CLINICAL OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE OF JIAJI (EX-B2) IN THE TREATMENT OF APOPLECTIC SPASTIC HEMIPLEGIA

Objective: To compare the therape utic effects of acupuncture of different acupoints in the treatment of spast ic hemiplegia of apoplexy. Methods: Eighty stro ke patients with spastic hemiplegia were evenly randomized into control grou p and treatment group. Forty cases of treatment group were given with acupun cture of Jiaji (夹脊 EX-B2) from T1 to L5, while forty cases of control gro up were treated with conventional acupoints as Jianyu (肩NFDA1 LI 15), Quchi (曲池 LI 11), Huantiao (环跳 GB 30), Zusanli (足三里 ST 36), Kunlun (昆仑 BL 60), etc. o n the diseased side, once daily, with 10 sessions being one therapeutic course, and 3 courses all together. The modified Ashworth Scale (MAS) and neurological d eficit grading scale (NDS) were used as the indexes to assess the therapeutic ef fects. Results: After treatment, the scores of NDS of both treat ment and control groups reduced and the difference value between post- and pre-treatment of tr ea tment group was significantly bigger than that of control group. MAS showed a si milar tendency in both groups. Of the 40 cases in treatment and control groups, 6 and 1 were cured, 20 and 15 had marked improvement, 9 and 11 had improvement, 4 and 8 failed, 1 and 5 got worse, with the total effective rates being 87.5% an d 67.5% respectively. The therapeutic effect of treatment group was significantl y superior to that of control group (P<0.01). Conc lusion: Acupuncture of Jiaji ( EX-B2) is superior to acupuncture of conventional acupoints in alleviating the state of spastic hemiplegia of apoplexy.

THE TREATMENT OF CERVICAL SPONDYLOPATHY BY LASER ACUPUNCTURE AT THE CERVICAL JIAJI POINTS: AN ANALYSIS OF THERAPEUTIC EFFECT OF 102 CASES

Laser acupuncture therapy was employed in the treatment of spondylopathy.Thetherapeutic effect of the three types of the spondylopathy,nerve root type,vertebral artery type andspinal cord type were stuied and compared.The results indicate a significant difference between thethree types of spondylopathy.The best therapeutic effect was obtained in nerve root type with a remarkable effective rate of 98.5％;the effective rates for the vertebral artery type and the spinal cordtype were 92.3％and 25％,respectively.Combining laser irradiatlon with acupuncture,the therapyposseses the functions of acupuncture,heat effect and mild moxibustion action.Therefore,it showedeffect quickly and had the advantages of short treatment course and high therapeutic effect.Clinicalobservation has confirmed that laser acupuncture is more effective than single laser irradiation.Thistherapy offers another simple but effective method for the treatment of spondylopathy.

TREATMENT OF 29 CASES OF LUMBAR INTERVETEBRAL DISC PROTRUSION WITH GINGER-SEPARATED MOXIBUSTION

Objective: To observe the effect of ginger-separated moxibustion for treatment of lumbar intervertebrai disc prolapse. Methods: 29 Iumbar intervertebral disc protrusion patients including 21 males and 8 females were treated with ginger-separated moxibustion of Ashi-point and Jiaji (EX-B 2 , the affected region), 5 - 6 cones every time, once every other day, continuously for 5 times. Then the therapeutic effect was analyzed. Results: After treatment, of the 29 cases, 23(79.3% ) were cured, and the rest 6(20.7% ) experienced improvement. Conclusion: Ginger-separated moxibustion is fairly effective and safe in treatment of lumbar intervertebral disc protrusion.

低频电针降低神经病理痛大鼠背根神经节p-CREB的表达

目的：观察低频脉冲电针对慢性神经病理痛大鼠背根神经节磷酸化环磷酸腺苷反应元件结合蛋白（p-CREB）表达的影响。方法：36只成年雄性SD大鼠,随机分为空白对照组、假手术组、模型对照组和电针治疗组,每组9只。模型对照组和电针治疗组采用右侧慢性坐骨神经结扎的方法,建立慢性神经病理痛模型。电针组大鼠给予低频电针刺激双侧＂夹脊＂穴和＂足三里＂穴,参数为波宽0.6 m s,频率2 Hz,电流强度分别为0.5、1和2 mA,各10 m in,共刺激30 m in。空白对照组、假手术组和模型对照组只陪同电针组抓取、固定,不做任何治疗。使用免疫印迹方法,观察各组大鼠右侧L4-6背根神经节p-CREB的表达变化。结果：模型对照组的热痛阈较空白对照组显著降低,并伴见p-CREB表达的显著增高（P〈0.01）。电针治疗组的热痛阈和p-CREB表达,较模型对照组均有显著变化（P〈0.05）。结论：低频脉冲电针的镇痛作用可能部分是通过抑制p-CREB的表达实现。电针可以通过改变初级传入神经元中基因的表达而对疼痛起到调控作用。

Effectiveness of electroacupuncture at Jiaji acupoints(EX-B 2), plus moxibustion and intermediate on postherpetic neuralgia: a randomized controlled trial

OBJECTIVE:To investigate the effectiveness of electroacupuncture at Jiaji acupoints(EX-B 2)plus moxibustion and intermediate frequency on postherpetic neuralgia(PHN).METHODS:A total of 140 outpatients who satisfied the inclusion criteria and volunteered for this treatment were randomly divided into treatment(n=70)and control(n=70)groups.Both groups received a localized lesion area and electroacupuncture treatment combined with moxibustion and intermediate frequency.The treatment group(TG)increased acupuncture at Jiaji acupoints(EX-B 2)and electroacupuncture.Pain and anxiety were assessed before and after 5,10,15,and 20 treatments by using visual pain simulation score(VAS)and Hamilton anxiety scale(HAMA),respectively.Clinical efficacy was also evaluated.RESULTS:The baseline between the two groups did not significantly differ(P>0.05).The VAS and HAMA scores of the two groups after treatment significantly decreased compared with those of various treatment stages(P>0.05).The HAMA score(P<0.01)of TG was lower than that of the control group(CG).The VAS score of TG was lower than that of CG in the 5th and 10th treatments(P<0.01).In the 15 th and 10 th scores,CG was also superior to TG(P<0.05).CONCLUSION:The combined treatment of electroacupuncture at Jiaji acupoints(EX-B 2),moxibustion,and intermediate frequency can relieve the pain and anxiety symptoms of PHN.The efficacy of the combined treatment was superior to traditional acupuncture.

针刺颈夹脊穴对卒中后血管性痴呆患者血清BDNF、VEGF、MMP-9水平的影响

目的观察卒中后血管性痴呆(vascular dementia,VD)患者采用针刺颈夹脊穴治疗的有效性及安全性,分析该针刺手段对患者血清学指标的影响.方法选取卒中后VD患者80例,根据随机数字表法分为两组,每组40例.对照组接受常规针刺治疗,观察组在对照组基础上针刺颈夹脊穴,对比两组治疗后疗效.检测并记录患者治疗前后的证候总积分、血清学指标[脑源性神经生长因子(brain-derived neurotrophic factor,BDNF)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、基质金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)]水平变化情况;评估并对比两组患者治疗前后各量表[简易精神状态量表(minimum mental state examination,MMSE)、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、日常生活活动能力量表(activity of daily living scale,ADL)]变化情况;同时记录针刺治疗期间患者不良反应发生情况.结果观察组临床疗效优于对照组,差异有统计学意义(P<0.05);两组治疗前证候总积分、血清学相关指标水平、各量表评分比较差异均无统计学意义(P>0.05);两组治疗后证候总积分及BDNF、VEGF、MMP-9水平均较治疗前降低,MMSE评分、ADL评分均较治疗前提升,NIHSS评分较治疗前降低,且观察组治疗前后变化幅度较对照组高,差异均有统计学意义(P<0.05);两组患者治疗期间均无感染、折针、断针等情况发生.结论卒中后VD经针刺颈夹脊穴治疗,患者临床症状更好更快改善,血清学指标恢复好,认知功能、神经功能明显提升,且无感染等风险,安全有效.

Treatment of 100 Cases of Cervical Spondylotic Radiculopathy by Electroacupuncture of Jiaji(Ex-B2)plus Oblique Needling Ashi Point

100例患者经症状,体征和 X 线检查确诊为神经根型颈椎病,治疗方法是针刺病变节段及上下相邻两节脊椎夹脊穴得气后,接针灸治疗仪,同时在肩部及上肢选取麻、沉不适区,触及条索状物,为阿是穴,从条索最明显处垂直刺入皮肤,沿条索纵向斜刺深入。3～4疗程后显效90例,有效10例。

夹脊穴电针治疗对急性脊髓损伤大鼠microRNA-21及其介导的神经元凋亡的影响

目的:观察夹脊穴电针治疗对急性脊髓损伤大鼠miR-21的表达及其介导的神经元凋亡的影响。方法:SD大鼠随机分为假手术组、模型组、电针组和甲强龙组,通过改良版Allen's打击法复制急性脊髓损伤大鼠模型。各组于造模后2 h给予相应的干预治疗,其中电针组予胸8~胸12夹脊穴电针治疗,甲强龙组给予甲泼尼龙琥珀酸钠30 mg/kg腹腔注射,假手术组和模型组不予处置。分别观察各组大鼠治疗后肢体运动功能评分,并取损伤节段脊髓组织,通过Nissl染色观察脊髓神经病理形态的改变,RT-qPCR法检测组织中miR-21的表达水平,Western-Blot法检测组织中凋亡蛋白(Bax、Bcl-2和cleaved-Caspase-3)的表达丰度。结果:与除假手术组相比,模型组术后BBB、神经元存活率和组织中miR-21的表达水平明显低,神经元凋亡率明显增高,组织中Bax、Bcl-2、cleaved Caspase-3蛋白的表达及Bax/Bcl-2的比值均明显增加,差异均具有统计学意义(P<0.05);夹脊穴电针治疗能够明显升高ASCI大鼠术后BBB评分、神经元存活率和组织中miR-21的表达,降低神经元凋亡率和Bax/Bcl-2的比值,抑制组织中Bax、Bcl-2、cleaved Caspase-3蛋白的表达,与模型组比较,差异均具有统计学意义(P<0.05)。结论:夹脊穴电针治疗可明显促进SCI后小鼠神经功能的恢复,其作用机制可能与其上调组织中miR-21的表达进而抑制Bax/Bcl-2/cleaved Caspase-3信号通路的活化密切相关。

以TCD观察针刺对颈椎病椎-基底动脉血流速度异常的影响

目的 :研究针刺不同的颈部穴位组对颈椎病椎 基底动脉血流速度紊乱的干预作用。方法 :针刺不同的颈部穴位组 ,经穴组取大椎、风池、天柱 ,夹脊组取相应的夹脊穴 ,并通过经颅多普勒对针刺前后的血流速度进行观察。结果 :针刺对颈椎病椎 基底动脉血流速度异常状态有明显的即刻效应及近期疗效 ,针刺不同的颈部穴位导致的即刻效应有差异。结论 :针刺颈部不同的穴位组均能以双向调节的方式有效地改善椎动脉的供血强度 。

针刺颈椎夹脊穴治疗椎-基底动脉供血不足综合征疗效观察

目的 :观察比较针刺颈椎夹脊穴和药物治疗椎 基底动脉供血不足综合征的临床疗效。方法 :临床随机分为针刺组 5 5例 ,药物组 4 2例。针刺组采用针刺颈椎夹脊穴 ,药物组静滴丹参注射液、口服太极通天液和西比灵。结果 :针刺组治愈率为 5 2 7% ,总有效率为 96 3% ;药物组治愈率为2 8 6 % ,总有效率为 73 8%。经统计学处理 ,两组疗效差异具有非常显著性意义 (P <0 .0 1)。 结论

针刺开音1号穴配合颈夹脊穴治疗声带小结25例临床观察

【目的】观察针刺开音1号穴配合颈夹脊穴治疗声带小结的临床疗效。【方法】将47例声带小结患者随机分为治疗组25例和对照组22例。治疗组以针刺开音1号穴配合颈夹脊穴3-5为主治疗,对照组以口服金嗓散结丸治疗。2组均以20 d为1个疗程。观察2组的临床疗效及安全性。【结果】治疗后治疗组愈显率为56.00%,对照组为36.36%,2组比较差异有显著性意义（P〈0.05）。治疗组患者治疗后的症状积分有明显改善（与治疗前比较,P〈0.05）;对照组治疗后的症状积分也有所改善,但与治疗前比较差异无显著性意义（P（0.05）。2组治疗后比较差异有显著性意义（P〈0.05）,说明治疗组对症状积分的改善作用明显优于对照组。2组病例均未出现任何不良反应。【结论】针刺开音1号穴配合颈夹脊穴为主治疗声带小结是临床安全有效的治法。

电针夹脊穴对佐剂性关节炎大鼠脊髓背角内磷酸化ERK、NK-1信号转导通路的影响

目的：观察电针夹脊穴对佐剂性关节炎大鼠脊髓背角内磷酸化细胞外信号调节激酶（ERK）、神经激肽-1（NK-1）表达的影响,从信号转导的角度研究电针镇痛可能的作用机理.方法：80只Wistar成年雄性大鼠随机分为正常对照组、单纯电针组、模型30分钟组、模型24小时组、模型48小时组及电针治疗30分钟组、电针治疗24小时组、电针治疗48小时组,每组10只.以完全弗氏佐剂注入大鼠左后足垫皮肤内制作炎性痛模型,电针大鼠双侧L3～L5夹脊穴,采用免疫组化技术,分别检测各组大鼠痛阈及脊髓背角内磷酸化ERK与NK-1表达.结果：与正常对照组及单纯电针组比较,模型各组大鼠痛阈明显下降（均P＜0.01）,同时同侧脊髓背角内磷酸化ERK明显增多（P＜0.01）;电针治疗各组大鼠痛阈亦下降,但与同时段模型组比较痛阈明显提高,同侧脊髓背角内ERK磷酸化水平亦较同时段模型组明显降低（均P＜0.01）.与正常对照组及单纯电针组比较,模型24小时组与电针治疗24小时组大鼠同侧脊髓背角内NK-1受体表达均明显增加（P＜0.05或P＜0.01）.结论：电针夹脊穴可明显缓解佐剂性关节炎大鼠炎性痛,提高痛阈,而ERK可能作为电针镇痛中一个重要的信号转导分子,通过脊髓背角的磷酸化激活及其对NK-1表达的调控在炎症痛敏形成及电针镇痛过程中起重要作用.

针刺对椎动脉型颈椎病患者椎-基底动脉血流动力学的影响

目的观察针刺风池、后溪配合夹脊穴对椎动脉型颈椎病患者椎-基底动脉血供异常的影响。方法对40例椎动脉型颈椎病患者采用针刺治疗,取风池、后溪穴配合颈夹脊穴,采用常规针刺,治疗前行经颅多普勒超声检查,治疗1周后再观察患者血流动力学变化及患者眩晕症状的缓解情况,并判断临床疗效。结果患者治疗后基底动脉(BA)血流及双侧椎动脉(VA)的收缩期峰流(Vs)、平均峰流(Vm)较治疗前明显升高,血管搏动指数(PI)及阻力指数(RI)显著下降,差异有统计学意义(P<0.05);患者经过治疗后,眩晕、头痛、颈肩痛等症状明显得到缓解,症状评分较治疗前明显升高,差异有统计学意义(P<0.05)。结论针刺风池、后溪配合颈夹脊穴可改善椎动脉型颈椎病患者血流动力学相关指标,有效缓解患者颈部眩晕症状。

夹脊电针对ALS-SOD1^(G93A)转基因小鼠腰髓前角运动神经元形态学的影响

目的:观察夹脊电针对ALS-SOD1^(G93A)转基因小鼠腰髓前角运动神经元形态学的影响。方法:本实验以ALS-SOD1^(G93A)转基因小鼠为实验对象,选用经PCR鉴定的ALS-SOD1^(G93A)转基因小鼠24只,按照随机数字表法将小鼠随机分为电针组、手针组和模型组(均n=8只),取同窝野生型小鼠8只作为阴性对照组。于小鼠日龄60天开始干预,电针组针刺双侧L_(1~2)、L_(5~6)夹脊穴,躯干同侧2 Hz电针治疗;手针组针刺双侧L_(1~2)、L_(5~6)夹脊穴;模型组予以捆绑固定,20 min/次,2次/周,共4周;阴性对照组不做任何处置。于小鼠日龄120天时取腰膨大组织进行HE染色和尼氏染色来观察各组小鼠腰髓前角运动神经元胞体及胞核的状态并对运动神经元进行计数,透射电镜观察腰髓前角神经元超微结构变化。结果:HE染色可见模型组小鼠腰髓前角运动神经元数目明显减少,神经细胞结构不清、固缩,胞质胞核染色不清,核固缩,出现空泡状改变;与模型组比较,手针组和电针组小鼠腰髓前角运动神经元数目增多,神经细胞结构形态有所改善,空泡化减少,且电针组效果优于手针组。尼氏染色可见模型组小鼠腰髓前角运动神经元数目明显减少,非神经细胞增多,病变的神经元出现尼氏体不清,核固缩,细胞体积减小;与模型组比较,手针组和电针组小鼠腰髓前角运动神经元数目增多,神经细胞结构形态有所改善,能够明显减轻运动神经元的丢失,且电针组效果优于手针组。运动神经元计数:模型组小鼠腰髓前角运动神经元数目明显减少(P<0.01);手针组和电针组小鼠腰髓前角运动神经元数目较模型组增多(P<0.05或P<0.01),且电针组较手针组增多更明显(P<0.05)。透射电镜可见模型组小鼠腰髓前角神经细胞萎缩,细胞膜皱缩,线粒体不同程度肿胀,嵴出现断裂、减少,有些线粒体虽可辨认,但已呈空泡状,核膜凹陷变形或部分破裂,异染色质聚集成块,变性的神经细胞周围可见胶质细胞围绕形成卫星现象;与模型组比较,手针组和电针组小鼠腰髓前角神经细胞超微结构有所改善,且电针组改善更明显。结论:夹脊电针能够改善ALS-SOD1^(G93A)转基因小鼠腰髓前角运动神经元形态学变化,其效果优于手针治疗。

皮肤针治疗带状疱疹后遗神经痛研究进展

带状疱疹后遗神经痛(postherpetic neuralgia,PHN)病位在皮部,主要累及肝、脾二脏,久则及肾。其发生涉及内、外两个因素,内因有年老体弱、素体亏虚、正气不足、情志内伤、饮食不节等,外因则与外感火毒湿热时邪有关。其病机有虚实两种,实为肝经湿热火毒蕴积与血气搏结,造成局部气血凝滞,经脉瘀阻不通,脏腑气机不畅则痛;虚为正气虚弱,无力抗邪,外感火毒之邪后,余邪未尽日久化火,耗伤阴血,阴血亏虚不能濡养肌肤经脉,不荣则痛。故该病治疗需要兼顾内外虚实,以扶正祛邪、理气活血、通络止痛为主。皮肤针治疗PHN可因势利导、诱邪外出,既能活血祛瘀、通络止痛,又可振奋经气、调节脏腑,常用治疗方法有:皮肤针放血、皮肤针联合普通针刺、皮肤针联合灸法、皮肤针联合中药、皮肤针联合西药等。皮肤针治疗PHN,临床叩刺部位选择主要为局部叩刺,其次是阿是穴、夹脊穴的穴位叩刺。目前,皮肤针治疗PHN的临床研究仍存在以下问题:观察的样本量较小,缺乏多中心、大样本研究;疗效评价以观察性指标为主,缺乏实验室指标观察,实验结果主观性较强,缺乏客观真实性;临床应用型研究多,基础理论型研究少;PHN易复发,病程迁延时间长,部分临床研究仅关注近期疗效,缺少后期随访;治疗主要以缓解疼痛为主,缺乏对患者的心理疏导。建议加强皮肤针治疗PHN的基础研究,注重客观疗效标准,同时注意后期随访及心理疏导,设计更为严谨的科研方案。

温针灸治疗稳定期慢性阻塞性肺疾病的疗效观察

目的基于冬病夏治理论,观察三伏天温针灸夹脊穴治疗稳定期慢性阻塞性肺疾病的临床疗效。方法将符合纳入标准的60例稳定期慢性阻塞性肺疾病患者随机分为对照组和治疗组,每组30例。对照组予穴位贴敷治疗,治疗组在对照组穴位贴敷治疗基础上予温针灸夹脊穴治疗。比较两组治疗后3个月和治疗后6个月的临床疗效和患者症状加重次数。观察两组治疗前、治疗后3个月和治疗后6个月慢阻肺评估测试问卷评分(chronic obstructive pulmonary disease assessment test,CAT)评分的变化。结果治疗后3个月,治疗组总有效率为93.3%,高于对照组的73.3%,差异具有统计学意义(P<0.05)。治疗后6个月,两组总有效率比较,差异无统计学意义(P>0.05)。治疗后3个月和治疗后6个月,两组CAT评分和患者症状加重次数均低于同组治疗前(P<0.05),且治疗组均低于对照组(P<0.05)。结论在穴位贴敷基础上,三伏天温针灸夹脊穴治疗稳定期慢性阻塞性肺疾病可降低患者6个月内症状加重次数,改善咳嗽、咳痰和胸闷症状,提高临床疗效。

电针对模型兔退变腰椎间盘蛋白多糖、Netrin-1表达的影响

目的观察夹脊电针对模型兔退变腰椎间盘蛋白多糖、Netrin-1表达的影响。方法20只新西兰兔随机分为正常组、模型组、假模型组、模型+电针组、模型+假电针组,每组4只。采用轴向压力诱导制造腰椎间盘退变模型。第28天正常组、模型组、假模型组取出椎间盘组织,模型+电针组和模型+假电针组行夹脊电针干预,第56天取椎间盘组织。用AB-PAS检测椎间盘蛋白多糖含量,采用免疫组化方法检测Netrin-1在椎间盘中的表达。结果正常组与假模型组PAS染色、Netrin-1表达差异无统计学意义(P>0.05);对比假模型组,模型组PAS染色增强、Netrin-1增多(P<0.05);与模型组比较,模型+电针组PAS染色部分减弱、Netrin-1明显下调(P<0.05);模型+假电针组PAS染色较模型+电针组明显减弱,而Netrin-1表达有所上调(P<0.05)。结论电针能上调椎间盘组织中黏多糖表达及水的含量,下调退变椎间盘Nerin-1中的表达,促进椎间盘组织修复。

针刺治疗椎-基底动脉供血不足疗效观察

目的观察针刺项后9穴为主治疗椎-基底动脉供血不足的临床疗效。方法将100例椎-基底动脉供血不足患者随机分为治疗组和对照组,每组50例。治疗组采用针刺风府、风池、完骨、天柱、C3夹脊穴治疗,对照组采用口服尼莫地平片治疗。观察两组治疗前后TCD各项指标及眩晕评定量表的评分系统(DARS)平均评分,并比较两组临床疗效。结果治疗组治疗后TCD各项指标与同组治疗前比较,差异均具有统计学意义(P<0.05)。对照组治疗后TCD相关指标[Vs(RVA)、Vd(BA、LVA)、Vm(BA、RVA)、PI(BA)]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TCD相关指标[Vs(BA、LVA、RVA)、Vd(BA、RVA)、Vm(BA、LVA)、PI(BA)]与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗7 d后DARS平均评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。两组治疗后DARS平均评分与同组治疗7 d后比较,差异均具有统计学意义(P<0.01)。治疗组治疗7 d后及治疗后DARS平均评分与对照组比较,差异均具有统计学意义(P<0.01)。治疗组愈显率和总有效率分别为76.0%和98.0%,对照组分别为44.0%和96.0%。两组愈显率比较,差异具有统计学意义(P<0.05)。结论针刺项后9穴是一种治疗椎-基底动脉供血不足的有效方法。

夹脊电针通过miR-128-3p/ATG12轴干预大鼠脊髓损伤后神经功能的机制研究

目的分析夹脊电针对大鼠脊髓损伤后神经功能的影响,并探讨其可能机制。方法将40只Wistar大鼠随机分为假手术组、模型组、夹脊电针组以及夹脊电针+anta-miR-128-3p组,每组10只。假手术组与模型组不做处理,夹脊电针组给予电针干预(每日1次,每次20 min,连续2周),夹脊电针+anta-miR-128-3p组在末次电针刺激后,尾静脉注射anta-miR-128-3p。干预结束后通过行为学(Basso Beattie Bresnahan,BBB)评分评估大鼠运动功能;苏木素-伊红染色与原位末端标记法染色观察大鼠脊髓病理改变以及凋亡情况;免疫荧光法测定脊髓组织神经元特异性核蛋白(neuron-specific nuclear protein,NeuN)阳性表达;qRT-PCR法检测脊髓组织miR-128-3p、自噬相关蛋白12(autophagy-related protein 12,ATG12)mRNA水平;Western blot法检测ATG12蛋白表达;双荧光素酶报告基因验证miR-128-3p与ATG12关系。结果假手术组脊髓结构完整,排列整齐;模型组大鼠脊髓结构紊乱,神经元数量减少,存在大量炎性浸润;夹脊电针组脊髓结构紊乱现象有所减轻,炎性浸润减少;与夹脊电针组比较,夹脊电针+anta-miR-128-3p组脊髓损伤加剧;与假手术组比较,模型组大鼠BBB评分、miR-128-3p水平、NeuN阳性神经元数量降低(P<0.05),凋亡率、ATG12 mRNA水平与ATG12蛋白表达升高(P<0.05);夹脊电针组大鼠BBB评分、miR-128-3p水平、NeuN阳性神经元数量高于模型组(P<0.05),凋亡率、ATG12 mRNA水平与ATG12蛋白表达低于模型组(P<0.05);与夹脊电针组比较,夹脊电针+anta-miR-128-3p组大鼠BBB评分、miR-128-3p水平、NeuN阳性神经元数量降低(P<0.05),凋亡率、ATG12 mRNA水平与ATG12蛋白表达升高(P<0.05);miR-128-3p与ATG12靶向结合。结论夹脊电针可能通过调控miR-128-3p/ATG12轴,改善脊髓损伤大鼠神经功能损伤。

CLINICAL OBSERVATION ON 40 CASES OF ANKYLOSING SPONDYLITIS TREATED WITH ACUPUNCTURE AND CHINESE DRUGS

Objective: To observe the clinical therapeutic effect of acupuncture plus Chinese herbal medicines for ankylosing spondylitis (AS). Methods: A total of 80 cases of AS patients were evenly and randomly divided into treatment group and control group. In treatment group, patients were treated with acupuncture of Jiaji (夹脊EX-B 2) and oral administration of Yishen Tongdu Wan (益肾通督丸,Bolus for Reinforcing the Kidney and Dredging Governor Vessesl) and those of control group treated with oral administration of Sulfasalazin (0.5 g, twice daily). Before and after treatment, the thoracic-dilaion scale, Schober test, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) were detected separately. Results: After 6 months of treatment, of the both 40 cases in treatment and control groups, 27 (67.5%) and 13 (32.5%) were improved remarkably, 11 (27.5%) and 16 (40.0%) effective, and 2 (5.0%) and 11 (27.5%) failed, with the effective rates being 95.0% and 72.5% separately. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). After treatment, the thoracic-dilaion scale and Schober test values increased significantly (P<0.05), while BASDAI, BASFI, ESR and CRP lowered considerably (P<0.01, P<0.05). Comparison between two groups indicated that after treatment, the decreased values of BASDAI, BASFI, ESR and CRP of treatment group were significantly lower than those of control group (P<0.01), while those of the thoracic-dilaion scale and Schober test of treatment group were significantly higher than those of control group (P<0.05, P< 0.01). Results displayed that both acupuncture combined with Chinese drugs and Sulfasalazin could lower BASDAI, BASFI, ESR and CRP, raise the thoracic-dilaion scale and Schober test values considerably in AS patients, and the therapeutic effect of combined acupuncture and Chinese drugs was apparently superior to that of Western medicine. Conclusion: Joint application of acupuncture and Chinese drugs is superior to Western medicine in the therapeutic effect for AS and has fewer side effects.