Effects of moxibustion at bilateral Feishu(BL13)and Xinshu(BL15)combined with benazepril on myocardial cells apoptosis index and apoptosis-related proteins cytochrome c and apoptosis-inducing factor in rats with chronic heart failure

OBJECTIVE:To observe the effects of moxibustion at bilateral Feishu(BL13)and Xinshu(BL15)combined with benazepril on myocardial cells apoptosis index,the expression levels of apoptosis-related proteins cytochrome c(Cyt-C)and apoptosis-inducing factor(AIF)in chronic heart failure(CHF)rats.METHODS:Sixty-five rats were randomly divided into normal group(n=10)and model-I group(n=55).After modeling,CHF rats in model-I group were divided into model group,moxibustion group,benazepril group,moxibustion plus benazepril group(abbreviated as aibei group,the same below),10 rats in each group.Echocardiogram index was examined by echocardiography.Hemodynamic indices were measured by rat cardiac function meter.Serum B-type brain natriuretic peptide(BNP)was detected by enzymelinked immunosorbent assay.Myocardial cells apoptosis index was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling staining.Pathological changes of myocardial tissues were observed by hematoxylin and eosin staining.The expression levels of Cyt-C and AIF in myocardial tissues were detected by Western blot.RESULTS:Compared with normal group,ejection fraction and left ventricular diameter shortening rate in model-Ⅰgroup were significantly reduced,myocardial cells of rats in model group exhibited unclear transverse striations,cells swellings and vacuoles,cardiac functions were deteriorated,serum BNP level,myocardial cells apoptosis index,and the expression levels of Cyt-C and AIF were significantly increased.Compared with model group,myocardial cells of rats in moxibustion group,benazepril group,and aibei group were dyed more evenly,muscle fibers were arranged relatively neatly,cardiac functions were improved,serum BNP level,myocardial cells apoptosis index,and the expression levels of Cyt-C and AIF were significantly decreased.Compared with aibei group,cardiac functions were worsened,myocardial cells apoptosis index,and the expression levels of Cyt-C and AIF were increased.CONCLUSION:Moxibustion at bilateral Feishu(BL13)and Xinshu(BL15)combined with benazepril could improve CHF better than moxibustion at bilateral Feishu(BL13)and Xinshu(BL15)or benazepril alone.The mechanisms might be that they can inhibit the expressions of Cyt-C and AIF,and inhibit the apoptosis of cardiomyocytes.

Orthogonal test on local temperature influenced by different parameters and manipulation types of An-pressing Xinshu (BL 15)

Objective:To explore the optimal thermal effect parameter combination of An-pressing manipulation based on the pressing force, time and frequency, and to compare the thermal effect differences between the rhythmic and the continuous An-pressing manipulations. Methods:Three levels of light, moderate and heavy pressing forces were determined according to the An-pressing forces of the clinical tuina physicians;the pressing time and frequency parameters were determined according to the literatures about An-pressing manipulation. The volunteers were stimulated by the homemade An-pressing manipulation stimulator on the right Xinshu (BL 15), and then the three-factor and three-level orthogonal tests were carried out according to the test sequence specified by the L9(34) orthogonal table, and the temperature before and after pressing was recorded by an infrared thermal imaging system to screen the best parameters for the thermal effect of the An-pressing manipulation, thus to determine the optimal pressing parameters. The optimal parameters were then used for both continuous and rhythmic An-pressing manipulations to stimulate the bilateral Xinshu (BL 15). The temperature changes after pressing and the duration of the thermal effect (temperature difference ≤0.5℃ on both sides) were recorded by the infrared thermal imaging system, to explore the differences in the thermal effects of different An-pressing manipulations. Results:Among the three factors of pressing force, time and frequency, the influences of different pressing forces on temperature were significantly different (F=32.843,P=0.030), and the influence of 2.5 kg pressing force was the most significant;the effects of different pressing time on temperature were significantly different (F=54.102,P=0.018), and the pressing time of 7.5 min was the most significant;the influences of different pressing frequencies on temperature were not statistically significant (F=2.181,P=0.314), though the influence of 10 times/min pressing frequency was the largest. The influences on temperature difference of the rhythmic and the continuous An-pressing manipulations were significantly different (P=0.031 on the left side andP=0.045 on the right side), but there was no statistical difference in the duration of the thermal effect (P=0.690). Conclusion:The An-pressing manipulation parameters that significantly affect the temperature difference are pressing force and time. The optimal combination of thermal effect parameters is pressing force of 2.5 kg, time of 7.5 min, and frequency of 10 times/min. The local thermal effect of the rhythmic An-pressing manipulation is significantly greater than of the continuous An-pressing manipulation.

Combined Acupuncture and Bloodletting on Chize(LU 5)and Weizhong(BL 40)for Chronic Eczema

Objective： To observe the clinical effect of combined acupuncture with bloodletting on Chize （LU 5） and Weizhong （BL 9） for chronic eczema. Methods： A total of 40 cases were randomly allocated into an observation group and a control group, 20 in each. Cases in the observation group were treated with acupuncture plus bloodletting on Chize （LU 5） and Weizhong （BL 9）, whereas cases in the control group were treated with acupuncture alone. The acupuncture was conducted once a day, bloodletting twice a week. The therapeutic efficacy was statistically analyzed after one month of consecutive treatment. Results： The recovery and total effective rates in the observation group were significantly higher than that in the control group （P〈O.05）. Conclusion： Combined acupuncture and bloodletting on Chize （LU 5） and Weizhong （BL 40） could obtain a better effect than acupuncture alone.

艾灸肺俞、心俞治疗慢性心衰临床观察

目的观察艾灸配合西药治疗慢性心衰的临床疗效。方法将60例患者随机分为对照组和治疗组,每组30例。对照组给予西药常规治疗;治疗组在西药常规治疗的基础上,采用艾条温和灸双侧肺俞、心俞穴,每穴灸治20 min,每日1次,共灸治4星期。比较两组治疗后临床疗效和心功能相关指标。结果对照组总有效率为76.7%,治疗组总有效率为90.0%,治疗组优于对照组(P<0.05);两组治疗后HR、CO、LVEF较治疗前有显著改善(P<0.01),治疗组治疗后HR、CO、LVEF与对照组比较有显著差异(P<0.01),治疗组治疗后HR、CO、LVEF改善状况优于对照组。结论艾灸配合西药治疗慢性心衰临床疗效优于单纯西药治疗。

内关、心俞与心脏相关的神经基础

应用辣根过氧化物酶（ＨＲＰ）法和荧光素双标记法，研究了家兔心脏与心俞穴、内关穴的外周神经联系，结果提示心脏和心俞穴、内关穴除通过中枢途径联系外，心俞穴和心脏可通过外周突分支投射的感觉神经元直接联系；支配心脏和内关穴的交感节后神经元之间，可能还存在直接或间接联系，此结果为穴位一内脏相关的机理提供了形态学证据。

肝俞、心俞埋线为主治疗甲亢262例临床观察

目的 :寻找安全有效、无毒副作用的治疗甲亢的方法。方法 :治疗组 1 40例 ,采用心俞、肝俞穴埋线配合小剂量他巴唑治疗 ;对照组 1 2 2例 ,采用单纯口服他巴唑治疗。两组治疗前后进行近期和远期疗效对比。结果 :治疗组近期总有效率 92 2 % ,远期总有效率 89 3 % ;对照组近期总有效率93 5 % ,远期总有效率 79 5 %。经统计学分析 ,两组近期疗效差异无显著性意义 (P >0 0 5 ) ,远期疗效差异有非常显著性意义 (P <0 0 0 5 )。结论

心俞、厥阴俞烧山火治疗心阳不振型早搏疗效观察

目的观察心俞、厥阴俞烧山火治疗心阳不振型心脏早搏的临床疗效。方法将114例心阳不振型心脏早搏患者随机分为A组、B组和C组,每组38例。A组针刺心俞、厥阴俞,行烧山火手法;B组针刺内关、神门、通里、巨阙、膻中等穴,行平补平泻手法;C组针刺悬钟、阳陵泉,行烧山火手法。3组均每日治疗1次,10次为1个疗程。治疗4个疗程后,比较各组动态心电图及临床疗效。结果 A组总有效率为76.3%,B组为31.6%,C组为23.7%,A组总有效率与B组和C组比较,差异均具有统计学意义(P<0.01)。A组治疗前后病情分级经Ridit分析,差异具有统计学意义(P<0.01)。B组和C组治疗前后病情分级经Ridit分析,差异均无统计学意义(P>0.05)。结论心俞、厥阴俞烧山火是一种治疗心阳不振型心脏早搏的有效方法。

穴位注射治疗冠心病的临床观察

目的 :寻找治疗稳定型冠心病的有效方法。方法 :将稳定型冠心病患者分为两组 ,实验组选取心俞、厥阴俞 ,用丹参注射液进行穴位注射 ,对照组按常规服用丹参滴丸。结果 :当实验组与对照组各 8例时 ,实验组疗效评价已优于对照组。结论 :穴位注射对稳定型冠心病有较好疗效。

“内关”“神门”“心俞”间协同作用与拮抗作用实验研究

目的 :探讨作用相似的腧穴间是否存在协同或拮抗作用。方法 :选用乌头碱诱发的家兔室性心律失常模型 ,以心律失常持续时间为指标 ,观察“内关”、“神门”、“心俞”单用及合用后的疗效差异。结果 :“内关”、“神门”、“心俞”单用有显著疗效 ,且作用相近 ,合用后疗效无显著提高或下降。结论 :作用相似且作用强度相近的腧穴间不易出现拮抗作用 。

针刺背俞穴治疗更年期抑郁症临床观察

目的观察针刺背俞穴为主治疗更年期抑郁症的临床疗效和不良反应。方法将60例患者随机分为治疗组30例和对照组30例,治疗组给予背俞穴为主的针刺治疗,主穴肺俞、心俞、膈俞、肝俞、脾俞、胃俞、肾俞,针刺补法;对照组口服尼尔雌醇（2 mg,每半月1次）加盐酸氟西汀胶囊（20~40 mg,1次/d）。10 d为1个疗程,2组分别观察3个疗程。采用HAMD量表为评定工具,分别于患者治疗前、治疗1、2、3个疗程后各评定1次,评价治疗效果和不良反应观察。结果 2组HAMD总分均逐渐下降,治疗组在治疗前、治疗1、2、3个疗程后的HAMD总分分别为：（26.97±5.13）、（23.59±6.15）、（16.13±6.93）、（11.73±5.58）,对照组的HAMD总分分别为：（27.15±3.69）、（23.18±4.56）、（19.08±1.30）、（15.32±3.86）,在2、3个疗程后,治疗组的总分明显低于对照组（P〈0.05）,差异有统计学意义;2组间的总有效率有显著性差异（P〈0.05）,差异有统计学意义,治疗组总有效率为93.33%,对照组为86.67%,治疗组优于对照组。结论针刺背俞穴为主从补益与调理脏腑入手,改善更年期抑郁症患者的症状。

Effect of electroacupuncture on expressions of acetylcholine and mucin 5AC in the lungs of rats with chronic obstructive pulmonary disease

Objective： To observe the effect of electroacupuncture （EA） on the expressions of acetylcholine （ACh） and mucin 5AC （MUC5AC） in the lungs of rats with chronic obstructive pulmonary disease （COPD）, and explore the mechanism of EA in treating COPD. Methods： Thirty Sprague-Dawley （SD） rats were randomly divided into a control group, a COPD group, and an EA group, with 10 rats in each group. The control group was a group of normal rats. The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide （LPS）. The COPD rats were treated with EA at bilateral Feishu （BL 13） and Zusanli （ST 36） in the EA group, 30 rain each time, once a day, successively for 14 d. The lung function was tested. The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid （BALF） were detected by enzyme-linked immunosorbent assay （ELISA）. Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs. The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction （RT-PCR） and Western blot （WB）, respectively. The immune response of MUC5AC was observed by immunohistochemistry. Results： Eight rats were left in each group, and the other two died. Compared with the control group, the total airway resistance （Raw） increased significantly and dynamic compliance （Cdyn） decreased significantly in the COPD group （P〈0.01）; compared with the COPD group, the Raw level declined significantly and Cdyn increased significantly in the EA group （P〈0.01）. The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group （P〈0.01, P〈0.001）; compared with the COPD group, the contents of ACh and MUC5AC were significantly lower in the EA group （P〈0.05, P〈0.001）. There was a negative correlation between MUC5AC content and lung function （P〈0.001）. The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group （P〈0.001）; compared with the COPD group, the expressions were significantly lower in the EA group （P〈0.01）. Compared with the control group, the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group （P〈0.001）; the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group （P〈0.001）. Conclusion： EA treatment can improve the lung function of COPD rats, which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.

Efficacy of electroacupuncture for patients with dry eye syndromes:a randomized controlled trial

Objective To observe the efficacy of electroacupuncture(EA)in treating dry eye syndromes(DES)and its regulatory effects on patient’s quality of life(QOL),anxiety,and depression.MethodsBy following a randomized controlled study design,eligible DES patients were allocated to an EA group(EAG)or an acupuncture group(AG).Patients in the AG were intervened by acupuncture alone,while in the EAG,electrical stimulation was applied to Cuanzhu(BL2)and Taiyang(EX-HN5)in addition to the same treatment in the AG.Changes in clinical manifestations,ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear-film break-up time(TF-BUT),cornea fluorescein staining(CFS),and corneal sensitivity(CS)were observed,as well as changes in the short-form 36-item health survey(SF-36)and hospital anxiety and depression scale(HADS)scores.ResultsThe scores of clinical symptoms,OSDI,and CFS decreased significantly in both EAG and AG when compared with the baseline values(P<0.05),respectively,while the TF-BUT and CS increased significantly(P<0.05),and the tear secretion of patients in the EAG increased(P<0.05).Compared with those before treatment,the scores of physical role functioning,general health perception,emotional role functioning,and mental health of patients in both EAG and AG showed significant increases after treatment(P<0.05),together with a marked decrease in the score of anxiety(P<0.05).Compared with the AG,the EAG obtained a more significant increase in STT-1(P<0.05).ConclusionDES patients respond well to both EA and acupuncture treatments,manifested by prolonged TF-BUT and improvement of CS.Meanwhile,the two approaches can improve QOL and reduce anxiety.Furthermore,EA appears more effective in increasing tear secretion than acupuncture alone.

麦粒灸对双转基因阿尔茨海默病小鼠额叶皮层及海马区Aβ_(1-42)表达的影响

目的:探讨在阿尔茨海默病(Alzheimer’s disease,AD)病理早期采用麦粒灸"心俞""肾俞"穴对转基因AD小鼠的治疗作用。方法:采用PCR法鉴定淀粉样前体蛋白/早老素1(APP/PS1)双转基因AD传代小鼠的基因表型,选取1.5月龄雌性转基因阳性Tg6799小鼠17只,随机分为模型组(9只)和治疗组(8只),同龄、同背景的C57BL/6J野生型雌性小鼠9只作为正常组。治疗组取双侧"心俞""肾俞"穴行麦粒灸治疗,每日1次,10次为一疗程,共治疗9个疗程。模型组、正常组均给予抓取、固定及放置未燃烧的艾炷等刺激。应用Morris水迷宫中逃避潜伏期、穿越平台的次数及目标象限停留时间百分比来评价小鼠的学习记忆能力,苏木精-伊红(HE)染色法观察小鼠脑组织形态学的改变,免疫组化法检测小鼠额叶皮层及海马区β-淀粉样蛋白1-42(β-amyloid protein,Aβ1-42)的表达水平。结果:经麦粒灸法治疗后,治疗组小鼠学习记忆能力提高,与模型组比较,逃避潜伏期缩短,穿越平台次数增多,目标象限停留时间延长(均P<0.05);治疗组穿越平台次数及目标象限停留时间与正常组比较差异无统计学意义(均P>0.05)。与正常组相比,模型组AD小鼠大脑额叶皮层、海马区Aβ1-42表达阳性面积和总光密度明显增高(均P<0.01);与模型组相比,治疗组大脑额叶皮层、海马区Aβ1-42表达阳性面积和总光密度明显减少(P<0.01,P<0.05)。结论:麦粒灸"心俞""肾俞"穴可显著改善APP/PS1转基因AD小鼠的学习记忆能力,抑制Aβ1-42的过度表达、聚集。

内关、心俞贴敷治疗缓慢性心律失常疗效观察

目的:观察吴茱萸穴位贴敷治疗缓慢性心律失常的疗效。方法:将患者随机分为观察组、对照组,每组30例。观察组给予吴茱萸内关、心俞贴敷,每日1次;对照组给予口服心宝丸,每次3丸,每日3次。两组均治疗4周后,观察患者疗效、24h动态心电图改善情况。结果:两组治疗后24h平均心率均较治疗前明显改善(均P<0.01),治疗后两组24h平均心率差异无统计学意义(P>0.05)。观察组临床疗效总有效率为86.7%(26/30),对照组总有效率为83.3%(25/30),两组疗效相当。结论:吴茱萸穴位贴敷治疗缓慢性心律失常能显著提高患者24h平均心率水平,其改善患者症状与心率水平的程度与心宝丸相仿。

电针对冠状动脉粥样硬化性心脏病模型大鼠血清氧化低密度脂蛋白及其受体表达的影响

目的:探讨电针治疗冠状动脉粥样硬化性心脏病(CHD)的作用机制,为临床腧穴配伍提供实验依据。方法:清洁级健康雄性Wistar大鼠60只,随机选择24只作为正常对照组和针刺预处理组,每组12只。其中针刺预处理组大鼠和其余36只大鼠饲喂高脂饲料12周,复制冠状动脉粥样硬化性心脏病模型,将模型复制成功的其余大鼠随机分为模型对照组、针刺治疗组、药物对照组,每组12只。电针预处理组穴取"内关"和"心俞",用华佗牌SDZ-Ⅳ型电子针疗仪进行电针刺激,刺激电流1mA,频率2Hz,每次刺激30min,隔日1次,共干预14周;针刺治疗组取穴及针刺方法同针刺预处理组,治疗2周;药物对照组予以阿托伐他汀混悬液灌胃给药,0.25mg/kg,每天1次,治疗2周。采用生物素双抗体夹心酶联免疫吸附法测定动物血清中氧化低密度脂蛋白(oxLDL)含量;采用Western blot法检测冠状动脉组织血凝素样氧化型低密度脂蛋白受体(LOX-1)含量;采用荧光定量PCR法检测冠状动脉组织LOX-1mRNA表达情况。结果:模型对照组大鼠血清oxLDL含量以及冠状动脉组织LOX-1蛋白及mRNA表达较正常对照组显著升高(均P<0.01);与模型对照组相比较,针刺预处理组、针刺治疗组和药物对照组大鼠血清oxLDL含量以及冠状动脉组织LOX-1蛋白及mRNA表达显著减少(均P<0.01)。结论:电针"内关""心俞"穴可以有效地降低CHD模型大鼠血清oxLDL以及冠状动脉组织LOX-1蛋白及mRNA表达水平,氧化修饰的低密度脂蛋白及其特异性受体系统可能是针刺防治CHD的重要途径之一。

Experimental study on the influence of pressing force and time on thermal effect of An-pressing manipulation

Objective:To observe the influence of pressing force and time on the thermal effect of An-pressing manipulation.Methods:Eight healthy volunteers were recruited to receive An-pressing manipulation at Xinshu (BL 15) on the right side.The pressing force and time were both divided into five levels:the force described as extremely mild,mild,moderate,strong and extremely strong and time given by 2.5 min,5.0 min,7.5 min,10.0 min and 15.0 min.The real-time change in local acupoint temperature as well as the change during 1.0-15.0 min after the manipulation were observed.Results:Compared with the baseline data,the real-time changes in the temperature after An-pressing Xinshu (BL 15) on the right side with different levels of force (from mild to strong) were respectively (1.88t0.64) ℃,(2.05±0.68) ℃,(2.25±0.59) ℃,(2.35±0.61) ℃ and (2.32±0.69) ℃;the changes in 15.0 min after the manipulation were respectively (-0.11±0.11) ℃,(0.03±0.14) ℃,(0.59±0.58) ℃,(1.38±0.70) ℃ and (2.09±0.98) ℃.The real-time temperature changes after the manipulation for different durations (from short to long) were respectively (1.94±0.37) ℃,(2.33±0.29) ℃,(2.49±0.31) ℃,(2.51±0.39) ℃ and (2.41±0.55) ℃;the changes in 15.0 min after the manipulation were respectively (0.53±0.49) ℃,(0.33±0.30) ℃,(0.52±0.33) ℃,(0.55±0.38) ℃ and (0.76±0.36) ℃.Conclusion:The thermal effect presented an increasing tendency with the extension of pressing time,and the temperature reached the top at 7.5 min;the thermal effect showed an increasing tendency with the rise of pressing force,and the temperature reached the top upon a moderate level of force.The pressing time can produce a greater influence on the real-time temperature than the pressing force;the pressing force can produce a greater influence on maintaining the temperature than the pressing time.