陈峰运用“手体配伍针刺法”治疗运动性软组织损伤经验

人体在体育运动过程中所发生的损伤,称为运动损伤,与运动训练、运动技术、运动项目、运动环境和装备等有密切关系^([1])。运动性损伤主要累及人体的运动系统^([2]),临床上多以运动性闭合性软组织损伤常见^([3])。调查研究显示,运动性软组织损伤好发部位以踝、足、膝部最多见,分别为23.0%、19.6%和16.0%^([3-4])。陈峰教授系全国老中医药专家学术经验继承工作指导老师、浙江省名中医,从事中医针灸临床工作近40余年,善用骨边刺法、上补下泻针法、手穴疗法等治疗运动性损伤、神经系统疾病及消化系统疾病。

头体针巨刺法联合本体感觉神经肌肉促进技术治疗脑卒中后偏瘫临床研究

目的:观察头体针巨刺法联合本体感觉神经肌肉促进技术(PNF)对脑卒中后偏瘫患者肢体功能及体感诱发电位的影响。方法:选取150例脑卒中后偏瘫患者为研究对象,按随机数字表法分为3组各50例。对照1组予PNF治疗,对照2组予头体针巨刺法治疗,观察组予PNF联合头体针巨刺法治疗。比较3组临床疗效,并比较3组神经功能缺损评分(NFD)、改良Barthel指数(MBI)评分、Fugl-Meyer运动功能量表(FMA)评分、Berg平衡量表(BBS)评分、正中神经体感诱发电位及脑卒中专门化生活质量量表(SS-QOL)评分。结果:治疗后,观察组总有效率92.00%,高于对照1组70.00%及对照2组72.00%(P<0.05)。治疗1个月、3个月,3组NFD评分均逐渐降低(P<0.05),MBI指数评分均逐渐升高(P<0.05),且观察组NFD评分低于同期对照1组、对照2组(P<0.05),MBI评分高于同期对照1组、对照2组(P<0.05)。治疗1个月、3个月,3组FMA上肢评分、下肢评分均逐渐升高(P<0.05),且观察组FMA上肢评分、下肢评分均高于同期对照1组、对照2组(P<0.05)。治疗1个月、3个月,3组BBS评分均逐渐升高(P<0.05),且观察组高于同期对照1组、对照2组(P<0.05)。治疗1个月、3个月,3组正中神经N20潜伏期均逐渐缩短(P<0.05),且观察组短于同期对照1组、对照2组(P<0.05),3组正中神经N20-P25波峰振幅均逐渐增大(P<0.05),且观察组大于同期对照1组、对照2组(P<0.05)。治疗1个月、3个月,3组SS-QOL评分均逐渐升高(P<0.05),且观察组高于同期对照1组、对照2组(P<0.05)。结论:头体针巨刺法联合PNF技术治疗脑卒中后偏瘫,疗效确切,能改善患者神经功能及平衡能力,减轻肢体障碍程度,促进正中神经体感诱发电位恢复,提高患者生活能力及生活质量。

神经松动术联合头体针巨刺法对卒中后患者功能恢复的影响

目的:探究神经松动术联合头体针巨刺法应用于卒中后偏瘫患者的效果。方法:选取2019年1月至2021年8月多中心收治的126例卒中后偏瘫患者,按照治疗方案不同随机分为联合组(n=42)、头体针组(n=42),神经松动组(n=42),头体针组患者进行头体针巨刺法,神经松动组进行手法神经松动术,联合组患者在进行头体针巨刺法基础上进行手法神经松动术;3组患者在治疗前、治疗后4周、8周进行美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评估神经功能,Berg平衡量表(Berg Balance Scale,BBS)评估肢体平衡功能,采用肌电图诱发电位仪检测患侧正中神经波幅、阈值,并应用Fugl-Meyer运动功能评定量表(Fugl-MeyerAssessmentScale,FMAS)评估肢体运动功能,barthel指数(Modified barthel index,MBI)评分、计时起立-行走测试(Time Up and Go Test,TUGT)评分评估日常活动能力。结果:与同组治疗前相比,治疗后4周、8周时3组患者的NIHSS评分、水肿分级评分、肩部疼痛VAS评分均降低(各项均P<0.05),BBS评分、上肢运动、下肢运动评分、MBI评分均升高(各项均P<0.05);患侧正中神经F波阈值降低,F波波幅升高,TUGT时间缩短(P<0.05);组间相比,治疗4周、8周后联合组NIHSS评分较头体针组、神经松动组低(P<0.05),BBS评分、肢体运动功能评分较头体针组、神经松动组高(P<0.05);联合组患侧正中神经F波阈值低于头体针组、神经松动组(P<0.05);F波波幅高于头体针组、神经松动组(P<0.05);联合组水肿分级评分、肩部疼痛VAS评分较头体针组、神经松动组低(P<0.05);联合组TUGT时间短于头体针组、神经松动组,MBI评分较头体针组、神经松动组高(P<0.05)。结论:头体针巨刺法与神经松动术联合应用于卒中后偏瘫可有效缓解神经损伤,促进肢体运动功能恢复,提高平衡功能及日常活动能力。

头穴长留针与体针半刺法辅治痉挛型脑瘫的临床疗效

目的分析头穴长留针+体针半刺法辅治痉挛型脑瘫儿童的临疗效,为痉挛型脑瘫的临床治疗提供实践经验。方法将广州军区157医院2015年1月1日—2018年12月31日收治80例痉挛型脑瘫儿童按随机数字表法分观察组(n=40)与对照组(n=40);对照组给予常规康复训练,观察组辅以头穴长留针+体针半刺法治疗。比较两组疗效及内收肌肌张力、表面肌电。结果治疗后,两组踝关节活动度(ROM)、GMFM-88量表各维度评分较治疗前均显著上升,膝关节及髋关节ROM较治疗前显著下降,且观察组踝关节ROM、GMFM-88量表高于对照组,膝关节及髋关节ROM显著低于对照组(均P<0.05);同时,治疗后,两组Ashworth量表评分、被动活动状态下iENG、CR较治疗前显著下降,但观察组低于对照组;内收肌角度、被动活动状态下MF、MIVC下iENG及MF较治疗前显著上升,观察组高于对照组(P<0.05)。结论较常规康复训练,头穴长留针+体针半刺法辅治痉挛型脑瘫儿童效果更佳,对内收肌肌张力及表面肌电的改善更显著,值得临床推介。

肌内效贴联合体穴针刺法在小儿脑性瘫痪异常姿势中的疗效观察

目的:分析肌内效贴联合体穴针刺法在脑性瘫痪异常姿势患儿中的应用价值。方法:98例脑性瘫痪异常姿势患儿,按照随机数字表法将其分为观察组与对照组,各49例。分别给予体穴针刺法治疗、联合肌内效贴治疗。将两组的临床效果、康复情况以及步态功能进行对比。结果:观察组的治疗总有效率(93.88%)较对照组(75.51%)高(P<0.05);治疗后,相比于对照组,观察组的CDE区评分明显升高(P<0.05)。结论:肌内效贴联合体穴针刺疗法明显改善了脑瘫患儿异常姿势情况。

针灸治疗假性延髓麻痹的研究进展

介绍近10年来针灸治疗假性延髓麻痹的临床及机制研究进展。从取穴,治疗方法,疗效评价标准、机制研究等方面对近10年来针灸治疗假性延髓麻痹的文献报道做以综述。针灸治疗假性延髓麻痹具有疗效显著,操作简单,费用低廉,副作用小等优点。但在临床疗效评定标准,临床研究设计科学化,针灸作用机制研究,治疗选穴的规范化,针灸治疗最佳方案等方面尚存在一些亟待解决的问题。

链格孢菌毒素对紫茎泽兰致病性及生物测定方法的研究

以紫茎泽兰(EupatoriunadenophorumSpreng.)为生物测定材料,对链格孢菌毒素的生物测定方法进行了比较研究,筛选出离体叶片针刺法可作为该毒素的生物测定方法,为进一步研究该毒素提供了可靠的生物检测手段。

Clinical observation of body acupuncture combined with FANG’s scalp acupuncture for limb dysfunction in the remission stage of stroke

Objective:To observe the clinical efficacy of body acupuncture combined with FANG’s scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism.Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG’s scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated.Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG’s scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG’s scalp acupuncture can produce better results.

Research of efficacy assessment of post-stroke hemiplegic spasticity treated with acupuncture and rehabilitation:a multi-centre randomized controlled trial

Objective To observe the therapeutic effect of acupuncture and rehabilitation on poststroke hemiplegic spasticity, and probe into the indices of efficacy assessment of the disease. Methods According to the randomized, controlled and blind clinical trial design, 229 cases enrolled in accordance with the inclusive criteria were divided into 3 groups based on visiting sequence： treatment group 1 （74 cases）, treated with acupuncture [Jianyu （肩髃 LI 15）, Quchi （曲池 LI 11）, Waiguan （外关 TE 5） etc. on the affected side]; treatment group 2 （75 cases）, treated with acupuncture as treatment group 1 and combined with rehabilitation as control group; control group （80 cases）, treated with rehabilitation （Bobath facilitation technique）. 5 treatments were given each week, continuously for 4 weeks. The clinical efficacy on post-stroke hemiplegic spasticity was observed systematically after the treatment of acupuncture combined with rehabilitation. Results The research showed that the baseline situations of 3 groups were good, the group division was proportionate, indicating strong comparability （P〉0.05）. Based on the modified Ashworth Spasticity Scale （modified ASS）, the total effective rate was 63.01% （46/73） in treatment group 1, 66.67%（50/75） in treatment group 2 and 44.00% （33/75） in control group, indicating a statistical significant difference among 3 groups （P〈0.05）. Based on MAS motor function scale, the function improvement in treatment group 2 was superior to that in treatment group 1 and control group, indicating statistical significant differences among 3 groups （both P〈0.05）. Based on modified Barthel index, the daily life activity in treatment group 2 was superior in the improvement as compared with treatment group 1 and control group, but without statistical significant difference indicated （P〉0.05）. Conclusion The efficacy of post-stroke hemiplegic spasticity is definite with acupuncture combined with rehabilitation, and the acupuncture program is safe and effective.

Effect of acupuncture on the luteal function of rats with embryo implantation dysfunction

Objective To observe the effects of acupuncture on the luteal function of rats with embryo implantation dysfunction, and to explore its mechanism. Methods The early pregnant rats were randomly divided into normal control group （N）, model group （M）, acupoint group （A）, and non-acupoint group （AC）. The model of embryo implantation dysfunction in Group M, A, and AC was established with Mifepristone. For rats in Group A, bilateral ＂Housanli＂ （后三里 ST 36） and ＂Sanyinjiao＂ （三阴交 SP 6） were needled, while the non-acupoints beside the acupoints were needled in Group AC. In this experiment, the serum levels of luteinizing hormone （LH）, estradiol （E2）, and progesterone （P） were detected with radioimmunoassay, the expression of vascular endothelial growth factor （VEGF） in the rat ovarian tissue was detected by using Western-blot. The mRNA expressions of VEGF and luteinizing hormone receptor （LHR） in the ovarian tissue were detected by using RT-PCR. Results The serum levels of LH and P were significantly higher in group A than in group M and AC （all P〈0.05）, showing no statistical significance when compared with group N. The VEGF content, and expressions of VEGF mRNA and LHR mRNA in the ovarian tissue of group A were significantly elevated than those in group M and group AC （all P〈0.05）, showing no statistical significance when compared with group N. Conclusion Needling at ＂Housanli＂ （后三里 ST 36） and ＂Sanyinjiao＂ （三阴交 SP 6） could elevate the serum levels of LH and P of rats with embryo implantation dysfunction, and up-regulate the expression of LHR mRNA, VEGF and its mRNA in the ovarian tissue. It may enhance the luteal function of rats with embryo implantation dysfunction and improve its embryo implantation environment.

Acupuncture of lifting and pressing manipulation for upper limb paralysis after stroke

Objective To compare the difference of clinical efficacy between acupuncture of lifting and pressing manipulation and conventional acupuncture in motor function recovery of hemiplegic upper limb after stroke, so as to provide referential support for clinical application. Method Fifty-nine patients with upper limb hemiplegia after stroke were selected and divided into group A （conventional acupuncture ± lifting and pressing manipulation, 30 cases} and group B （conventional acupuncture, 29 cases} according to random number table method. Upper limb motor function and activity of daily living of patients in the two groups were scored before and after treatment, and the results were analyzed and compared. Results The score of upper limb FugI-Meyer motor function of patients was 22.4 ± 2.83 and 32.97 ± 2.92 before and after treatment in group A, and was 19.89 ± 3.13 and 26.62 ± 3.31 before and after treatment in group B, and the difference between the two groups before and after treatment was significant （P〈0.01}. The score of Barthel index of patients was 60.67 ± 4.65 and 73.00 ± 3.82 before and after treatment in group A, and was 50.52 ± 5.15 and 60.17 ± 4.89 before and after treatment in group B, and the difference between the two groups before and after treatment was not statistcally significant {P〉0.05）. Conclusion Lifting and pressing manipulation combined with conventional acupuncture can better improve upper limb motor function of upper limb paralysis of patients after stroke.

Observation of efficacy on prolapse of lumbar intervertebral disc treated with body acupuncture and wrist-ankle acupuncture

Objective To observe the clinical effects of body acupuncture and wrist-ankle acupuncture on prolapse of lumbar intervertebral disc, Methods One hundred and eighty cases of prolapse of lumbar intervertebral disc were randomly divided into body acupuncture and wrist-ankle acupuncture group （observation group） and simple body acupuncture group （control group）, 90 cases in each one. In observation group, body acupuncture was applied on Ahshi points of lumbar region, lumbar Jiájǐ （夹脊EX-B 2）, Dàchángshú（大肠俞 BL 25）, etc. and wrist-ankle acupuncture was applied on lower No. 4, 5 and 6 regions. In control group, simple body acupuncture was applied on the same points as observation group. Results The lumbar vertebral function and pain scale were improved in either group in comparison before and after treatment （P〈0.05）. Concerning pain improvement, the total effective rate was 95.6% in observation group, which was superior to that （86.7%） in control group （P〈0.05）. Concerning the improvement of lumbar vertebral function, the total effective rate was 90.0% in observation group and 93.3% in control group, without significant difference between two groups （P〉0.05）. Conclusion Combined therapy of body acupuncture and wrist-ankle acupuncture demonstrates apparent analgesia in prolapse of lumbar intervertebral disc.

Promotion of Tissue Regeneration with Acupuncture

Acupuncture can promote the regeneration of tissues. That acupuncture therapy can be called “Regenerative Acupuncture”, which is based upon the idea that by the unlimited and universal power of qi the process of creation can be triggered again, disabled or destroyed physiological functions of organs and tissues can be restored, and even the reconstruction and renewal of a physically disabled or destroyed organ or tissue might be possible. Regenerative Acupuncture, its point selection and its rationale are based on the ancient and modem Chinese acupuncture literature and clinical experiences of the authors. Now this acupuncture method was introduced by one case report.

Effect of Acupuncture on Expressions of InsR—β;mRNA and Protein in the Liver of Rats with Insulin Resistance

Objective： To observe the effect of acupuncture on the expressions of insulin receptor β （InsR-β） mRNA and protein in the liver of experimental rats with insulin resistance （IR）. Method： Twenty-four rats were randomly divided into 3 groups, control group （n=8）, model group （n=8） and acupuncture group （n=8）. Rats in the control group were fed with conventional food, and the other rats were induced into insulin resistance model with high fatsugar-salt food. Once model was induced successfully, rats in the control group were fed with conventional food continually, rats in the model group were fed with high fat-sugar-salt food continually, and rats in the acupuncture group were fed with high fat-sugar-salt food, and treated with acupuncture for 2 weeks. The expression of InsR-β mRNA was detected by real-time fluorescent quantitative RT-PCR, and the expression of InsR-β protein was detected by Western blot. Result： Expressions of InsR-β mRNA and protein in the model group were significantly lower than those in the control group （P〈0.01）, and those in the acupuncture group were higher than those in the model group （P〈0.0l, P〈0.05）. The expressions of InsR-β mRNA and protein between the acupuncture and control group had no significant difference. Conclusion： Acupuncture treatment can increase the expressions of InsR-β mRNA and protein in IR rats＇ liver to improve insulin resistance.

Clinical Observation on Acupuncture Intervention for Children with Attention Deficit Hyperactivity Disorder

Objective： To observe the effect of acupuncture for children with attention deficit hyperactivity disorder （ADHD）. Methods： A total of 36 cases were recruited in this study. Before treatment, a Chinese medical constitution survey was conducted on these children. Based on the survey findings, the children were divided in different groups for acupuncture intervention. Additionally, the heart rate variability and attention were detected respectively before treatment, in the 12th and 24th week after treatment. Results： ADHD kids commonly manifest as a body constitution of yang predominance and heat exuberance. The kids＇ Body Mass Indexes （BMI） are moderately correlated with attention deficit disorder （ADD）. After the treatment of 24 weeks, the ADHD scores were reduced from （10.94±1.98） to （8.56±2.48）, showing a statistical significance （P〈0.05）; in addition, the low frequency/high frequency （LF/HF） and normalized low frequency （nLF） between the two groups were also statistically different （P〈0.05）. Conclusion： Most ADHD kids present with a body constitution of yang predominance and heat exuberance. A well-controlled BMI is helpful for ADHD treatment. Acupuncture can be a supplementary therapy to improve the ADHD symptoms.

Clinical Study on Simple Obesity Treated with Abdomen Acupuncture

Objective： To observe the clinical effects of simple obesity treated with abdomen acupuncture. Methods： Sixty patients with simple obesity were allocated to abdomen acupuncture group and body acupuncture group based on the randomized and controlled principle, 30 patients in each group. Fifteen treatments made up one course. The cases were treated for 2 courses. The clinical effects were evaluated by body mass index （BMI） and the declining of body height. Result： The change of BMI and clinical effects were of no significant difference between two groups after 1 course, but there were significant differences after two courses. Conclusion： The clinical effect of abdomen acupuncture treating simple obesity is better, and the effect is persistent and stable.

Effect of acupuncture on hippocampal mitochondrial proteome expression in SAMP8 mouse model with Alzheimer disease

Objective：To observe the effect of acupuncture on the expression of mitochondrial proteome in hippocampus of senescence-accelerated mouse prone g （SAMPg） mice models with Alzheimer disease （AD）,and to explore the possible protective mechanism of acupuncture on mitochondria.Methods：Sixty 6-month-old male SAMP8 mice were randomly divided into an acupuncture at acupoint group,an acupuncture at non-acupoint group and a model group,20 mice in each group.The 20 male senescence-accelerated mouse/resistance 1 （SAMR1） mice of the same age were used as a normal control group.Shenshu （BL 23）,Baihui （GV 20）,Xuehai （SP 10） and Geshu （BL 17） were selected for acupuncture intervention in acupuncture at acupoint group.After an 8-week intervention,mitochondrial tissues were extracted from the hippocampus.Differentially expressed proteins were identified by subcellular organelle proteomics.Western blot was used to verify the expressions of some related proteins in hippocampal mitochondria.Results：Compared with the model group,there were 13 differentially expressed protein spots in the acupuncture at acupoint group,of which,9 were up-regulated,including neurofilament light polypeptide （NFL）,actin （cytoplasmic 1,database ID：ACTB）,tubulin beta-2A chain （TBB2A）,tropomodulin-2 （TMOD2）,pyruvate dehydrogenase E1 component subunit beta （PDHE1-β）,NADH-ubiquinone oxidoreductase 75 kDa subunit （database ID：NDUS1）,heat shock cognate 71 kDa protein （HSC71）,pyruvate dehydrogenase E1 component subunit alpha （PDHE1-α） and ATP synthase beta subunit （ATP-β）;4 were down-regulated,including glial fibrillary acidic protein （GFAP）,pyruvate dehydrogenase phosphatase 1 （PDP1）,mitochondrial-processing peptidase subunit alpha （MMP-α） and adenosine kinase （ADK）.According to the information provided in the protein database,most of the differentially expressed proteins involve the regulation of mitochondrial function and structure.The expression levels of NFL and TBB2A in the normal control group and the acupuncture at acupoint group were significantly higher than those in the acupuncture at non-acupoint group （P〈0.05）.ATP-β and NDUS1 expression levels were significantly higher in the acupuncture at acupoint group than those in the acupuncture at non-acupoint group （P〈0.05）;there was no significant difference between the acupuncture at non-acupoint group and the model group （P〉0.05）.Conclusion：Acupuncture may achieve the potential therapeutic effect on AD by regulating the structure and functional proteins of hippocampal mitochondria.

Treatment of Retinochorioiditis Caused by Toxoplasmosis with Traditional Symptom-related Acupuncture and Chronoacupuncture／Zi Wu Liu Zhu.A Case Study

Object: To show that increased and invigorated movement of qi and bloodwithin the organism and their concentration in the diseased organ is crucial for acupuncture andlimitations for acupuncture based upon Western medicine are not necessarily adequate. Methods:Symptom-related and chronoacupuncture were used within a five stages acupuncture beginning withneedling of competent pair of confluent points and followed by Zi Wu Liu Zhu chronoacupuncture.Results: After 58 symptom-related acupuncture treatments the vision increased from 10 to 70 percentand remained stable. 18 months later one Zi Wu Liu Zhu chronoacupuncture was carried out following aneedling concept of five stages. Within one hour the vision increased from 70 to 90 percent.Conclusions: Ophthalmologists should offer acupuncture to patients suffering from eye in-flammationsand retina scars. Acupuncturists should use Zi Wu Liu Zhu and powerful acupoints and acupointcombinations in order to invigorate and to move qi and blood strongly. This case shows theeffectiveness of acupuncture and chronoacupuncture in a case of retina scar caused by toxoplasmosis.Therefore, acupuncture treatment might be successfully applied in diseases where Western medicinecannot offer help.

Influence of Acupuncture on HPA Axis in a Rat Model of Chronic Stress-induced Depression

Objective： To investigate the neurobiological mechanism of depression pathogenesis and reveal the mechanism of acupuncture treatment of depression. Methods： Wistar rats were selected for subjects. A rat model of depression was made by individually housing with unpredicted chronic moderate stimuli. Changes in behavior and hypothalamus-pituitaryadrenocortical axis were examined in rat models of stress-induced depression. Meanwhile, the intervening effect of acupuncture was evaluated and the curative effects of different acupuncture methods compared. Results： CORT and ACTH contents of serum were significantly higher in the model and normal saline groups than in the control group （P〈0.05）, significantly lower in the hand acupuncture and electroacupuncture groups than in the model group （P〈0.05） and significantly lower in the medication group than in the normal saline group （P〈0.05）. There were no significant differences between the hand acupuncture, electroacupuncture and medication groups. Conclusion： Acupuncture of Baihui（GV 20） and Taichong （LR 3） has a marked antidepressant effect. Its mechanism may be related to the regulation of HPA axis by acupuncture.

Traditional Chinese Acupuncture and Acupuncture Microsystems

Acupuncture carried out with needles out of stone, bone, and probably wood and by using the methods of Ashi and local point needling started in the Stone Age in China. In historical times, the acupuncture of Neo＇ing （Inner Canon） （Neijing acupuncture） was added to Ashi point acupuncture. In our times, acupuncture microsystems were introduced, usually beside the rules set up by qi and ＂the web that has no weaver＂. The question is whether the microsystems are located outside or within the ＂the web that has no weaver＂ and they are included in the theory of the Neijing acupuncture？ Most of the microsystems rest on theories of their own based on the location of the acupoint, and do not care for their intersections with the ＂Neijing acupuncture＂, neither in theory nor in clinic. However, there exist two acupuncture theories to explain acupuncture, but which one is the better？ These questions will be explained and discussed.