EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

Objective： To evaluate the short-term and middle-long-term therapeutic effects of deep puncture of Tianshu （天枢 ST 25） for slow transit constipation （STC）. Methods： Sixty cases of STC patients were evenly randomized into Methods： group and medication group. In acupuncture group, electroaoupuncture （EA, 20 Hz, continuous waves and tolerable strength） was applied to bilateral Tienshu （ST 25） for 30 min after deep puncture. The treatment was given once daily, 5 sessions every week, two weeks altogether. Patients of control group were ordered to take Lactulose （ 10mL/time, b. i. d）, two weeks altogether. Cleveland Constipation Score （CCS） and colonic transit time （COT） were used to evaluate the therapeutic effect. Results： After treatment, both COS and COT showed that the therapeutic effect of acupuncture group was significantly superior to that of medication group （P〈0.05）. Six-months＇ follow up showed that the therapeutic effect of acupuncture still maintained in 13 of the 22 cases visited, while that of control group only maintained in 1 of the 19 cases. Conclusion： The therapeutic effect of deep puncture of Tianshu （ST 25） for STC is definite and has a middle-long-term effect. The patients have no any unfavorable reactions.

Clinical observation on Tui-pushing the Large Intestine Meridian plus point sticking at Tianshu(ST 25) in prevention of post-stroke constipation

Objective： To observe the prevention effect of Tui-pushing the Large Intestine Meridian plus point sticking at Tianshu（ST 25） for post-stroke constipation. Methods： Seventy eligible patients with post-stroke constipation were randomized into a treatment group and a control group, 35 cases in each group. Both groups were intervened by conventional treatment and care in Western medicine, while the treatment group was also by Tui-pushing the Large Intestine Meridian and point sticking at Tianshu（ST 25）. The treatment lasted for 14 d. Therapeutic efficacy was evaluated by the first defecation time, constipation incidence and Chinese stroke scale（CSS） score. Results： After treatment, the first defecation time was（1.86 ± 0.74） d in the treatment group, shorter than（2.77 ± 0.83） d in the control group; constipation incidence was 14.3% in the treatment group, significantly lower than 37.1% in the control group, and the between-group differences in the two items were statistically significant（both P〈0.05）. CSS score in both groups dropped significantly after treatment（both P〈0.05）; the improvement in the treatment group was better than that in the control group, and the inter-group difference was statistically significant（P〈0.05）. Conclusion： Tui-pushing the Large Intestine Meridian plus point sticking at Tianshu（ST 25） can effectively prevent post-stroke constipation, and can also promote the rehabilitation of nerve functions.

Extracellular signal-regulated kinase, substance P and neurokinin-1 are involved in the analgesic mechanism of herb-partitioned moxibustion

Herb-partitioned moxibustion can effectively mitigate visceral pain, a major symptom in inflammatory bowel disease, but the analgesic lnechanism is still unclear. Moreover, extracellular signal-regulated kinase, substance P, and neurokinin-1 are involved in formation of central hyperalgesia. Thus, we postulated that the analgesic effect of herb-partitioned moxibustion may be associated with these factors. Accordingly, in this study, we established an inflammatory bowel disease visceral pain model in rat by enema with a mixed solution of 5% trinitrobenzenesulfonic acid and 50% ethanol. Bilateral Tianshu （ST25） and Qihai （CV6） points were selected for herb-partitioned moxi- bustion. Our results showed that herb-partitioned moxibustion improved visceral pain and down-regulated extracellular signal-regulated kinase, substance P, and neurokinin-1 protein and mRNA expression in dorsal root ganglia. These results indicate that down-regulation of extracellular signal-regulated kinase, substance E and neurokinin-1 protein and mRNA may be a central mechanism for the analgesic effect of herb-partitioned moxibustion.

A Systematic Review on Safety of Acupuncture for Chronic Constipation

Objective:The purpose of this study is to systematically evaluate the safety of acupuncture in the treatment of chronic constipation in order to minimize clinical risk.Methods:The Cochrane database,MEDLINE,EMBASE,CBM,CNKI,VIP database and Wanfang database were searched systematically.Randomized controlled trials(RCTs)with safety assessment of acupuncture for chronic constipation were included.The included trial data were independently extracted by two authors and analyzed using Cochrane Collaboration Review Manager software(Rev Man 5.3.5)after bias risk assessment.The primary outcome measure in this systematic review was the incidence of adverse effects.Results:A total of 20 RCTs were included,involving 3,747 patients,and were treated for 2 to 8 weeks.After integrating data from 9 trials comparing acupuncturing Tianshu(ST25)solely with oral lactulose,the incidence of adverse effects in the experimental group was significantly lower than that in the control group(RR 0.38,95%CI 0.23 to 0.64).Seven studies compared deep ST25 with shallow ST25 showed no significant difference in the incidence of adverse effects(RR 1.39,95%CI 0.59 to 3.28).6 studies compared acupuncture a group of points including ST25 with western medicine,result indicated the incidence of adverse effects in the experimental group was significantly lower than that in the control group(RR 0.42,95%CI 0.32 to 0.55).Conclusion:Acupuncture for chronic constipation is generally safe.The operation of deep acupuncture at Tianshu(ST25)should be conducted by professional acupuncturists with certain experience,and individualized deep acupuncture should be used as far as possible.The needle insertion should be slow,without lifting,inserting,twisting and other manipulations.

Clinical Research of Irritable Bowel Syndrome Treated by Electroacupuncture on Tianshu（ST 25）

Objectives： By observing and evaluating the clinical curative effect systematically of electrical acupuncture （EA） on Tianshu （ST 25） on diarrhea-predominant irritable bowel syndrome （D-IBS）, to make it benefit for the application and spread of EA on Tianshu （ST 25） on D-IBS. Methods： 103 D-IBS matched the involved standards were allocated into treatment group （EA on ST 25, n=53） and control group （EA on Daheng, SP 15, n=50） in randomized, controlled and single-blind ways. Curative effect differences were analyzed by Ridit analysis. Results： The incidence of diarrhea, abdominal pain, abdominal distention or abdominal discomfort, borborygmus, defecation urgency and defecation incompletion feeling were 100%, 89.3%, 71.8%, 74.8%, 83.5% and 78.6% respectively in D-IBS. Generally, after treatment, 11 cases got excellent results, 34 cases improved and 8 failed in treatment group, totally effective rate was 84.9%; while in control group, 4 cases got excellent effects, 26 improved and 20 failed, totally the effective rate was 60.0%. Conclusion： Compared with control group, EA on Tianshu （ST 25） has a better curative effect on D-IBS.

Effect of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV 6) for the treatment of diarrhea-dominant irritable bowel syndrome： a patient-blinded pilot trial with orthogonal design

OBJECTIVE: To investigate the effects of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV6) in patients with diarrhea-dominant irritable bowel syndrome(D-IBS) by assessing predominant factors, and determining the best factor combinations and their interactions. To identify the optimal quantity of warming moxibustion Tianshu(ST 25, bilateral) and Qihai(CV 6) to achieve optimal efficacy.METHODS: An L9(3~4) orthogonal design was applied to 233 confirmed subjects based on the three most influential factors and the three most frequently used levels. Nine programs were designed.Subjects were assigned to four subgroups according to age and gender; each subject underwent one of the nine programs randomly. We selected Tianshu(ST 25, bilateral) and Qihai(CV 6). The scores of symptoms and the IBS Quality of Life(IBS-QOL) were evaluated after the final treatment.RESULTS: After treatment, clinical symptoms of all patients were significantly improved(P = 0.001).Quality of life also improved significantly(P < 0.05).For all the participants, frequency was the dominating factor regarding symptoms(P = 0.01). Duration was the dominating factor for quality of life(P =0.0001). The best combination for improving symptoms in 30-40-year-old male and female patients was two courses of 10 min each once a day, and for41-50-year-old male and female patients it was three courses of 10 min(males) or 30 min(females)twice a day. The best combination for quality of life was three courses of 20 min once a day. No interaction was found between frequency and course, or frequency and duration.CONCLUSION: Warming moxibustion Tianshu(ST25, bilateral) and Qihai(CV 6) is a promising therapy for D-IBS. To acquire optimal efficacy, the three main factors(duration, frequency and treatment course) of the warming moxibustion should reach a specific quantity and be combined appropriately.

Clinical Study on Deep Insertion at Tianshu (ST 25) for Colonic Slow Transit Constipation

Objective：To observe the clinical effect of deep insertion at Tianshu（ST 25）for colonic slow transit constipation（STC）.Methods：120 cases of STC patients were randomly divided,60 cases in a deep insertion group,30 cases in an electroacupuncture group and 30 cases in a medication group by 2：1：1 ratio.The deep insertion group was treated with deep insertion at Tianshu（ST 25）.The electroacupuncture group was treated with routine insertion at Tianshu（ST 25）.The medication group was treated with oral administration of Lactulose oral liquid.The first voluntary defecation time,and constipation scores before the treatment,four weeks after the treatment and relevant scores of clinical symptoms were assessed in the three groups of the patients.Results：The scores of the clinical symptoms in improvement of constipation were better in the deep insertion group than in the electroacupuncture group and medication group,with differences in statistical significance（P〈0.01）.The unsuccessful numbers in the improvement of defecation and abdominal pain were also better in the deep insertion group than in the other two groups,and better in instant effect in the deep insertion.Conclusion：The improvement of STC clinical symptoms was better by deep insertion at Tianshu（ST 25）than by medication and routine acupuncture method at Tianshu（ST 25）.

Comparative study of electroacupuncture and moxibustion in influencing Tianshu(ST 25) regions mast cells in visceral hyperalgesia rats

Objective：To evaluate and compare electroacupunctures（EA） with different parameters and moxibustion at different temperatures influencing the activation of mast cells（MC） in Tianshu（ST 25） regions of visceral hyperalgesia model rats.Methods：Rats（except for model group） respectively accepted 1 m A or 3 m A EA or moxibustion at 43 or 4 to ℃ ℃stimulate Tianshu（ST 25） points after randomization of the fifty visceral hyperalgesia model rats,and then were compared with that in model and normal groups.Number,degranulation numbers,degranulation rates in Tianshu（ST 25） regions MC of rats in each group were observed using toluidine blue staining.Abdominal withdrawl reflex（AWR） score was used to evaluate the rat visceral hyperalgesia reactions.Results：Compared with the normal group and the model group,MC numbers（P〈0.05,P〈0.01,P〈0.01,P〈0.01）,degranulation numbers and degranulation rates（P〈0.01,P〈0.01,P〈0.05,P〈0.01） of Tianshu（ST 25） MC in regions tissues in 43 and 4 moxibustion groups,and 1 m A and 3 m℃ ℃A EA groups all increased significantly.Compared with the model group,AWR scores were significantly lower in 43 and 4 ℃ moxibustion groups,and 1 m A and 3 m℃A EA groups under the stimulation of 20 mm Hg,40 mm Hg,0 mm Hg or 80 mm Hg colorectal distension（CRD）（P〈0.05 in 1 m A and 3 m A EA groups under the stimulation of 20 mm Hg,P〈0.01 in the other groups）.AWR scores in 43 ℃and 4 ℃moxibustion groups under the stimulation of 20 mm Hg,40 mm Hg,0 mm Hg or 80 mm Hg CRD were not significantly different from those in the normal group（all P〈0.05）;AWR scores in 1 m A EA group under the stimulation of 0 mm Hg or 80 mm Hg were significantly higher than that in the normal group（P〈0.01）;AWR score in 3 m A EA group under the stimulation of 0 mm Hg was significantly higher than that in the normal group（P〈0.01）,and AWR scores in 3 m A EA group under the stimulation of 20 mm Hg or 80 mm Hg were also higher than that in the normal group（P〈0.05）.AWR scores were higher in 1 m A EA group under the stimulation of 40 mm Hg or 80 mm Hg than that in 4 moxibustion group（℃ P〈0.05）;AWR score was higher in 3 m A EA group under the stimulation of 40 mm Hg than that in 4 moxibustion group（℃ P〈0.05）.Conclusion：There are differences among EA of different parameters and moxibustion of different temperatures in activating on Tianshu（ST 25） regions MC of visceral hyperalgesia model rats,as well as in improving the visceral hyperalgesia reaction.The effect of 4 moxibustion℃ is the most significant.

Effect of herbal-partitioned moxibustion at Tianshu(ST 25) and Qihai(CV 6) on pain-related behavior and emotion in rats with chronic inflammatory visceral pain

Objective：To observe the effect of herbal-partitioned moxibustion （HPM） on pain-related behavior and emotion in a rat model of chronic inflammatory visceral pain, and to investigate the mechanism. 〈br〉 Methods：Twenty-four male Sprague-Dawley （SD） rats were randomly divided into three groups：a normal group, a model group and an HPM group. Except for the normal group, rats in the other two groups were clystered with mixed liquor of Trinitrobenzene Sulfonic Acid （TNBS） and 50%ethanol to induce the chronic inflammatory visceral pain model. After the models were established successfully, rats in the HPM group were treated with HPM at bilateral Tianshu （ST 25） and Qihai （CV 6）. Rats in the normal group and the model group were only fixed as those in the HPM group without treatment. Abdominal withdrawal reflex （AWR） score, mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL） were adopted to detect the visceral and somatic pain;meanwhile, open field test （OFT） and elevated plus maze test （EPMT） were employed to evaluate pain emotions such as depression and anxiety. 〈br〉 Results：Compared with the normal group, AWR scores of the model group were significantly increased under different stimulus expansion pressure level （P〈0.01）, MWT and TWL were significantly decreased （P〈0.05）;in OFT, the values of horizontal activities and vertical activities were significantly decreased （P〈0.01）;in EPMT, the proportion of the number of entry into the open arms （OE%） and that of residence time in the open arms （OT%） significantly decreased （P〈0.01）, indicating that the model was successful. Compared with the model group, the AWR score of the HPM group was decreased significantly （P〈0.05）, MWT and TWL were significantly increased （P〈0.05）, the values of horizontal activities and vertical activities in the model group were significantly increased （P〈0.01）;in OFT and EPMT, OE%and OT%were significantly increased （P〈0.01）. 〈br〉 Conclusion：HPM has analgesic effect on chronic inflammatory visceral pain. It can reduce the visceral and somatic pain in rats and markedly improve the emotions such as anxiety and depression induced by chronic visceral pain.

Therapeutic Effect Observation on Moxibustion at Tianshu (ST 25) for Acne Vulgaris

Objective： To observe the clinical efficacy of moxibustion at Tianshu （ST 25） for acne vulgaris. Methods： Medicinal cake based on pattern identification was used to conduct moxibustion on Tianshu （ST 25）. Results： After three courses of treatment, the recovery and marked effect rates reached 83.9%. The recovery and marked effect rates in those within 1-year duration reached 94.4%, including the recovery rate of 50.0%. This result is significantly better than those with longer than 1-year duration （P〈0.01）. The recovery and marked effect rates of acne vulgaris due to damp-heat in the stomach and intestine were superior to that due to wind-heat in the lung meridian （P〈0.05）. Conclusion： Medicinal cake-partitioned moxibustion can obtain a better effect for acne vulgaris. The earlier the treatment starts, the better the effect gets. In addition, this therapy works better for acne vulgaris due to damp-heat in the stomach and intestine than wind-heat in the lung meridian.

Effects of Acupuncture at Tianshu(ST25)and Shangjuxu(ST37)on the Intestinal Mucosa and Metabolites of Local Skin Tissues at Tianshu(ST25)in 2,4,6-Trinitrobenzene Sulfonic Acid and Ethanol-induced Rats

Objective:To observe the effect of acupuncture on local skin tissue metabolites of Tianshu(ST25)in rats with Crohn's disease(CD)using metabolomics and to explore the mechanism of acupuncture treatment metabolites and pathway on local skin tissue of Tianshu(ST25).Materials and Methods:Thirty-eight Sprague-Dawley rats were randomly assigned to a normal group(n=14)and a CD modeling group(n=24).Rats in the CD modeling group were administered with 2,4,6-trinitrobenzene sulfonic acid and ethanol enema,in addition to the normal group.Four normal rats and four CD modeling rats were selected at random after model identification was established.Furthermore,CD modeling group rats were randomly assigned to two groups of 10 rats:the model group and acupuncture group.Rats in the acupuncture group underwent acupuncture of Tianshu(ST25)and Shangjuxu(ST37)for 7 days.After the intervention,the colon tissue was collected from each group of rats and the pathological changes were observed through hematoxylin and eosin(HE)staining.The local skin tissues at Tianshu(ST25)of the rats in each group were taken,and the proton nuclear magnetic resonance technique was used to detect the metabonomics of the local skin tissues of Tianshu(ST25)in rats.Results:Compared with the normal group,the following were observed in the model group after HE staining:irregular colon morphology and other pathological changes such as intestinal mucosal hyperemia,edema,ulcers,polyps,and inflammatory cell infiltration.In the acupuncture group,colon tissue structure was relatively complete and layered,the colon gland structure was restored,and inflammatory cell infiltration was significantly improved.The choline,glycerin,glycine,guanidoacetic acid,and proline levels were significantly higher in the model group than in the normal group(P<0.05 or P<0.01).Compared with the model group,the acupuncture group had significantly increased contents of alanine,leucine,L-phenylalanine,and tyrosine in the skin(P<0.05 or P<0.01).Valine,leucine,and L-isoleucine biosynthesis and L-phenylalanine metabolism were the main metabolic pathways involved in the changes in the local skin tissues of the rats in each group,biosynthesis of tyrosine,and tryptophan.Conclusion:The change in the metabolites in the local area of Tianshu(ST25)may be related to intestinal disease.The acupuncture of Tianshu(ST25)can improve intestinal inflammatory reaction in rats with CD,and this finding may be related to the regulation of amino acid metabolites and their pathways in the local acupoint tissues of Tianshu(ST25)by acupuncture.

Effects of acupuncture at “Tianshu”(ST25) on electro-activity and mechanical motility of migrating motor complex during jejunal digestion period in rats with detached jejunum

Objective To observe the effects of acupuncture at"Tianshu"(ST 25)on electro-activity and mechanical motility at different phases of migrating motor complex(MMC)during jejunal digestion period in rats with detached jejunum,so as to explore the effect and mechanism of acupuncture on regulating intestinal movement.Methods Sixteen adult SD rats were selected.

针刺俞募配穴治疗功能性便秘疗效观察

【目的】比较针刺俞募配穴与口服枸橼酸莫沙必利片治疗功能性便秘的远期疗效。【方法】采用随机对照研究方法,将63例功能性便秘患者随机分为俞募组33例和药物组30例。俞募组给予针刺俞募配穴治疗(取穴双侧天枢、大肠俞),药物组给予口服枸橼酸莫沙必利片治疗。2组均连续治疗4周。比较2组在治疗后第1、4、8周总排便次数、粪便性状及排便困难程度与基线期的变化情况。【结果】治疗后,2组的周总排便次数、粪便性状、排便困难度均较治疗前显著改善,差异有统计学意义(P<0.05)。组间比较,除治疗第1周2组的周总排便次数、粪便性状、排便困难度与治疗第4周2组的排便困难程度的改善无显著性差异(P>0.05)外,俞募组的周总排便次数、粪便性状的改善均显著优于药物组(P<0.05)。随访期第8周,2组3个指标均较治疗前显著改善(P<0.05),且俞募组的改善优于药物组(P<0.05)。【结论】针刺俞募配穴治疗功能性便秘的远期疗效优于口服枸橼酸莫沙必利片。

深刺天枢治疗老年性便秘近期观察

目的 :评价深刺天枢治疗老年性便秘近期疗效。方法 :采用随机单盲 (盲患者 )安慰对照前瞻性研究方法 ,对照观察深刺天枢和常规深度针刺天枢治疗老年性便秘的近期疗效 ,并初步评价深刺天枢的安全性。结果 :深刺组总有效率 10 0 0 % ,近期治愈率 5 7 7% ;常规针刺组分别是 38 0 %及 0 ,差异具有非常显著性意义 ,而且深刺天枢穴是安全的。结论 :深刺天枢是治疗老年性功能性便秘的较好方法。

电针天枢穴对重症急性胰腺炎大鼠血清促炎和抗炎因子的影响

目的:探讨电针天枢穴对牛黄胆酸钠诱导的重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠血清促炎和抗炎因子的影响。方法:将66只SD雄性大鼠随机分为假手术组、模型组、电针组,每组22只。通过胆胰管注射3.5%牛黄胆酸钠制作SAP模型。电针组分别在模型制作成功后和处死前给予电针天枢穴治疗各30min(2/100Hz,2mA)。各组大鼠分别于术后3、6和12h分批处死,留取血液及胰腺组织标本,酶联免疫吸附法检测各组血清中肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)和白细胞介素10(interleukin-10,IL-10)的浓度,苏木精和伊红染色观察各组胰腺组织病理变化并进行评分。结果:在术后3、6和12h时模型组血清TNF-α、IL-6浓度和3、6h时的IL-10浓度均高于假手术组(P<0.05)。术后6和12h时,电针组血清TNF-α、IL-6浓度较模型组明显降低,IL-10浓度、IL-10/TNF-α浓度比值较模型组升高(P<0.05),胰腺组织病理学评分较模型组明显降低(P<0.05)。结论:电针天枢穴可以减轻SAP大鼠胰腺病理损伤,其作用机制可能是通过下调TNF-α、IL-6等促炎细胞因子的释放,并一定程度提高抗炎细胞因子IL-10水平,重建促炎和抗炎细胞因子的平衡,减轻SAP炎症的进一步发展。

不同穴位电针治疗偏头痛效果及其影响因素的研究

目的:比较电针丘墟穴和天枢穴对偏头痛的疗效,探讨影响疗效的因素。方法:将275例患者随机分为试验组138例,采用电针丘墟穴治疗;对照组137例,采用电针天枢穴治疗。观察两组的疗效,并对影响因素进行分析。结果:试验组即时有效率为70.3%,对照组为58.4%,两组比较,P<0.05,治疗4周、随访3个月和6个月疗效比较均P<0.001,电针丘墟穴的效果优于电针天枢穴;电针治疗偏头痛对从事脑力劳动人群、治疗时疼痛评分高、偏头痛发作次数多的人群即时镇痛效果更好;电针治疗偏头痛的长期疗效丘墟穴优于天枢穴。结论:电针丘墟穴治疗偏头痛的疗效优于天枢穴,患者的职业和病情等是影响疗效的因素。

深刺天枢穴联合个体化生物反馈对功能性便秘患者盆底表面肌电及胃肠激素的影响

目的观察深刺天枢穴联合个体化生物反馈治疗功能性便秘患者的临床疗效和对盆底表面肌电与胃肠激素水平的影响。方法 94例功能性便秘患者随机分为对照组和观察组,每组47例。对照组采用针刺联合固定模式生物反馈治疗,观察组在对照组基础上采用深刺天枢穴联合个体化生物反馈治疗。观察两组治疗前后盆底表面肌电、胃肠激素、临床症状积分的变化,并比较两组临床疗效。结果观察组总有效率为97.9%,对照组总有效率为87.2%,观察组总有效率与临床疗效优于对照组(P<0.05)。两组治疗后盆底表面肌电、胃肠激素水平、临床症状积分均较同组治疗前改善(P<0.05),且观察组均优于对照组(P<0.05)。结论个体化深刺天枢穴联合生物反馈可提高功能性便秘患者的临床疗效,改善盆底表面肌电特征指标与胃肠激素分泌水平,减轻患者临床症状程度。

艾灸预处理天枢穴对溃疡性结肠炎大鼠结肠TLR4/TRIF信号通路调节作用的研究

目的观察艾灸预处理天枢穴对溃疡性结肠炎(ulcerative colitis,UC)大鼠结肠TLR4/TRIF信号通路的影响,探讨艾灸预处理防治UC的作用机制.方法将28只SD雄性大鼠随机分为正常组、模型组、隔药灸预处理组和温和灸预处理组.采用4%葡聚糖硫酸钠水溶液连续饮用7 d制备UC模型.隔药灸预处理组、温和灸预处理组先干预7 d后,模型组、隔药灸预处理组、温和灸预处理组再制备UC模型.采用HE染色法,观察大鼠结肠组织病理学变化;应用免疫组化、免疫印记技术检测大鼠结肠TLR4、TRIF、TRAF6、IRF3、IKK的蛋白表达.结果模型组大鼠结肠黏膜结构损伤较正常组明显加重;隔药灸预处理组和温和灸预处理组,结肠黏膜结构损伤较模型组明显改善.与正常组比较,模型组结肠TLR4、TRIF、TRAF6、IRF3、IKK蛋白表达均显著升高(P<0.05);与模型组比较,隔药灸预处理组、温和灸预处理组结肠TLR4、TRIF、TRAF6、IRF3蛋白表达均显著降低(P<0.05),隔药灸预处理组结肠IKK蛋白表达显著降低(P<0.05).结论艾灸预处理天枢穴能下调UC大鼠结肠TLR4、TRIF、TRAF6、IRF3蛋白表达;下调TLR4/TRIF信号通路相关分子的蛋白表达可能是艾灸预处理防治UC的作用机制之一.

天枢穴结合头部足运感区埋线对脑卒中后便秘患者血清SP、VIP含量影响的研究

目的:观察双侧天枢穴、双侧头部足运感区埋线治疗中风后便秘的临床效果及其对血清SP、VIP含量的影响。方法:选择90例符合纳入及排除标准的脑卒中患者为研究对象,按随机数字表法进行随机分组,分别为埋线组、针刺组和番泻叶组3组,每组各30例。均给予常规基础护理,埋线组采用双侧天枢、双侧足运感区穴位埋线治疗,每7天埋线1次,共埋2次;针刺组采用针刺双侧天枢、双侧头部足运感区治疗,每日针刺1次,治疗2周;番泻叶组每日服用1次番泻叶,间断或连续服用2周。3组患者分别于治疗前后进行大便性状评分量表、临床评分量表(CCS)、便秘患者生存质量量表(PAC-QOL)评定和测定血清中SP、VIP含量。结果:治疗后3组患者大便性状、CCS和PAC-QOL评分均较疗前明显降低(P<0.05),但疗后3组间大便性状评分比较无统计学差异(P>0.05),CCS、PAC-QOL评分比较埋线组、针刺组均较番泻叶组明显降低(P<0.05),且埋线组降低更为明显(P<0.05)。针刺组与其他两组临床总有效率比较均无统计学差异(P>0.05),而埋线组临床总有效率明显优于番泻叶组(P<0.05);埋线组愈显率明显优于其他两组(P<0.05)。与疗前相比3组患者疗后血清SP含量明显升高、VIP含量明显降低(P<0.05),且治疗后埋线组与其他两组比较有统计学差异(P<0.05)。结论:天枢穴结合头部足运感区埋线治疗脑卒中后便秘疗效较好,能显著改善中风后便秘患者的症状,其发挥作用可能与调节血清中SP、VIP的含量、促进消化道平滑肌的收缩、加快蠕动、重塑排便反射有关。

电针深刺天枢穴改善结肠慢传输型便秘患者临床症状及满意度的疗效观察

目的:评价电针深刺天枢穴对结肠慢传输型便秘患者临床症状及满意度改善的有效性及安全性。方法:将结肠慢传输型便秘患者128例,以2:1:1比例随机分为深刺组、西药组及浅刺组。3组均治疗4周,疗后12周及疗后6个月随访,评价各组治疗前、后的排便相关症状、治疗满意度以及电针深刺天枢穴的安全性等。结果:电针深刺天枢穴改善结肠慢传输型便秘患者临床症状的疗效与乳果糖口服液一致,且在某些症状的改善方面较乳果糖口服液有明显优势,可有效改善随访满意度评分,并具有良好的安全性。结论:深刺电针天枢穴对改善结肠慢传输性便秘患者的临床症状及满意度疗效肯定、安全性高,其综合疗效优于国内外推荐的有循证医学证据的一线便秘药物乳果糖口服液,是一种值得临床推广运用的针灸方案。