不同精灸灸度治疗颈椎病颈痛的临床疗效研究

目的:探讨3种不同精灸灸度对颈椎病颈痛的治疗,评价不同灸度对疗效的影响。方法:将84例受试者随机分为普通灸组(30例)、发泡灸1组(30例)、发泡灸2组(24例)。采用Northwick Park颈痛量表(NPQ)、视觉模拟评分法(VAS)、简式Mc Gill疼痛量表(MPQ)评分来观察不同时点组内及组间疗效差异。结果:3组患者治疗结束及随访1个月时NPQ、MPQ、VAS量表总得分均较治疗前下降(P<0.05)。疗程结束及随访1个月时,发泡灸1组、发泡灸2组均较普通灸组NPQ、MPQ、VAS评分下降(P<0.05,P<0.01);发泡灸1组与发泡灸2组在疗程结束及随访1个月时评分差异无统计学意义。结论:不同精灸灸度治疗颈椎病颈痛均有效,发泡灸1组与发泡灸2组在改善颈椎病疼痛方面疗效类同,均优于普通灸组。

灸法量效关系的现代研究进展

灸量的控制是影响灸法疗效的核心因素,对于形成灸法的标准化、探寻疗效的最优化、阐述疗法的科学性是最为核心的问题之一。本文整理了近20年来研究者们依据时间、温度、操作方法、灸感等不同角度对构成灸量和灸度的因素进行了分析,对艾灸疗法的量效规律进行了初步总结。

CLINICAL AND ELECTROPHYSIOLOGICAL OBSERVATIONS ON DIABETIC PERIPHERAL NEUROPATHYTREATED BY WARM NEEDLING AND MOXIBUSTION

Objective To observe clinical therapeutic effects of warm needling and moxibustion on diabetic peripheral neuropathy （DPN） and their influence on nerve conduction velocity. Methods Fifty two cases were randomly divided into a treatment group （n =26） and a control group （n =26）. In addition to basic treatment for lowering blood sugar in both groups, Pǐshū （BL 20）, Shènshū （BL 23）, Huántiào （GB 30）, Zùsānlǐ （ST 36）, Yánglíngquán （GB 34）, Sānyīnjiāo （SP 6）, Tàixī （KI 3）, Qǔchí （LI 11）, Wàiguān （TE 5） and Hégǔ （LI 4） were selected for warm needling and moxibustion in the treatment group. Methycobal was intramuscularly injected in the control group. Clinical symptoms and conduction velocities of the tibial nerve and common peroneal nerve were compared before and after treatment. Results Warm needling and moxibustion could alleviate such clinical symptoms as numbness of limbs, pain and hypoesthesia, and obviously improve the conduction velocities of both tibial and common peroneal nerves. Conclusion Warm needling and moxibustion exhibit good therapeutic effects on diabetic peripheral neuropathy.

The Effect of Acupuncture on Bone Mineral Density in Postmenopausal Women

According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.……

Design and application of automatic constant temperature moxibustion box

Objective:To explore the clinical application effect of self-designed automatic constant temperature moxibustion box.Methods:From June 2016 to January 2017,150 patients with neck,shoulder,back and leg pain admitted to our hospital were treated with moxibustion under the informed consent of the patients.The patients were randomly divided into control group and observation group,75 cases each.The group used traditional moxibustion box for moxibustion treatment,and the observation group used automatic constant temperature moxibustion box for moxibustion treatment for 15 days.After the treatment,the patient's safety,comfort,satisfaction and adverse reactions were compared,and the results were analyzed using SPSS 20 statistical software.Results:The comfort and satisfaction in study group were all superior to that of control group,with statistically significant difference(P<0.01).For patient's safety,the ratio of patients suffered from scald in study and control groups was 5.3/100 and 0,respectively.Conclusions:It is of great significance for improving clinical efficacy and preventing medical risks.It is worthy of clinical application.

INFLUENCE OF DIFFERENT INTERVALS OF ACUPUNCTURE TREATMENT ON BONE INTENSITY IN PRIMARY OSTEOPOROSIS PATIENTS

Objective: To observe the influence of different intervals of acupuncture treatment on bone intensity in primary osteoporosis subjects. Methods: A total of 45 cases of primary osteoporosis female patients were randomly divided into 1 treatment/week (1-T/W), 2 treatments/week (2-T/W) and 3 treatments/week (3-T/W) groups, with 15 cases being in each group. Guanyuan (CV 4), Zusanli (ST 36), Sanyinjiao (SP 6), Shenshu (BL 23), Taixi (KI 3) and Pishu (BL 20) were used and stimulated with reinforcing needling manipulation. For patients with deficiency syndrome of kidney-yang, thermal acupuncture was applied to Shenshu (BL 23), and for patients with spleen-deficiency syndrome, thermal acupuncture applied to Zusanli (ST 36). Results: After 6 months’ treatment, in 1-T/W group, no apparent change of bone intensity was observed, while in 2-T/W and 3-T/W groups, the bone intensity was increased significantly (P<0.05, 0.01). Conclusion: Acupuncture plus moxibustion treatment twice or 3 times every week can obviously improve the bone intensity.

THEORETICAL ANALYSIS ON THE DEPTH OF NEEDLE-INSERTION

In the present paper, the author sums up and analyzes descriptions about needle-insertion depth in Chinese classical medical book Huang Di Nei Jing (《黄帝内经》The Yellow Emperor’s Internal Classic). In many chapters of Nei Jing, the needle-insertion depth is stressed to be various according to 1) the deficiency or excess of syndromes, 2) the patients’ constitution, 3) the severity of disease, 4) the duration of disease, 5) the location of disease, 6) the patient’s age, 7) the location of the needled acupoint, 8) the season, 9) the patient’s temperament, 10) the pulse condition, 11) the state of “Deqi”, and 12) the location of the running course of meridians. In addition, different kinds of diseases and different stages of diseases also need different depths of needle insertion, different manipulating skills and different stimulating quantity.

Clinical observation on acupuncture for male osteoporosis

Objective To compare the therapeutic effects of acupuncture combined with drug and simple drug for treatment of male osteoporosis. Methods Fifty-five cases were divided into a comprehensive therapy group （observation group, 25 eases） and a medication （control group, 30 cases） randomly. The observation group was treated with acupuncture and moxibustion at Pishu （脾俞BL 20）, Shenshu （肾俞 BL 23）, Mingmen （命门 GV 4）, Shenque （神阙 CV 8） and so on combined with oral administration of Alendronate, while the control group was treated with oral administration of Alendronate simply. The improvement of both Integral of Clinical Symptoms （ICS） and Bone Mineral Density （BMD） of two groups were observed after 6 months treatment. Results The ICS of two groups after treatment both decreased significantly （both P〈0.001）, and the decreasing degree in observation group was more significant than that in control group （P〈0.001）. The BMD of lumbar vertebrae and femur in observation group increased obviously than that before treatment （P〈0.01, P〈0.05）. The increasing degree of BMD of lumbar vertebrae in observation group after treatment was more obvious than that in control group （P〈0.05）. There were abdominal pain, diarrhea, nausea, vomiting, dyspepsia and other adverse reaction in control group, while the degree and occurrence rate of those in observation group alleviated and decreased obviously. Conclusion The effect of acupuncture combined with drug for male osteoporosis is good with little adverse reaction. This method is better than taking Alendronate.

Preliminary observation on effect of cupping on the skin surface temperature of patients with back pain

Objective To preliminarily observe the effects of cupping on localized skin temperature of patients with back pain.Methods A total of 43 patients with back pain were included in this study.They were treated with medium-sized cups with a volume of 260 mL The randomly selected Xinshu（心俞 BL 15）on one side（37 cases） was given cupping treatment while that on the other side as the control.And Shenshu（肾俞 BL 23）（6 cases） was treated in the same way.The thermal infrared imager was used to record the changes in localized skin temperature before and after cupping（for 10 minutes）,and then comparison was made with that of the control side.Results After cupping,the localized skin temperature fell and then rose.When the cup was removed after retaining for 10 minutes,the localized skin temperature was（0.4±0.9） ℃（P=0.004） lower than that before cupping;10 minutes after cupping off,the localized skin temperature was（0.4±1.1） ℃（P=0.016） higher than that before cupping while（0.8±0.9） ℃ higher than that when cupping off.The skin surface temperature on the control side declined steadily.Conclusion After cupping treatment,the localized skin temperature fell and then rose while that of the control side declined steadily.It might be related to therapeutic effects.

Temperature variation during penetration moxibustion on abdomen

Objective To seek safe, effective and popular penetration moxibustion therapy through exploring the optimum duration and temperature of penetration moxibustion by means of observing the relationship among the duration, temperature and effect of moxibustion on abdomen. Methods Thirty-two healthy persons were selected as subjects, and moxibustion was performed, centering on navels, on their abdomens. The temperature of moxibustion box was recorded once a minute since the beginning of moxibustion, and other items, including the temperature and time at which and when the subject felt heated, the temperature at which the subject felt reduced, temperature reduction time, temperature difference on the skin, time course of penetration moxibustion and subject＇s reaction, were also recorded. Results Among32 subjects, 2 dropped out from the study; flushing was shown on 30 subjects, sweating on 7, brindle on 5, and reaction on 7. The time course of penetration moxibustion was（28.37±2.37） min, the temperature at which the subject felt heated was（35.79±0.85） ℃, and the temperature at which the subject felt reduced was（44.23±1.62） ℃. Conclusion 1 During the course of penetration moxibustion, sense of warmth penetrate into abdominal cavity and waist from epidermis, and penetrate into head upwards and knee downwards;2 flushing, sweating and brindle are the important indices for the effect of penetration moxibustion; 3 penetration moxibustion can be lasted for 28–32 min, and the temperature should be controlled at 43–45 ℃, so as to not only reduce the impact of smoke on the indoor environment, but also make patients feel no pain.

Thoughts on the conclusion of no differences between acupuncture and sham acupuncture in clinical researches of migraine in foreign countries

Aiming at the conclusion that ＂there is no difference in efficacy between acupuncture and sham-acupuncture＂ in clinical research field of migraine in foreign countries in recent years, through the discussions on the definition of sham acupuncture （placebo acupuncture）, the principles required to be obey in satisfactory placebo acupuncture, the definition, location, function as well as clinical results of shallow puncture, the authors probed into whether shallow puncture could be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. It was demonstrated in the results that ＂acupuncture with minimal stimulation on skin superficial layer of meridian points or non-meridian points＂, the so-called control method of ＂sham acupuncture （placebo acupuncture）＂ excited holistic regulation of human body quite probably through ＂shallow puncture on cutaneous region of meridians＂ to achieve therapeutic effects. Hence, this method is not the appropriate control method of placebo acupuncture and cannot be the control method of sham acupuncture （placebo acupuncture） in clinical research of acupuncture. Therefore, it is naturally to repudiate the conclusion that ＂there is no difference in efficacy between acupuncture and sham acupuncture＂ in the research where this method is taken as the control of placebo acupuncture.

Relationship between the sensor temperature and moxibustion distance of mild moxibustion

Objective To explore the relationship between the receptor temperature and moxibustion distance of mild moxibustion, and provide evidence for clinical moxibustion distance. Methods Mild moxibustion was carried out for 15min by adopting moxibustion shelf, and the moxibustion ash was shook off automatically for once every 3 min. The distance between moxa stick and temperature sensor was set as 2 cm, 3 cm, 4 cm and 5 cm, respectively, by ruler. The temperature was recorded for once every 2 s with photothermal detection system for moxibustion combustion to form a temperature profile. The initial temperature, maximum temperature and average temperature were observed, and the experimental data were analyzed via SPSS18.0 statistical software. Results The initial receptor temperature was （25.33±0.29） ℃ when the moxibustion distance was 2 cm, （25.29±0.05） ℃ when the moxibustion distance was 3 cm, （25.43±0.17） ℃ when the moxibustion distance was 4cm, and （25.16±0.22） ℃ when the moxibustion distance was 5 cm, respectively. The maximum temperature was （74.96±1.20） ℃ when the moxibustion distance was 2 cm, （51.70±0.74） ℃ when the moxibustion distance was 3 cm, （49.33±0.40） ℃ when the moxibustion distance was 4 cm, and （42.50±0.26） ℃ when the moxibustion distance was 5 cm, respectively. The average temperature was （62.40±7.84） ℃-（62.68±7.58） ℃ when the moxibustion distance was 2 cm, （44.77±3.31） ℃-（45.11±3.21） ℃ when the moxibustion distance was 3 cm, （42.72＋3.86） ℃-（43.12±3.54） ℃ when the moxibust-ion distance was 4 cm, and （38.45±1.67） ℃-（38.50±1.63） ℃ when the moxibustion distance was 5 cm, respectively. The temperature curve showed that the fluctuation range was the maximum when the moxibustion distance was 2 cm, larger when the moxibustion distance was 3 cm, smaller when the moxibustion distance was 4 cm, and minimum when the moxibustion distance was 5 cmo There was no significant difference in the initial temperature of mild moxibustion at different distances, however, the maximum temperature, average temperature and the fluctuation range of temperature curve were closely related to the moxibustion distance. Conclusion The nearer the distance is, the higher the maximum temperature and average temperature as well as the larger the fluctuation range will be, and the farther the distance is, the lower the maximum temperature and average temperature as well as the smaller the fluctuation range will be. Accordin8 to preliminary analysis, the temperature will be the most suitable when the moxibust-ion distance is 3 cm-4 cm.

Clinical Observation on the Post-stroke Shoulder Pain and Blood Viscosity Treated by Acupuncture-moxibustion Therapy

Objective： To reveal the therapeutic effect of acupuncmre-moxibustion therapy for the treatment of post-stroke shoulder pain. Methods： Ninety patients with post-stroke shoulder pain were randomized into three groups at ratio of 1：1：1, to receive acupuncture-moxibustion therapy （AM）, acupuncture-moxibustion plus Chinese herbal decoction （AMCH）, and Chinese herbal decoction （CH） respectively. Results： In the comparison of the therapeutic effects and blood viscosity, there was significant difference between the AM and CH group, as well as between the AMCH and CH group （P〈0.01）; the difference was not significant between the AM and AMCH group. Conclusion： Acupuncture-moxibustion is an effective therapy in the treatment of the post-stroke shoulder pain, and it can also reduce the blood viscosity in short-term.

Long-term effectiveness of moxibustion on herbs for moderate-severe persistent allergic rhinitis population:A study protocol for a randomized controlled trial

Background： Allergic rhinitis（AR） is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently used for treating AR in clinical practice. Western medicine is good at quick symptomatic relief,while offer little or no sustainable and steady long-term effect. Little established evidence is available to support the long-term effectiveness of moxibustion on herbs for AR.Objective： This study is a randomized controlled trial to assess the long-term effectiveness of moxibustion on herbs in moderate-severe persistent AR population.Methods： The study sample size is 56 patients. Eligible patients with moderate-severe persistent AR will be randomized into a moxibustion on herbs combined with conventional treatment group（MOHCT group） and a conventional treatment group（CT group） in a 1：1 ratio. Patients in the MOHCT group will receive a 30-min moxibustion on herbs treatment on Zhiyang（至阳 GV 9）, Dàzhuī（大椎 GV 14） and bilateral Shenshu（肾俞 BL 23）, Fèishū（肺俞 BL 13） for a total of 12 times on the basis of conventional treatment, while those in the CT group will receive conventional treatment alone. The primary outcome measure is VAS score for total nasal symptoms, which will be obtained via a self-recorded AR diary. The secondary outcome measures include the average occurrence of symptoms per week, use of medication and Rhinoconjunctivitis Quality of Life Questionnaire（RQLQ）.Discussion： The objectives of this study include（1） to evaluate the long-term effectiveness and safety of moxibustion on herbs for treating AR;（2） to evaluate whether moxibustion on herbs can reduce the frequency of AR symptoms in patients with moderate-severe persistent allergic rhinitis. The finding of this study will provide evidence on the long-term effectiveness of moxibustion on herbs for moderatesevere persistent AR.

Experimental observation of effects of acupoints,cone numbers and durations of moxibustion with different moxibustion methods on skin surface and inside temperature

Objective:To observe the effects of acupoints,cone numbers and durations of moxibustion with different moxibustion methods on skin surface and inside temperature,and to provide references for the clinical standardization of moxibustion amount.Methods:The 42 big-ear white rabbits were divided into 6 groups according to the random number table method,a 2-cone direct moxibustion group,a 2-cone direct moxibustion group,a 3-cone direct moxibustion group,a 1-cone herbal cake-partitioned moxibustion group,a 2-cone herbal cake-partitioned moxibustion group,and a 3-cone herbal cake-partitioned moxibustion group,with 7 rabbits in each group.Shenque(CV 8);Shenshu(BL 23)and Zusanli(ST 36)were used in each group,but the moxibustion methods,cone numbers and durations of moxibustion were different・Rabbits in each group received moxibustion once every other day for 5 times in total.During the intervention,a thermoelectricity coupled probe and a temperature recorder were used to record the real-time-acupoint skin temperature and the temperature at different time points,so as to observe,analyze and process the real-time changes in the temperature difference between the surface and inside of acu point skin.Results:For herbal cake-partitioned moxibustion,the best temperature for cone changing was(46.38±0.51)℃when the highest surface temperature was(49.20±0.52)℃;the multi-factor comparison of acupoint×cone number×time and acupoint×moxibustion method×time showed that time×acupoint,time×moxibustion method and cone number×acupoint had interactive effects(all P<0.05).Comparing skin temperature differences between different cone numbers at the same acupoint,Shenque(CV 8)on the 1st and the 5th days,Shenshu(BL 23)on the 3rd and the 7th days,Zusanli(ST 36)on the 1st and the 9th days of experiment showed statistically significant differences(all P<0.05).The skin temperature comparison of different moxibustion methods at the same acupoint all had statistical differences(all Pv0.05),except for Shenque(CV 8)before moxibustion,Shenshu(BL 23)before moxibustion and on the 5th day;Zusanli(ST 36)only showed statistical differences on the 5th and 7th days(both P<0.05).The skin temperature differences of different acupoints after moxibustion in the 1-cone,2-cone and 3-cone groups were statistically different(all P<0.05);direct moxibustion and herbal cake-partitioned moxibustion at different acupoints were all statistically different(all P<0.05).Conclusion:Cone changing temperature under the same specifications of herbal cake-partitioned moxibustion was confirmed.Temperature differenee between surface and inside of different acupoint skin at the same maximum temperature was significantly different due to the cone numbers and moxibustion methods,which showed the highest at Shenshu(BL 23),the sec ond at Shenque(CV 8),and the lowest at Zusanli(ST 36).The in fluence of acupoint factor should be considered to determine the quantitative indicators of moxibustion.

Efficacy of moxibustion by stimulating acupoints of Danzhong(CV 17) and Ganshu(BL 18) on hyperplasia of mammary gland in rats

OBJECTIVE: To evaluate the efficacy of moxibustion, through stimulating acupoints of Danzhong(CV 17) and Ganshu(BL 18) in rats with hyperplasia of mammary gland(HMG) which induced by estrogen and progestogen.METHODS: Thirty female Sprague-Dawley rats were randomly divided into saline control group,HMG model group, and HMG moxibustion group with 10 in each group. Saline control was the group injected by saline. HMG model were created by injection of estrogen and progestogen. Moxibustion group was also injected of estrogen and progesto-gen with moxibustion at the same time. The Changes of nipple diameter and height were measured.The rats' skin temperature was recorded by an infrared thermal camera at the nipples, mammary areas,Danzhong(CV 17) and Ganshu(BL 18). Pathological changes of mammary gland in rats were also observed under light microscope.RESULTS: The diameter and height of the nipples in model group were prominently bigger and higher than that in control group(P < 0.01). The diameter and height in moxibustion group were prominently smaller and lower than that in model group(P < 0.01), and there was no significant difference between moxibustion group and control group.Compared with control group, skin temperature of the nipples, mammary area, and acupoints Danzhong(CV 17) and Ganshu(BL 18) decreased prominently in model group(P < 0.01-0.05). Compared with model group, skin temperature of that in moxibustion group increased prominently(P <0.05).CONCLUSION: Treatment with moxibustion can effectively decrease the HMG rats' nipple diameter and height, and increase the skin temperature in HMG model rats at the nipples, mammary areas,Danzhong(CV 17) and Ganshu(BL 18). This study convinces the therapeutic effect of moxibustion on mammary gland hyperplasia.

Therapeutic effect of heat-sensitive moxibustion plus medications for senile osteoporosis and its effect on serum BMP-2 and OPG levels

Objective:To observe the clinical efficacy of heat-sensitive moxibustion plus medications on senile osteoporosis(SOP),and to explore the related mechanisms.Methods:A total of 70 elderly participants with osteoporosis were randomly divided into an observation group and control group,with 35 cases in each group.The control group was treated with conventional drugs,and the observation group was treated with heat-sensitive moxibustion on the basis of the conventional drugs.Both groups were treated for 3 months.Before and after treatment,assessed the visual analog scale(VAS)and Oswestry disability index(ODI)scores,determined the bone mineral density of the participants'lumbar spine(L2-L4)and left femoral neck,and detected the participants'serum bone morphogenetic protein-2(BMP-2)and osteoprotegerin(OPG)levels.Results:After treatment,the VAS scores of both groups were lower than before treatment(both P<0.05),and the VAS score of the observation group was significantly lower than that of the control group(P<0.05).After treatment,the bone mineral density values of the lumbar spine and left femoral neck in both groups were significantly higher than before treatment(both P<0.05),and the bone mineral density values of the observation group were higher than those of the control group(P<0.05).After treatment,the ODI scores of the two groups were lower than those before treatment(both P<0.05),and the ODI score of the observation group was lower than that of the control group(P<0.05).After treatment,the serum BMP-2 and OPG levels in the observation group were significantly higher than those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus medications for SOP can significantly relieve patients'pain,improve dysfunction,and increase bone density,which may be related to the improvement of the serum BMP-2 and OPG levels.

Mechanism study of the transmission of moxibustion heat in human acupoint tissues

Objective: To discuss the topical action characteristics of the biological transmission of moxibustion heat via temperature collection and numerical modeling. Methods: Temperature of moxibustion was measured at multiple points at a distance of 3 cm to obtain the moxibustion temperature field nephograms by the high-accuracy temperature measure array. Finite element analysis was used to imitate the three-dimensional dynamic distribution of temperature in acupoint tissues. Results: Through numerical analysis, the one-dimensional, two-dimensional and three-dimensional distributions of temperature in human acupoint tissues at 5 min of moxibustion were established. The result showed that moxibustion heat mainly tran smitted from the surface of the tissue to the internal, and the in flue nee of moxibusti on heat decreased with the depth of the tissue. The analysis of the nephograms of acupoint tissue temperature at 5,10, 15 and 20 min of moxibustion showed that with the in crease of the moxibusti on time, the temperature in acupoint tissues consta ntly rose, and the transmission depth of moxibustion heat also further expanded inside acupoint. Conclusion: By establishing the three-dimensional dynamic model of heat transmission inside acupoint tissues with the biological parameters of human tissues and the temperature values obtained, this study used finite element analysis software ANSYS 14.0 and discovered the rules in the transmission of heat in body tissues during moxibustion, and the features in moxibustion heat transmission (from the proximal to the distant) and heat penetration (from the surface to the intern al). This study provides theoretical and experime ntal support for the application of moxibusti on in clinical practice.