腧穴热敏灸应用概况

针灸疗法是中医治疗学的重要组成部分,由于种种原因,针法在临床应用广泛,而灸法却处于一种逐渐萎缩的状态。近年来,腧穴热敏灸的出现,在一定程度上推动了灸法的临床运用及学科发展,现就热敏化穴位探寻、热敏化现象及临床应用进行综述。

Effect of moxibustion at sensitized-acupoints on quality of life in patients with chronic superficial gastritis

Objective:To compare the efficacy difference between moxibustion at sensitized-acupoints and non-sensitized-acupoints using the same group of acupoints.Methods:A total of 139 patients with chronic superficial gastritis were divided into a sensitized acupoint group(102 cases)and a non-sensitized acupoint group(37 cases)based on whether acupoint sensitization occurred.The SPSS version 19.0 statistical software propensity score matching function was used to balance the baseline data between the groups.Finally,29 pairs of matched patients were included,namely 29 cases in the sensitized acupoint group and 29 cases in the non-sensitized acupoint group.Both groups were treated with moxibustion therapy.The treatment lasted for 30 min per time,and was performed every other day for 8 weeks.Changes in the traditional Chinese medicine(TCM)symptom score and the short-form 36-item health survey(SF-36)score in both groups were observed before and after treatment,as well as the clinical efficacy.Results:The covariates of age,course of disease,TCM symptom score and SF-36 score in the two groups were balanced after matching(all P>0.05).After treatment,the total effective rate was 100.0%in the sensitized acupoint group and 79.3%in the non-sensitized acupoint group.The difference in the total effective rate between the two groups was statistically significant(P<0.01).After treatment and at the 4-week follow-up,the TCM symptom scores in the sensitized acupoint group were significantly lower than those in the non-sensitized acupoint group(all P<0.01);the SF-36 scores in the sensitized acupoint group were significantly higher than those in the non-sensitized acupoint group(all P<0.01).Conclusion:With the same group of acupoints,the sensitized acupoints have a better therapeutic effect and long-term efficacy than the non-sensitized acupoints in the treatment of chronic superficial gastritis.

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.

Therapeutic observation of acupuncture plus heat-sensitive moxibustion for chronic pelvic inflammatory disease

Objective：To observe the therapeutic efficacy of acupuncture plus heat-sensitive moxibustion in treating chronic pelvic inflammatory disease （CPID）, for selecting an effective acupuncture-moxibustion method in treating chronic pelvic inflammation. Methods：Eighty CPID subjects were enrolled and divided into two groups by randomized single-blind method, 40 in each group. The observation group was intervened by acupuncture plus heat-sensitive moxibustion, while the control group was by acupuncture plus box-moxibustion, once every other day, 10 sessions as a treatment course, but the period time was skipped. The therapeutic efficacy was observed after 3 treatment courses. Results：The recovery rate was 45.0% and the total effective rate was 95.0% in the observation group, versus 20.0% and 80.0% in the control roup. There were significant differences in comparing the recovery rate and the total effective rate between the two groups （P〈0.05）. Conclusion：Acupuncture plus heat-sensitive moxibustion can produce a higher therapeutic efficacy in treating CPID than acupuncture plus box-moxibustion, and this is an easy-to-operate and safe method without adverse effect.

Efficacy of knee-balancing manipulation plus heat-sensitive moxibustion for knee osteoarthritis and its influence on CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3

Objective To observe the efficacy of knee-balancing manipulation plus heat-sensitive moxibustion in treating knee osteoarthritis(KOA)and its impact on the expression of C-telopeptide of type I collagen(CTX-Ⅰ),tartrate-resistant acid phosphatase 5b(TRACP-5b),A disintegrin and metalloproteinase with thrombospondin motifs 4(ADAMTS-4),and matrix metalloproteinase 3(MMP-3).Methods A total of 134 unilateral KOA patients were randomized into a knee-balancing group,a heat-sensitive moxibustion group,and a joint intervention group.The knee-balancing group received knee-balancing Tuina(Chinese therapeutic massage)manipulation for treatment.The heat-sensitive moxibustion group received heat-sensitive moxibustion treatment.The joint intervention group received the heat-sensitive moxibustion in addition to the knee-balancing manipulation.The intervention period lasted for four weeks.After the treatment,and at the 2-week and 6-week follow-ups,the three groups were assessed using the visual analog scale(VAS)for knee joint pain and Western Ontario and McMaster Universities arthritis index(WOMAC),and clinical efficacy was also evaluated.The enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3.Results The knee-balancing group had 44 participants,but one dropped out;there was no dropout case among the 44 participants in the heat-sensitive moxibustion group;among the 46 participants in the joint intervention group,two cases dropped out.After the treatment,and at the 2-week and 6-week follow-ups,the total effective rate was found higher in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups(P<0.05).Compared with the baseline,the VAS and WOMAC scores and the serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 decreased significantly in all three groups after treatment and at the 2-week and 6-week follow-ups(P<0.05).At the same three time points,the VAS and WOMAC scores and serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 were lower in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups(P<0.001).Conclusion Either used alone or combined,the knee-balancing manipulation and heat-sensitive moxibustion therapy can improve the symptoms and down-regulate the serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 in KOA patients,producing durable efficacy;nevertheless,a more significant efficacy can be achieved by combining the two methods.

Effect Observation on Heat-sensitive Moxibustion for Abdominal Distension Following Laparoscopic Cholecystectomy

Objective: To observe the clinical effect of heat-sensitive moxibustion on abdominal distension following laparoscopic cholecystectomy. Methods: A total of 240 cases were randomly allocated into an observation group and a control group according to their admission sequence, 120 in each group. Cases in the observation group were treated with conventional care, glycerol enema and heat sensitive moxibustion, whereas cases in the control group were only treated with conventional care and glycerol enema. Then the passage of gas by anus within 24 h and improvement of abdominal distension were observed in both groups. Results: There were statistical differences in the emergence time of bowel sounds and the initial passage of gas by anus between the two groups(both P<0.05). The therapeutic effect in the observation group was better than that in the control group(P<0.05). Conclusion: Heat-sensitive moxibustion has reliable effect for abdominal distension following laparoscopic cholecystectomy.