针刺复合麻醉用于危、老、弱、特病人手术疗效分析

我院继临床施行各种针刺麻醉手术5600余例之后,于一九八八年又着重研究危重、老年体弱、特殊疾病手术的针刺复合麻醉。分为针刺复合硬膜外麻醉(简称针药组)和硬膜外麻醉(简称对照组)各37例进行比较,取得较满意的效果,总结如下。

督脉针麻施行760例肝胆胃肠手术效果的研究

一九七四年五月，我院与第四军医大学及郊东县人民医院协作，研究了督脉针刺麻醉法。先后施行腹部手术四十多种计2300余例，其中用于肝胆胃肠手术760例，按全国针麻效果评定标准，本组的成功率为98．28％，Ⅰ、Ⅱ级率占80．52％。

Pain modulation triggered by high－intensity Stimulation ：implication for acupuncture analgesia？

The spinal transmission of nociceptive signals is modulated by both spinal and supraspinal systems. Spinal networks underlie segmental inhibitions, which are mediated via myellnated cutaneous afferent fibres activated by mechanical stimuli (e. g. rubbing,etc. ) Diffuse noxious inhibitory controls (DNIC) are triggered by peripheral A(^- and C-fibres, involve brain structures confined to the caudal-most part of the medulla including the subnucleus reticularis dorsalis (SRD) and are mediated by descending pathways in the dorsolateral funiculi. Combined psychophysical measurements and recordings of nociceptive reflexes (RI) ) in both normal volunteers and patients with lesions in the spinal cord or brain suggest the existence of identical or equivalent inhibitory processes in man. Both these mechanisms could be triggered to produce hylz,oalgesia by acupuncture needles or moxibustion. When applied near a painful focus, the techniques have similarities to highfrequency, low-intensity transcutaneous nerve stimulation, which brings segmental inhibitory mechanisms into play. When applied to remote areas, the techniques might be related to "counter-irritation" or "counter-stimulation" phenomena which, in addition to involving complex autonomic functions, seem to involve DNIC. Experimental data in both animals and humans. support these conclusions.

SUMMARY OF CLINICAL STUDY ON ACUPUNCTURE COMBINED WITH EPIDURAL ANESTHESIA FOR CHOLECYSTECTOMY

Objective: TO study clinical effect and anesthetic method of acupuncture anesthesia combined with epidural administration of small dose of anesthetic for cholecystectomy. Methods: A total of 194 cases of cholecystectomy patients were randomly divided into acupuncture combined with epidural anesthesia group (group A, n = 66), acupoint-skin electrical stimulation combined with epidural anesthesia group (group B, n = 63) and simple epidural anesthesia group (group C, n=65). Observations were conducted using single-bland method. Bilateral Neiguan (PC 6) and Zusanli (ST 36) were punctured and stimulated electrically in group A and only stimulated electrically via cutaneous electrodes in group B. Epidural anesthetic used was 1.5% Lidocaine and the anesthetic level was controlled to reach T4-11 . Results: The class-I (excellent) rates of group A, B and C were 75.76%, 60.32% and 13.85% respectively, showing significant differences between group A and C and group B and C (P <0.001). The initial dose, doses of every hour and every case of group A and B were lower than those of group C. The dose of every hour of group C was 36.23% and 3. 75% higher then group A and B respectively (P < 0. 001), suggesting that acupuncture or acupoint-skin electrical stimulation could strengthen anesthetic effect and reduce the dose of epidural anesthetic. During operation, indexes of the life signs as HR, MAP, RR, TV, MV, SpO2 and ECG kept basically stable and all patients in group A passed surgical operation safely. Conclusion: Acupuncture or acupoint-skin electrical stimulation combined with epidural anesthesia can be used as one of the anesthetic methods for cholecystectomy.

EFFECTS OF COMPOUND ACUPUNCTURE AND MEDICINE ANESTHESIA ON TNF AND INF-Γ CONTENTS IN THE PATIENT OF PNEUMONECTOMY

Objective To explore effects of acupuncture on senJm tumor necrosis factor （TNF） and ,γ-inter- feron （INF-γ） contents in the operative patient of lung cancer. Methods In the first stage, electroacupuncture （EA） stimulation was given to 25 cases of lung cancer before operation, once daily for 3 consecutive days, with continuous EA stimulation during operation; EA was given once each day from the 5^th-7^th days after operation. In the second stage, EA was added from the 8^th- 10^th days after operation in 30 cases, once daily. Serum TNF and INF-γ contents were compared before and after operation. Results Serum TNF content on the 8th day after operation in the first stage study was lower （P〈0.05） and on the 12th day after operation in the second stage study was higher （P〈0.05） in the compound anesthesia group than that in the general anesthesia group; serum INF-γ contents in the compound anesthesia group on the 8^th day after operation in the first stage and on the 12^th day after operation in the second stage were significantly higher than those in the general anesthesia group （P〈0.01, P〈0.05）. Conclusion Acupuncture can regulate serum TNF and INF-γ contents in the patient of operation of lung cancer, with dual-directional regulation on immunologic function.

CLINICAL OBSERVATION ON TREATMENT OF ALLERGIC BRONCHIAL ASTHMA WITH ACUPOINT APPLICATION THERAPY

In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of powder of Mahuang (Herba Ephedrae), Xixin (Herba Asari), Baijiezi (Semen Sinapis Albae), etc.] at the acupuncture points could improve symptoms and signs of allergic asthma patients, with the total effective rate being 69.57% (16/23) for the short term effect, and 52.17%(12/23) for the long term effect. In medication (Aminophylline) group, of the 25 cases of allergic asthma, 16 (64.0%) were effective after 4 weeks of treatment, while 6 (24.0%) were still effective that was shown by 6 months’ follow up. The therapeutic effect of acupoint application group was significantly better than that of medication group in the long term effect. Results also showed that no obvious interrelation between the short term therapeutic effect and the duration or the severity of the disease. Results also display that acupoint application therapy is an effective, safe and handy method with fewer side effects for asthma.

Guiding Role of Muscle Region Theory in Acupuncture Anesthesia

As a part of acupuncture system, acupuncture anesthesia can promote the development of acupuncture theory. Muscle region is also a part of acupuncture system and plays a guiding role in clinical application of acupuncture anesthesia. The correlation between the distribution of muscle regions and nerves acts as the substantial foundation of the guiding role. At the same time, acupuncture anesthesia has been promoting the continuous development of muscle region theory. The cyclic development relation between the two （practice-theory-practice） is consistent with the dialectical development view.

Effect of acupuncture anesthesia on acne vulgaris of pricking-blood-letting cupping: a single-blind randomized clinical trail

OBJECTIVE: To evaluate the effect on acne vulgaris of pricking-bloodletting cupping at Dazhui(GV 14) under acupuncture anesthesia, and establish whether providing anesthesia to the treatment area by manipulating Hegu(LI 4) and Quchi(LI 11) might have an additional therapeutic benefit. METHODS: Thirty-eight patients were recruited and randomized into a control group and an intervention group with a single-blind(observer-blind) method. The control group was treated by pricking-bloodletting cupping at Dazhui(GV 14) and the studied group by pricking-bloodletting cupping at Dazhui(GV 14) under acupuncture anesthesia at Hegu(LI 4) and Quchi(LI 11). Both groups were treated twice weekly for 6 weeks. The analgesic and therapeutic effects of acupuncture were evaluated on a visual analog scale(VAS) and global acne grading system(GAGS), respectively.RESULTS: There were differences in the VAS scores of pain on pricking and in the pricked area, and the duration of pain between the groups. After 12 treatments, there was a significant reduction in GAGS scores from baseline in both groups, but there was no significant difference between the groups. CONCLUSION: Acupuncture anesthesia at Hegu(LI 4) and Quchi(LI 11) is an effective means of alleviating the pain of pricking-bloodletting cupping and reducing the duration of pain in the treatment area. Pricking-bloodletting cupping at Dazhui(GV 14) improves the skin lesions of patients with moderate acne vulgaris, but acupuncture anesthesia does not appear to have an additional therapeutic effect.

Regulation of Acupuncture on Interferon-γand Tumor Necrosis Factor of Lung Cancer-Operative Cases

Objective： To investigate tumor necrosis factor （TNF） of lung the regulation of acupuncture on γ-interteron （LNF-γ） and cancer-operative cases. Methods： to determine the INF-γ and TNF contents in the blood serum of lung cancer patients by double antibody sandwich immunoenzymatic method （ELISA）; to measure the INF-γ and TNF contents of 30 lung cancer patients in the acupuncture anesthesia group and 30 lung cancer patients in general anesthesia group before the operation and at the 8th days, the 12th day after the operation respectively and make comparison between the two groups. Results. The pre-operation INF-γ contents of the two groups showed no significant difference （P〉 0.05）; the post operation INF-γ contents of the two groups showed significant difference at 8th day and 12th day after the operation （P〈 0.05）; the acupuncture anesthesia group was superior to the general anesthesia group; the self-comparison of the anesthesia group showed significant difference at the 12th day and 8th day after the operation （P〈 0.05）; the pre-operation TNF contents of the two groups showed no significant difference （P〉 0.05） and the post-operation TNF contents of the two groups showed significant difference at the 8th day and 12th day after the operation （P〈 0.05）. Conclusion：Acupuncture can increase the serum INF-γ and TNF contents of lung cancer patients and therefore regulate the immunity of the patients.