青龙摆尾针刺辅助治疗膝骨关节炎效果及对微循环血流灌注、T淋巴细胞亚群的影响

目的:探讨青龙摆尾针刺辅助治疗膝骨关节炎(KOA)的效果,分析其对微循环血流灌注、T淋巴细胞亚群的影响。方法:回顾性选取2019年1月—2022年2月本院收治的85例KOA患者为研究对象,随机分为对照组42例、研究组43例。对照组予以玻璃酸钠注射液+硫酸氨基葡萄糖胶囊治疗,研究组在此基础上予以青龙摆尾针刺治疗。比较两组临床疗效及治疗前后股直肌形态(股直肌羽状角、肌肉厚度、弹性应变率)、微循环血流灌注量(MBPU)、视觉模拟量表(VAS)评分、膝关节Lysholm评分。对比分析两组治疗前后病情相关因子[类风湿因子(RF)、C-反应蛋白(CRP)、红细胞沉降率(ESR)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平。结果:研究组总有效率为95.35%,高于对照组的80.95%(P<0.05);治疗后研究组股直肌羽状角、肌肉厚度、Lysholm评分高于对照组,弹性应变率、MBPU、VAS评分低于对照组(P<0.05);治疗后研究组血清RF、CRP、ESR水平低于对照组(P<0.05);治疗后研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05)。结论:青龙摆尾针刺辅助治疗KOA疗效显著,可改善其临床症状,降低疼痛程度,改善股直肌形态、膝关节功能,纠正免疫功能紊乱状态,减缓病情发展进程。

改良青龙摆尾针刺法治疗带状疱疹后遗神经痛疗效研究

目的:观察改良青龙摆尾针刺法治疗带状疱疹后遗神经痛疗效。方法:将本院收治的91例带状疱疹后遗神经痛患者(2020年2月—2022年6月)纳入研究,以随机数字表法将纳入患者分为针刺组(46例)与常规组(45例),常规组患者采取常规疗法(甲钴胺+维生素+吲哚美辛肠溶片)治疗,针刺组治疗方法在常规组基础上结合改良青龙摆尾针刺法治疗,比较治疗效果、治疗前后患者中医证候积分变化、血清炎症因子水平变化及疼痛评分(VAS)变化与睡眠质量(PSQI)评分变化、皮肤病生活质量评估量表(DLQI)评分变化、不良反应和6个月疾病复发率。结果:针刺组患者与常规组治疗总有效率分别为95.65%(44/46)、82.22%(37/45),针刺组更高,差异具有统计学意义(P<0.05);两组患者治疗前中医证候积分、白介素-6(IL-6)及C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)等血清炎症因子水平、VAS评分、PSQI评分和DLQI评分比较,差异无统计学意义(P>0.05),治疗后各组患者中医证候积分、血清炎症因子水平(IL-6、CRP及TNF-α)、VAS评分、PSQI评分和DLQI评分均改善,针刺组患者治疗后各指标均优于常规组,差异具有统计学意义(P<0.05);针刺组患者不良反应率为4.35%(2/45),与常规组的4.44%(2/46)比较,差异无统计学意义(P>0.05);针刺组患者6个月内疾病复发率为0.00%(0/46)低于常规组的8.89%(4/45),差异具有统计学意义(P<0.05)。结论:带状疱疹后遗神经痛患者采取改良青龙摆尾针刺法治疗甚佳,患者症状明显改善,疼痛缓解,睡眠与生活质量佳,不良反应较少,且6个月内疾病复发率较低,值得应用。

李思康运用针灸治疗肩关节周围炎经验

李思康主任认为,肩关节周围炎病机有二,一是肩部气血阻滞,运行不畅,不通则痛;二是年老体弱,气血亏虚,筋脉得不到气血濡养,不荣则痛,日久不愈,终使肩关节屈伸不利。提出“一清二温三补”的治疗原则,“一清”即通过运用青龙摆尾针刺法调节肩关节局部的气机,疏通经络,清除局部瘀血;“二温”为对肩前(经外奇穴)、肩髃(手阳明经穴)、肩髎(手少阳经穴)三穴施以温针灸法;“三补”为针刺手四针穴,即曲池、合谷、外关、后溪。李主任重视传统复式针刺手法的运用,采用青龙摆尾针刺法,坚持以气血立论,把“一清二温三补”原则贯彻到肩关节周围炎的诊治中,取得良好疗效。

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE TREATMENT OF 123 CASES OF SCAPULOHUMERAL PERIARTHRITIS

Objective: To observe the therapeutic effect of Qinglong Bai Wei Zhen Fa (Green Dragon Shaking Tail Needling) in the treatment of scapulohumeral periarthritis. Methods: A total of 231 cases of scapulohumeral periarthritis patients were randomized into treatment group (n=123) and control group (n=108). In treatment and control groups, Jianyu (LI 15), Jianqian and Jianhou were used as the main acupoints and stimulated with Green Dragon Shaking Tail Needling and conventional needling separately. Additionally, in control group, Waiguan (TE 5) and Binao (LI 14) were supplemented. The treatment was given once daily, with 10 days being a therapeutic course, 2 courses altogether. Results: After the first course of treatment, in treatment and control groups, the cured, the markedly improved, the effective and ineffective cases were 49 and 12, 61 and 33, 11 and 40, 2 and 23, with the total effective rates being 98.4% and 78.7% respectively. There was a marked difference between two groups in the therapeutic effect (P<0.05). Following 2 courses of treatment, the cured, the markedly improved, the effective and ineffective cases were 66 and 21, 47 and 41, 10 and 39, 0 and 7, with the total effective rates being 100% and 93.5% separately. No significant difference between two groups in the total effective rates, but the cure rate of treatment group was strikingly higher than that of control group. Conclusion: Green Dragon Shaking Tail Needling is significantly superior to that of conventional needling in the treatment of scapulohumeral periarthritis.

Effect of modified Qing Long Bai Wei needling on the levels of IL-1β, IL-6 and INF-α in synovial fluid of knee osteoarthritis patients

Objective:To compare the modified Qjng Long Bai Wei needling method and ordinary acupuncture method in the effects of improving the levels of interleukin (IL)-1β,IL-6 and tumor necrosis factor (TNF)-α in the treatment of knee osteoarthritis (KOA),and to determine the advantage of the modified Qing Long Bai Wei needling method for KOA.Methods:One hundred KOA patients were randomized into a treatment group and a control group by using the random number table,with 50 cases in each group.The treatment group was intervened by the modified Qing Long Bai Wei needling method,and the control group was given ordinary acupuncture.The two groups were observed before and after the treatment to determine the changes in the levels of IL-1β,IL-6 and TNF-α in synovial fluid,and the clinical efficacies were compared between the two groups.Results:The total effective rate and clinical recovery rate were 97.9％ and 52.1％ respectively in the treatment group,versus 85.1％ and 25.5％ in the control group,and the between-group differences were statistically significant (both P＜0.01).After the treatment,the levels of Ib1β,IL-6 and TNF-cα in synovial fluid changed significantly in both groups (all P＜0.01);there were significant differences in the levels of IL-1β,IL-6 and TNF-α in synovial fluid between the two groups (all P＜0.01).Conclusion:The modified Qjng Long Bai Wei needling is an effective method for KOA and it can significantly improve the levels of IL-1β,IL-6 and TNF-α in synovial fluid.