基于BDNF/TrkB/AMPK/SIRT1信号通路探讨耳电针刺激对癫痫大鼠记忆力和癫痫发作的影响

目的基于脑源性神经营养因子(BDNF)/原肌球蛋白相关激酶B(TrkB)/腺苷酸活化蛋白激酶(AMPK)/沉默信息调节因子1(SIRT1)信号通路,探讨耳电针刺激对癫痫大鼠记忆力、癫痫发作的影响及其分子机制。方法将36只雄性SD大鼠随机分为正常4周组、模型4周组、耳电针4周组、正常8周组、模型8周组、耳电针8周组,每组6只。2个模型组和2个耳电针组大鼠均建立锂-匹鲁卡品癫痫模型。癫痫模型建立24 h后,耳电针4周组和耳电针8周组大鼠分别给予耳电针刺激4周和8周,每周连续刺激3 d。每组干预结束后,采用抑制性回避试验测定大鼠空间记忆力,脑电图测定48 h内癫痫大鼠自发癫痫次数,ELISA测定大鼠海马组织中BDNF含量,Western blot法测定大鼠海马组织中TrkB、AMPK、SIRT1蛋白表达情况。结果模型4周组、模型8周组大鼠的黑盒滞留时间均明显长于对应时间的正常组(P均<0.05),48 h内出现多次自发癫痫,海马组织中BDNF含量和p-TrkB、p-AMPK、SIRT1蛋白相对表达量均明显低于对应时间的正常组(P均<0.05);耳电针4周组和耳电针8周组大鼠的黑盒滞留时间均明显短于对应时间的模型组(P均<0.05),48 h内自发癫痫次数均明显少于对应时间的模型组(P均<0.05),海马组织中BDNF含量和p-TrkB、p-AMPK、SIRT1蛋白相对表达量均明显高于对应时间的模型组(P均<0.05),且耳电针8周组上述指标改善情况均明显优于耳电针4周组(P均<0.05)。结论耳电针刺激可呈时间依赖性改善癫痫大鼠的记忆能力,减少癫痫发作,机制可能与调控海马组织中BDNF/TrkB/AMPK/SIRT1信号通路有关。

耳电针治疗难治性抑郁症增效效应的临床观察

目的耳甲电针已被证明类似迷走神经刺激(Vagus Nerve Stimulation,VNS),治疗抑郁症有效,本研究探讨耳甲电针治疗难治性抑郁症(Treatment Resistant Depression,TRD)的临床效应。方法通过门诊及广告招募到23例TRD患者,采用耳迷走神经刺激仪(SDZ-IIB,华佗牌)刺激患者双侧耳甲区进行治疗,每天早晚各1次,每次30 min,共2次,原基础药物治疗保持不变。分别于治疗前及治疗2、4、8周采用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD-17)、抑郁自评量表(Self-rating Depression Scale,SDS)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA-14)、焦虑自评量表(Self-rating Anxiety Scale,SAS)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)、冗思反应量表(Rumination Response Scale,RRS)等6个临床心理量表评定临床疗效。结果除脱落3例外,大部分患者治疗2、4、8周后,症状逐渐减轻,HAMD、HAMA、SDS、SAS量表评分减分率均具有统计学意义(P <0.001),HAMD平均减分率分别为43.77%、61.74%、74.83%,临床痊愈9例(9/20),8例显著进步,2例进步,1例无效,总反应率为95.0%。治疗8周后RRS、PSQI量表评分与治疗前比较,显示差异均有统计学意义(P <0.005)。结论耳电针对TRD具有一定的治疗作用。

电针耳甲对2型糖尿病模型大鼠抗炎镇痛作用的实验研究

目的通过观察电针耳甲对2型糖尿病模型大鼠炎性因子、痛阈值和致痛因子的影响,探讨电针耳甲对2型糖尿病的抗炎镇痛作用。方法 30只SD大鼠随机分为正常组(n=8)和造模组(n=22)。采用高脂饮食加链脲佐菌素(STZ)腹腔注射法诱导2型糖尿病大鼠模型,以3次随机血糖≥16.7 mmol·L-1大鼠为2型糖尿病模型大鼠,继续高脂饲料喂养,通过热敏感度值和痛阈值测定,将阈值异常的大鼠(n=16)随机分为模型组(n=8)和耳电针组(n=8)。耳电针组大鼠在麻醉下进行耳甲电针干预,参数4mA,30Hz,每日1次,每次30 min,5次为1疗程,疗程间休息2日,连续干预4周。通过观察各组大鼠的一般情况、体质量、血糖值、热敏感度值、痛阈值和血清炎症因子TNF-α、IL-10和致痛因子5-HT的水平,初步探讨电针耳甲对2型糖尿病大鼠的抗炎镇痛机制。结果 (1)与正常组相比,模型组大鼠经电针干预2周后热敏感度值和痛阈值均升高,但与模型组相比,只有痛阈值差异有统计学意义,但经4周后热敏感度值和痛阈值均明显升高,与模型组相比差异均有统计学意义;(2)从血清炎症因子水平来看,与正常组相比,模型组大鼠血清中TNF-α升高,IL-10水平降低,而电针干预4周后的血清中TNF-α水平明显低于模型组,而IL-10水平高于模型组。(3)从血清致痛因子水平来看,与正常组相比,模型组大鼠血清中5-HT明显升高,而电针干预4周后的血清中5-HT水平明显降低。结论电针耳甲区能够降低2型糖尿病模型大鼠血清中促炎因子TNF-α,升高抗炎细胞因子IL-10,以及降低致痛因子5-HT,提高痛阈值,发挥了抗炎镇痛的作用,其机制可能与胆碱能抗炎通路有关,为电针耳甲治疗2型糖尿病提供了依据。

耳-体穴电针对大鼠十二指肠组织中胃泌素含量的影响及其促进胆汁分泌的作用

在过去研究的基础上进一步探讨耳 体穴疗法促进胆汁分泌的作用机制。当电针双侧耳穴“肝胆区”和体穴“胆俞”后 ,大鼠胆汁流量显著增加 ,其十二指肠组织中胃泌素含量最高 ,将组织提取液注射于另一只大鼠静脉内 ,也能产生胆汁流量增加的效果。但是 ,如流出的胆汁不使其进入十二指肠 ,虽进行电针 ,胆汁流量不仅不增加 ,反而显著降低 ,其十二指肠组织中胃泌素含量最低 ,组织提取液也不能使另一只大鼠胆汁流量增加。说明电针和胆汁正常流入十二指肠是促进胆汁增加的两个因素 ,其机制除了电针通过迷走神经和胆汁 (通过肠肝循环 )能直接作用于肝细胞外 ,二者也可能通过促进十二指肠组织释放胃泌素而促使肝细胞分泌胆汁。

耳-体穴电针对家兔胆道功能的调节及迷走神经的作用

目的:探讨耳-体穴电针对胆道系统疾病的治疗及迷走神经在调节胆道系统功能中的作用.方法:建立家兔实验性胆总管结石症的模型;以家兔胆汁流量、胆道压力及奥狄氏括约肌(oddi)肌电为指标,观察迷走神经对胆道系统功能的影响;以20Hz频率电针耳穴"胰胆区"及体穴"胆俞"30min,观察各项指标的变化.结果:结石症家兔因结石的存在,诱发了胆汁流量、胆道压力、oddi括约肌放电病理性增加,oddi括约肌肌电从有规律发放转变为无序的爆发性发放(胆汁流量、胆道各部位压力分别为15.50±5.10vs11.35±4.06,41.26±2.31vs16.70±2.33,41.30±2.56vs16.70±2.43,52.80±3.10vs29.33±3.73,均P<0.01);耳-体穴电针的调节作用促使胆石症模型家兔的胆汁流量进一步增加,以利结石排出(针后立即及针后30min依次为17.25±7.29,18.16±5.05vs15.66±5.66,P<0.05,P<0.01),针后30min胆道上端压力稍有增加(43.58±1.77vs42.00±1.70,P<0.01),但胆总管压力和oddi括约肌张力皆降低(前者40.03±0.77vs41.25±1.72,P<0.05;后者48.25±2.91vs53.50±3.20,P<0.01),并恢复节律性放电;耳-体穴电针对去除迷走神经的胆石症家兔胆道功能的即时调整作用不明显,但停电针30min后可见胆汁流量增加,胆总管压力和oddi括约肌张力降低(均P<0.05).结论:迷走神经对维持家兔的正常胆道系统功能是必须的;耳-体穴电针主要通过迷走神经对胆道功能失常动物发挥及时的、快速的调整作用,可能有体液途径对胆道系统功能发挥缓慢的、持久的调整作用.

电针耳压配药茶治疗单纯性肥胖症82例

目的:探讨治疗单纯性肥胖症的有效方法。方法:将单纯性肥胖症辨证分为脾虚湿阻、胃肠实热及肝郁气滞三型,采用电针腹部穴为主,配合辨证取穴,耳穴压丸及服药茶,同时指导患者合理饮食、运动。结果:本组82例,显效20例占24.4%;有效56例占68.2%,无效6例占7.4%,总有效率92.6%。结论:采用电针耳压配服药茶治疗单纯性肥胖症疗效确切。

电针耳三穴联合聪耳通窃汤辅治神经性耳鸣临床观察

目的:观察电针耳三穴联合聪耳通窃汤辅治神经性耳鸣疗效及对中枢神经递质含量和生活质量的影响。方法:60例随机分为两组各30例,单一组给予聪耳通窃汤治疗,联合组给予电针耳三穴联合聪耳通窃汤治疗。结果:治疗后联合组的5-HT水平、耳鸣严重程度评分低于单一组(P<0.05)。结论:电针耳三穴联合聪耳通窃汤治疗神经性耳鸣疗效较好。

耳-体穴电针疗法对急性尿潴留大鼠膀胱功能及细胞凋亡率的影响

目的:探讨耳-体穴电针疗法对急性尿潴留大鼠膀胱功能及细胞凋亡率的影响。方法:将32只SD大鼠按照随机数字表法分为正常组、模型组、耳-体穴电针组和非穴位电针组,每组各8只。除正常组大鼠外,其余3组均以生理盐水进行膀胱灌注,建立大鼠急性尿潴留模型。正常组、模型组不予干预,耳-体穴电针组及非穴位电针组均在造模前1 h电针干预,耳-体穴电针组取双侧膀胱(耳穴)和关元穴(体穴);非穴位电针组在双侧膀胱(耳穴)和关元穴(体穴)旁开约0.5 cm处作为对照电针刺激。比较各组大鼠膀胱容量、最大逼尿肌收缩压及逼尿肌细胞凋亡率变化情况。结果:造模后模型组、耳-体穴电针组及非穴位电针组膀胱容量及最大逼尿肌收缩压均低于造模前,且耳-体穴电针组造模后膀胱容量及最大逼尿肌收缩压高于模型组,差异具有统计学意义(P<0.05)。耳-体穴电针组逼尿肌细胞凋亡率低于模型组及非穴位电针组,差异均有统计学意义(P<0.05);非穴位电针组细胞凋亡率低于模型组,但差异无统计学意义(P>0.05)。结论:耳-体穴电针疗法有助于急性尿潴留大鼠膀胱功能恢复,减少膀胱逼尿肌细胞的凋亡。

Electroacupuncture combined with auricular acupressure in the treatment of nervous tinnitus

Objective To observe the clinical efficacy of electroacupuncture combined with auricular acupressure in treatment of nervous tinnitus. Methods One hundred and four patients with nervous tinnitus were randomly divided into a group A and a group B according to the method of random number table, with 52 patients in each group. In the group A, acupuncture at Yìfēng（翳风 TE 17）, Tīnggōng（听宫 SI 19）, Tīnghuì（听会 GB 2）, ěrmén（耳门 TE 21） and Fēngchí（风池 GB 20） combined with auricular acupressure, such as Shènshàngxiàn（肾上腺 TG 2p）, Jiāog？n（交感 AH6a）, Nèifēnmì（内分泌 CO18）, Nèi？r（内耳 LO 6）, Wài？r（外耳 TG1u）, Shèn（肾 CO10） and Gān（肝 CO12） were applied; in the group B, intravenous injection with compound Dānshēn（丹参 Radix et Rhizoma Salviae Miltiorrhizae） dissolved in 250 m L of 0.9% Na Cl injection were applied, combined with oral administration of 10 mg of Vitamin B1 and 0.5 mg of mecobalamin tablets. After treatment for three courses in the two groups, efficacy was evaluated based on Reference Standards of Severity, Assessment and Efficacy Evaluation of Tinnitus. Results In the group A（75 ears with nervous tinnitus）, 30 ears were cured, markedly effective was seen in 21 ears, and effective in 22, and the total effective rate was 97.4%; in the group B（76 ears with nervous tinnitus）, 17 ears were cured, markedly effective was seen in 20 ears, and effective in 23, and the total effective rate was 79.0%. The total effective rate in the group A was obviously superior to that in the group B, and the difference between the two groups was statistically significant（P〈0.05）. Compared before the treatment, the score of tinnitus severity both reduced in two groups（both P〈0.05）, and the reducing amplitude of score in the group A was greater than that in the group B（P〈0.05）. Conclusion Electroacupuncture combined with auricular acupressure in treatment of nervous tinnitus is worthy of clinical promotion and application since it has significant efficacy, which is obviously superior to drug therapy, and without adverse effect.

Effect of electroacupuncture at ear and body acupoints on the instant fasting blood glucose level of machins with type 2 diabetes mellitus

Objective To observe the effect of electroacupuncture at ear and body acupoints for the instant fasting blood glucose of model machins with type 2 diabetes mellitus（T2DM）.Methods For 10 machins with type2 diabetes,the electroacupuncture was applied at ＂Zusanli＂（足三里 ST 36）,＂Sanyinjiao＂（三阴交 SP 6） and three ＂Jiangtangdian＂（降糖点） in the ear continuously for 5 days,with the frequency of 2/15 Hz（The 2 Hz and the 15 Hz were transferred every second） and current of2 mA.The treatment was given once every day for 30 min.The fasting blood glucose was measured before acupuncture,after acupuncture for15 min and 30 min in the 5 days.Results On the first day,after 30-minute acupuncture the fasting blood glucose was reduced obviously compared with that before treatment（P〈0.01）.On the third and the fifth days,after acupuncture for 15 min and 30 min the fasting blood glucose was apparently lower than that before acupuncture（all P〈0.05）.On the fourth day,after acupuncture for 30 min the fasting blood glucose was decreased markedly than that before acupuncture（P〈0.05）.After 30-minute acupuncture on the fifth day,the fasting blood glucose was lower obviously than that before treatment on the first day（P〈0.05）.Conclusion ①The electroacupuncture at ear and body acupoints can reduce the instant fasting blood glucose of T2 DM machins apparently.② There is time effect on instant fasting blood glucose of T2 DM machins treated by electroacupuncture.The efficacy of 30-minute stimulation is superior to that of 15-minute acupuncture.After acupuncture continuously for 4 days,the effect is better than that with acupuncture for3 days successively.

Effects of electroacupuncture combined with auricular plaster on F% and waist-hip ratio in simple obesity patients

Objective To observe and compare the difference of clinical therapeutic effect of electroacupuncture combined with auricular plaster therapy and electroacupuncture therapy on simple obesity. Methods sixty female patients of simple obesity were randomly divided into two groups： an electroacupuncture group and a combined group. Each group had 30 patients treated respectively with electroacupuncture and electroacupuncture therapy combined with auricular point pressing therapy. The changes of the body mass index （BMI）, body fat percentage （F%）, and waist-hip ratio （WHR） were observed to evaluate the effect of loosing weight. Results Compared with the scores before treatment, the BMI, F%, WHR level in two groups dropped （ all P〈0.01 ） in all 60 patients. And compared with the electroacupuncture group, the combined group dropped more obviously （ P〈0.05, P〈0.01 ） . Conclusion The effects of electroacupuncture therapy and electroacupuncture combined with auricular plaster therapy on simple obesity were both remarkable, but more in the combined group, so it indicates that the combined therapy is better than single therapy.

Clinical observation on the different frequency hearing damages in sudden deafness treated by electroacupuncture combined with western medicine comprehensive therapy

Objective To compare the difference in the clinical efficacy on the different frequency hearing damages for the patients with sudden deafness between the comprehensive therapy of electroacupuncture and western medicine and the simple western medicine comprehensive therapy. Methods Fifty-eight cases were randomized into an acupuncture plus medication group （28 cases, 32 damaged ears） and a western medicine group （30 cases, 34 damaged ears）. In the acupuncture plus medication group, the comprehensive therapy of electroacupuncture and western medicine was used. The main points were ěrmén （耳门 TE 21）, Tīnggōng （听宫 SI 19）, Tīnghuì （听会 GB 2）, Yìfēng （翳风 TE 17）, etc. The western medicine therapy was the comprehensive treatment with vasodilators, the medicines for promoting nerve function and releasing inner ear edema and hyperbaric oxygen. In the western medicine group, the western medicine comprehensive therapy was adopted. 10-day treatment made one session. Two sessions of treatment were required. In 1 or 2 sessions of treatment, the efficacy was observed, the electric audiometry was evaluated. Additionally, the blood routine and liver and kidney functions were detected. Results The total effective rate was 50.0% （16/32） in the acupuncture ＋ medication group and was 55.9% （19/34） in the western medicine group. The efficacies were similar between the two groups （P〉0.05）. In 1 and 2 sessions of treatment, at 250 Hz, 500 Hz and 1 kHz, the electric audiometry values in either group were recovered significantly as compared with those before treatment （all P〈0.01）. At 2 kHz, in 1 and 2 sessions of treatment, the improvements of the electric audiometry values were significant as compared with those before treatment in the acupuncture plus medication group separately （P〈0.05, P〈0.01）. At 4 kHz, the differences were not significant statistically before and after treatment in either group （all P〉0.05）. There were no abnormalities in the blood routine and liver and kidney function detections before and after treatment in either group. Conclusion Either the comprehensive therapy of electroacupuncture and western medicine or the simple western medicine comprehensive therapy is effective in the treatment of low frequency hearing damage of sudden deafness. Either of them has no effect on high frequency hearing damage. But for the middle frequency hearing damage, the efficacy of the comprehensive therapy of electroacupuncture and western medicine is superior to that of the simple western medicine comprehensive therapy.

Ear Acupuncture for Perimenopause Syndrome:A Multi-centered Randomized Controlled Trial

Objective： To observe and evaluate the clinical effect of ear acupuncture in treating perimenopause syndrome. Methods： A multi-centered randomized controlled trial was conducted and the enrolled participants were divided into an ear acupuncture group and a control group. The ear acupuncture group was treated by electroacupuncture at auricular points, and the control one was prescribed for Geng Nian An （Menopause Helper） tablets. The therapeutic effects were evaluated after 10-day treatments. Results： For pre-menopausal patients, the total effective rate was 96.8% in the ear acupuncture group, versus 56.3% in the control. For post-menopausal patients, the total effective rate was 85.7% in the ear acupuncture group, versus 53.0% in the control. Conclusion： Both ear acupuncture and Geng Nian An （Menopause Helper） tablets were effective in ameliorating symptoms of perimenopause syndrome, with satisfactory compliance and safety. The clinical effect of ear acupuncture is better than that of Geng Nian An （Menopause Helper） tablets.

Review of Vascular Headache Treated by Acupuncture from 1949 to 2004

Summary To review the general situation of acupuncture in treating vascular headache between 1949-2004 in an attempt to promote acupuncture practice, clinical references concerning acupuncture treatment of vascular headache were analyzed on the basis of Chinese Modern Acupuncture Database. From 1956, these references increased annually and steadily. In clini cal practice, needling is cardinally used, and the acupoints are selected adjacent to diseased oart and on syndrome differentiation.

Clinical efficacy of electroacupuncture in controlling myopia in children and its influence on retinal blood flow

Objective:To observe the clinical efficacy of electroacupuncture(EA)in controlling myopia in children and its effect on retinal blood flow.Methods:Sixty-eight myopic children were randomly divided into an observation group and a control group,with 34 cases in each group.The control group was given auricular acupressure treatment alone,and the observation group was treated with EA once a week in addition to the treatment used in the control group.The spherical equivalent refraction(SER)and axial length(AL)were measured at baseline,and after 3 months and 6 months of treatment.Optical coherence tomography angiography was used to measure the vessel density(VD)and perfusion density(PD)in the surface layer of the retina.Results:After 3 months and 6 months of treatment,the changes in SER between the two groups were not statistically significant(P>0.05).After 3 months of treatment,the changes in AL between the two groups were not statistically significant(P>0.05);after 6 months of treatment,the change amount of AL in the observation group was smaller than that in the control group(P<0.05);after 3 months and 6 months of treatment,the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group(P<0.01).Conclusion:EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.

Electroacupuncture Combined with Auricular Point Sticking for Hiccups in Late-stage Cancer

Objective：To observe the clinical efficacy of electroacupuncture combined with auricular point sticking for hiccups occurring in late-stage cancer.Methods：A total of 30 cases of hiccups in late-stage cancer were included and treated with electroacupuncture combined with auricular point sticking.Results：Of the 30 cases,10 cases showed marked effect,18 cases showed improvement and 2 cases failed,with a total effective rate of 93.3%.Conclusion：Electroacupuncture combined with auricular point sticking is an effective method to relieve hiccups in late-stage cancer.

Clinical Observation on Treatment of Simple Obesity with Acupuncture

Altogether 128 cases were treated with comprehensive therapy of electroacupuncture, point-toward-point and plaster of auricular points based on syndrome differentiation, and the result showed that the total effective rate was 92.2% and there was no significant difference in the total effective rate among different syndrome patterns （P 〉 0.05）, which indicated that satisfactory results can be obtained electroacupuncture, point-toward-point and differentiation. through comprehensive therapy plaster of auricular points based on including syndrome