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.

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.

百会穴久留针法改善缺血性脑卒中小鼠神经功能的作用及机制

目的研究百会穴久留针法通过脑源性神经营养因子(BDNF)/酪氨酸受体激酶B(TrkB)通路改善缺血性脑卒中小鼠神经功能的作用及机制。方法选择雄性C57BL/6J小鼠48只,随机分为假手术1组、模型1组、久留针1组、普通留针组,每组12只。后3组采用线栓法制备缺血性脑卒中模型,手术造模后第1天起久留针1组和普通留针组分别给予百会穴久留针和普通留针治疗,连续14 d。另选择雄性C57BL/6J小鼠40只,随机分为假手术2组、模型2组、久留针2组、久留针3组,每组10只。后3组采用线栓法制备缺血性脑卒中模型,针灸治疗前分别给予腺相关病毒100μl单次尾静脉注射。采用改良神经功能缺损评分(mNSS)及水迷宫实验的逃避潜伏期、目标象限停留时间、穿越原平台次数评价神经功能。结果与假手术1组比较,模型1组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织BDNF、TrkB表达明显降低,细胞凋亡率及裂解型半胱氨酸天冬氨酸蛋白酶3(Caspase-3)表达明显增加,差异有统计学意义(P<0.05);与模型1组比较,久留针1组和普通留针组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织BDNF、TrkB表达明显增加,细胞凋亡率及裂解型Caspase-3表达明显降低,且久留针1组上述变化较普通留针组更为显著,差异有统计学意义(P<0.05)。与久留针2组比较,久留针3组mNSS评分、目标象限停留时间、穿越原平台次数及缺血脑组织中BDNF表达明显降低(P<0.05),细胞凋亡率及裂解型Caspase-3表达明显增加[(16.41±2.25)%vs(7.59±1.09)%;1.46±0.16 vs 0.94±0.12,P<0.05]。结论百会穴久留针治疗对缺血性脑卒中小鼠神经功能的改善作用更为显著,激活BDNF/TrkB通路是其发挥神经保护作用的相关分子机制。

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。

电针预处理对大鼠脑缺血再灌注后小胶质细胞极化的影响

目的探讨电针预处理对大鼠脑缺血再灌注(IR)后小胶质细胞极化的影响以及与酪氨酸激酶2(JAK2)/信号传导及转录活化因子3(STAT3)通路的关系。方法选择健康清洁级雄性SD大鼠45只,随机分为假手术组、IR组和电针组,每组15只。IR组采用线栓法建立大鼠IR损伤模型,电针组造模前连续5 d行电针刺激百会穴,假手术组仅暴露颈部血管。再灌注后24 h,采用改良神经功能缺损评分(mNSS)观察各组大鼠神经功能损伤程度,氯化三苯四氮唑染色观察脑梗死体积,Western blot检测经典激活型(M1)标志物诱导型一氧化氮合酶(iNOS)和替代激活型(M2)标志物精氨酸酶1(Arg-1)、磷酸化JAK2、JAK2、磷酸化STAT3及STAT3蛋白表达,定量聚合酶链反应检测M1标志物iNOS mRNA和M2标志物Arg-1 mRNA表达,检测肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)表达。结果与假手术组比较,IR组和电针组mNSS、脑梗死体积、磷酸化JAK2/JAK2、磷酸化STAT3/STAT3、iNOS蛋白、iNOS mRNA、Arg-1蛋白、Arg-1 mRNA、TNF-α和IL-10表达明显升高,差异有统计学意义(P<0.01)。与IR组比较,电针组mNSS、脑梗死体积、磷酸化JAK2/JAK2、磷酸化STAT3/STAT3、iNOS蛋白、iNOS mRNA、TNF-α表达明显降低(P<0.01),Arg-1蛋白、Arg-1 mRNA、IL-10表达明显升高[2.0±0.2 vs 1.5±0.1,4.2±0.8 vs 3.1±0.3,(49.1±7.1)pg/mg vs(27.9±5.9)pg/mg,P<0.01]。结论电针预处理可促进脑IR后小胶质细胞向M2极化,抑制向M1极化,其机制可能与抑制JAK2/STAT3通路有关。

项七针针刺联合百会压灸治疗颈性眩晕的疗效观察

目的观察项七针针刺联合百会压灸治疗颈性眩晕的临床疗效。方法将90例颈性眩晕患者随机分为治疗组和对照组,每组45例。对照组采用项七针针刺治疗,治疗组在对照组基础上采用百会穴压灸治疗。两组治疗后均采用海特光照射颈枕部。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、颈性眩晕症状与功能评估量表(evaluation scale for cervical vertigo,ESCV)评分及颈部红外热成像温度的变化情况,比较两组临床疗效。结果两组治疗后ESCV评分及红外热成像温度均较同组治疗前显著升高,VAS评分显著降低,差异均具有统计学意义(P<0.05)。治疗组治疗后ESCV评分及红外热成像温度明显高于对照组,VAS评分明显低于对照组,差异均具有统计学意义(P<0.05)。治疗组治疗后总有效率为93.2%,明显高于对照组的77.8%,差异具有统计学意义(P<0.05)。结论项七针针刺联合百会穴压灸可明显改善颈性眩晕患者的临床症状,缓解疼痛,有助于提高患者生活质量。

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.

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.

不同针刺量对大鼠脑缺血后突触可塑性的影响

【目的】观察不同针刺量对脑缺血后海马齿状回(DG)突触可塑性的影响。【方法】选用Wistar大鼠36只,随机分为假手术组、缺血模型组、治疗1组(每日针刺1次)、治疗2组(每日针刺2次),采用热凝闭大鼠大脑中动脉法复制局灶性脑缺血模型,治疗1、2组给予电针百会、大椎穴治疗。观察不同针刺次数对脑缺血后DG区突触可塑性的影响。【结果】与假手术组比较缺血模型组兴奋性突触后电位(EPSP)、群峰电位(PS)的输入/输出曲线(I/O曲线)幅度显著降低(P<0.05);与缺血模型组比较治疗1组EPSP、PS的I/O曲线显著升高(P<0.01或P<0.05),与假手术组比较无显著性差异(P>0.05)。与缺血模型组比较治疗2组EPSP、PS的I/O曲线显著升高(P<0.05),与假手术组比较EPSP的I/O曲线幅度降低(P<0.05),而PS的幅度无显著性差异(P>0.05);与治疗1组比较治疗2组EPSP的I/O曲线幅度降低(P<0.05),PS的幅度无显著性差异(P>0.05)。EPSP的长时程增强(LTP)幅度缺血模型组较假手术组显著升高(P<0.05),两个治疗组较假手术组显著升高(P<0.05),与缺血模型组比较及组间比较均无显著性差异(P>0.05)。PS的LTP幅度缺血模型组较假手术组显著降低(P<0.05),两个治疗组显著高于缺血模型组(P<0.05),与假手术组比较及组间比较均无显著性差异(P>0.05)。EPSP的长时程抑制(LTD)幅度缺血模型组较假手术组降低(P<0.05),两个治疗组EPSP的LTD幅度较假手术组显著降低(P<0.05),与缺血模型组比较及组间比较均无显著性差异(P>0.05)。缺血模型组PS的LTD幅度与假手术组比较无显著性差异(P>0.05),治疗1组PS的LTD幅度与假手术组比较显著升高(P<0.05),与缺血模型组比较无显著性差异(P>0.05);治疗2组与其他3组比较均无显著性差异(P>0.05)。【结论】针刺对缺血引起的海马DG区EPSP、PS的I/O曲线幅度变化起保护作用,能修复缺血造成的海马DG区PS的LTP诱导的损害,而不同针刺量对改变脑缺血后海马的LTP诱导方面的作用无显著性差异。

电针对不同时间段局灶性脑缺血大鼠缺血区突触数密度、面密度的影响

【目的】探讨电针对脑缺血后突触重建的干预作用。【方法】45只Wistar大鼠随机分为假手术组、缺血模型组和电针组,每组又分为1 h、1 d、3 d、1周、3周5个时间段进行观察,采用热凝闭大脑中动脉法复制局灶性脑缺血模型,电针组给予电针百会、大椎穴治疗。每个时间段后分别取材,采用透射电镜观察缺血区大脑皮层突触的结构、数密度、面密度的变化规律以及电针对其影响。【结果】缺血模型组于1 h、1d、3 d时数密度、面密度显著性下降(P<0.001,与同时段假手术组比较),3周时数密度有所升高但仍与假手术组有显著性差异(P<0.01);电针组数密度、面密度于1d时较缺血模型组显著性升高(P<0.01),3d、1周后进一步升高(P<0.001),与假手术组相仿。【结论】电针从早期即可抑制脑缺血后的突触数量、面积的减少,并在恢复过程中促进其尽快地修复。这为电针在不同时间段促进突触重建和脑缺血恢复提供了形态学基础。

针刺调节MAPK/ERK通路对脑缺血模型大鼠的干预作用

【目的】观察电针调节丝裂原活化蛋白激酶/细胞外信号调节激酶(MAPK/ERK)通路对脑缺血模型大鼠的干预作用。【方法】选用SD大鼠,随机分为假手术组、模型组和电针组,每组又分为2 h、1 d、3 d 3个亚组,后2组采用热凝闭大脑中动脉法复制局灶性脑缺血模型。电针组针刺百会、大椎穴,每天1次,分别治疗2 h、1 d、3 d。每组均进行神经行为学评分及Y迷宫测试,并采用免疫组化法检测脑组织CA1区、CA3区磷酸化EPK(p-EPK)阳性细胞表达的积分光密度值总和(Dsum)。【结果】模型组大鼠神经行为学评分显著升高、Y迷宫测试时间显著延长(均P<0.01),电针1 d、3 d组可显著降低神经行为学评分,缩短Y迷宫测试时间,与模型组及电针2 h组比较差异均有显著性意义(P<0.05或P<0.01)。假手术组无p-EPK阳性细胞表达,模型组CA1区和CA3区Dsum显著升高(均P<0.01),电针各组CA1区、CA3区Dsum均较模型组显著降低(P<0.05或P<0.01),而电针1 d、3 d组Dsum降低幅度显著大于电针2 h组(均P<0.05)。【结论】电针可以通过调节MAPK/ERK通路,降低p-ERK在脑缺血早期的表达,从而改善脑缺血模型大鼠的脑组织损伤。

电针对局灶性脑缺血大鼠缺血区皮层神经生长因子表达的影响

探讨针刺对缺血性脑损伤的保护作用。【方法】SD大鼠36只,随机分为假手术组、缺血模型组和电针组, 每组又分为2周和5周两个时间段组;除假手术组外,其他组均采用热凝闭大鼠大脑中动脉法复制局灶性脑缺血模型,采用免疫组化法观察缺血2周和5周后缺血区皮层神经生长因子(NGF)的变化规律以及针刺对其影响。【结果】两个假手术组大鼠手术侧皮层只见到很少的NGF免疫阳性细胞;两个缺血组大鼠脑缺血区皮层NGF免疫活性细胞的表达与假手术组比较显著增多(P<0．01),缺血5周组与缺血2周组相比缺血区皮层NGF阳性细胞的数量下降(P<0．01);电针组在2周时缺血区皮层NGF免疫阳性细胞的表达增高,与缺血2周组、假手术2周组相比差异具有显著性意义(P<0．01);电针5周组大鼠脑缺血区皮层NGF免疫阳性细胞表达虽呈下降趋势,但仍高于同时间段的缺血组大鼠(P<0．01)。【结论】电针可以增加大鼠脑缺血区皮层NGF的分泌和表达时程,这可能是其保护缺血性脑损伤的机制之一。

病理状态下针刺百会穴对脑功能成像特征的影响

【目的】观察病理状态下,针刺百会穴对脑部作用的特异性。【方法】选择10例血管性痴呆(VD)患者,随机分为A、B 2组。A组以针对偏瘫的常规针刺,B组加用百会穴治疗,共完成20次治疗。治疗前后所有患者接受正电子发射型计算机断层显像(PET)和单光子发射型计算机断层显像(SPECT)脑功能成像检查,并比较常规针刺和加用百会穴后局部脑区葡萄糖代谢和血流量变化幅度。【结果】B组加用百会穴后,VD患者患脑额叶、丘脑、尾核、小脑的葡萄糖代谢升高幅度大于常规针刺治疗的A组(P<0.05);健脑额叶、顶叶、枕叶、丘脑、豆状核、小脑的葡萄糖代谢升高幅度大于常规针刺治疗的A组(P<0.05)。VD患者患脑额叶、颞叶、小脑的血流量升高幅度大于常规针刺治疗的A组(P<0.05);健脑顶叶、颞叶、枕叶、小脑的血流量升高幅度大于常规针刺的A组(P<0.05)。【结论】针刺百会穴,能够相对特异地作用于VD患者的各脑叶和小脑,提高其葡萄糖代谢和血流量。

电针对血管性痴呆大鼠学习记忆能力的改善作用及其机理探讨

【目的】观察电针对血管性痴呆(vascular dementia,VD)大鼠学习记忆能力的影响及其可能的机理。【方法】选择SPF级成年健康SD大鼠50只,随机抽取8只大鼠为假手术组,其他42只均采用4血管阻断法复制缺血模型。将造模成功的大鼠按随机数字表法分为电针组、尼莫通组和模型组。假手术组和模型组同等条件下饲养,未予任何治疗。电针组针刺模型大鼠头部百会穴,背部双侧膈俞穴、脾俞穴和肾俞穴,连接电针仪,施以连续波,频率150 Hz,1次/d,连续治疗15 d。尼莫通组模型大鼠给予尼莫通12 mg/kg,1次/d,连续15 d。治疗15 d后采用Morris水迷宫学习记忆行为测试法测定大鼠学习记忆能力,采用双波长分光光度计法检测大鼠血浆CO含量,分光光度比色法测定缺血脑组织中NO的含量。【结果】模型大鼠表现出明显的学习记忆障碍,在水迷宫实验中,其逃避潜伏期显著性延长,在原平台象限跨越相应平台次数与其他3个象限无显著性差异,血浆CO和脑组织NO水平显著性升高。而电针组逃避潜伏期较模型组显著性缩短,相同时间内跨越原平台次数显著性多于其他3个象限,血浆CO和脑组织NO含量较模型组大鼠显著降低(均P<0.05或P<0.01)。【结论】电针治疗血管性痴呆的作用可能与其改善VD大鼠学习记忆能力,显著性降低血浆CO和脑组织NO含量有关。

Therapeutic observation on improving efficacy of moxibustion at Bǎihuì(百会 GV 20) for insomnia

Objective To compare the therapeutic effect between needling combined with moxibustion at Baihui （百会 GV 20） and conventional needling for treatment of insomnia, and to verify the synergy of moxibustion at Baihui （百会 GV 20） on insomnia. Methods Two hundreds and seven cases of insomnia patients were randomly divided into observation group and control group. The conventional needling combined with moxibustion at Baihui （百会 GV 20） was applied in observation group, and the conventional needling was employed in control group, once a day, and for 5 consecutive days per week, 4 weeks as a course, and 1 course in total. Pittsburgh Sleep Quality Index （PSQI） Scale was adopted before and after the treatment, and the therapeutic effects of two groups as well as of asthenia and sthenia syndromes and among syndromes were observed and compared in observation group. Results After treatment, PSQI scores of both groups significantly improved （both P〈0.05）, and the score of observation group was superior to that of control group （P〈0.05）; after 1 course, the total effective rate in observation group was 88.0% （88/100）, superior to 74.5% （73/98） in control group （P〈0.05）; in observation group, the total effective rate was 92.4% （61/66） of asthenia syndrome, superior to that of 79.4% （27/34） of sthenia syndrome （P〈0.05）. Conclusion Needling combined with moxibustion at Baihui （百会 GV 20） has marked therapeutic effect on insomnia, with better effect on prolonging the time of sleep, improving the sleep quality than that of single needling. And the therapeutic effect on asthenia syndrome was superior to that of sthenia syndrome.

针刺对抑郁症患者康复及血清中细胞因子的影响

目的探讨针刺百会、足三里对抑郁症患者康复疗效的影响及其相关机制。方法将90例抑郁症患者随机分为电针观察组、电针对照组、药物对照组。电针观察组取百会、足三里穴;电针对照组取太冲、三阴交、内关、神门穴;药物对照组给予百优解口服,20mg/次,每日1次。3组均治疗6周。在治疗前后分别用汉密尔顿抑郁量表(HAMD)评分。采用酶联免疫分析法(ELISA)检测血清中白细胞介素2(IL-2),白细胞介素4(IL-4)以及干扰素-γ(IFN-γ)的水平。结果与治疗前比较,治疗后3组患者的HAMD评分明显降低(P<0.01);临床疗效等级分布具有明显差异,提示针刺百会、足三里穴有较好的疗效;血清中IL-4水平较治疗前明显降低(P<0.01)。治疗后电针观察组和电针对照组血清中IL-2和IFN-γ升高(P<0.01,P<0.05),药物对照组也有升高,但无统计学意义。结论电针观察组与电针对照组比药物对照组起效快;电针观察组疗效优于电针对照组和药物对照组;3种治疗方法能够改善血清中IL-2、IL-4和IFN-γ的水平,从而改善抑郁症症状。但是3种治疗方法疗效比较没有差异。