热敏穴灸治疗肌筋膜疼痛综合征：多中心随机对照研究

目的:观察热敏穴灸治疗肌筋膜疼痛综合征(MPS)的临床疗效,以期肯定该项新疗法治疗MPS的高效性。方法:采用3个中心、单盲、随机、对照研究方法,将107例患者随机分为观察组(57例)和对照组(50例)。观察组给予热敏穴灸治疗,对照组给予针刺加拔罐加TDP常规治疗。采用简化麦吉尔疼痛量表为观察指标,以治疗前后疼痛评定指数(PRI)、视觉模拟评分(VAS)和现时疼痛强度(PPI)的变化来评价疗效。结果:观察组的愈显率为86.0%,优于对照组的24.0%(P<0.001)。2组PRI、VAS、PPI积分较治疗前有极显著改善(P<0.001),且观察组优于对照组(P<0.001)。结论:热敏穴灸疗法对MPS具有高效性。

Irritable bowel syndrome with diarrhea (IBS-D) treated with moxibustion on heat-sensitive acupoints: a randomized controlled trial

Objective To compare the effects between acupuncture combined with moxibustion on heat-sensitive acupoints and acupuncture on irritable bowel syndrome with diarrhea （IBS-D）. Methods Sixty-four cases were randomly divided into an acupuncture and moxibustion group （n=32） and an acupuncture group （n=32）. Conventional acupuncture at Tiānshū （天枢 ST 14）, Zúsānlǐ （足三里 ST 36）, Gōngsūn （公孙 SP 4） and other acupoints was used in the two groups, and moxibustion on heat-sensitive acupoints was added in the acupuncture and moxibustion group. The treatment frequency was 5 times a week, and 4 weeks were a course. After 2 courses, the therapeutic effect was evaluated. Results The clinical symptom scores after treatment in two groups decreased obviously than those before treatment （both P〈0.01）. The cured and markedly effective rate in the acupuncture and moxibustion group was 87.5% （28/32）, and that in the acupuncture group was 37.5% （12/32）, so the effect in the acupuncture and moxibustion group was better than that in the acupuncture group （P〈0.01）. The improvement of all kinds of symptom scores in the acupuncture and moxibustion group was all better than that in the acupuncture group （all P〈0.05）. Conclusion The clinical effect of acupuncture combined with moxibustion on heat-sensitive acupoints on IBS-D is better than that of acupuncture.

Effect comparason of thermosensitive moxibustion and estazolam on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation

Objective： To observe the effect of thermosensitive moxibustion on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation.Methods： From January 2015 to January 2017, 60 patients of insomnia differentiated as liver qi stagnation were collected in Shijiazhuang Municipal Chinese Medicine Hospital. According to the random number table, the patients were randomized into a moxibustion group（30 cases） and an estazolam group（30 cases）. In the moxibustion group, the thermosensitive moxibustion was adopted alternatively to the bilateral yuan-source points of the liver and gallbladder meridians. In the estazolam group, estazolam, 1 mg was prescribed for oral administration before sleep every day. After 15-day treatments, the sleep quality, the severity of anxiety and depression and the therapeutic effects were observed before and after treatment in the two groups.Results： Before treatment, the differences were not significant in the scores of Pittsburgh sleep quality index（PSQI）, the self-rating anxiety scale（SAS） and the self-rating depression scale（SDS） between the two groups（all P〉0.05）. After treatment, the scores of PSQJ, SAS and SDS were all reduced remarkably as compared with those before treatment in the two groups（all P〈0.05）. PSQI score was（6.72 ±2.311）points in the moxibustion group and was（5.37 ±2.621） points in the estazolam group. SAS score was（31.76 ± 6.511） points in the moxibustion group and was（39.62 ± 4.371） points in the estazolam group.SDS score was（35.98 ±5.161） points in the moxibustion group and was（46.38 ±4.971） points in the estazolam group. After treatment, the scores of PSQI, SAS and SDS in the moxibustion group were reduced more remarkably as compared with the estazolam group, indicating the significant differences（all P 〈0.05）. After treatment, the scores of sleep efficacy and TCM symptoms were（72.65 ± 14.36） points and（69.36 ±4.28） points respectively in the moxibustion group, better than the estazolam group, indicating the significant differences（all P〈0.05）.Conclusion： The thermosensitive moxibustion at the yuan-source points of the liver and gallbladder meridians significantly improves the sleep quality, relieves the symptoms of anxiety and depression and enhances the therapeutic effects in the patients of insomnia differentiated as liver qi stagnation. Hence,this therapy deserves to be recommended in clinical practice.

Clinical observation on heat-sensitive moxibustion plus lactulose for postoperative constipation of mixed hemorrhoid due to spleen deficiency

Objective:To observe the clinical effect of heat-sensitive moxibustion plus lactulose oral liquid for postoperative constipation of mixed hemorrhoid.Methods:A total of 70 patients were randomized into a treatment group and a control group,with 35 cases in each group by a random number table.Patients in the control group received lactulose oral liquid alone,while those in the treatment group received additional heat-sensitive moxibustion at Shenque(CV 8).The treatment was given once a day for 15 consecutive days.The defecation interval time,defecation duration,the scores of stool form,visual analog scale(VAS)and patient assessment of constipation quality of life questionnaire(PAC-QOL),as well as the serum substance P(SP)and nitric oxide(NO)levels were measured before and after treatment.Results:After treatment,the stool form score,defecation interval time and defecation duration in the two groups dropped significantly(all P<0.05),and they were lower in the treatment group than in the control group(all P<0.05).After treatment,the VAS scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the PAC-QOL scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the serum SP and NO levels in the two groups improved significantly(all P<0.05),and showed statistically significant differences between the treatment group and the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus lactulose oral liquid can improve stool form,shorten defecation interval time and defecation duration,alleviate defecation pain,and improve quality of life(QOL)for patients with postoperative constipation of mixed hemorrhoid,which may be related to the regulation of the SP and NO levels.

Study on the thermesthesia features of heatsensitive acupoints in patients with knee osteoarthritis

Objective： To observe the thermesthesia thresholds of the heat-sensitive acupoints in patients with knee osteoarthritis （KOA）, and to provide scientific evidence for acupoint selection based on acupoint sensitization. Methods： Forty-six patients with KOA of swelling type were recruited. By using the quantitative thermesthesia testing, the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance at Xuehai （SP 10）, Neixiyan （EX-LE 4） and Yinlingquan （SP 9） were detected. The subjects were then divided into heat-sensitive groups and non-heat-sensitive groups according to whether there was a phenomenon of heat-sensitive moxibustion sensation at each acupoint, to compare the thermesthesia thresholds between the two groups. Results： The thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively （38.21±2.03） ℃, （44.47±1.86） ℃ and （48.59＋0.74） ℃ in the heat-sensitive group of Xuehai （SP 10）, versus （36.76±1.93） ℃, （42.91±2.05） ℃ and （46.95±1.14） ℃ in the non-heat-sensitive group of Xuehai （SP 10）; the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively （37.47±1.77）℃, （44.55＋1.63） ℃, and （47.48±0.47） ℃ in the heat-sensitive group of Neixiyan （EX-LE 4）, versus （35.92±1.69） ℃, （42.72±1.94）℃ and （45.53±0.41） ℃ in the non-heat-sensitive group of Neixiyan （EX-LE 4）; the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance were respectively （37.30±2.23） ℃, （44.39±1.92） ℃ and （47.76±0.58） ℃ in the heat-sensitive group of Yinlingquan （SP 9）, versus （36.06±1.86） ℃, （42.63±1.88） ℃ and （45.91±0.72） ℃ in the non-heat-sensitive group of Yinlingquan （SP 9）. The statistical analyses showed that the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of each heat-sensitive group （all the three acupoints） were significantly higher than those of each corresponding non-heat-sensitive group （P〈0.01）. Conclusion： There were differences in the thermesthesia thresholds between heat-sensitized and non-heat-sensitized acupoints in patients with KOA of swelling type; and the thermal sensation threshold, thermal pain threshold, and threshold of thermal pain tolerance of the heat-sensitized points were significantly higher than those of the non-heat-sensitized ones.