综述针灸治疗失眠的临床经验分享

失眠,即不得眠、少寐、不寐,是一种脏腑功能紊乱,阴阳失调,不能正常睡眠的疾病。症见睡眠的深度欠佳,及时间的欠缺,症状较轻者主要有入睡较难,或时醒时睡,睡但不深,或醒后不能复睡,严重者可整夜难眠。失眠在临床上作为一种常见病、多发病,让许多患者深受其扰,苦不堪言。而针灸作为我国传统医学的一种治疗手段,包括单纯针刺、穴位治疗等,具有操作简单、适应证多、疗效显著、无不良反应等优点。在临床上运用针灸技术来治疗失眠,既发挥了中国传统医疗的特色,又对提高人们的生活品质起到了重要作用。该文通过查阅大量文献资料,收集了近十年临床医者运用针灸来临床治疗失眠的临床经验分享,对此做出综述,并浅谈对针灸学科的思考。

谈谈如何提升针灸临床治疗的疗效

伴随当前医疗行业的快速发展,针灸法在临床治疗中,由于没有药物的毒副作用,而且治疗效果较好,因此得到了较为普遍的运用,文章主要从针灸治疗的方法、时间影响因素等方面对针灸治疗进行阐述,以期提升针灸临床治疗的效果。 在临床治疗过程中,只有对于针灸的治疗方法进行科学运用,才能进一步提升针灸在临床治疗中发挥作用。

符文彬针灸治疗经验撷要

简要介绍符文彬教授针灸治疗的部分经验,他重视中医经典,并能综合运用针刺、麦粒灸、埋皮内针三法进行治疗,临床上屡起沉疴。

经络诊察理论的临床应用和意义

经络诊察理论的临床应用和意义张地芬（北京护国寺中医医院１０００３５）经络理论是中医针灸学的理论核心，又是针灸治疗学的基础。《内经》指出经脉是疾病的反应系统同时也是疾病的治疗系统，并为经络诊察提供了重要的理论根据。《灵枢·刺节真邪》曰：＂用针者，必先察...

BRIEF INTRODUCTION TO THEORETICAL INTENTION OF "NEEDLING METHOD FOR TRANQUILLIZATION AND CALMING THE MIND" FOR TREATMENT OF INSOMNIA

A set of scientific theories and an effective acupuncture therapy for insomnia about ＂the needling method for tranquillization and calming the mind＂ are gradually formed through many years＇theoretical and clinical studies. In this paper, the theoretical intention about ＂the needling method for tranquillization and calming the mind＂ for treatment of insomnia are briefly introduced mainly from the cause of disease, pathogenesis, therapeutic method and characteristics of composition of a prescription, etc. in order to provide a new train of thoughts and a new method for working out scientific and standard prescriptions in the treatment of insomnia.

PERIPHERAL FACIAL PARALYSIS TREATED BY MULTI-DIRECTIONAL NEEDLING

Objective：To search for an effective therapy in treating peripheral facial paralysis. Methods： One hundred and eight patients were randomly divided into treatment group （n = 68） and control group （n = 40）. The multi-directional needling technique was used by selecting Jiache （颊车 ST 6）, Yangbai （阳白 GB 14） and Dicang （地仓 ST 4） in the treatment group, and the traditional acupuncture technique with conventional needle selection was used in the control group. The treatment was given once daily with 10 treatments constituting a therapeutic course, and 2 courses of treatment were given in both the groups. Results： After the treatment, of the 68 and 40 cases in treatment and control groups, 56 （82.3%） and 28 （70.0%） were cured, 11 （16.2%） and 8 （20.0%） improved in clinical symptoms and signs, 1 （1.5%） and 4 （10.0%） failed, with the total effective rate being 98.5% and 90.0% respectively, and the therapeutic effect of treatment group was significantly superior to that of control group （ P 〈 0.05）. Conclusion： The multi-directional needling is an effective therapy for treating peripheral facial paralysis.

300 CASES OF HYPERPLASIA OF MAMMARY GLANDS TREATED WITH RED-HOT NEEDLE PLUS FILIFORM NEEDLE

Clinical observations on 300 cases of hyperplasia of mammary glands (group A) treated by red hot needle plus filiform needle are reported in the present study. "Ashi" points were used as the main acupoints. For comparison, other 300 cases (group B) were treated with routine acupuncture method, and Rugen (ST 18) was used as the main acupoint. In addition, other auxiliary acupoints were supplemented in the light of the concrete syndromes in these two groups. The treatment was given once daily, with 10 sessions being a therapeutic course. Of the 300 cases in group A, 240 were clinically cured, amounting to 80%; 58 were effective, amounting to 19.3%; 2 were failed, with a total effective rate of 99.3%. Of the 300 cases in group B, 113 were clinically cured, 165 effective, 22 were failed, with a total effective rate of 92.7%. The therapeutic effect of group A is significantly superior to that of group B (P<0.05).

EFFECT OF MOXIBUSTION ON CATECHOLAMINE

Objective：To investigate whether moxibustion affects the secretion of catecholamine as adrenalin, noradrenaline and dopamine. Methods： Twenty Wistar rats were allocated to two groups. One was moxibustion-group （10 rats）, and the other was non-moxibustion-group （10 rats）. Four ignited moxa-cones were applied to bilateral “Shenshu” （肾俞 BL 23）. When a moxa-cone burned out, another one was replaced. At the end of each experiment, blood sample （2 mL/rat） was collected from the heart for assaying plasma adrenalin, noradrenaline and dopamine contents with high pressure liquid chromatography. Results： The presented results showed that plasma adrenalin and noradrenaline contents of moxibustion-group are significantly higher than those of non-moxibustion-group （P 〈 0.01）. However, there is no significant difference of dopamine between moxibustion-and non-moxibustion-groups （P 〉 0.05）. Conclusion： These results demonstrated that moxibustion stimulates the secretion of adrenaline and noradrenaline in normal rats.

DEVELOPMENT OF RESEARCHES ON THE TREATMENT OF BRONCHIAL ASTHMA WITH ACUPUNCTURE AND MOXIBUSTION

Acu-moxibustion therapy is one of the commonly-used remedies for the prevention and treatmerit of asthma. In the present article, the authors review development of clinical studies on acu-moxibustion treatment of asthma in recent 5 years from ① changes of pulmonary function as forced expiratory volume in 1 second （FEV1）, forced vital capacity （FVC）, FEV1%, peak expiratory flow （PEF）, maximum mid expiratory flow （MMEF）, etc., ② changes of immune function as serum IgE, IgG, subgroups of T lymphocytes, inflammatory mediators, cytokines, etc, and ③ changes of the nervous system and related receptors including nitric oxide （NO）, vasoactive intestinal peptide （VIP）, substance P （SP）, and cAMP/cGMP. Additionally, the authors also introduce the development of experimental researches from the effects of acu-moxibustion on ① inflammatory cells, ② nervous system and receptors, ③ patho-morphological changes of the lung tissue, and ④serology of acupuncture.

BRIEF ANALYSIS ON THEORETIC EVIDENCE OF FOUR-GATE POINTS IN TREATMENT OF DISEASE

In the present paper, the authors expound the approaches of four-gate points on treatment of diseases and the relevant theoretic evidence. The analysis and discussion were carried on in the aspects of the origins of four-gate points and the relationships of four-gate points with primary qi, running course of meridian, qi and blood and biaoben qijie of meridian and collateral. Being the major points in clinic, four-gate points provide extensive indications and good therapeutic effects, which are supported thoroughly by the theoretic evidence.

ACUPUNCTURE COMBINED WITH INHALATION OF OXYGEN FOR TREATMENT OF 60 CASES OF EXTENSIVE ANXIETY

Objective: To observe the therapeutic effects and adverse effects of "channel-oxygen therapy" for extensive anxiety. Methods: Sixty cases of extensive anxiety patients were treated with "channel-oxygen therapy" once daily and continuously for 4 weeks. Neiguan(内关PC 6) and Zusanli(足三里ST 36) were needled in combination with nasal inhalation of oxygen, 30 min each session. The therapeutic effects were assessed by Hamilton Anxiety Scale (HAMA) and the adverse effects by Treatment Emergent Symptom Scale (TESS). Results: Of the 60 cases, 35 were cured, 13 improved and 12 were ineffective, with the effective rate being 80.0% and the cured rate 58.3%. No evident adverse effects were found. Conclusion: The "channel-oxygen therapy" is safe and effective for extensive anxiety.

ADVANCES IN CLINICAL AND EXPERIMENTAL STUDIES ON ACUPUNCTURE TREATMENT OF ACUTE CEREBRAL HEMORRHAGE

In the present paper, the authors review recent advances in clinical and experimental studies on acupuncture treatment of cerebral hemorrhage(CH). Regarding clinical studies, the resuscitation-inducing needling maneuver, and main points of Shuigou(水沟GV 26),Baihui(百会 GV 20) and scalp-points Motor Area(MS 6), Sensory Area(MS 7), etc. are often involved. Concerning experimental studies, the underlying mechanisms of acupuncture of GV-26+“Neiguan”(内关 PC 6), GV-20,GV-26+GV-20, etc. in improving acute CH are introduced. In a word, acupuncture therapy works well in improving clinical symptoms and signs of CH patients, and acupuncture stimulation induced ameilioration of cerebral blood flow, favorable modulation of some bioactive substances as excitatory and inhibitory amino acids, endothelin, CGRP, heat shock protein 70, etc. and neuro-endocrine-immune network may contribute to the effect of acupuncture on CH. In addition, acupuncture combined with medicine and earlier application of acupuncture therapy in the acute stage of CH are recommended in clinical practice.

Clinical Effects of Acupuncture for Diabetic Peripheral Neuropathy

Objective:To observe the clinical effects of acupuncture for diabetic peripheral neuropathy.Methods:Totally 65 patients were randomly divided into a treatment group of 32 cases and a control group of 33 cases. On the basis of conventional treatment of diabetes,acupuncture was used in the treatment group,and inositol was orally administered in the control group.During a 3-month treatment,changes in the symptoms were observed.Results:In the treatment group,16 cases were markedly relieved,12 cases improved,and 4 cases failed,with a total effective rate of 87.5%.In the control group,7 cases were markedly relieved,14 cases improved and 12 cases failed,with a total effective rate of 63.6%.There was a significant difference in the total effective rate between the 2 groups(P<0.05) .Conclusion:Acupuncture may show good effects for diabetic peripheral neuropathy.

Effect of stimulating acupoint Guanyuan(CV 4) on lower back pain by burning moxa heat for different time lengths: a randomized controlled clinical trial

OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.

Clinical Observation on Acupuncture Treatment for Post-stroke Spastic Hemiplegia

Objective:To observe the clinical effect of contralateral needling plus rehabilitation for post-stroke spastic hemiplegia. Methods:Thirty-six patients with post-stroke spastic hemiplegia were randomly divided into a treatment group and a control group, 18 cases in each group. The two groups were all given rehabilitation training. The contralateral needling was adopted in the treatment group on the acupoints group of brain-refreshing and orifice-opening needling method. The routine acupuncture was applied in the control group on the same acupoints. Respectively before and after the treatment, the modified Ashworth scale (MAS) and clinical spasticity index (CSI) were used to assess the therapeutic effects. Results:The total effective rate was 94.4% in the treatment group and 67.7% in the control group, with a statistical difference in comparison of the two groups (P<0.05). In comparison of MAS and CSI scores after the treatment between the treatment group and control group, the differences were statistically significant (P<0.05). Conclusion:The contralateral needling plus rehabilitation training is an effective method for the treatment of post-stroke spastic hemiplegia.

Clinical Observation on the Combined Use of Acupuncture and Herbal Medicine for Treatment of Chloasma

Objective:To observe the clinical effects of the combined use of acupuncture and herbal medicine for treatment of chloasma.Methods:Totally 60 patients were randomly divided into a treatment group of 30 cases,treated by acupuncture and herbal medicine,and a control group of 30 cases,administered Vitamin C and Vitamin E.The clinical effects were observed.Results:The total effective rate of the treatment group is 93.3%better than that of the control group(76.7%) ,the difference was significant(P<0.01) .Conclusion:Combined use of acupuncture and herbal medicine may yield definite therapeutic effects in treating chloasma patients.

Review of controlled clinical trials on acupuncture versus sham acupuncture in Germany

OBJECTIVE: To examine German controlled clinical trials on the therapeutic effects of acupuncture vs sham acupuncture, and to find whether there are problems with the conclusion that sham acupuncture has no significant deviation from acupuncture. METHODS: We focused on literature from the last ten years (2002-2011) included in PubMed about controlled clinical trials on acupuncture vs sham acupuncture carried out in Germany. The methods applied in sham acupuncture are summarized, and the difference between the acupuncture and sham groups were analyzed. We measured effects based on the following criteria: acupuncture is effective and superior to sham, acupuncture is effective but similar to sham, both of them have uncertainty regarding treatment effect, or no significant effect. Finally, we reviewed the hypotheses of different scholars on sham acupuncture and analyzed their results.RESULTS: Four types of controlled clinical trials including sham acupuncture on non-Traditional Chinese Medicine acupoints, minimal acupuncture on non-acupoints, placebo needle and sham laser acupuncture had varying results in the 57 articles analyzed. Some showed that acupuncture had a better effect than sham, while some suggest acupuncture and sham had similar effects. In all studies using sham acupuncture on non-therapeutic points, sham electrodes, and sham electro-acupuncture, the therapeutic effect was better than sham. Of the trials, 37 demonstrated that acupuncture had a better effect than sham acupuncture. Only nine trials found no significant difference between acupuncture and sham. Two controlled trials for the same condition (neck pain) conducted by two different German research institutes used the same control method, but reached contradictory conclusions. CONCLUSION: We found problems in conclusions based on results of controlled clinical trials of sham acupuncture in Germany. Therefore, there is still not enough evidence to support the statements that "acupuncture and sham acupuncture have no difference in treatment effect" and "acupuncture is just a placebo effect." The control methods of sham acupuncture used in Germany may not be standardized and may not be suitable for acupuncture clinical trial research. We suggest that research on the methodology of sham acupuncture should be given priority in the design of acupuncture trials in the future.

Clinical observation on Wang Juyi＇s applied channel theory in treating stroke-sequel patients

OBJECTIVE:To explore the advantages of acupuncture treatment guided by channel palpation on stroke-sequel patients.METHODS:This research was randomized,traditional acupuncture controlled trial using channel palpation acupuncture to treat stroke-sequel patients.Totally 148 patients who were randomly assigned to two experimental groups.The treatment group,i.e,the channel palpation group was treated with Dr.Wang Juyi's Channel Palpation.Patients in control group received acupuncture according to New Century Acupuncture.Every patient was needled at Renzhong(GV 26),Baihui(GV 20),Neiguan(PC 6),Jiquan(HT 1),Chize(LU 5),Weizhong(BL 40),Sanyinjiao(SP 6),Zusanli(ST 36),and each acupuncture treatment was modified according different syndrome differentiations including liver yang rising [Taichong(LR 3),Taixi(KI 3)],wind-phlegm blocking collaterals [Fenglong(ST 40),Hegu(LI 4)],phlegm-heat occupying in the Fu-organs [Quchi(LI11),Neiting(ST 44),Fenglong(ST 40)],Qi deficiency with blood stasis [Qihai(CV 6),Xuehai(SP 10)],Yin Deficiency with wind [Taixi(KI 3),Fengchi(GB 20)];for wry mouth,add Jiache(ST 6),Dicang(ST 4);for paralyzed arms,add Jianyu(LI 15),Quchi(LI 11),Shousanli(LI 10) and Hegu(LI 4),for paralyzed legs,add Huantiao(GB 30),Yinlingquan(SP 9) and Fengshi(GB 31).The duration of each treatment was 6 weeks.Then the Fugl-Meyer score,the Stroke Specific Quality of Life scale(SS-QOL),and the National Institute of Health Stroke Scale(NIHSS) were assessed before treatments,after 6 and 12 weeks of treatments to evaluate the acupuncture effect in each group.The data were collected and analyzed after the completion of treatment by SPSS 17 using paired sample t-test.RESULTS:Totally 148 participants were recruited,and 136 eligible patients were included in this study.The results showed that for FMA motor function and Fugl-Meyer balance function and NIHSS,there is no statistic difference between two groups at the baseline period,after 6-week treatment and after 12-week follow-up(P > 0.05);However,for NIHSS and SS-QOL,there is no statistic difference between two groups at the baseline period and 6 weeks after treatment(P > 0.05).However,statistical difference starts to appear after 12-week(P =0.028,0.037 < 0.05).CONCLUSION:We conclude that as for improving the nerve function and the quality of life,Dr.Wang Juyi's Applied Channel Theory presents a better clinical result.