Effectiveness and safety of electroacupuncture analgesia in controlling intraoperative pain and hemodynamics during total thyroidectomy:A randomized controlled trial

Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture.The patients were randomized into two groups.The electroacupuncture analgesia(EA)group received EA stimulation at five acupuncture points:Hegu(LI 4),Neiguan(PC 6),Shuitu(ST 10),Quepen(ST 12),and Yifeng(SJ 17),while the control group received a bilateral superficial cervical plexus block.Primary outcomes included the level of analgesia and perioperative vital signs in both groups.Additionally,pain thresholds and serum b-endorphin levels were measured before and after electroacupuncture in the EA group.Results:Complete analgesia(Level A)was attained in 86%and 76%of the patients in the EA and control groups,respectively,with no significant difference between the two groups(P¼1.00).In the EA group,the mean pain threshold after receiving EA doubled(648.7(77.4)g/s vs.305.3(45.3)g/s,P<.001),and the mean serum b-endorphin level increased by approximately 13.5 pg/mL(P<.001).All patients remained hemodynamically stable throughout the surgery.Conclusion:EA,in conjunction with additional medications that stimulate five acupuncture points,LI 4,PC 6,ST 10,ST 12,and SJ 17,was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.

Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.

Electroacupuncture with different waveforms for primary dysmenorrhea:A randomized controlled trial

Objective To observe and compare the clinical effects of different electroacupuncture waveforms on primary dysmenorrhea.Methods This was a prospective,randomized,three-group,parallel-controlled trial.Participants with primary dysmenorrhea were randomly divided into dense-sparse wave,continuous wave,and discontinuous wave groups in a 1:1:1 ratio.Two lateral Ciliao(BL 32)points were used.All three groups started treatment 3–5 days before menstruation,once a day for six sessions per course of treatment,one course of treatment per menstrual cycle,and three menstrual cycles.The primary outcome measure was the proportion with an average visual analog scale(VAS)score reduction of≥50%from baseline for dysmenorrhea in the third menstrual cycle during treatment.The secondary outcome measures included changes in dysmenorrhea VAS scores,Cox Menstrual Symptom Scale scores and the proportion of patients taking analgesic drugs.Results The proportion of cases where the average VAS score for dysmenorrhea decreased by≥50%from baseline in the third menstrual cycle was not statistically significant(P>.05).Precisely 30 min after acupuncture and regarding immediate analgesia on the most severe day of dysmenorrhea,there was a statistically significant difference in the dense-sparse wave group compared with the other two groups during the third menstrual cycle(P<.05).Additionally,there was a statistically significant difference between the dense-sparse wave and discontinuous wave groups 24 h after acupuncture(P<.05).Conclusions Waveform electroacupuncture can alleviate primary dysmenorrhea and its related symptoms in patients.The three groups showed similar results in terms of short-and long-term analgesic efficacy and a reduction in the number of patients taking analgesic drugs.Regarding achieving immediate analgesia,the dense-sparse wave group was slightly better than the other two groups.

Electroacupuncture targeting the immune system to alleviate sepsis

Sepsis is a life-threatening inflammatory syndrome with high morbidity and mortality rates.However,options for sepsis are still limited to general treatment in intensive care units(ICUs),and effective therapies that improve sepsis survival are required.Immune disturbances play a vital role in the pathology of sepsis and are associated with protracted inflammation,susceptibility to infections,and death.Therefore,many investigators have focused on the potential benefits of immunomodulation therapy for sepsis.Electroacupuncture(EA)has been practiced in clinics for many years and has shown advantages in treating infectious diseases.Over the last few decades,our understanding of the efficacy and mechanisms of EA in sepsis has undergone considerable developments.We searched the literature regarding“CNKI,Wan Fang Data,VIP Database,PubMed,and Ingenta Connect”from 2010 to 2023,using the keywords“sepsis”“septic”and“electroacupuncture”and 336 sources were searched.Finally,we included 82 studies that targeted the immune system to determine EA’s anti-inflammatory and immunomodulatory effects on sepsis.In this review,we found that EA has clinical benefits in relieving septic inflammation,improving immune function,and attenuating related multi-organ injury through several mechanisms,such as activation of the cholinergic anti-inflammatory pathway(CAP),vagaladrenal axis,inhibition of the nuclear factor Kappa-B(NF-κB)signaling pathway,signal transducers and activators of transcription(STAT)signaling pathway,and improvement of immune cell function.Therefore,EA may be a promising complementary therapy for sepsis treatment.We also expect these data will contribute to further studies on EA in sepsis.

Exploring the mechanism of electroacupuncture at different acupoints on acute colitis rats based on JAK2/STAT3/SOCS1 signaling pathway

Objective:To investigate the mechanism of JAK2/STAT3/SOCS1 signaling pathway in electroacupuncture of different acupoints on acute colitis rats.Methods:36 SPF SD rats were randomly divided into 6 groups,with 6 rats in each group.The rat model of acute colitis was prepared by enema with glacial acetic acid solution.After the model was established,electroacupuncture was given to each acupoint group,with density wave,frequency 2Hz-50 Hz,intensity 2 mA,muscle tremor as the degree 20 min/time,1 time/day,for 3 consecutive days.Observe the general condition of rats;the pathological changes of colonic mucosa in rats were observed by HE method.The contents of serum interleukin-4(IL-4)and interleukin-8(IL-8)were detected by ELISA.Western blot and RT-PCR were used to detect the expression of JAK2,STAT3,SOCS1 protein and mRNA in rat colon tissue.Results:In contrast to the normal group,the overall condition of the model group was worse,the colonic mucosa was severely damaged,even necrotic,and the ulcer surface was obvious.The content of IL-4 in serum was obviously reduced,and the content of IL-8 was obviously go up(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously go up,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously reduced(P<0.01).In contrast to the model group,the general condition of rats in each acupoint group was significantly improved,the damage and necrosis of colonic mucosa and ulcer surface were obviously alleviated,the content of IL-4 in serum was obviously go up,and the content of IL-8 was significantly decreased(P<0.01).The protein content of JAK2,STAT3 and the expression of JAK2,STAT3 mRNA in colon tissue of rats were obviously reduced,while the protein content of SOCS1 and the expression of SOCS1 mRNA were obviously go up(P<0.05,P<0.01).Comparison of different acupoint groups,the colonic mucosal injury in the Zusanli group was significantly reduced,the content of serum IL-4 was significantly increased,and the content of IL-8 was significantly decreased(P<0.05,P<0.01).The protein content and mRNA expression of JAK2 and STAT3 in colon tissue were significantly down-regulated,while the protein content and mRNA expression of SOCS1 were significantly go up(P<0.05,P<0.01).Conclusion:Electroacupuncture at each acupoint can improve the damage of colonic mucosa and reduce the inflammatory response.The therapeutic effect of Zusanli(ST36)is better than that of Tianshu(ST25),Dachangshu(BL25)and Shangjuxu(ST37).The mechanism may be related to the regulation of JAK2/STAT3/SOCS1 signaling pathway related proteins and inflammatory cytokines IL-4 and IL-8.

Electroacupuncture improves myocardial fibrosis in heart failure rats by attenuating ECM collagen deposition through modulation of TGF-β1/Smads signaling pathway

Background: To explore the effects of electroacupuncture on cardiac function and myocardial fibrosis in rat models of heart failure, and to elucidate the underlying mechanism of electroacupuncture in heart failure treatment. Methods: Healthy male Sprague-Dawley rats were allocated into three groups: Sham group, Model group, and electroacupuncture (Model + EA) group, with each group comprising 8 rats. The model underwent a procedure involving the ligation of the left anterior descending coronary artery to induce a model of heart failure. The Model + EA group was used for 7 consecutive days for electroacupuncture of bilateral Shenmen (HT7) and Tongli (HT5), once a day for 30 min each time. Left ventricular parameters in rats were assessed using a small-animal ultrasound machine to analyze changes in left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction, and left ventricular fractional shortening. Serum interleukin-1β (IL-1β), cardiac troponin (cTn), and N-terminal brain natriuretic peptide precursor levels were measured using ELISA. Histopathological changes in rat myocardium were observed through HE staining, while collagen deposition in rat myocardial tissue was assessed using the Masson staining method. Picro sirius red staining, immunohistochemical staining, and RT-qPCR were utilized to distinguish between the various types of collagen deposition. The expression level of TGF-β1 and SMAD2/3/4/7 mRNA in rat myocardial tissues was determined using RT-qPCR. Additionally, western blot analysis was conducted to assess the protein expression levels of TGF-β1, SMAD3/7, and p-SMAD3 in rat myocardial tissues. Results: Compared with the Sham group, the left ventricular ejection fraction and left ventricular fractional shortening values of the Model group were significantly decreased (P < 0.01);the left ventricular end-diastolic volume and left ventricular end-systolic volume values were remarkably increased (P < 0.01);serum N-terminal brain natriuretic peptide precursor content was increased (P < 0.01);serum IL-1β and cTn levels were increased (P < 0.01);myocardial collagen volume fraction were increased (P < 0.01);and those of the expression of TGF-β1 and SMAD2/3/4 mRNA was increased (P < 0.01);the expression of SMAD7 mRNA was decreased (P < 0.01);the protein expression levels of TGF-β1, SMAD3, and p-Smad3 were increased (P < 0.01);the protein expression level of SMAD7 was decreased (P < 0.01) in the Model group. Compared to the Model group, the expression levels of the proteins TGF-β1, SMAD3, and p-Smad3 in myocardial tissue were found to be decreased (P < 0.01), and the expression level of the protein SMAD7 was found to be increased (P < 0.01) in the Model + EA group;the collagen volume fraction and deposition of type Ⅰ /Ⅲ collagen were decreased (P < 0.01) in the Model + EA group. Conclusion: Electroacupuncture alleviates myocardial fibrosis in rats with heart failure, and this effect is likely due to attributed to the modulation of the TGF-β1/Smads signaling pathway, which helps reduce collagen deposition in the extracellular matrix.

电针舌三针辅助星状神经节阻滞对脑梗死后吞咽障碍患者吞咽功能的影响

目的探讨电针舌三针辅助星状神经节阻滞(Stellate ganglion block,SGB)对脑梗死后吞咽障碍患者吞咽功能的影响。方法选取2022年1月—2023年1月期间河北北方学院附属第二医院收治的90例脑梗死后吞咽障碍患者,依据简单随机数字表法分为对照组和研究组,每组各45例。对照组采取SGB治疗,研究组在对照组基础上采取电针舌三针疗法,共治疗14 d。统计两组患者治疗前后舌骨移动度、吞咽用时、吞咽功能(Standardized swallowing assessment,SSA)及生活质量(Swallowing Quality-of-Life Instrument,SWAL-QOL)评分、营养状态指标[白蛋白(Prealbumin,PA)、转铁蛋白(Transferrin,TRF)、白蛋白(Albumin,ALB)]平及不良事件发生情况。结果治疗后两组患者舌骨上、下移动度较治疗前增大,差异有统计学意义(P<0.05);且研究组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者喉关闭用时、咽运送用时、口腔运送用时、吞咽反应用时较治疗前缩短,差异有统计学意义(P<0.05);且研究组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SSA评分较治疗前降低、SWAL-QOL评分较治疗前升高,差异有统计学意义(P<0.05);且研究组SSA评分低于对照组,SWAL-QOL评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者PA、ALB、TRF水平较治疗前升高,差异有统计学意义(P<0.05);且研究组高于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良事件发生率4.44%(2/45)明显低于对照组17.78%(8/45),差异有统计学意义(P<0.05)。结论采取电针舌三针辅助SGB治疗脑梗死后吞咽障碍可增大舌骨移动度,缩短吞咽用时,利于改善吞咽功能及营养状态,提升生活质量,并降低不良事件发生风险。

电针对骶上脊髓损伤后神经源性膀胱大鼠尿流动力学及脊髓组织ERK/CREB/Bcl-2通路表达的影响

目的观察电针“次髎”“中极”“三阴交”“大椎”对骶上脊髓损伤后神经源性膀胱大鼠尿流动力学及脊髓组织ERK/CREB/Bcl-2通路表达的影响。方法60只雌性SD大鼠随机选取24只分为空白组和假手术组各12只,其余36只采用脊髓横断法造模,将成模大鼠随机分为模型组和电针组,每组12只。电针组取单侧“次髎”“中极”“三阴交”“大椎”进行电针刺激,每次30 min,1次/d,连续7 d。干预结束后行尿流动力学检测,HE染色观察大鼠膀胱逼尿肌组织形态,TUNEL法检测脊髓组织细胞凋亡情况,Western blot测定脊髓组织p-ERK1/2、p-CREB、p-p90Rsk、CRE、Bcl-2、Bax蛋白表达。结果与假手术组比较,模型组大鼠膀胱基础压力、最大压力及漏尿点压明显增加(P<0.01),膀胱最大容量及顺应性明显降低(P<0.01);膀胱平滑肌细胞结构严重破坏、排列紊乱,伴大量炎性细胞浸润;脊髓组织细胞凋亡率明显升高(P<0.01),脊髓组织p-ERK1/2、p-p90Rsk、p-CREB、CRE、Bcl-2蛋白表达明显降低,Bax蛋白表达明显升高(P<0.01)。与模型组比较,电针组大鼠膀胱基础压力、最大压力及漏尿点压均明显降低(P<0.05),膀胱最大容量及顺应性明显增加(P<0.05,P<0.01);膀胱平滑肌细胞完整性增强,细胞水肿程度降低,炎性细胞浸润减轻;脊髓组织细胞凋亡率明显降低(P<0.05),脊髓组织p-ERK1/2、p-p90Rsk、p-CREB、CRE、Bcl-2蛋白表达明显升高,Bax蛋白表达明显降低(P<0.05,P<0.01)。结论电针可促进骶上脊髓损伤后神经源性膀胱大鼠膀胱逼尿肌组织修复,增加膀胱最大容量及顺应性,缓解膀胱内高压状态,其机制与激活ERK/CREB/Bcl-2通路、减少受损神经元继发性凋亡、改善膀胱的神经支配、保护膀胱功能有关。

电针气海、中极、关元穴改善压力性尿失禁尿道括约肌线粒体损伤机制研究

目的:观察电针对压力性尿失禁(SUI)环境下尿控的影响,并基于线粒体动力学探讨相关作用机制。方法:对SD大鼠进行随机分组,空白组未采取任何处理,假手术组完成手术解剖未干预,模型组行双侧卵巢切除+阴道扩张,假针组予非穴位电针,电针组进行穴位电针。尿动力学仪测量各组大鼠的最大膀胱容量(MBC)和腹腔漏尿点压力(ALPP)和漏尿点压力(LPP);HE染色观察尿道括约肌肌纤维形态改变;ELISA试剂盒检测线粒体膜电位、ATP和氧化应激相关指标;电镜观察尿道括约肌线粒体形态;Western blot检测尿道括约肌线粒体动力学相关因子线粒体融合素1(Mfn1)、Mfn2、线粒体动力相关蛋白1(Drp1)、线粒体分裂因子(MFF)、沉默信息调节因子1(SIRT1)和过氧化物酶体增殖物激活受体γ共激活因子-1α(PGC-1α)蛋白表达。结果:与假手术组比较,模型组大鼠尿控指标MBC、ALPP和LPP显著降低(均P<0.05),尿道括约肌纤维断裂、排列紊乱,线粒体明显肿胀,嵴增宽;线粒体膜电位、ATP、琥珀酸脱氢酶(SDH)和超氧化物歧化酶(SOD)水平显著降低(均P<0.05),丙二醛(MDA)水平显著升高(P<0.05);SIRT1、PGC-1α、Mfn1和Mfn2蛋白表达显著降低(均P<0.05),Drp1和MFF蛋白表达显著升高(均P<0.05)。与假针组比较,电针组大鼠的MBC、ALPP和LPP显著升高(均P<0.05),尿道括约肌纤维断裂、排列紊乱及线粒体的肿胀、嵴增宽情况显著改善;线粒体膜电位和ATP水平以及SDH和SOD活性显著升高(均P<0.05),MDA水平显著降低(P<0.05);SIRT1、PGC-1α、Mfn1、Mfn2蛋白表达显著升高(均P<0.05),Drp1和MFF蛋白表达显著降低(均P<0.05)。结论:电针可通过调控线粒体动力学改善SUI环境下尿道括约肌肌纤维形态和线粒体形态及功能障碍。

电针刺激对慢性心力衰竭模型大鼠及心肌纤维化细胞模型的影响

目的观察电针刺激对慢性心力衰竭(CHF)大鼠模型及心肌纤维化细胞模型的影响,探讨电针对CHF的治疗作用机制。方法选取24只雄性Wistar大鼠随机分为4组,分别为假手术组、假手术+电针组、心肌纤维化组及心肌纤维化+电针组,每组6只。将H9c2大鼠心肌细胞随机分为4组,对照组、对照+电针组、血管紧张素Ⅱ处理组及血管紧张素Ⅱ处理+电针组。心肌纤维化组大鼠采用腹主动脉缩窄法建立CHF模型,假手术组大鼠仅分离腹主动脉不进行钳夹,心肌纤维化+电针组大鼠在心肌纤维化组的基础上联合电针刺激大鼠双侧“内关”穴干预,假手术+电针组大鼠在假手术组的基础上联合电针刺激大鼠双侧“内关”穴干预。血管紧张素Ⅱ处理组采用含血管紧张素Ⅱ的培养基对H9c2大鼠心肌细胞进行培养及传代,对照组H9c2大鼠心肌细胞在正常培养基内进行培养及传代,血管紧张素Ⅱ处理+电针组是血管紧张素Ⅱ处理组的基础上在培养皿中予以电刺激,对照+电针组在对照组的基础上在培养皿中予以电刺激。检测各组大鼠干预12、16、20周室间隔舒张末期厚度(IVSd)、左室舒张末期后壁厚度(LVPWd)、左室收缩末期内径(LVEDs)、左室舒张末期内径(LVEDd)及左室射血分数(LVEF),以及血清B型钠尿肽(BNP)、乳酸脱氢酶(LDH)、肌酸激酶(CK)水平,检测各组H9c2大鼠心肌细胞在干预12、16、20周重组蛋白基质金属蛋白酶9(MMP9)及基质金属蛋白酶抑制剂-1(TIMP-1)相对表达情况。结果与假手术组干预同期比较,心肌纤维化组干预12、16、20周时IVSd、LVPWd、LVEDs及LVEDd均升高(P<0.05),LVEF降低(P<0.05),但假手术+电针组干预12、16、20周时各项指标与假手术组干预同期比较差异均无统计学意义(P>0.05)。与心肌纤维化组干预同期比较,心肌纤维化+电针组干预12、16、20周时IVSd、LVPWd、LVEDs及LVEDd均降低(P<0.05),LVEF升高(P<0.05)。与假手术组干预同期比较,心肌纤维化组干预12、16、20周时BNP、LDH及CK水平均升高(P<0.05),但假手术+电针组干预12、16、20周时各项指标与假手术组干预同期比较差异均无统计学意义(P>0.05)。与心肌纤维化组干预同期比较,心肌纤维化+电针组干预12、16、20周时BNP、LDH及CK水平均降低(P<0.05)。与对照组干预同期比较,血管紧张素Ⅱ处理组干预12、16、20周时MMP-9及TIMI-1相对表达水平均升高(P<0.05),但对照+电针组干预12、16、20周时各项指标与对照组干预同期比较差异均无统计学意义(P>0.05)。与血管紧张素Ⅱ处理组干预同期比较,血管紧张素Ⅱ处理+电针组干预12、16、20周时MMP-9及TIMI-1相对表达水平均降低(P<0.05)。结论电针对CHF的治疗作用可能是通过抑制心室重构,改善心功能,保护心肌细胞,减轻心肌纤维化而实现。

电针干预围绝经期失眠大鼠睡眠觉醒的实验研究

目的观察电针干预围绝经期失眠大鼠睡眠觉醒的效应并探索其相关机制。方法100只雌性成熟SD大鼠,随机分为假手术组(Sham组)、模型组(OVX组)、电针组(EA组)、假电针组(sham EA组),每组25只,除假手术组外,其余3组采用去卵巢(ovariectomized,OVX)术制备围绝经期大鼠失眠模型,电针组与假电针组于造模后给予电针或假电针干预,观察各组大鼠造模后、电针干预后睡眠觉醒状态、体质量、阴道脱落细胞、血清性激素水平、肾上腺皮质结构变化。结果OVX术后,模型组大鼠较假手术组大鼠日间觉醒增多,睡眠增多(rapid eye movement,REM),睡眠减少(non-rapid eye movement,NREM),难以维持长期睡眠,大鼠动情周期消失,停留在动情间期,体质量增加(P<0.05),血清雌激素水平降低(P<0.05),卵泡刺激素水平升高(P<0.05),肾上腺网状带细胞增生。电针干预后,OVX大鼠日间觉醒减少,NREM睡眠增多,NREM睡眠持续时间延长,大鼠阴道涂片中出现了类似动情后期表现的脱落细胞,体质量减少(P<0.05),血清雌激素水平升高(P<0.05),卵泡刺激素水平降低(P<0.05),肾上腺网状带细胞增生明显。结论(1)去卵巢手术使大鼠睡眠觉醒状态发生变化,呈现类似于人的围绝经期失眠。(2)电针干预能够改善OVX大鼠睡眠觉醒状态,增加NREM睡眠量,并增加NREM睡眠稳定性。(3)电针改善OVX大鼠睡眠状态可能是通过提高雌激素水平实现的,而肾上腺皮质网状带代偿性增生可能是雌激素水平升高的原因。

电针联合神经减压/地塞米松对面神经受损家兔面神经病变及神经生长因子、Caspase-3表达的影响

目的观察电针联合神经减压/地塞米松对面神经损伤家兔面神经病变及血清神经生长因子(NGF)水平、面神经纤维组织中Caspase-3蛋白表达的影响,探讨其作用机制。方法将120只健康家兔随机分为假手术组、假手术+西医组、假手术+中医组、假手术+中西医组、模型组、模型+西医组、模型+中医组、模型+中西医组,每组15只。除假手术各组外,其余组均制备面神经损伤模型。术后假手术组、模型组不给予干预,假手术+西医组和模型+西医组均每天给予地塞米松1 mg/kg肌肉注射及面神经减压,假手术+中医组和模型+中医组均每天给予电针治疗(每次30 min,连续电针5 d休息2 d为1个周期),假手术+中西医组和模型+中西医组均每天给予地塞米松肌肉注射、面神经减压及电针治疗,各组均干预至术后第21天。分别于术后第1,7,21天检测外周血中NGF水平,HE染色观察面神经病变情况,免疫组化法检测面神经组织中Caspase-3阳性表达情况。结果术后第1,7,21天,模型各组血清NGF水平均明显低于假手术各组(P均<0.05);模型+中西医组血清NGF水平均明显高于模型组、模型+西医组、模型+中医组(P均<0.05),模型+西医组、模型+中医组均明显高于模型组(P均<0.05),模型+西医组与模型+中医组比较差异均无统计学意义(P均>0.05)。术后第1天,模型各组的Caspase-3阳性表达强度评分均明显高于假手术各组(P均<0.05);模型各干预组术后第1,7,21天的Caspase-3阳性表达强度评分均明显高于相应假手术各干预组(P均<0.05);模型+中西医组术后第1天和第7天的Caspase-3阳性表达强度评分均明显低于同期模型组和模型+西医组(P均<0.05),与模型+中医组比较差异均无统计学意义(P均>0.05);模型各组间术后第21天的Caspase-3阳性表达强度评分比较差异均无统计学意义(P均>0.05)。结论电针联合神经减压/地塞米松有促进面神经损伤修复的作用,其机制可能与上调血清NGF水平、下调面神经组织中Caspase-3蛋白的表达有关。

电针联合阿仑膦酸钠对骨质疏松大鼠Integrinα2/FAK/Runx2通路的影响

目的探讨电针联合阿仑膦酸钠对去卵巢大鼠骨质疏松症的改善作用及对Integrinα2/FAK/Runx2通路调节作用。方法选取30只大鼠随机分为假手术组(6只)及造模组(24只),采用手术切除卵巢法建立骨质疏松症大鼠模型。将造模后的大鼠随机分为骨质疏松模型组、电针治疗组、阿仑膦酸钠组及联合治疗组,每组6只。电针治疗组、阿仑膦酸钠组及联合治疗组分别按照相应干预方法干预8周。通过酶联免疫吸附(ELISA)试剂盒测定大鼠血清碱性磷酸酶(ALP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶(TRACP)-5b、Ⅰ型胶原羧基末端肽(ICIP)、I型胶原氨基端延长肽(PINP)水平;双能X射线测定大鼠股骨骨密度及骨矿物含量;骨生物力学测定仪测定大鼠骨生物力学指标;苏木精-伊红(HE)染色法检查股骨组织病理学变化;实时定量聚合酶链式反应(RT-qPCR)测定股骨组织Integrinα2、FAK及Runx2 mRNA水平;免疫印记法(Western blot)测定股骨组织Integrinα2、FAK及Runx2蛋白水平。结果与假手术组比较,骨质疏松模型组血清ALP、BGP、TRACP-5b、ICIP、PINP水平显著升高(P<0.05),骨密度、骨矿物含量、最大载荷、最大应力、刚度,股骨组织Integrinα2、FAK及Runx2 mRNA及蛋白水平显著降低(P<0.05);与骨质疏松模型组比较,电针治疗组、阿仑膦酸钠组及联合治疗组血清ALP、BGP、TRACP-5b、ICIP、PINP水平显著降低(P<0.05),骨密度、骨矿物含量、最大载荷、最大应力、刚度,股骨组织Integrinα2、FAK及Runx2 mRNA及蛋白水平显著升高(P<0.05);与电针治疗组及阿仑膦酸钠组比较,联合治疗组血清ALP、BGP、TRACP-5b、ICIP、PINP水平显著降低(P<0.05),骨密度、骨矿物含量、最大载荷、最大应力、刚度,股骨组织Integrinα2、FAK及Runx2 mRNA及蛋白水平显著升高(P<0.05)。结论电针联合阿仑膦酸钠能够显著提高绝经后骨质疏松症大鼠骨密度,抑制骨质疏松病理进展,改善大鼠骨代谢及骨生物力学改变,其机制可能与调节Integrinα2/FAK/Runx2通路有关。

调神健脾针刺法联合电针治疗腹泻型肠易激综合征的疗效观察及对肥大细胞活化的影响

目的观察调神健脾针刺法联合电针治疗对腹泻型肠易激综合征(irritable bowel syndromediarrheal,IBS-D)的临床疗效及其对患者肠黏膜肥大细胞活化的影响。方法将60例IBS-D患者按随机数字表法分为药物组和观察组,每组30例。药物组予口服马来酸曲美布汀分散片治疗,观察组予调神健脾针刺法联合电针治疗。观察两组治疗前后肠易激综合征症状严重程度量表(irritable bowel syndrome-symptom severity scale,IBS-SSS)评分、肠易激综合征生活质量量表(irritable bowel syndrome-quality of Life,IBS-QOL)评分和医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评分及肠黏膜肥大细胞(mast cells,MCs)活化程度的变化。比较两组临床疗效。结果观察组总有效率优于药物组(P<0.05)。治疗后,两组IBS-SSS和HADS评分均降低(P<0.05),且观察组均优于药物组(P<0.05)。治疗后,两组IBS-QOL评分均升高(P<0.05),且观察组高于药物组(P<0.05)。治疗后,两组MCs数量与脱颗粒比例均降低(P<0.05),且观察组优于药物组(P<0.05)。结论“调神健脾”针刺法联合电针治疗IBS-D的临床疗效优于单一口服药物治疗,可缓解腹痛等临床症状,提高生活质量,改善抑郁状态,降低MCs活化程度。

电针对2型糖尿病大鼠骨骼肌GLUT4表达影响的研究

[目的]观察电针对2型糖尿病大鼠骨骼肌葡萄糖转运蛋白4(glucose transporter 4,GLUT4)表达的影响,探讨电针调节血糖的机制。[方法]将24只2型糖尿病大鼠随机分为空白对照组、运动干预组及电针组,每组8只,运动干预组大鼠给予2周跑台运动干预;空白对照组大鼠不给予任何干预;电针组大鼠开始将电针置于大鼠双侧足三里穴,进行连续波穴位刺激2周。分别检测各组大鼠治疗前后空腹血糖水平、胰岛素抵抗指数及治疗后大鼠骨骼肌细胞GLUT4水平。[结果]与干预前比较,运动干预组和电针组空腹血糖水平显著下降(P<0.001,P=0.028),胰岛素抵抗指数显著下降(P<0.001,P<0.001)。干预后组间比较,三组大鼠空腹血糖水平及胰岛素抵抗指数差异均有统计学意义(P<0.001),GLUT4表达水平差异有统计学意义(P<0.001)。[结论]电针刺激能改善2型糖尿病大鼠的胰岛素敏感性,并降低其血糖水平,其中调节骨骼肌细胞GLUT4水平可能是其调节血糖的一个重要机制。

电针对慢传输型便秘大鼠肠道运动及促炎性因子表达影响

目的观察电针下合穴“足三里”“上巨虚”对慢传输型便秘(STC)大鼠肠道运动及促炎性因子表达的影响。方法24只健康清洁级SD大鼠随机分为空白组、模型组、药物组和电针组,每组各6只。采用复方地芬诺酯混悬液10 mg·kg^(-1)剂量灌胃制备STC大鼠模型,每天1次,连续14 d。空白组予等剂量0.9%氯化钠溶液灌胃。电针组给予双侧“足三里”“上巨虚”电针治疗,选择疏密波,频率2/50 Hz,电流大小以局部肌肉轻微抖动为度,每次治疗20 min,每天1次,连续治疗14 d。药物组予枸橼酸莫沙必利片混悬液按照1.37 mg·kg^(-1)、1 mL·100 g^(-1)剂量灌胃治疗,疗程同上。观察各组治疗后首粒黑便排出时间、小肠推进率,采用HE染色观察结肠组织病理形态学变化,采用Western-blot法检测肠道肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)、CD68蛋白表达。结果模型组大鼠首粒黑便排出时间较空白组显著加长,小肠推进率显著降低(P<0.05);药物组和电针组大鼠经治疗后,与模型组比较,首粒黑便排出时间显著减少、小肠推进率显著提高(P<0.05)。HE染色可见造模后大鼠结肠黏膜组织出血,组织形态学结构破坏,伴上皮细胞变性坏死及炎性细胞浸润;电针和药物治疗能够减少炎性细胞浸润,改善组织形态学变化。Western-blot结果显示,模型组大鼠TNF-α、IL-1β、CD68蛋白表达较空白组显著升高(P<0.05);药物组和电针组大鼠经治疗后,结肠组织TNF-α、IL-1β、CD68蛋白表达较模型组显著降低(P<0.05)。结论电针治疗能够改善STC大鼠肠道运动功能,修复结肠组织病理形态学改变,其机制可能与下调TNF-α、IL-1β、CD68蛋白表达,抑制炎性反应有关。

电针对慢性前列腺炎大鼠TLR4/NF-κB/NLRP3通路蛋白表达的影响

目的观察电针对慢性前列腺炎大鼠前列腺Toll样受体4/核转录因子κB/NOD样受体蛋白3(TLR4/NF-κB/NLRP3)通路的影响,探讨电针治疗慢性前列腺炎的可能机制。方法将40只SPF级健康雄性SD大鼠随机分为空白组、模型组、电针组、抑制剂组、激动剂组,各8只。除空白组外,其余各组采用前列腺蛋白提取及免疫注射法制备大鼠慢性前列腺模型,于造模后1 d对电针组、抑制剂组及激动剂组大鼠行电针干预,穴取“白环俞”“会阳”,连续波,频率2 Hz,每日1次,每次20 min,7 d为1个疗程,每疗程后休息1 d,共治疗2个疗程。基于开野实验和糖水消耗实验开展行为学测试;取大鼠前列腺组织,计算前列腺湿重及前列腺指数;HE染色观察大鼠前列腺组织形态学变化;TUNEL法观察前列腺细胞凋亡;Western blot法检测前列腺组织中TLR4、NF-κB、NLRP3蛋白表达。结果与空白组比较,模型组大鼠水平运动评分、垂直运动评分和糖水消耗量均显著下降(P<0.05);与模型组比较,电针组大鼠水平运动评分、垂直运动评分和糖水消耗量显著增加(P<0.05);与电针组比较,抑制剂组大鼠水平运动评分、垂直运动评分和糖水消耗量显著增加,而激动剂组大鼠水平运动评分、垂直运动评分和糖水消耗量显著下降(P<0.05)。与空白组比较,模型组大鼠前列腺湿重和前列腺指数显著升高(P<0.05),前列腺细胞凋亡升高(P<0.05);与模型组比较,电针组大鼠前列腺湿重和前列腺指数显著下降(P<0.05),前列腺细胞凋亡显著下降(P<0.05);与电针组比较,抑制剂组大鼠前列腺湿重和前列腺指数显著下降(P<0.05),而激动剂组大鼠前列腺湿重和前列腺指数显著升高(P<0.05),且抑制剂组大鼠前列腺细胞凋亡进一步下降(P<0.05),而激动剂组大鼠前列腺细胞凋亡升高(P<0.05)。与空白组比较,模型组大鼠前列腺组织中TLR4、p-NF-κB/NF-κB、NLRP3蛋白表达显著增加(P<0.05),与模型组比较,电针组大鼠前列腺组织中TLR4、p-NF-κB/NF-κB、NLRP3蛋白表达显著减少(P<0.05);与电针组比较,抑制剂组大鼠前列腺组织中TLR4、p-NF-κB/NF-κB、NLRP3蛋白表达显著下降(P<0.05),而激动剂组大鼠前列腺组织中TLR4、p-NF-κB/NF-κB、NLRP3蛋白表达显著升高(P<0.05)。结论电针白环俞、会阳可明显改善慢性前列腺模型大鼠症状,降低细胞凋亡水平,其机制可能与下调TLR4/NF-κB/NLRP3通路蛋白表达,进而抑制前列腺细胞凋亡有关。

电针督脉及情感区对血管性痴呆大鼠学习记忆能力及炎症的改善作用

目的通过观察电针督脉及情感区对血管性痴呆(vascular dementia,VD)大鼠学习记忆能力及海马区细胞形态、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及转化生长因子-β(transforming growth factor-β,TGF-β)的影响,探讨该疗法治疗VD的作用机制。方法随机选取24只雄性SD大鼠进行Morris水迷宫测试,通过测试后,按随机数字表法将24只大鼠分为空白组、模型组、假手术组及治疗组,每组6只。其中空白组单纯喂养不行其他处置,模型组及治疗组予双侧颈总动脉永久性结扎(2-VO阻断法)制备模型,假手术组仅暴露颈动脉三角区,并将颈总动脉及迷走神经分离后缝合。于第7日(模型及治疗组侧支循环形成)行Morris水迷宫检测,确定造模成功,第8日进行治疗,治疗组予电针“百会”“风府”“大椎”及“情感区”干预,每次30 min,共治疗2周,其余3组常规饲养2周。治疗后再次对4组大鼠进行Morris水迷宫进行行为学检测,将脑组织取材后行HE染色、免疫组化检测,取大鼠腹主动脉血行ELISA检测,观察大鼠海马组织细胞形态,TNF-α、TGF-β数量的变化及血清中TNF-α、TGF-β含量的表达。结果模型组大鼠与假手术组比较,逃避潜伏期以及游泳路程延长(P<0.05),海马CA1区细胞形态较为均匀,排列较规则,水肿程度减轻,海马体内TNF-α阳性细胞数增多且含量增多,TGF-β阳性细胞数减少且含量降低;治疗组大鼠与模型组比较,逃避潜伏期以及游泳路程缩短(P<0.05),海马CA1区神经元结构相对清晰完整,形态较为规则,排列相对均匀,细胞间质水肿程度低,海马体内TNF-α阳性细胞数减少且含量降低,TGF-β阳性细胞数增加且含量升高。结论电针督脉及情感区能有效改善VD大鼠学习记忆能力,其机制可能与减轻炎症反应相关,但有待进一步研究。

电针预处理对切口痛大鼠中脑导水管周围灰质5-HT_(7)受体表达的影响

目的:建立足趾部切口痛大鼠模型,探讨重复电针预处理对切口痛大鼠镇痛效果及其对中脑导水管周围灰质(periaqueductal gray,PAG)5-HT_(7)受体(5-HT_(7)R)表达的影响。方法:40只成年雄性SD大鼠按随机数字表法均等分为对照组(Control,Con组)、切口痛模型组(Incision pain,IP组)、正常+电针预处理组(Control+Electroacupuncture,Con+EA组)、模型+电针预处理组(Incision Pain+Electroacupuncture,IP+EA组)。IP组和IP+EA组大鼠右足趾部行疼痛造模,且造模前,Con+EA组和IP+EA组大鼠行右侧“足三里”穴和“环跳”穴电针刺激(2/10 Hz疏密波,刺激强度数值为1档,每日1次30 min),连续5天。于第1次电针预处理前2 h(T1)、术前2 h(T2)、术后4 h(T3)、术后24 h(T4)测定大鼠机械刺激缩足反射阈值(mechanical withdrawal threshold,MWT)和热缩足潜伏期(thermal withdrawal latency,TWL);酶联免疫吸附法检测脑脊液中5-HT浓度;免疫组化和免疫荧光方法分别检测大鼠PAG中c-Fos和5-HT_(7)R蛋白表达情况。结果:与Con组比较,IP组大鼠T3、T4时间点MWT和TWL均明显降低,脑脊液中5-HT浓度增加,PAG中c-Fos蛋白和5-HT_(7)R表达明显上调(P<0.05);Con+EA组和IP+EA组脑脊液中5-HT含量和PAG中5-HT_(7)R表达均上升(P<0.05)。与IP组相比,IP+EA组大鼠T3、T4时间点的MWT和TWL显著升高,PAG中c-Fos蛋白表达减少,5-HT_(7)R蛋白表达增加(P<0.05)。结论:电针预处理可能通过上调PAG中5-HT_(7)R蛋白表达发挥镇痛作用。

耳穴贴压联合电针对膝骨关节炎模型大鼠滑膜纤维化及内质网应激的抑制作用研究

目的观察耳穴贴压联合电针对膝骨关节炎模型大鼠滑膜纤维化及内质网应激的抑制作用。方法将60只Sprague-Dawley(SD)大鼠随机分为正常组(10只)和其余组(50只),其余组造模成功后再次随机分为模型组、耳穴组、电针组、联合组及药物组,每组10只。耳穴组使用磁珠贴于大鼠两侧肾耳穴进行干预,电针组予电针干预,联合组予耳穴磁珠贴压联合电针干预,药物组予塞来昔布水溶液灌胃干预。观察各组大鼠膝关节肿胀度的变化。观察各组大鼠血清白介素-1(interleukin-1,IL-1)、白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、锰超氧化物歧化酶(manganese superoxide dismutase,Mn-SOD)、过氧化氢酶(catalase,CAT)和丙二醛(malondialdehyde,MDA)的水平,观察关节液中环氧合酶-2(cyclooxygenase-2,COX-2)、前列腺素E2(prostaglandin E2,PGE2)和一氧化氮(nitric oxide,NO)的水平,观察各组大鼠滑膜组织中白介素-1β(interleukin-1β,IL-1β)及TNF-α的水平。观察大鼠软骨组织病理学变化,比较各组滑膜组织中葡萄糖调节蛋白78(glucose regulated protein 78,GRP78)、C/EBP同源蛋白(C/EBP-homologous protein,CHOP)、基质金属蛋白酶13(matrix metalloproteinase 13,MMP13)、α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)、金属蛋白酶组织抑制剂1(tissue inhibitor of metalloproteinase 1,TIMP1)、胶原蛋白Ⅰ(collagenⅠ,Col-Ⅰ)、胶原蛋白Ⅱ(collagenⅡ,Col-Ⅱ)mRNA水平和蛋白水平。结果与正常组比较,模型组大鼠关节肿胀度,血清IL-1、IL-6、TNF-α和MDA水平,关节液COX-2、PGE2和NO水平,滑膜组织IL-1β和TNF-α水平,滑膜组织GRP78、CHOP、MMP-13、α-SMA、TIMP1、Col-Ⅰ、Col-ⅡmRNA及蛋白水平,均显著升高(P<0.05);模型组大鼠血清Mn-SOD和CAT水平显著降低(P<0.05)。与模型组比较,耳穴组、电针组、联合组和药物组大鼠关节肿胀度,血清IL-1、IL-6、TNF-α和MDA水平,关节液COX-2、PGE2和NO水平,滑膜组织IL-1β和TNF-α水平,滑膜组织GRP78、CHOP、MMP-13、α-SMA、TIMP1、Col-Ⅰ、Col-ⅡmRNA及蛋白水平,均显著降低(P<0.05);血清Mn-SOD和CAT水平显著升高(P<0.05);大鼠关节软骨组织病理学明显改善。与耳穴组和电针组比较,联合组大鼠关节肿胀度,血清IL-1、IL-6、TNF-α和MDA水平,关节液COX-2、PGE2和NO水平,滑膜组织IL-1β和TNF-α水平,滑膜组织GRP78、CHOP、MMP-13、α-SMA、TIMP1、Col-Ⅰ、Col-ⅡmRNA及蛋白水平,均显著降低(P<0.05);血清Mn-SOD和CAT水平均显著升高(P<0.05)。结论耳穴贴压联合电针能显著改善膝骨关节炎大鼠关节肿胀程度,抑制病理进展,缓解大鼠滑膜组织炎症反应,修复氧化应激损伤,进而修复膝骨关节炎大鼠滑膜组织纤维化及内质网应激反应。