点按三脘穴对慢性肾脏病3-4期伴消化功能紊乱患者的干预研究

目的:观察点按三脘穴对慢性肾脏病3-4期伴消化功能紊乱患者消化功能的治疗效果。方法:选取慢性肾脏病3-4期伴消化功能紊乱患者60例,根据随机数字表分为对照组和干预组各30例。对照组给予促进胃肠动力、保护胃黏膜等常规治疗,干预组在常规治疗的基础上点按三脘穴(上脘、中脘、下脘)。2周后对两组患者临床症状评分、临床疗效、胃泌素水平进行比较分析。结果:两组患者临床症状(上腹胀、腹痛、早饱、食欲不振、恶心、呕吐)较干预前均有一定改善;组间比较,干预组临床症状减轻更为显著,差异有统计学意义(P<0.05)。临床疗效比较,干预组总有效率93.3%,对照组66.7%,干预组优于对照组,差异有统计学意义(P<0.05)。胃泌素检测结果,两组患者均较干预前有一定程度上升;组间比较,干预组临床疗效更为显著,差异有统计学意义(P<0.05)。结论:点按三脘穴(上脘、中脘、下脘)对慢性肾脏病3-4期伴消化功能紊乱有较好的辅助治疗作用,能有效改善患者的临床症状,提高临床疗效。

以芒针从三焦论治带状疱疹急性期并发剧烈头痛验案1则

带状疱疹是由水痘-带状疱疹病毒侵犯神经节进而引起神经节炎症而导致的一种常见感染性皮肤病。常见集簇性皮疹呈神经节段或单侧分布,伴发热、全身乏力等症状。中医病名为“蛇串疮”“缠腰火丹”等。病因病机为肝胆湿热、脾湿蕴热、气虚血瘀、气滞血瘀等,治疗多以西药结合针灸、传统电针、放血拔罐疗法为主。阎莉教授以打通枢纽、通利三焦之法进而达到论治急性期带状疱疹的目的,运用芒针结合电针、放血拔罐疗法,以期快速改善患者疼痛症状,降低带状疱疹后遗神经痛的发生率。

Effect of herbal cake-partitioned moxibustion on MEK1/2 and ERK1/2 expressions of gastric tissues in rats with spleen deficiency syndrome

Objective： To observe the effect of herbal cake-partitioned moxibustion on the expressions of mitogen-activated protein kinase （MEK：1/2） and extracellular regulatory protein kinase （ERK：1/2） in gastric tissues of rats with spleen deficiency syndrome, and to explore the possible mechanisms of herbal cake-partitioned moxibustion in treating spleen deficiency syndrome. Methods： Sixty Sprague-Dawley （SD） rats were randomly divided into a blank control group （group A）, a model group （group B）, a ranitidine group （group C）, and a herbal cake-partitioned moxibustion group （group D） by random digit, 15 rats in each group. Rat models of spleen deficiency syndrome were made by intragastric administration of 4℃ 200% concentrated Da Huang （Radix et Rhizoma Rhei）. After successful modeling, the rats in group C were treated with 25 mg/（kg.bw） ranitidine by intragastric adminstration and rats in group D were treated with herbal cake-partitioned moxibustion at Zusanli （ST 36） and Zhongwan （CV 12）, for 8 d. Excepted for rats in group A, all the other rats were treated with indomethacin at 5 mg/（kg.bw） at 8：00 a.m. on the second day after finishing all the intervention and sacrificed 7 h later to isolate the stomach. Histopathological changes of the gastric tissues were observed under light microscope after hematoxylin-eosin （HE） staining. The protein expressions of MEK：1/2 and ERK：1/2 in the gastric tissues were detected by immunohistochemistry. Results： After intervention, the gastric mucosal injury in group B was significantly severer than that in group A, with large breakage and ablating; the damage of gastric mucosa was decreased in group C compared with group B; the gastric mucosal surface remained relatively complete, and the status of breakage and ablating was significantly improved. After intervention, compared with group A, the protein expressions of MEK：1/2 and ERK：12 in gastric tissues of the other groups were significantly higher （P〈0.01）. Compared with group B, the protein expressions of MEK：1/2 and ERK：1/2 in group C and D were significantly higher （all P〈0.01）. Compared with group C, the protein expressions of MEK：1/2 and ERK：1/2 in group D were significantly higher （P〈0.01）. Conclusion： Herbal cake-partitioned moxibustion promotes the repair of gastric mucosa in rats with spleen deficiency syndrome, via improving protein expressions of MEK：1/2 and ERK：1/2 in gastric tissues, as well as activating MEK/ERK signaling pathway.

Efficacy observation on acupuncture for diabetic gastroparesis

Objective： To observe the effect of acupuncture on gastric motility, plasma motilin and serum gastrin in patients with diabetic gastroparesis （DGP） and evaluate its clinical efficacy. Methods： A total of 100 eligible cases were randomly allocated into an acupuncture group （n=50） and a control group （n=50）. Patients in the acupuncture group were treated by needling Zhongwan （CV 12）, Zusanli （ST 36） and Neiguan （PC 6）, whereas patients in the control group were treated with oral administration of Domperidone. The clinical efficacies of the two groups were compared; and changes in gastric motility, plasma motilin and serum gastrin in both groups were observed before and after treatment. Results： After treatment, the symptom scores, gastric motility and contents of plasma motilin and serum gastrin were significantly improved in both groups （P〈0.05）. There were between-group statistically significant differences in symptom scores, gastric motility and levels of plasma motilin and serum gastrin after treatment （all P〈0.05）. The total effective rate was 96% in the treatment group, versus 78% in the control group, showing a statistically significant difference （P〈0.05）. Conclusion： Acupuncture is effective for DGP and can reduce the levels of plasma motilin and serum gastrin.

Therapeutic efficacy observation on needling Yangming method for facial palsy

Objective： To observe the clinical efficacy of Prof. Gao Yu-chun＇s needling Yangming method for facial palsy, as well as to inherit and further develop the academic idea.Methods： A total of 70 cases were randomly allocated into a treatment group（n=35） and a control group（n=35）. Cases in the treatment group were treated with needling Yangming method, whereas cases in the control group were treated with traditional acupuncture method. The treatment was done once a day in both groups（6 times a week） for a total of 6 weeks. Then the therapeutic efficacies were evaluated before and after treatment using the House-Brackmann（H-B） scale and scores of signs and symptoms. Results： After 2 weeks of treatment, patients in the treatment group obtained a better H-B score and recovery rate than those in the control group（P〈0.05）. After 4 weeks of treatment, the H-B score, scores of signs and symptoms and recovery rate in the treatment group were better than those in the control group（P〈0.05, P0.01, P〈0.05）. After 6 weeks of treatment, there were no between-group statistical differences in the above aspects（P〉0.05）. Conclusion： Needling Yangming method can obtain a faster effect, a higher early-stage recovery rate and shorter course of treatment than traditional acupuncture method.