Effects of electroacupuncture at Zusanli(ST36) on inflammatory cytokines in a rat model of smokeinduced chronic obstructive pulmonary disease

OBJECTIVE： Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease （COPD）, but little is known about the underlying mechanisms. Because an immune response imbalance could be seen in COPD, we hypothesize that electroacupuncture （EA） may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD. METHODS： A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established. The rats were randomly divided into four groups （control, sham, COPD, and COPD plus EA）, and COPD model was evaluated by measuring pulmonary pathological changes and lung function. EA was applied to the acupuncture point Zusanli （ST36） for 30 min/d for 14 d in sham and COPD rats. Bronchoalveolar lavage fluid （BALF） was used to measure levels of tumor necrosis factor-a （TNF-a）, interleukin-113 （IL-113）, and malonaldehyde （MDA）. RESULTS： Compared with the control rats, COPD rats had significant changes in lung resistance （R,） and lung compliance （C,） （both P〈0.01）, bronchi and bronchiole airway obstruction （P〈0.01）, and levels of MDA, TNF-α, and IL-1β（P〈0.01）. There were no significant differences between the control and the sham groups. Compared with the COPD rats, the COPD plus EA rats had decreased R, and increased CL （both P〈0.05）, and reduced bronchi and bronchiole airway obstruction （P〈0.05, P〈0.01, respectively）, while levels of TNF-α, IL-1β, and MDA in BALF were lowered （P〈0.05 and P〈0.01, respectively）. However, TNF-α and IL-1β levels of the EA group rats remained higher than those of the control group （P〈0.05）. CONCLUSION： EA at ST36 can reduce lung injury in a COPD rat model, and beneficial effects may be related to down-regulation of inflammatory cytokines. The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.

Effects of pre-moxibustion at Zusanli (ST36) on heat shock protein 70 expression in rats with gastric mucosal lesions after neurotomy

Studies have shown that pre-moxibustion protects the gastric mucosa by up-regulating the expression of heat shock protein 70. However, the signaling pathway underlying this effect remains unclear. Rats were intragastrically administered absolute alcohol, causing obvious lesion of the gastric mucosa. Following pre-moxibustion at Zusanfi （ST36） for 8 days, the ulcer index decreased to different degrees. The results of an enzyme linked immunosorbent assay and western blotting showed significant upregulation of heat shock protein 70 expression in the gastric mucosa and serum. None out of transection of the spinal cord, damage to the nucleus of the solitary tract, neurotomy of the vagal nerve and neurotomy of the common peroneal nerve affected the decrease in ulcer index or the increase in heat shock protein 70 expression in serum after pre-moxibustion at Zusanfi, and heat shock protein 70 expression was obviously decreased in the gastric mucosa. These findings suggest that pre-moxibustion at Zusanfi can protect the gastric mucosa against lesioning, and that the mechanism underlying this effect involves its induction of heat shock protein 70 expression. Neural pathways participate in the regulatory effects of moxibustion on heat shock protein 70 expression in the gastric mucosa.

Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

Moxibustion at ST36 activates peritoneal macrophages in CTX-induced immunosuppression in mouse model via IFN-γ

Background:To explored whether moxa cone moxibustion can reduce peritoneal inflammation by increasing the content of peritoneal macrophages and B cells via interferon-gamma.Methods:The mice were randomly divided into three groups with six mice in each group:the control group,model group,and moxibustion group,and the model was established in mice using cyclophosphamide.In the moxibustion group,the mice received moxa cone moxibustion at Zusanli(ST36)for 7 days.Analysis of Peritoneal cell were detected by flow cytometry and immunofluorescence,the protein expression level in the peritoneal fluid were measured with mouse cytokine antibody arrays and verified by enzyme linked immuno sorbent assay test,and RNA-Sequencing was used for peritoneal cell RNA analysis.Results:Our results showed that moxa cone moxibustion could reduce the loss of large peritoneal macrophages and B1 cells(P<0.05).With the cytokine array analysis and enzyme linked immuno sorbent assay test of peritoneal fluid,we found that IFN‐γwas up-regulated in moxibustion group(P<0.05).There were 169 genes were down-regulated in the model group and up-regulated in the moxibustion group while 19 genes that were up-regulated in the model group and down-regulated in the moxibustion group via RNA-sequencing.Kyoto Encyclopedia of Genes and Genomes pathway analysis of 188 intersect differentially expressed genes were found that the top 3 pathways with the highest enrichment of up-regulated genes included Hematopoietic cell lineage,Inflammatory bowel disease and Malaria.The differentially expressed genes visualization protein-protein interaction network shows the top 10 genes including Ifng,Grb2,CCR7,CTLA4,CXCR5,Foxp3,kit,PRF1,CD5 and klrg1.Conclusion:These findings showed that moxa cone moxibustion can alleviate chemotherapy-induced diarrhea by reducing the loss of large peritoneal macrophages and B1 cells in the peritoneal cavity,possibly through up-regulating inflammatory bowel disease signaling pathway via interferon-gamma to regulate the survival and function of large peritoneal macrophages and B1 cells.

EXPERIMENTAL STUDY ON MOXIBUSTION AT ZUSANLI(ST 36) AND LIANGMEN (ST 21) INDUCING HEAT SHOCK PROTEIN 70 (HSP70) EXPRESSION TO RESIST OXIDATIVE INJURY OF GASTRIC MUCOSA

To observe effect of moxibustion at Zusanli （足三里 ST 36） and Liangmen （梁门 ST 21 ） on expression of heat shock protein 70 （HSP70） in gastric mucosa of the rat of stress ulcer （SU） to explore the mechanism of moxibustion in resisting oxidative injury of the gastric mucosa. Methods： Sixty SD rats were evenly randomized into 4 groups, a blank group, a model group, an acupoint moxibustion group and a non-acupoint moxibustion group. Water restraint stress （WRS） method was used to make stress gastric ulcer rat model. The ulcerative index （Ul） of gastric mucosa was evaluated by using GUTH method, the gastric mu- cosa blood flux （GMBF） was detected by a laser Doppler bloodflow monitor, and HSP70 expression and malondialdehyde （MDA） content in the gastric mucosa were determined respectively with immunohistochemical and thiobarbiturate methods. Results： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） significantly de- creased Ul, up-regulated HSP70 expression, increased GMBF, and decreased MDA content in the gastric mucosa in the rat of stress gastric ulcer, with significant differences as compared with the model group and the non-acupoint moxibustion group （P 〈 0.05 or P 〈 0.01 ）. Conclusion： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） can induce high expression of HSP70 and decrease MDA content in the gastric mucosa, so as to resist oxidative injury, with relative acupoint specificity.

Comparison of protective effects of electroacupuncture and moxibustion at Zusanli(ST 36)on perinatal nicotine exposure-induced lung phenotype in rat offspring

Objective:To compare the effects of electroacupuncture(EA)and moxibustion at Zusanli(ST 36)on the lung phenotype of rat offspring exposed to nicotine during the perinatal period.Methods:Pregnant Sprague-Dawley rats were randomly divided into 4 groups:the control group(saline only),the model group(nicotine only),the EA group(nicotine+EA at ST 36 acupoints bilaterally),and the moxibustion group(nicotine+moxibustion at ST 36 acupoints bilaterally).n=6 rats per group.On postnatal day 21,the body weight,lung weight,and pulmonary function were determined and lung morphometry was performed.Peroxisome proliferator-activated receptor gamma andβ-catenin levels in the lung tissue of offspring were also determined.Results:Perinatal nicotine exposure(PNE)results in decreased body and lung weights of offspring rats,abnormal lung tissue morphology,and significantly altered pulmonary function,showing an increase in total airway resistance and a decrease in tidal volume,minute ventilation,total airway compliance,and peak expiratory flow.Bilateral EA at ST 36 acupoints could block all of these perinatal nicotine-induced effects.Although moxibustion also had protective effects in nicotine-induced offspring lungs,some of these effects did not reach statistical significance,e.g.,protection against the upregulation ofβ-catenin,the downregulation of PPARγsignaling,and the increase in peak expiratory flow.Conclusion:Maternal EA at ST 36 blocked the PNE-induced changes in key developmental signaling pathways,prevented the PNE-induced changes in lung morphology,and protected pulmonary function.Moxibustion at ST 36 showed similar but weaker protective effects against the PNE-induced changes in the exposed offspring.It is important to note that the mechanism underlying the protective effects of moxibustion at ST 36 may be different from those of EA at ST 36,and further research is needed to understand these differences.

TREATMENT WITH ACUPUNCTURE AT ZUSANLI (St 36) FOR EPIGASTRIC PAIN IN THE ELDERLY

Acupuncture at a single point is a spe-cial feature in the treatment of acute symp-toms for its simplicity and effectiveness.Theauthor experienced many cases of acuteepigastric pain treated with acupuncture at asingle acupoint with satisfactory results.Pain in the elderly is most often of

世界知识产权组织ST.36与ST.96标准的比较研究

本文通过对WIPO的XML专利旧数据标准ST.36和ST.96多方面的比较和研究,增进对WIPO新标准的理解,探索未来WIPO标准的发展动向,以期为我国知识产权行业的数据业务发展提供一定的借鉴。

Downregulation of electroacupuncture at ST36 on TNF-α in rats with ulcerative colitis

AIM: To investigate the regulatory effect of electroacupuncture (EA) at Zusanli (ST36) on tumor necrosis factor-alpha (TNFα) in rats with ulcerative colitis (UC), and further elucidate the therapeutic mechanism of EA on UC.METHODS: Thirty-two male Sprague-Dawley (SD) rats were randomly divided into four groups (n=-8): normal control group, UC control group, UC+ST36 group and UC+nonacupoint group. A solution containing ethanol and 2,4,6-trinitrobenzenesulfonic acid (TNBS) was instilled into the distal colon in the rat (at a dose of 100 mg/kg) to set up UC rat model. Rats in wakefulness state of UC+ST36 group were stimulated at ST36 by EA once a day, while those of UC+nonacupoint group were done at 0.5 cm beside ST36. After 10d treatment, all rats were sacrificed simultaneously. Colon musocal inflammation and damage were assessed by measuring colon mass, morphologic damage score, colonic myeloperoxidase enzyme (MPO) activity, serum TNF-α and colonic TNF-α mRNA level. Morphologic damage score was examined under stereomicroscope. Colonic MPO activity was measured by spectrophotometer method. Serum TNF-αconcentration was determined by radioimmunoassay (RIA).Colonic TNF-α mRNA expression level was analyzed by semiquantitative reverse transcription polymerase chain reaction (RT-PCR).RESULTS: Ratio of colonic mass/body mass (mC/mB) and activity of colonic MPO (μkat/g tissue) markedly increased (8.5±2.6 vs 2.5±0.4; 145±25 vs 24±8, P＜0.01 vs normal control group). Compared with normal control rats, serum TNF-α and colonic TNF-α mRNA level in UC control group were increased 2.5 fold (2 278±170 vs 894±248, P＜0.01)and 4.3 fold (0.98±0.11 vs 0.23±0.11, P＜0.01)respectively. After EA at ST36, mc/mB and MPO activity were reduced significantly (5.3±2.0 vs 8.5±2.6; 104±36 vs145±25, P＜0.01, 0.05) compared with those of UC control group. Serum TNF-α and colonic TNF-α mRNA level were inhibited by EA stimulation at ST36 (P＜0.01). The inhibitory rate was 16 % and 44 % respectively.Morphologic damage score was also increased markedly in rat with UC (P＜0.01), whereas it was decreased by EA at ST36 (P＜0.05). There was no significant difference between UC control group and UC+EA at non-acupoint (P＞0.05). Furthermore, these parameters were highly correlated with each other (P＜0.01).CONCLUSION: Serum TNF-α concentration and colonic TNF-α mRNA expression level are increased significantly in UC rats in correlation with the severity of disease. It indicates that TNF-α is closely involved in the immune abnormalities and inflammatory responses in UC. EA at ST36 has therapeutic effect on UC by downregulating serum TNF-r and colonic TNF-r mRNA expression. High levels of TNF-αand its corresponding mRNA expression seem to be implicated in the pathogenesis of UC.

新型抗缺血药物治疗急性冠状动脉综合征的评价:雷诺嗪用于减少非ST段抬高型急性冠状动脉综合征局部缺血的代谢效能(MERLIN)-TIMI36试验的试验设计与原理

Background: Despite advances in antithrombotic therapies and invasive technology, the risk of recurrent ischemic complications in patients with non-ST-elevation acute coronary syndromes(NSTE-ACSs) remains substantial. Ranolazine is a novel agent that inhibits the late sodium current thereby reducing cellular sodium and calcium overload and has been shown to reduce ischemia in patients with chronic stable angina. Study Design: MERLIN-TIMI 36 is a phase III, randomized, double-blind, parallel-group, placebo-controlled, multinational clinical trial to evaluate the efficacy and safety of ranolazine during long-term treatment of patients with NSTE-ACS receiving standard therapy(N=6500). Eligible patients are randomized 1 ∶1 to ranolazine or matched placebo, initiated as 200 mg intravenously over 1 hour, followed by an 80-mg/h infusion(40 mg/h for patients with severe renal insufficiency) for up to 96 hours and oral ranolazine ER 1000 mg BID or matched placebo until the end of study. The primary end point is the time to first occurrence of any element of the composite of cardiovascular death, myocardial infarction, or recurrent ischemia. Secondary end points include ischemia on Holter monitoring, hospitalization for new or worsening heart failure, quality of life measures, and exercise performance. The evaluation of longterm safety will include death from any cause and symptomatic documented arrhythmia. Recruitment began in October 2004. The trial will continue until 730 major cardiovascular events and 310 deaths are recorded with expected completion in 24 to 28 months. Conclusions: MERLIN-TIMI 36 will evaluate the role of ranolazine in the acute and chronic management of patients presenting with NSTE-ACS.

血运重建对非ST段抬高急性冠脉综合征患者生活质量的影响

目的探讨血运重建对非ST段抬高急性冠脉综合征(NSTE-ACS)患者生活质量的影响。方法将559例NSTE-ACS患者分为完全血运重建组(完全介入治疗组、冠脉搭桥手术组)、不完全血运重建组(不完全介入治疗组)、单纯药物治疗组,通过SF-36生活质量量表随访2年患者的生活质量变化。结果 (1)经过2年的随访调查,发生重大心血管事件的有111例。(2)在SF-36量表中的各个维度改善情况显示,单纯药物治疗组对各个维度的改善率普遍偏低,且与其他三组相比,差异有统计学意义(P<0.01或P<0.05);而在躯体疼痛、社会功能、情感职能、精神健康、健康变化5个维度中,完全介入治疗组改善率优于冠脉搭桥手术组(P<0.05)。结论完全冠状动脉血运重建可显著改善NSTE-ACS患者远期的生活质量,完全介入治疗对躯体疼痛的改善率最高;冠状动脉搭桥对生理职能改善率最高。

中药内服联合电针对行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能的影响

目的:观察中药内服联合电针对行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能的影响。方法:将64例行Halsted疝修补术的老年腹股沟嵌顿疝患者随机分为治疗组和对照组,每组32例。对照组给予常规治疗,治疗组在对照组治疗的基础上给予中药内服联合电针足三里治疗。观察两组患者肠鸣音恢复时间、肛门排气时间、排便时间、胃肠减压时间及术后围手术期腹胀发生率等。结果:治疗组肠鸣音恢复时间、肛门排气时间、排便时间、胃肠减压时间短于对照组,差异有统计学意义(P<0.05);治疗组腹胀发生率为18.75%,对照组腹胀发生率为53.13%,治疗组腹胀发生率低于对照组,差异有统计学意义(P<0.05)。结论:中药内服联合电针能够促进行Halsted疝修补术的老年腹股沟嵌顿疝患者胃肠功能及早恢复,降低腹胀发生率,减轻腹胀程度。

Adenosine triphosphate mediates the pain tolerance effect of manual acupuncture at Zusanli(ST36) in mice

OBJECTIVE:To investigate the mechanisms behind the effects of acupuncture in Traditional Chinese Medicine,we delved into the adenosine triphosphate/peripheral purinergic P2X receptor 3(ATP/P2X3)receptor signaling system as an indicator of the body's energy state,commonly referred to as"Qi".METHODS:The tail-flick test was utilized to explore the impact of acupuncture on pain tolerance threshold(PTT)in mice,while also assessing adenosine(ADO)levels and adenylate energy charge(EC)at Zusanli(ST36).The study further investigated the dose-dependent effects of acupuncture on PTT and ADO levels at Zusanli(ST36).To shed light on the underlying mechanisms of acupuncture's effects,the study examined the impact of ATP,a P2X3 receptor antagonist,and adenosine disodium on PTT following acupuncture administration.RESULTS:Acupuncture at Zusanli(ST36)led to significant improvements in PTT in mice,with the most effective interventions being twirling for 2 min and needle retention for 28 min.These interventions also resulted in significant increases in ATP levels.The effects of acupuncture were further augmented by administration of different doses of ATP at Zusanli(ST36),and pretreatment with a P2X3 receptor antagonist decreased PTT.Adenylate EC peaked at 30 min after intraperitoneal injection of ATP,and pretreatment with various doses of i.p.ATP 30 min prior to acupuncture increased PTT in a dose-dependent manner.Additionally,pretreatment with an i.p.or intramuscular injection of adenosine disodium enhanced the effects of acupuncture.CONCLUSION:This research provides compelling evidence that ATP is involved in the regulation of PTT through acupuncture,revealing new avenues for achieving enhanced clinical outcomes.

Long-term acupuncture treatment has a multitargeting regulation on multiple brain regions in rats with Alzheimer＇s disease：a positron emission tomography study

The acute effect of acupuncture on Alzheimer＇s disease,i.e.,on brain activation during treatment,has been reported.However,the effect of long-term acupuncture on brain activation in Alzheimer＇s disease is unclear.Therefore,in this study,we performed long-term needling at Zusanli（ST36）or a sham point（1.5 mm lateral to ST36）in a rat Alzheimer＇s disease model,for 30 minutes,once per day,for 30 days.The rats underwent 18F-fluorodeoxyglucose positron emission tomography scanning.Positron emission tomography images were processed with SPM2.The brain areas activated after needling at ST36 included the left hippocampus,the left orbital cortex,the left infralimbic cortex,the left olfactory cortex,the left cerebellum and the left pons.In the sham-point group,the activated regions were similar to those in the ST36 group.However,the ST36 group showed greater activation in the cerebellum and pons than the sham-point group.These findings suggest that long-term acupuncture treatment has targeted regulatory effects on multiple brain regions in rats with Alzheimer＇s disease.

皮内针刺激足三里对STZ诱导的2型糖尿病大鼠损伤的影响

目的观察皮内针刺激足三里对STZ诱导的2型糖尿病大鼠损伤的影响。方法雄性Wistar大鼠30只,分为A组(正常组)、B组(模型组)、C组(皮内针组),采用尾静脉注射链脲佐菌素(streptozotocin,STZ)结合高脂饲料建立2型糖尿病大鼠模型,检测大鼠空腹血糖、血清中活性氧(reactive oxygen species,ROS)、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)及胰岛素(Insulin)水平。采用HE染色法观察各组大鼠胰岛组织的变化情况,采用PCR法检测p22phox、NOX4的mRNA水平。采用Western blot法检测各组大鼠氧化应激相关蛋白p22phox、NOX4的表达情况。结果结果显示,B组、C组与A组比较,ROS、MDA水平明显升高,而SOD及胰岛素水平明显降低,差异有统计学意义(P<0.05)。C组与B组比较,ROS、MDA水平降低(P<0.05),SOD及胰岛素水平明显升高(P<0.05)。HE染色结果显示,A组胰腺胰岛内细胞排列整齐,大小一致,分布均匀;B组胰岛内细胞分布稀疏,形状不规则,排列紊乱,可见空泡样变;C组胰岛内细胞结构明显改善。PCR结果显示,B组、C组p22phox、NOX2 mRNA含量与A组比较差异有统计学意义(P<0.05)。C组p22phox、NOX2 mRNA水平明显低于B组(P<0.05)。Western blot结果显示,B组、C组p22phox和NOX2蛋白含量与A组比较差异有统计学意义(P<0.05)。C组p22phox、NOX2蛋白含量比B组明显减少(P<0.05)。结论皮内针刺激足三里对STZ诱导的T2MD大鼠的损伤有改善作用,其作用机制是通过缓解机体的氧化应激起作用。

Anti-aging effects of moxa cone moxibustion As a free radical scavenger complement

Therapies that complement free radical scavenging are an important approach for treating aging in the brain. In the present study, two formulations of moxa cone moxibustion were applied at acupoints Zusanfi （ST 36） and Xuanzhong （GB 39）, and at acupoints Baihui （DU 20） and Guanyuan （RN 4）, in D-galactose-induced senile mice. The results revealed that moxa cone moxibustion improved total superoxide dismutase and Cu/Zn-superoxide dismutase activity in the homogenates of the cerebral tissue, as well as ameliorating deficits in neuronal morphology and neuronal density in the cerebral cortex and hippocampal CA3. Moxa cone moxibustion also enhanced learning and memory functions of senile mice. Moxa cone moxibustion at Zusanli, Xuanzhong, Baihuiand Guanyuan acupoints can thus be used to complement free radical scavengers, with efficacy that is equal to that of electroacupuncture at Zusanliand Xuanzhong, and superior to that of nimodipine treatment.

PRELIMNARY STUDY ON THE EFFECT OF SUBSTANCE P IN THE PROCESS OF FORMATION OF NEEDLING SENSATION

Object: To study the effect of SP in the process of formation of needling sensation in the rat. Methods: The pain threshold was determined by inducing rat’s tail swing reaction when the electrical stimulation was gradually increased to a certain extent via two electrodes inserted in the bilateral sides of the tail. Right Zusanli (ST 36) was stimulated electrically for 30 min by setting the stimulating parameters as continuous waves, frequency of 20 Hz and a suitable strength (just generating slight muscular tremor). The relative SP contents of the spinal cord and the small intestine were displayed by using immunohistochemical method and evaluated using gray density value. The effect of "Zusanli" injection of SP on pain threshold was observed by injecting 25 μL of SP (5 nm) into the bilateral ST 36. In control group, normal saline (25 μL) was injected into the bilateral ST 36. Results: ① After elctroacupuncture (EA) of ST 36, both the pain threshold and SP content of the spinal dorsal horn on the EA side increased significantly (P< 0.05); and ② Both EA and injection of SP could raise the pain threshold remarkably. Conclusion: SP may play an important role in the process of formation of needling sensation in the primary nerve center.

针灸足三里穴位周围肌肉微循环的超声造影评估

目的探讨超声造影评价正常人足三里穴位针灸前后局部肌肉微循环情况的价值。资料与方法前瞻性收集2018年9月—2020年5月于福建医科大学附属第二医院超声科就诊的72例健康志愿者,分别于针灸前、针灸得气最强时、针灸后2h进行超声造影,观察胫前肌内微血管血流灌注情况,分析感兴趣区中的小动脉、肌肉组织和小静脉,获得时间-强度曲线和造影剂渡越时间(CTTs)。采用针灸者结合受灸者的客观评分标准评价针感。于针灸前、针灸得气最强时、针灸后2 h检测胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平。结果①针灸得气最强时,胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs明显缩短,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2hCTTs差异无统计学意义(P>0.05);②针灸得气最强时,志愿者血清内胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平升高,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2h差异无统计学意义(P>0.05);③针灸得气最强时,胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平与胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs均呈正相关(r=0.360~0.702,P<0.001)。结论针刺足三里得气最强时,可造成骨骼肌周围微循环改变,导致CTTs明显缩短,同时也能促进胃肠道的分泌功能。

坐骨神经胞外核苷酸酶在针刺缓解大鼠踝关节炎性痛中的作用

目的 探讨坐骨神经胞外核苷酸酶[CD39(NTPDase1)]在针刺缓解大鼠踝关节炎性痛中的作用。方法 将54只雄性大鼠随机分为9组,即空白组、踝关节炎性痛模型组、针刺组、坐骨神经腺苷三磷酸(ATP)水解酶抑制(ARL67156注射)+针刺组、坐骨神经CD39上调(三磷酸腺苷双磷酸酶注射)组、坐骨神经CD39特异性抑制(噻氯匹啶注射)+针刺组、坐骨神经CD73特异性抑制(α,β-亚甲基腺苷5′-二磷酸钠盐注射)+针刺组、穴区CD39上调(三磷酸腺苷双磷酸酶注射)组、穴区CD39特异性抑制(噻氯匹啶注射)+针刺组,每组6只。除空白组外,其余各组大鼠均采用注射完全弗氏佐剂建立佐剂性关节炎疼痛模型;造模48 h后,需针刺组大鼠针刺患侧“足三里”穴20 min,需注射药物组于针刺前20 min进行局部相关试剂注射。以大鼠患侧足底机械痛阈值和热痛阈值作为疼痛评价指标;采用实时荧光定量逆转录聚合酶链式反应(RT-qPCR)法和Western blot法检测坐骨神经以及“足三里”穴胞外核苷酸酶的表达。结果 (1)调节坐骨神经ATP水解酶活性:与空白组比较,踝关节炎性痛模型组和坐骨神经ATP水解酶抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组热痛阈值和机械痛阈值明显上升(P<0.05)。(2)调节坐骨神经CD39活性:与空白组比较,坐骨神经CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组和坐骨神经CD39上调组热痛阈值和机械痛阈值明显上升(P<0.05);与针刺组比较,坐骨神经CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05)。(3)调节穴区CD39活性:与空白组比较,穴区CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组和穴区CD39上调组热痛阈值和机械痛阈值明显上升(P<0.05);与针刺组比较,穴区CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05)。(4)调节坐骨神经CD73活性:与空白组比较,坐骨神经CD73特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组热痛阈值和机械痛阈值明显上升(P<0.05)。(5)针刺对坐骨神经以及穴区CD39表达的影响:Western blot法检测结果显示,与空白组比较,踝关节炎性痛模型组坐骨神经CD39的表达显著增加(P<0.05);与踝关节炎性痛模型组比较,针刺组CD39表达显著下调(P<0.05)。RT-qPCR法检测结果显示,与踝关节炎性痛模型组比较,针刺组CD39 mRNA表达水平明显上调(P<0.05)。结论 坐骨神经局部CD39参与了针刺缓解大鼠踝关节炎性痛的机制,这可能与CD73联合促进胞外ATP向腺苷转化有关。

针灸气海、关元、足三里治疗结直肠癌化疗患者癌因性疲乏:一项随机对照试验

目的:观察针灸气海、关元、双侧足三里治疗结直肠癌患者化疗后所致癌因性疲乏(CRF)的疗效及其对肿瘤坏死因子α(TNF-α)的影响。方法:共51例接受化疗后出现CRF的结直肠癌患者纳入分析,随机分成两组,其中针灸组25例,对照组26例。两组患者均接受常规化疗,其中针灸组化疗期间配合针灸治疗,分别于化疗前1天、化疗第1~3天接受针灸治疗,每天1次,每次30分钟,两个疗程(对应两个化疗周期),共8次针灸治疗。主要疗效指标为Piper疲乏量表,次要疗效指标为中医证候评分、TNF-α含量。分别于随机化入组后的第一程化疗前,第二程化疗结束后及第二程化疗后2周进行评估。结果:Piper疲乏量表评分方面,随着针灸干预次数的增加,针灸组内患者Piper疲乏评分逐渐下降(F=67.425,P<0.001),说明随时间的推移,针灸组癌因性疲乏程度改善。与对照组比较,针灸组Piper疲乏评分明显下降(F=6.706,P=0.013),说明针灸组患者的疲乏程度改善显著优于对照组。中医证候总疗效方面,针灸组和对照组的有效率分别为68%、34.6%,针灸组有效率显著提高(χ^(2)=5.68,P=0.017)。其中,针灸组单项症状中的“体倦乏力”(χ^(2)=14.41,P <0.001)、“神疲”(χ^(2)=7.06,P=0.008)等单项疗效对比对照组亦显著性改善。针灸组治疗后TNF-α含量较治疗前下降(t=1.14,P=0.26),对照组治疗后TNF-α含量较治疗前上升(t=-1.02,P=0.31),呈现出针灸抑制CRF患者TNF-α含量的趋势。结论:针灸气海、关元、双侧足三里4穴减轻结直肠癌患者化疗致CRF的疲乏程度,改善“体倦乏力”“神疲”症状,且存在下调TNF-α水平的趋势,初步提示下调TNF-α促炎细胞因子水平可能是针灸治疗CRF的作用机制之一。