针刺四关穴缓解无痛胃镜诊疗术中并发呃逆疗效观察

目的 基于“气逆动膈”理论,观察针刺四关穴缓解无痛胃镜诊疗术中并发呃逆的有效性和安全性。方法 将100例无痛胃镜诊疗术中并发呃逆的患者随机分为治疗组和对照组,每组50例。治疗组采用针刺双侧合谷、太冲穴治疗,对照组不做任何治疗。观察并记录两组呃逆持续时间、胃镜治疗时间、麻醉苏醒时间及不同时间点各项血流动力学指标[平均动脉压(mean arterial pressure, MAP)、心率(heart rate, HR)、血氧饱和度(oxygen saturation, SPO_(2))],比较两组临床疗效。结果 治疗组治疗后治愈率和总有效率分别为50.0%和82.0%,明显高于对照组的14.0%和48.0%,两组比较差异均具有统计学意义(P<0.05)。治疗组呃逆持续时间、胃镜治疗时间均明显少于对照组(P<0.05)。两组呃逆开始时SPO_(2)水平均较基础值显著下降(P<0.05)。治疗组施针后5 min和10 min SPO_(2)水平均明显高于对照组,两组比较差异均具有统计学意义(P<0.05)。结论 针刺四关穴治疗无痛胃镜诊疗术中并发呃逆疗效确切,能有效减少患者呃逆持续时间和胃镜治疗时间。

电针合谷对牙髓痛大鼠模型三叉神经节和牙髓中P2X4受体的影响

目的观察电针合谷对实验性牙髓痛大鼠三叉神经节和牙髓中P2X4受体表达的影响.方法成年雄性SD大鼠42只,随机分为正常组(N组)、对照组(C组)、牙髓痛组(M组)、拮抗剂组(A组)、电针组(E组)、拮抗剂+电针组(AE组),每组7只.N组不做任何处理;C组在钻好的牙髓腔内注入与M组等量的生理盐水,浸润后将牙洞封闭;M组在钻好的牙髓腔内注入大肠杆菌内毒素(LPS),浸润后牙洞封闭;A组造模方法同M组,在注入LPS时,将A-317491同时注射进牙髓;E组同M组造模后,电针双侧合谷,留针30 min,每日1次,共治疗3次;AE组按A组造模后按E组方法治疗.每日治疗后观察大鼠的行为学变化及体质量变化,第4天处死所有大鼠,运用RT-PCR方法分别检测大鼠三叉神经节和牙髓中P2X4受体(mRNA)表达,比较各组P2X4受体mRNA相对表达量.结果 A组、E组、AE组行为学变化均显著低于M组(P<0.01);E组、AE组体质量差值均显著高于M组(P<0.01);AE组体质量差值显著高于A组和E组(P<0.01);E组体质量差值高于A组(P<0.05);E组、AE组三叉神经节和牙髓中P2X4受体mRNA表达量低于M组(P<0.01).结论 LPS诱导大鼠牙髓痛时三叉神经节和牙髓P2X4受体mRNA表达量增加,电针合谷可降低LPS诱导牙髓痛大鼠P2X4受体mRNA表达,这可能是电针合谷镇痛的机制.

电针上肢穴位对运动皮层躯干脑区皮质脊髓兴奋性的影响

目的观察电针上肢穴位对健康受试者初级运动皮层(primary motor cortex,M1)躯干脑区皮质脊髓兴奋性的影响。方法纳入15名健康受试者,采用交叉设计。试验一观察电针上肢穴位对竖脊肌(erector spinae,ES)皮质脊髓兴奋性的影响,受试者随机先后进入3组试验,A组电针合谷穴,B组电针孔最穴,C组假针合谷穴。运用经颅磁刺激,检测干预前后对侧M1第一骨间背侧肌、桡侧腕屈肌及ES的运动诱发电位(motor evoked potentials,MEPs)的波幅和潜伏期,ES的MEPs波幅升高者进入试验二。试验二为抑制背侧前运动皮层(premotor cortex,PMd)后电针上肢穴位对ES的皮质脊髓兴奋性的作用研究,受试者随机先后进入两组试验,D组采用抑制PMd配合电针合谷穴干预,E组采用抑制PMd配合电针孔最穴干预。观察并比较两组对侧M1上肢脑区和躯干脑区MEPs的波幅和潜伏期。结果A组和B组干预后上肢脑区及躯干脑区MEPs总波幅均较同组干预前显著增加(P<0.001,P<0.01)。A组干预后上肢脑区及躯干脑区MEPs总波幅均明显高于C组,B组干预后仅躯干脑区MEPs总波幅明显高于C组,差异均具有统计学意义(P<0.001)。D组干预后上肢脑区最佳刺激点MEPs平均波幅及总波幅较同组干预前均显著增加(P<0.05)。D组和E组干预前后躯干脑区最佳刺激点的MEPs平均波幅及总波幅比较,差异也均无统计学意义(P>0.05)。结论生理状况下,电针合谷、孔最穴均可增强ES的皮质脊髓兴奋性,二者之间无明显差异,PMd可能参与其过程。

Study on the Regulatory Effect of Electro-acupuncture on Hegu Point (LI4) in Cerebral Response with Functional Magnetic Resonance Imaging

Objective： To study, through blood oxygen level dependent functional magnetic resonance imaging （BOLD fMRI）, the cerebral activated areas evoked by electro-acupuncturing （EA） the right Hegu point （LI4） or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods： EA was applied at volunteers＇ right LI4 （of 9 subjects in the LI4 group） and facial non-acupoint points （of 5 subjects in the control group）, and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm^3 used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results： Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients＇ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group （P〈0.01）. In the LI4 group, the areas which showed signal activation were： midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were： bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were： bilateral frontal lobe, postcentral gyrus, Reil＇s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion： The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect＇s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research.

应用磁共振波谱研究针刺对健康人前额叶神经递质影响的性别差异

目的采用磁共振波谱MEGA-PRESS序列,观察针刺合谷穴对不同性别健康人前额叶内神经递质谷氨酸(glutamate,Glu)、谷氨酰胺(glutamine,Glx)及r-氨基丁酸(γ-aminobutyric acid,GABA)浓度变化的影响。方法分别采集76例健康受试者刺激前及刺激(手针和纤毛针)合谷穴时磁共振波谱(MRS)数据,采用t检验及Pearson统计,分析刺激前后Glu^(+)、Glx^(+)和GABA^(+)浓度变化的性别差异及相关性。结果手针刺激前男性Glu^(+)浓度明显高于女性(P<0.05),手针刺激时男性Glu^(+)和Glx^(+)浓度均明显高于女性(P<0.05);纤毛针刺激前男性Glx^(+)浓度明显高于女性(P<0.05),纤毛针刺激时男性Glu^(+)和Glx^(+)浓度均明显高于女性(P<0.05);但手针和纤毛针刺激前和刺激时男性GABA^(+)浓度与女性比较,差异无统计学意义(P>0.05)。手针刺激前和刺激时,性别与Glu^(+)及Glx^(+)浓度均呈正相关(P<0.05);纤毛针刺激前和刺激时,男性与Glu^(+)及Glx^(+)浓度呈正相关(P<0.05);手针和纤毛针刺激前和刺激时,性别与GABA^(+)浓度均无明显相关性(P>0.05)。结论大脑前额叶内兴奋性神经递质(Glu和Glx)浓度可能存在性别差异,针刺合谷穴对大脑兴奋性神经递质浓度的影响可能存在性别差异。

Influence of Needling Point Hegu(LI4)on Colonoscopy

目的:研究结肠镜检前针刺双合谷对镜检患者及对插镜时间的影响。方法:依接受镜检单、双序号将全部结肠镜检患者185例分为针刺组(93例)、对照组(92倒)。针刺组在镜检前30min 针刺双合谷,对照组不予任何防治措施。分别观察两组过乙状结肠和横结肠时的疼痛级别并记录插镜时间。结果:共有165例患者完成插镜确定为有效病例,其中针刺组84例,对照组81例。统计表明,针刺组患者在过横结肠及乙状结肠时疼痛级别较对照组显著低(P<0.01),针刺组的插镜时间较对照组短(P<0.05)。结论:结肠镜检前针刺双合谷可有效降低结肠镜检时患者的不适并缩短镜检时间。

基于磁共振波谱研究针刺合谷穴对健康人前额叶代谢物影响的性别差异

目的应用磁共振波谱研究针刺合谷穴对健康人前额代谢物浓度影响的性别差异。方法纳入68例健康受试者,其中男19例,女49例。毫针或纤毛针刺激右侧合谷穴,分别采集刺激前及刺激时磁共振波谱数据,分析不同性别刺激前和刺激时肌醇(inositol,Ins)、总胆碱(total choline,tCho)、N-乙酰天门冬氨酸(N-acetyl-aspartate,NAA)、总乙酰天冬氨酸(total N-acetyl-aspartate,tNAA)、总肌酸(total creatine,tCr)浓度变化。结果不同性别刺激前和刺激时,毫针和纤毛针Ins^(+)、tCho^(+)、NAA^(+)、tNAA^(+)、tCr^(+)浓度比较,差异均无统计学意义(P>0.05)。毫针和纤毛针刺激前,不同性别Ins^(+)、NAA^(+)、tNAA^(+)、tCr^(+)浓度比较,差异无统计学意义(P>0.05);毫针刺激前,男性tCho^(+)浓度高于女性,差异有统计学意义(P<0.05);纤毛针刺激前,男性tCho^(+)浓度略高于女性,差异无统计学意义(P>0.05)。男性毫针和纤毛针刺激时Ins^(+)、tCho^(+)、NAA^(+)、tNAA^(+)、tCr^(+)浓度与刺激前比较,差异无统计学意义(P>0.05);女性毫针刺激时Ins^(+)浓度较刺激前降低(P<0.05);女性纤毛针刺激时NAA^(+)浓度较刺激前降低(P<0.05);女性毫针和纤毛针刺激时tNAA^(+)浓度较刺激前升高(P<0.05)。结论健康人大脑前额叶代谢物浓度存在性别差异,针刺能引起健康女性大脑前额叶代谢物浓度变化。

针刺四关穴联合益肾熄风汤治疗帕金森病的疗效观察

目的观察针刺四关(合谷和太冲)穴联合益肾熄风汤治疗帕金森病老年患者的临床疗效。方法用随机数字表法将103例帕金森病老年患者分为观察组(51例)和对照组(52例)。两组均予常规治疗,在此基础上,对照组采用口服益肾熄风汤治疗,观察组采用针刺四关穴联合口服益肾熄风汤治疗。比较两组临床疗效,比较两组治疗前后氧化应激指标[超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)和谷胱甘肽(glutathione,GSH)]水平和日常生活能力[统一帕金森病评分量表Ⅱ(unified Parkinson’s disease rating scaleⅡ,UPDRSⅡ)]评分的变化。结果治疗后,观察组总有效率高于对照组(P<0.05)。治疗后,两组血清MDA水平均较治疗前降低(P<0.05),SOD和GSH水平均较治疗前升高(P<0.05)。治疗后,两组UPDRSⅡ评分均较治疗前降低(P<0.05),且观察组UPDRSⅡ评分低于对照组(P<0.05)。结论在常规治疗基础上,针刺四关穴联合益肾熄风汤治疗老年帕金森病可提高疗效,改善患者日常生活能力,能调节患者氧化应激指标的水平。

Effect of electroacupuncture at Ximen(PC 4) and Hegu(LI 4) on expression of Akt in rats with myocardial ischemia-reperfusion injury

OBJECTIVE: To investigate the effect of electroacupuncture(EA) at acupoints on the pericardium meridian on the expression of phosphorylated Akt(p-Akt) protein in rat myocardium after ischemia and reperfusion.METHODS: Seventy Wistar rats were evenly randomized into seven groups: the sham operation group(group A), ischemia-reperfusion model Ⅰgroup(group B), ischemia-reperfusion model Ⅱgroup(group C), EA at Neiguan(PC 6) group(group D), EA at Ximen(PC 4) group(group E), EA at Hegu(LI 4) group(group F), and LY294002 + EA at Neiguan(PC 6) group(group G). All processes were monitored by electrocardiography. In group A, the left anterior descending coronary artery was only threaded without ligation for 100 min. In group B,the left anterior descending coronary artery was ligated for 40 min and reperfused for 60 min. The left anterior descending coronary artery in group C was ligated for 40 min and reperfused for 100 min.Groups D, E, and F received EA for 20 min before undergoing ischemia for 40 min, and then received EA for 20 min before undergoing reperfusion for 60 min. Before modeling, group G was injected with LY294002(0.3 mg/kg) into the tail vein, and then underwent the same intervention as the other EA groups. After reperfusion, myocardial tissue from the left cardiac ventricle was collected to enable Western blot analysis of the p-Akt level, and analysis of electrocardiographic changes.RESULTS: In groups B and C, electrocardiography showed obvious elevation of the ST-segment Ⅱlead(ECG-STⅡ), while the ECG-STⅡvalues were significantly lower in groups D, E, and G(P < 0.01). The p-Akt levels in groups D and E were significantly greater than those in groups B and C(P < 0.01).Compared with all other groups, group G showed a significantly different expression of p-Akt(P < 0.01).CONCLUSION: The expression of p-Akt protein in cardiomyocytes was significantly greater in rats that were injected with LY294002 and received EA at Ximen(PC 4) compared with all other groups.This suggests that EA at Ximen(PC 4) resulted in activation of the phosphoinositide 3-kinase/Akt signaling pathway and phosphorylation of Akt.

Differences in thermal effects of moxibustion at Zusanli(ST 36) and Hegu(LI 4) on various facial areas in healthy people

OBJECTIVE:To study the effects of temperature on different facial areas by suspended moxibustion at two points,Zusanli(ST 36) and Hegu(LI 4),and probe the phenomena underlying self-regulation in the human body after thermal stimulation.METHODS:Thirty healthy volunteers accepted moxibustion over Zusanli(ST 36) and Hegu(LI 4),and the order of moxibustion points was randomly determined.Moxibustion method:suspension of moxibustion over Zusanli(ST 36) and Hegu(LI 4) on both sides was performed using an ignited moxa stick stuck in a support for 20 min.Observation method:An infrared thermal image of the face was taken before and after suspended moxibustion using a CK350 medical infrared thermal imaging instrument.Data analysis:A thermal microscopic section view system(TMTSys) was used to analyze the change in temperature in special facial areas.Statistical analysis was carried out using SPSS 14.0 software.RESULTS:Before moxibustion was suspended,the facial thermal image showed a T-shaped thermal area related to the vascular distribution with even temperature and good symmetry on both sides.Suspended moxibustion over Zusanli(ST 36) have a very significant increase in temperature at the forehead,around the nose,at the corners of the mouth,and at the cheeks and lips(P<0.01).Suspended moxibustion over Hegu(LI 4) also have a significant(P<0.05) increase in temperature around the nose,the corners of the mouth,the cheeks,and lips,where has a new high temperature area was formed(P<0.01).Suspended moxibustion over Hegu(LI 4) raised the temperature at the middle point of the lips more obviously than did Zusanli(ST 36) in the same person,(P<0.05).After 10 min of moxibustion over Zusanli(ST 36) and Hegu(LI 4),the change in temperature in the facial area reached its peak value.CONCLUSIONS:Facial infrared thermography of healthy people revealed a T-shaped thermal area reflecting a physiological thermal area.Moxibustion over Zusanli(ST 36) or Hegu(LI 4) raised the temperature in this facial T-shaped thermal area.Hegu(LI 4) led to the formation of a new thermal area in the lips.The time required for moxibustion to regulate human body temperature was 10 min.

Effects of Hegu (LI 4) and Taichong (LR 3) on Vascular Dilation and Constriction in Migraine Patients

Hegu(LI 4)and Taichong(LR 3)are the Yuan-Primaryacupoints of the Large Intestine and LiverMeridian,and are collectively named as Si Guan(four gates)point.Combined use of these twoacupoints can harmonize yin and yang,regulate

Analgesic effect of acupuncture at Hegu (LI 4) on transvaginal oocyte retrieval with ultrasonography

OBJECTIVE: To observe the analgesic effect of acupuncture at Hegu (LI 4) in vitro fertilization-embryo transfer (IVF-ET) transvaginal oocyte retrieval using ultrasonography and explore its mechanism. METHODS: Ninety patients undergoing IVF-EF oocyte retrieval were randomly divided into three groups: an acupuncture group with needles inserted into bilateral Hegu (LI 4) points, a placebo group given placebo needles, and a control group with routine oocyte retrieval. Each group had an indometacin enema 30 min before the operation. We compared the pain-rated index (PRI), visual analogy scale (VAS), and present pain intensity (PPI) immediately after operation and 1 h after operation. We also determined the neuropeptide Y (NPY) level of the follicular fluid. RESULTS: PRI, VAS, and PPI after operation and 1 hafter operation in the acupuncture group were significantly lower than those in the control group (P< 0.01). No obvious difference (P>0.05) was observed in PRI,VAS, and PPI after operation and 1 h after operation between the placebo group and the control group.The NPY level of the follicular fluid in the acupuncture group was significantly higher than that in the control group (P<0.01). No obvious difference (P>0.05) was observed in the NPY level of the follicular fluid between the placebo group and the control group. CONCLUSION: The analgesic effect of acupuncture at Hegu in transvaginal oocyte retrieval using ultrasonography may be related to the increase in the NPY level of the follicular fluid.

基于数据挖掘探析复溜主治优势病症与配伍规律

目的:探析1949年10月前文献中复溜的主治优势病症及配伍规律。方法:检索1949年10月前复溜穴相关文献,建立SQL Server数据库,应用“五输穴主治与配伍数据挖掘软件QLZJ1.0版”对数据进行频数分析、关联分析和聚类分析。结果:共纳入符合标准的文献条文561条,频数分析结果示单穴主治优势病症为腰痛、脉厥等28种,配伍主治优势病症为水肿、伤寒无汗等26种,配伍腧穴频率最高的是合谷,频率最高的经脉是足太阳膀胱经,特定穴使用频率最高的是五输穴;关联分析结果示复溜优势配穴7对;聚类分析结果示复溜优势配伍穴组4类。结论:复溜主治优势病症以肢体经络、气血津液、肾系及脾胃系病症为主,尤以腰痛、汗证、水肿为核心优势病症;复溜配伍多采用表里经配穴法和本经配穴法,多与阳经腧穴相配,配伍特定穴时以交会穴、原穴和合穴为主。

Treatment of Toothache by Puncturing Hegu （LI 4）

目的：观察针刺合谷穴治疗牙痛的临床疗效。方法：将278例病例随机分为治疗组（139例）和对照组（139例），治疗组采用电针针刺合谷穴治疗，对照组采用电针针刺承山穴治疗，疗程为3d，分别对疼痛分级及镇痛情况进行观察。结果：治疗ld拔针前显效率比较，实验组与对照纽无统计学意义（P〉0．05），其余各时间点显效率实验组均明显高于对照组（P〈0．05）。结论：针刺合谷穴治疗牙痛有效。

Forty-five Cases with Epigastric Pain Treated with Puncturing Hegu(LI 4)

Epigastric pain,also known as stomach pain,is presented with frequently recurrent pain in the upper abdomen or stomach area,which is mainly caused by exogenous pathogen,improper diet or internal injuries due to seven emotions.All 45 cases with epigastric pain caused by various factors were treated with mainly needling Hegu(LI 4)between November 2010 and November 2012,and the report is given as follows.

“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病临床观察

目的:观察“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病的临床疗效。方法:选取2020年1月至2022年7月上海市静安区中医医院收治的颈椎病患者112例,按照随机数字表法分为对照组与研究组各56例。对照组给予常规针刺治疗,研究组在对照组治疗的基础上行“气伤痛”理论指导下针刺合谷穴、太冲穴治疗。观察两组患者治疗前后症状评分、疼痛视觉模拟评分(visual analogue scale, VAS)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein, CRP)、P物质(substance p, SP)、血管阻力指数(resistant index, RI)、搏动指数(pulsitility index, PI)、收缩期峰值血流速度(peak systolic velocity, PSV)及临床疗效。结果:研究组有效率为94.64%,对照组有效率为82.14%,研究组有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后症状评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);研究组治疗后TNF-α、CRP、SP低于对照组,差异有统计学意义(P<0.05);研究组治疗后RI、PI低于对照组,PSV高于对照组,差异有统计学意义(P<0.05)。结论:“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病,能有效减轻患者疼痛,改善患者症状。

The Safety of Electroacupuncture at Hegu(LI 4) plus Oxytocin for Hastening Uterine Contraction of Puerperants—A Randomized Controlled Clinical Observation

Objective:To investigate the safety of electroacupuncture plus oxytocin for uterine contraction of puerperants.Methods:276 puerperants with difficult labor were randomly divided into a medication group,treated with intravenous dripping of oxytocin,and an acupuncture plus medication group,in the medication group,intravenous dripping of oxytocin was given,and in the other group,acupuncture at bilateral Hegu(LI 4) was added.Heart rate,respiratory frequency,blood pressure of puerperants,fetal heart rate and birth process were observed.Results:During laboring,the indices observed,including heart rate,respiratory frequency,blood pressure,fetal heart rate and birth process,were all in normal range in all of the 276 cases,with better effects in acupuncture plus medication Group M.Conclusions:Electroacupuncture at bilateral Hegu(LI 4) plus intravenous dripping of oxytocin can intensify the uterine contraction,shorten the birth process to avoid probable systemic exhaustion due to excessive consumption,and with no side effects on life signs of the puerperants and newborns.

电针周围性面瘫患者左侧合谷穴的fMRI研究

目的:采用功能性磁共振成像(fMRI)技术,研究电针周围性面瘫患者合谷穴对脑功能的影响。方法:筛选左侧周围性面瘫患者6例为研究对象,电针刺激左侧合谷穴,同时行全脑fMRI扫描,SPM软件进行图像后处理,t检验(P<0.01)分析得出电针合谷穴的脑功能图像。结果:刺激左侧合谷穴引起同侧(左侧)中央前回、中央后回及多个脑区信号的变化。结论:从"可视性"角度揭示了电针合谷穴与面部存在密切的内在联系,并进行了推测。

“面口合谷收”神经生理机制的fMRI研究

目的:利用功能性磁共振(fMRI)探讨"面口合谷收"的神经生理机制。方法:研究对象为20例健康志愿者,均针刺左侧合谷穴,采用相同的磁共振扫描序列采集针刺任务态fMRI数据。利用AFNI程序分析任务态fMRI的针刺脑激活区,对所有的功能数据进行组分析,并利用Monte Carlo方法对分析结果进行多重比较校正(P=0.05,α<0.05)。结果:针刺左侧合谷穴引起多个脑区激活,信号增高区域包括右侧中央前回、中央后回、顶下小叶、颞横回、岛叶、丘脑、豆状核、壳核及双侧小脑;信号降低的脑区包括左侧额上回、额中回、中央前回、扣带回、颞中回等。其中,右侧中央后回中下部大面积区域均显示激活。结论:研究结果表明,针刺合谷穴能同时激活中央后回初级感觉皮层的手部投射区和面口部投射区,同时激活了面口部的运动皮层,直接反映了合谷穴和面口部的密切联系,为"面口合谷收"理论提供了客观的证据。

经皮神经电刺激用于分娩镇痛的临床研究

目的:观察经皮神经电刺激(TENS)合谷、三阴交、足三里穴用于分娩镇痛的临床效果并探讨其作用机制。方法:80例产妇随机分为2组,A组为TENS穴位组(临产后即予以TENS合谷、三阴交、足三里穴直至胎儿娩出);B组为对照组(不实施分娩镇痛)。记录2组产妇不同时点视觉模拟疼痛评分(VAS)、分娩结局及围生儿结局;于临产后(T_0)、宫口开全时(T_1)抽取静脉血检测2组产妇外周血β-内啡肽(β-EP)、皮质醇(Cor)及促肾上腺皮质激素(ACTH)的浓度。结果:A组产妇在产程潜伏期各时点VAS评分均低于B组,差异有统计学意义(P<0.05),但进入产程活跃期2组产妇VAS评分差异无统计学意义(P>0.05);A组产妇产程时间短于B组,差异有统计学意义(P<0.05);2组产妇产后出血量、新生儿Apgar评分差异无统计学意义(P>0.05)。与T_0时比较,2组产妇T_1时外周血β-EP、Cor及ACTH浓度均升高(P<0.05);A组产妇T_1时β-EP浓度高于B组(P<0.05),Cor及ACTH浓度低于B组(P<0.05)。结论:TENS合谷、三阴交、足三里穴可以很好地缓解潜伏期产痛,缩短产程,增加母婴安全性,其镇痛效果与β-EP含量明显增加及有效减少了产妇的应激反应有关,但活跃期镇痛不足是临床有待解决之处。