after real-acupuncture stimulation, the pain intensity declined significantly （ P〈0.01 ）. Following acupuncture of the right Sanyinjiao （SP 6）, multiple cerebral regions involving pain were activated （increase of glucose metabolism）, including ipsilateral lenticular nucleus （globus palliclus, putamen）, ipsilateral cerebellum and insular lobe, bilateral dorsal thalamus, ipsilateral paracentral Iobule, bilateral amygdaloid bodies, contralateral substantia nigra of the midbrain, bilateral second somatosensory （S Ⅱ ） areas, ispsilateral hippocampal gyms, frontal part of the ipsilateral cingulated gyrus, and bilateral mammary bodies of the hypothalamus. In addition, fewer regions of the cerebral cortex responded with decrease of the glucose metabolism after real acupuncture.

Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao(SP 6) in patients with primary dysmenorrhea: A randomized controlled trial

Objective: To explore the analgesic effects and uterine hemodynamics of perpendicular needling(PN)and transverse needling(TN) at SP 6 in patients with primary dysmenorrhea(PD).Methods: In this randomized controlled trial, patients with PD diagnosed with cold-dampness congealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min.Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain(VAS-P). The primary outcome was average menstrual pain(VAS-P). Secondary outcomes included the pulsatility index(PI), resistance index(RI), and systolic-diastolic peaks ratio(S/D) in uterine arteries as measured using color Doppler ultrasonography;anxiety as assessed using the Hamilton Anxiety Rating Scale(HAMA), blood pressure(BP),and heart rate(HR).Results: Forty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores(-5.71 mm, 95% confidence interval(CI): -8.78, -2.63, P =.001), RI values(-0.05, 95% CI:-0.09, -0.01, P=.015), and HAMA values(-2.50, 95% CI: -4.78, -0.22, P=.032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups(P >.05).Conclusion: TN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD.This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.

电针“三阴交”穴对急性胃溃疡家兔的胃黏膜及6-Keto-PGF lalpha的影响

目的:观察电针"三阴交"对急性胃溃疡家兔胃黏膜及6-Keto-PGF lalpha的影响并就其影响机制进行探讨。方法:无水乙醇灌胃,造成家兔急性胃黏膜损伤模型。按照随机数字法将家兔分为空白对照组,模型组,电针组(造模结束后30min电针双侧"三阴交"穴15 min),每组8只。采用非平衡法测定血液中6-Keto-PGF lalpha的含量,Guth计分法对胃黏膜损伤指数进行测定。经过组织切片后HE染色直接观测家兔胃黏膜的组织学改变。结果:与空白组比较,胃溃疡模型组6-Keto-PGF lalpha含量明显降低(p<0.05),胃黏膜损伤指数显著升高(p<0.05),HE染色图组可直接观测到溃疡处组织胃粘膜损伤明显,累及深层固有腺体有明显的出血和充血改变,粘膜表层大面积剥脱:与模型组比较,电针组家兔6-Keto-PGF lalpha含量明显升高(p<0.01),胃黏膜损伤指数显著降低(p<0.01),HE染色图组可直接观测到溃疡处胃粘膜损伤较小,仅累及浅层,有较明显的充血,出血点较少见,粘膜有小范围剥脱。结论:电针"三阴交"穴可以升高胃溃疡型家兔血液中的6-Keto-PGFlalpha含量,降低胃黏膜损伤指数,病理切片示电针组的组织充血,损伤较溃疡组明显减轻。这可能是电针"三阴交"穴在急性胃溃疡时对胃黏膜的保护机制之一。

Effects of electroacupuncture at Guanyuan(CV 4)or Sanyinjiao(SP 6)on hypothalamus-pituitary-ovary axis and spatial learning and memory in female SAMP8 mice

OBJECTIVE: To investigate the effects of electroacupuncture(EA) at the Guanyuan(CV 4) or Sanyinjiao(SP 6) acupoints on the hypothalamus-pituitary-ovary(HPO) axis and spatial learning and memory in female mice.METHODS: Nine-month-old female mice with senescence-accelerated mouse prone 8(SAMP8)were divided into three groups: the disease model,EA-Guanyuan and EA-Sanyinjiao groups. Concurrently, 9-month old female mice with senescence-accelerated mouse resistance 1(SAMR1)were set as the control model group. The two treatment groups were given the same pattern of EA stimulation. Gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone(FSH) and Serum estradiol levels in the Hypothalamus-pituitary-ovary axis were assessed by enzyme-linked immunosorbent assay to determinethe HPO axis function level. Spatial learning and memory were assessed by the Morris Water Maze(MWM) test.RESULTS:(a) HPO axis: compared with the control model group, the disease model group displayed a decrease in E2 levels(P < 0.01), and an increase in Gn RH, LH and FSH levels(P < 0.01). E2 levels were increased in EA treatment groups compared with the disease model group(P < 0.05). In contrast,Gn RH and LH and FSH levels were reduced(P <0.05). EA-Sanyinjiao group was superior than EA-Guanyuan group on increasing E2 and declining Gn RH levels(P < 0.01).(b) The MWM test demonstrated that the response latency in the EA-Sanyinjiao treatment group declined from day 2 to day5 compared with the disease model group(P <0.05), whereas the EA-Guanyuan treatment group showed no significant difference.CONCLUSION: EA can regulate hormone(E2, FSH,LH, Gn RH) levels in the HPO axis and the spatial learning and memory ability in female SAMP8 mice. Moreover, this effect may have been more pronounced in the EA-Sanyinjiao group than the EA-Guanyuan group. The underlying mechanism of the EA-induced changes may be related to gonadal hormone shifts in the HPO axis, followed by an improvement in spatial learning and memory.

Effect of Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)on uterine inertia during painless parturition

Objective:To observe the effect of Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)on uterine inertia during painless parturition.Methods:A total of 100 cases of patients with uterine inertia during painless parturition were randomized into an acupoint group and a medicine group by the SPSS programming,with 50 cases in each group.Patients in the acupoint group received the treatment of Anrou-pressing and kneading bilateral Hegu(LI 4)and Sanyinjiao(SP 6),while patients in the medicine group received intravenous oxytocin.The labor time and maternal-child safety were evaluated,and the labor stage was compared.Results:The latent and active phases in the 1st labor stage and the 2nd labor stage in the acupoint group were substantially shorter than those in the medicine group,and the between-group comparisons showed statistical significance(all P<0.05).The between-group comparison of the 3rd labor stage showed no statistical significance(P>0.05).The postpartum hemorrhage amount in both groups was within the safe range,and the between-group comparison showed no statistical significance(P>0.05).The newborn 1 min Apgar score was ranged 8-10 points,and the between-group comparison showed no statistical significance(P>0.05).The between-group comparison of the labor stage efficacy showed statistical significance(P<0.01),with a better progression in the acupoint group.Conclusion:Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)is both effective and safe for uterine inertia during painless parturition.

电针三阴交治疗围绝经期综合征临床观察

目的:客观评价电针三阴交治疗围绝经期综合征的有效性和安全性。方法:将纳入病例随机分为治疗组和对照组。治疗组采用电针双侧三阴交穴,刺激时间30分钟,每周3次,1个月为一疗程,连续治疗3个疗程。对照组采用口服尼尔雌醇,每次2mg,每月2次,连续用药3个月。对已绝经者,第3个月开始加用甲羟孕酮,每天6mg,连用7天。分别于治疗前、治疗1个月、治疗2个月、治疗3个月后,观察血管舒缩症状、精神神经症状以及Kupperman指数评分变化。结果:电针能明显降低围绝经期综合征患者的Kupperman指数评分,改善血管舒缩症状和精神神经症状,且治疗过程中未见严重不良反应。口服西药在Kupperman指数评分上略高于治疗组,但没有统计学意义,改善血管舒缩症状方面不如治疗组,对精神神经症状的改善方面优于治疗组。结论:电针三阴交治疗围绝经期综合征是有效的、安全的。

电针三阴交对围绝经期综合征患者生殖内分泌影响的随机对照研究

目的：观察电针三阴交对围绝经期综合征患者生殖内分泌的调整作用,为针灸治疗围绝经期综合征提供临床依据和理论依据。方法：将纳入病例采用密闭信封法随机分为电针三阴交治疗组与西药对照组。电针组电针双侧三阴交（2/100 Hz,8-10 mA,30 min,3次/周,共3个月）,西药组口服尼尔雌醇（2 mg/次,2次/月,共3个月）。治疗前后采用化学发光分析法检测血清卵泡刺激素（FSH）、促黄体生成素（LH）和雌二醇（E2）水平,所得数据用意向治疗分析集（ITT）和符合方案分析集（PP）对比分析。结果：电针后,ITT和PP数据集分析表明,患者血清FSH、LH含量显著降低（P〈0.001）,血清E2含量显著升高（P〈0.001）;与西药对照组比较,电针组血清FSH、LH、E2含量显著降低（P〈0.05）。结论：电针三阴交对围绝经期综合征患者生殖内分泌系统的功能具有较好的调整作用。

电针三阴交治疗围绝经期综合征多中心随机对照研究

目的：客观评价针刺三阴交穴治疗围绝经期综合征的临床疗效。方法：采用多中心、随机、对照、单盲临床试验，将175例患者分为针刺组（90例）和西药组（85例）。针刺组采用电针双侧三阴交穴（疏密波，2／100Hz，刺激强度8～10mA），每周治疗3次，1个月为1疗程，连续3个疗程。西药组口服尼尔雌醇，每次2mg，每月2次，连续3个月。对已绝经者，第3个月开始加用甲羟孕酮，每天6mg，连用10d。疗效评价包括：症候积分量表中症状改善程度及血清雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）水平检测（化学发光分析法）。结果：3个中心共纳入175例病例，157例完成试验。针刺组在治疗后患者的疗效评价症状积分均极显著降低（P〈0．01）。针刺组治疗后血清FSH、LH水平显著降低（P〈0．01），血清E2水平显著升高（P〈0．01），且针刺组在LH和E2水平的改善上与西药组相比差异有显著性意义（P〈0．05）。表明电针三阴交能明显改善患者的临床症状，良性调整患者血清性激素水平。电针治疗组和西药对照组之间的显效率和有效率差异均无显著性意义（P〉0．05）。结论：针刺三阴交穴治疗围绝经期综合征有较好的疗效。

针刺三阴交对痛经患者脑葡萄糖代谢的影响

目的:探讨针刺三阴交治疗痛经的中枢作用机制。方法:对6例痛经患者行经疼痛时行右侧三阴交假针刺和针刺,用数字疼痛强度分级法比较刺激前后疼痛情况,并在假针刺和针刺时利用正电子发射断层摄影技术(positronemissiontomograph,PET)对痛经患者行18FFDG脑功能成像,用SPM软件分析,获得针刺激活的脑解剖功能区。结果:假针刺前后疼痛值差异无显著性意义(P>0.05),针刺三阴交后疼痛值比针刺前明显降低(P<0.01)。针刺右侧三阴交引起痛经患者多个与疼痛相关脑区被激活,针刺使同侧豆状核(苍白球、壳)、同侧小脑、同侧岛叶、双侧背侧丘脑、同侧中央旁小叶、双侧杏仁体、对侧中脑黑质、双侧第Ⅱ躯体感觉区、同侧海马回、同侧扣带回前部、对侧下丘脑乳头体葡萄糖代谢增强,大脑皮质小区域葡萄糖代谢降低。结论:针刺三阴交能明显缓解痛经患者疼痛,其机理为针刺三阴交可激活皮质、皮质下边缘系统和小脑与疼痛相关脑区,可能通过平衡与疼痛有关的中枢网络而减轻疼痛,神经内分泌也可能在治疗中起作用。

电针不同穴位对大鼠子宫平滑肌电活动的影响

目的：比较电针不同穴区对子宫肌电活动的影响。方法：共79只Wistar大鼠,包括40只正常未孕和39只已孕18-19 d的临产大鼠,用1.5%氯醛糖（50 mg/kg）和25%乌拉坦（420 mg/kg）混合液腹腔麻醉。前者随机分为对照、内关、合谷、三阴交组,每组10只;后者随机分为对照、内关和三阴交组,每组13只。腹壁切开后,于左侧中段子宫浆膜下埋藏一对针式不锈钢电极,记录子宫平滑肌肌电活动。电针取双侧“内关”“合谷”“三阴交”,刺激参数为：频率2/15 Hz,强度1-2 mA,持续20 min。结果：1）在正常非孕鼠上,与对照组比,电针“三阴交”后,子宫肌电爆发波的频率及幅度、慢波的幅度明显增加（P〈0.05）;电针“合谷”对爆发波的频率有类似“三阴交”的作用;而电针“内关”穴后,爆发波的频率及幅度和慢波的频率明显降低（P〈0.05）。与内关组比较,“三阴交”“合谷”电针期间和停电针后0-5 min大多数指标均有显著性差异（P〈0.05,0.001）。2）在妊娠后期大鼠上,与对照组比,电针“三阴交”后,子宫肌电的爆发波频率和幅度及慢波的幅度增加（P〈0.05）且持久;电针“内关”穴后,子宫肌电爆发波、慢波的频率明显减低（P〈0.05）;两组相比,爆发波的频率和幅度、慢波波幅电针期间和停针后许多时程均有显著性差异（P〈0.05）。结论：电针“三阴交”和“合谷”穴可兴奋子宫平滑肌的电活动,“三阴交”穴的作用更强,而电针“内关”穴则抑制子宫肌的电活动,不同穴位的作用具有相对特异性。

电针合谷、三阴交对药物流产近期副反应的影响

目的：探讨减轻药物流产近期副反应的治疗方法。方法：将90例早孕患者随机分为3组：对照组只服用药物；电针1组在服用米索前列醇后30～60分钟内同时电针合谷、三阴交；电针2组在服用米索前列醇后30～60分钟内依次电针合谷、三阴交。结果：电针组电针后近期副反应减轻程度较对照组明显（P〈0．05），且先电针合谷后电针三阴交减轻腹痛的程度有更为显著的趋势。结论：电针合谷、三阴交可以减轻药物流产近期副反应，其中先电针合谷后电针三阴交减轻腹痛的程度更为显著。

隔药灸脐法治疗原发性痛经临床研究

目的观察隔药灸脐与针刺三阴交穴对原发性痛经患者症状的影响,比较其疗效差异。方法将60例原发性痛经患者随机分为灸脐组和针刺组,每组30例。观察治疗3个月经周期后COX痛经症状评分量表(the Cox Menstrual Symptom Scale)的变化,并比较两组之间的差异。结果灸脐组与针刺组治疗前后COX痛经症状评分比较差异均有统计学意义(P<0.05),且灸脐组疗效优于针刺组(P<0.05)。结论隔药灸脐法治疗原发性痛经疗效较好。

针灸“三阴交”穴择时治疗对脾阳虚家兔免疫功能的影响

目的 :为了探讨针灸择时治疗对免疫功能的影响。方法 :采用苦寒泻下加饥饱失常法造脾阳虚家兔模型 ,然后选择脾经气血盛衰的峰谷时辰巳时、亥时及非峰非谷的申时分别针灸“三阴交”穴 ,检测其T淋巴细胞转化率 ,红细胞CRI活性。结果 :针灸“三阴交”能提高脾阳虚家兔T淋巴细胞转化率 ,红细胞C3b受体花环率 ,与自愈组对照差异均有非常显著性意义 ,并以巳时组疗效最佳 ,申时组次之 ,亥时组又次之 。

足三里、三阴交、太冲三穴联合针刺的脑功能磁共振成像研究

目的:探讨足三里穴、三阴交穴、太冲穴3穴的联合针刺对相关脑功能区的影响。方法:根据事件相关功能磁共振(fMRI)的单组块设计,对10例健康成年男性志愿者采用PHILIPS Achieva 3.0T超高场强磁共振成像系统仪行脑功能成像扫描,采集在对左侧足三里穴、三阴交穴、太冲穴进行联合针刺前、中、后阶段的脑功能磁共振成像数据。用脑功能成像分析软件(AFNI软件)的感兴趣区分析法及SPSS 17.0软件对数据进行统计处理。结果:功能活动度明显改变的脑功能区有后扣带回、海马。(1)后扣带回:在留针阶段和拔针后效应阶段,脑功能活动度的信号均较纯静息状态明显增强(均P<0.01);拔针后效应阶段较留针阶段也有明显的脑功能活动度的信号增强(P<0.01)。(2)海马:仅右侧海马区在拔针后效应阶段较纯静息状态有明显的脑功能活动度的信号增强(P<0.01);在右侧海马区的其余阶段及左侧海马区的全部阶段中脑功能活动度的信号增强趋势变化差异均无统计学意义(P>0.05)。结论:足三里穴、三阴交穴、太冲穴配伍的针刺协同效应可能是通过调节与认知功能、内脏系统有关的脑功能区后扣带回和海马来实现的。

“合谷-三阴交”穴不同的电针和留针时间组合对大鼠怀孕后期子宫收缩的影响

目的：对比先“合谷”后“三阴交”穴不同的电针刺激时间组合对大鼠怀孕后期子宫收缩的影响。方法：选健康成年雌性Wistar大鼠60只，应用2X2析因试验设计方法，分为4个电针组（以针“合谷”穴20min或40min与加针“三阴交”穴5min或20min组合）、正常对照组及模型对照组。电针的同一对正负极连接双侧同名穴，簇形波，频率20Hz，强度1～3．5V。于子宫中段安放电极，通过肌肉张力换能器记录子宫收缩幅度、频率，作为判断宫缩变化的指标。结果：先针“合谷”穴、次针“三阴交”穴后，二穴共同留针时间的长短对子宫收缩的影响更为重要，留针5min较20min更能促进子宫收缩。而单独先针“合谷”穴期间留针20min或40min对子宫收缩影响不大。结论：针刺“舍谷一三阴交”穴促分娩的最佳时间组合是先针刺“合谷”穴20min，再加针“三阴交”穴5min。

论妊娠期禁针合谷、三阴交穴

针对古今针灸文献中有关妊娠期禁针问题的不同认识与观点,本文以合谷、三阴交这一传统下胎对穴为切入点,对妊娠禁针穴的依据、禁针的时期以及孕期如何安全合理使用禁针穴问题进行了初步探讨和分析。认为合谷、三阴交穴促进各孕期子宫收缩,从而存在导致流产的可能;妊娠子宫对电针刺激的敏感性随妊娠进展而逐渐增加,针刺作用又因其机体所处机能状态不同而对妊娠产生不同影响。建议在妊娠中期可适当选用禁针穴,在妊娠早期应慎用,妊娠晚期则应禁针。文中还提出了提高针刺下胎效果的初步设想。

原发性痛经患者不同子宫位置与三阴交穴效应关系的分析

目的通过对一项电针治疗原发性痛经的临床试验的相关数据进行分析,探讨子宫位置与经穴效应的关系。方法通过超声对每位受试者子宫位置进行评估,采用视觉模拟评分法(VAS)评估干预前后各时点的疼痛情况,采用痛经伴随症状表(RSS)值评估症状缓解程度。结果不同子宫位置间治疗前后各时点VAS值、起针即刻效应与后效应、反应者率比较差异均无统计学意义(P>0.05)。电针三阴交穴可以即刻缓解子宫前位患者的腹痛和痛经相关伴随症状,子宫后位其次,子宫中位者则未见缓解。结论电针三阴交穴可能对子宫前位腹痛和痛经相关伴随症状的缓解具有相对的特异性效应,子宫位置可能与相关经脉和脏腑有关。但现有统计结果提示子宫位置与经穴三阴交效应无关,其结果有待于前瞻性临床随机对照试验的证实。

Effect of moxibustion at Sānyīnjiāo (三阴交 SP 6) on uterine contraction pain in labor: a randomized controlled trial

Objective To investigate the effect of moxibustion at Sanyinjiao （三阴交 SP 6） for uterine contraction pain in labor, and evaluate the safety of the parturient and newborn. Methods One hundred and seventy-four cases of singleton pregnancy and cephalic presentation primipara were single blinded and randomly divided into three groups： observation group （59 cases）, placebo treated group （57 cases） and blank group （58 cases）.The observation group was treated with moxibustion at Sanyinjiao （三阴交 SP 6） for 30 min when the uterus cervix openning at 3 cm,the placebo treated group was treated with moxibustion at non-aeupoint for 30 min and the blank group was treated with routine labor nursing, the uterine contraction pain and the safety of the mother and infant were compared among three groups. Results （1） The uterine contraction pain was tested by Visual Analogue Scale （VAS）： the scores of VAS in the observation group were obviously decreased after 15 min and 30 min of moxibustion （both P〈0.05）, there were no obvious changes of the VAS scores in placebo treated group and the blank group, the scores of VAS in observation group decreased much more obviously than those in the other two groups （all P〈0.05）; （2）Midwife rating of the uterine contraction pain： after 30 min of moxibustion, the effective rate of labor analgesia was 69.5%（41/59） in observation group, which was higher than that of 45.6% （26/57） in placebo treated group and 43.1% （25/58） in blank group, with significant differences between them （both P〈0.05）; @The postpartum hemorrhage amount of the observation group was obviously lower than those of placebo treated group and blank group （both P〈0.05）; （4）The Apgar score of newborn was higher in observation group and placebo treated group than that of blank group （both P〈0.05）. Conclusion Moxibustion at Sanyinjiao （三阴交 SP 6） can relieve the uterine contraction pain, and has no side effect to mother and infant, it is one of the safe, effective and simple non-drug analgesia methods.

针刺不同穴位对总产程影响的临床观察

本文通过针刺不同穴位，对四组共１０１例孕妇进行了临床观察。结果，耳神门组和三阴交组都具有缩短产程的作用，与阳陵泉组和空白对照组比较有显著差异。其中耳神门组的作用最强，从临床观察看，其镇静止痛作用也较好。而阳陵泉穴即使配上合谷穴，对产程也没有影响，与对照组比较无统计学意义。

浮针疗法治疗原发性痛经的随机对照观察

目的:观察浮针疗法治疗原发性痛经(PD)的临床疗效。方法:120例PD患者随机分为浮针组和药物组各60例,浮针组采用浮针疗法远取三阴交穴治疗,药物组采用口服吲哚美辛肠溶片治疗,观察两组患者的止痛效果。结果:浮针组与药物组总有效率分别为93·3%和75·0%;两组治疗前后疼痛评分比较差异有极显著性意义(P<0·001),以浮针组更好(P<0·001);浮针组起效时间最快3分钟,明显快于药物组的30分钟(P<0·05)。结论:浮针疗法针刺三阴交穴治疗PD临床疗效优于口服吲哚美辛肠溶片。