Xingnao Kaiqiao needling method for acute ischemic stroke： a meta-analysis of safety and efficacy

OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and Pub Med were searched from June 2006 to March 2016.DATA SELECTION： We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions（Version 5.1）, and the study was carried out using Cochrane system assessment methods. Rev Man 5.2 was used for the meta-analysis of the included studies.OUTCOME MEASURES： The mortality rate, disability rate, activities of daily living（Barthel Index）, and clinical efficacy were observed.RESULTS： Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio（RR） = 0.51, 95% confidence interval（CI） = 0.27-0.98, z = 2.03, P 〈 0.05], elevated the activities of daily living（weighted mean difference = 12.23, 95% CI： 3.66-20.08, z = 2.80, P 〈 0.005）, and had greater clinical efficacy（RR = 1.61, 95% CI： 1.23-2.09, z = 3.53, P 〈 0.0004）. However, there was no significant difference in mortality rate（RR = 0.61, 95% CI： 0.15-2.45, z = 0.70, P 〉 0.05）. CONCLUSION： The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality randomized controlled trials are needed to provide reliable evidence of the efficacy and safety of Xingnao Kaiqiao acupuncture in the treatment of acute ischemic stroke.

BRIEF INTRODUCTION TO THEORETICAL INTENTION OF "NEEDLING METHOD FOR TRANQUILLIZATION AND CALMING THE MIND" FOR TREATMENT OF INSOMNIA

A set of scientific theories and an effective acupuncture therapy for insomnia about ＂the needling method for tranquillization and calming the mind＂ are gradually formed through many years＇theoretical and clinical studies. In this paper, the theoretical intention about ＂the needling method for tranquillization and calming the mind＂ for treatment of insomnia are briefly introduced mainly from the cause of disease, pathogenesis, therapeutic method and characteristics of composition of a prescription, etc. in order to provide a new train of thoughts and a new method for working out scientific and standard prescriptions in the treatment of insomnia.

EIGHTY CASES of SOFT TISSUE INJURY TREATED WITH LOCAL CONTRALATERAL NEEDLING METHOD

Contralateral needling method is a common and effective one of acupuncture analgesicmethods.It is used to treat a local pain in the limbs and trunk with a short course of disease,pain and swelling will disappear or be relieved immediately for one or two treatments.Really,there isan effect of relieving pain as soon as the needle is inserted.When the local contralateral needlingmethod is used,the key to improving the effectiveness lies in determining the pain position and its correspondingpoint correctly,the more correct the pain position and its corresponding point are determined,the better the effectiveness will be.In this group,80 cases soft tissue injury were treatedwith local contralateral needling method,the cure rate was 82％,and the total effective rate was100％.

CLINICAL OBSERVATION ON TREATMENT OF PERIPHERAL FACIAL PARALYSIS WITH DIFFERENT NEEDLING METHODS

Purpose: To observe the clinical therapeutic effect of different needling methods in the treatment of peripheral facial paralysis. Methods: A total of 158 cases of peripheral facial palsy patients are randomly divided into treatment group (n=116 cases, who are treated by penetration needling method) and control group (n=42 cases, who are treated with traditional acupuncture method). In treatment group, main acupoint pairs for penetration needling are Yangbai (GB 14) -Yuyao (EX-HN 4), Tongziliao (GB 1) -Taiyang (EX-HN 5), Jiache (ST 6) -Dicang (ST 4) and Chengjiang (CV 24) -Jiachengjiang (EX-HN) on the affected side, and in control group, the main acupoints used are Yifeng (TE 17), Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Jingming (BL 1) and Chengjiang (CV 24). The treatment is given once daily with 10 sessions being a therapeutic course. Results: After 3 courses of treatment, the cure rates of treatment group and control group are 81.8% and 66.7% separately, showing a significant difference between two groups (P<0.05). The total effective rates of treatment and control groups are 96.5% and 88.1% separately, presenting a significant difference between two groups (P<0.01). Conclusion: The therapeutic effect of penetration needling method is better than that of traditional acupuncture method.

Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

OBSERVATION ON THE EFFECT OF SHALLOW NEEDLING FOR TREATMENT OF PERIPHERAL FACIAL PARALYSIS IN 80 AFRICANS

This paper is a summary of 150 cases of facial paralysis in African black people treated with shallow needling and mild needling manipulation. After 3 courses of treatment, of the 80 cases in the shallow-needling group, 71 (88. 8% ) were cured, 5 (6. 3% ) had marked improvement, 3 (3. 7% ) had improvement and 1 (1. 2% ) failed; Of the 70 cases in traditional-needling group, 61 (87. 1 % ) were cured, 6 (8. 6% ) had evident improvement, 2 (2. 9% ) had improvement and 1 (1. 4 % ) had no striking change. Statistical analysis showed no significant difference between the two groups in the therapeutic effect (P >0. 5 ), indicating both the traditional needling method and shallow needling were effective in treatment of facial paralysis in black people. In addition, earlier treatment was very important in healing facial palsy; and the cure rate was higher in younger patients ard those with light severity.

Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

AIM To evaluate the efficacy of endoscopic ultrasoundguided fine needle aspiration(EUS-FNA) of pancreatic head cancer when pushing(push method) or pulling the echoendoscope(pull method).METHODS Overall, 566 pancreatic cancer patients had their first EUS-FNA between February 2001 and December 2017. Among them, 201 who underwent EUS-FNA for pancreatic head lesions were included in this study. EUS-FNA was performed by the push method in 85 patients, the pull method in 101 patients and both the push and pull methods in 15 patients. After propensity score matching(age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUSFNA-related factors were compared between the two groups.RESULTS Patient characteristics were not significantly different between the two groups. The distance to lesion was significantly longer in the push group than in the pull group(13.9 ± 4.9 mm vs 7.0 ± 4.9 mm, P < 0.01). The push method was a significant factor influencing the distance to lesion(≥ median 10 mm)(P < 0.01). Additionally, tumor diameter ≥ 25 mm(OR = 1.91, 95%CI: 1.02-3.58, P = 0.043) and the push method(OR = 1.91, 95%CI: 1.03-3.55, P = 0.04) were significant factors contributing to the histological diagnosis of malignancy.CONCLUSION The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.

Observation of the Effectiveness of 56 Male Patients with Sexaul Disorder Treated by Needle－pricking Method

ＯｂｓｅｒｖａｔｉｏｎｏｆｔｈｅＥｆｆｅｃｔｉｖｅｎｅｓｓｏｆ５６ＭａｌｅＰａｔｉｅｎｔｓｗｉｔｈＳｅｘａｕｌＤｉｓｏｒｄｅｒＴｒｅａｔｅｄｂｙＮｅｅｄｌｅ－－ｐｒｉｃｋｉｎｇＭｅｔｈｏｄ￥ＺｅｎｇＹｕｅｐｉｎｇ（ＦａｎｇｃｕｉＤｉｓｔｒｉｃｔＰｅｏ...

Effects of cluster needling of scalp acupuncture on neurofilament protein 200 and signal transducer and activator of transcription 3 in rats with acute cerebral ischemia

Objective:Cluster needling at scalp acupoints has showed satisfying effects with acute cerebral ischemia in clinic whereas the mechanisms are not yet clear completely.This study investigated the influence of cluster needling at scalp acupoints on neurological function,as well as on neurofilament protein 200(NF200)and signal transducer and activator of transcription 3(STAT3)expression,in rats with acute cerebral ischemia.Methods:Fifty-four Sprague-Dawley rats were randomly assigned in equal numbers to the false operation(group F),model(group M),or cluster needling scalp acupuncture(group C)groups.Each group was divided into three subgroups,of six rats each,by acupuncture treatment time(24 h,7 days,and 14 days).The rat local cerebral ischemia model was prepared using a modified suture occlusion method.Group C rats were treated by cluster needling scalp acupuncture,while groups F and M did not receive acupuncture treatment.Neurological effects were evaluated using the Longa score.NF200 and STAT3 expression were measured by western blotting.Results:At 24 h,there were no statistical difference between group C and group M in nerve function(P>.05).On days 7 and 14,nerve function scores in group C were significantly lower than that in group M(respectively were P<.05 and P<.01).In addition,on days 14,expression of NF200 was significantly higher in group C compared with group M(P<.05).Compared with group M,STAT3 expression was also higher in group C on days 7 and 14,although these differences were not statistically significant(both P>.05).Conclusion:Cluster needling scalp acupuncture were efficient in improving nerve function scores in rats with cerebral ischemia,and promoting the recovery of motor function.These improvements were associated with increases in NF200 and STAT3 expression.

Effect of Wei’s triple nine needling therapy on flash visual evoked potentials in rats with traumatic optic neuropathy

Objective:To investigate the effect of Wei’s triple nine needling therapy on the N2-P2 wave of the flash visual evoked potential(FVEP)in rats of the of the transverse directional pulling model.Methods:Thirty-six Wistar rats were randomly grouped,nine were in normal control group without any treatment,and the remaining 27 were surgically modelled in the right eyes.Eighteen of these rats were randomly divided into a Wei’s triple nine needling therapy group and a model group of nine rats each after the TON model was made using the transverse quantitative retraction method.The other 9 rats were sham-operated,and only the optic nerve was exposed without retraction.On the next day of modelling,the Wei’s triple nine needling therapy group was treated with Wei’s triple nine needling therapy for 20 minutes/1 time/1 day for 14 days.The model group,sham-operated group and normal control group were not intervened.Wei's triple nine acupoints were represented as follows:1st link:"Jingming"(BL1)and"Chengqi"(ST1);2nd link:"Sizhukong"(SJ23)penetrating"Taiyang"(EX-HN5);and the third:"Fengchi"(GB 20)and"Taichong"(LV3).The FVEP of each group was observed on 1d,7d and 14d.The FVEP of each group was observed on 1d,7d and 14d.Results:Compared with the model group,the N2 wave latency and P2 wave latency were shortened in the Wei’s triple nine needling therapy on 1d(P<0.05,P<0.01);on 7d,their N2 wave latency was shortened(P<0.01)and the N2-P2 wave amplitude was increased compared with the model group(P<0.05);on 14d,their P2 wave latency was shortened(P<0.05)and the N2-P2 wave amplitude was increased.There was no statistical difference in N2 wave latency,P2 wave latency and N2-P2 wave amplitude in the sham-operated group on 1d,7d and 14d(P>0.05).The delayed N2 and P2 wave latencies in the model group did not improve from 1d to 14d(P>0.05)and the amplitude decreased throughout,showing a significant difference on 14d compared to 1d(P<0.05).In contrast,the N2 wave latency in Wei’s triple nine needling therapy group was not significantly different until 7d to 14d(P<0.05);its P2 wave latency,although significantly delayed from 1d to 7d(P<0.05),recovered on 14d and reached a level that was not statistically different from 1d and 7d(P>0.05).There was also no significant decrease in N2-P2 wave amplitude between 1d and 14d in Wei’s triple nine needling therapy group(P>0.05).Conclusion:In this experiment,the TON rat model was successfully established by the transverse quantitative retraction method,and the treatment of TON rats with Wei’s triple nine needling therapy reduced the P2 wave delay of the FVEP electrophysiological signal and increased the N2-P2 amplitude,which had a certain positive effect on the repair of optic nerve injury,probably related to its effect of improving the conduction function of the optic nerve and protecting the retinal ganglion cells that had not been degenerated and necrosed.

经筋针刺法联合益肾壮骨方治疗膝关节骨性关节炎的效果及表面肌电图分析

目的探究经筋针刺法联合益肾壮骨方治疗膝关节骨性关节炎(KOA)的效果及表面肌电图分析。方法选取2022年3月至2023年3月北京市鼓楼中医医院收治的74例KOA患者作为研究对象,按照随机数字表法分为观察组(37例)与对照组(37例)。对照组采用益肾壮骨方治疗,观察组在对照组的基础上联合经筋针刺法治疗。比较两组患者治疗前后的中医证候积分、膝关节功能(Lysholm评分)、视觉模拟评分法(VAS)评分与表面肌电图指标。结果治疗后,观察组中医证候积分各维度评分低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组VAS评分低于对照组,Lysholm评分高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组伸展Mean值高于对照组,协同收缩比率低于对照组,差异有统计学意义(P<0.05)。结论经筋针刺法联合益肾壮骨方能缓解膝关节骨性关节炎患者中医证候积分,降低疼痛程度,提高膝关节功能,改善患者表面肌电图指标,值得推广。

关刺针法配合超声波治疗气滞血瘀型髌股关节疼痛综合征的临床观察

【目的】观察关刺针法配合超声波治疗气滞血瘀型髌股关节疼痛综合征的临床疗效。【方法】将86例气滞血瘀型髌股关节疼痛综合征患者随机分为观察组和对照组,每组各43例。对照组给予西医常规治疗联合功能锻炼,观察组在对照组治疗的基础上,给予关刺针法联合超声波治疗。连续治疗2周。治疗2周后,评价2组临床疗效,观察2组患者治疗前后膝关节疼痛视觉模拟量表(VAS)评分的变化情况,以及Kujala量表评分的情况。比较2组患者治疗前后患侧膝关节主动屈膝活动度(AROM)的变化情况。【结果】(1)治疗后,2组患者的VAS评分明显改善(P<0.05),且观察组在改善VAS评分水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的Kujala评分明显改善(P<0.05),且观察组在改善Kujala评分水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的AROM明显改善(P<0.05),且观察组在改善AROM水平方面明显优于对照组,差异有统计学意义(P<0.05)。(4)观察组总有效率为95.35%(41/43),对照组为81.40%(35/43)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】关刺针法配合超声波治疗髌股关节疼痛综合征,能明显缓解患者的疼痛症状,促进膝关节功能的恢复,临床疗效显著。

基于经筋理论的膝骨关节炎患者“筋结点”超声解剖学特征分析与针刀治疗的疗效评价研究

目的:借助可视化肌骨超声深入剖析膝骨关节炎患者膝关节局部经筋病灶点的病理特征,并综合评价弓弦平衡针刀法与常规针刺法治疗膝骨关节炎的疗效差异,为今后针刀精准辨位定点及安全入路研究提供客观参考依据。方法:将120例膝骨关节炎患者随机分为针刀治疗组和针刺对照组,每组60例。针刀治疗组进行弓弦平衡针刀法治疗,每周2次;针刺对照组选取犊鼻、内膝眼、阳陵泉、梁丘、鹤顶,及局部阿是穴进行针刺,同时根据不同的证型进行配穴加减,每周3次。2组均以3周为1个疗程,治疗3个疗程。根据肌骨超声下“筋结点”的精确定位、层次解剖、回声特点深入剖析经筋病灶点的超声影像学特征,采用股直肌羽状角、肌纤维横断面积、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)综合评价2组疗效差异。结果:治疗后,2组患者WOMAC评分、股直肌羽状角、平均肌纤维厚度、弹性应变率、IL-1β、TNF-α水平,及膝关节疼痛程度、僵硬、日常活动能力方面较治疗前均显著改善(P <0.05);其中,针刀治疗组在提升股直肌羽状角、增加肌纤维厚度、降低弹性应变率、降低致炎致痛因子水平方面优于针刺对照组,差异有统计学意义(P <0.05);与正常膝关节超声解剖结构相比,患者膝关节各针刀松解点(筋结点)处呈现出不同程度回声增强,同时伴有滑膜增厚、增生、关节腔积液、滑囊积液等典型超声影像学特征。结论:肌骨超声能够精准呈现膝骨关节炎患者膝关节经筋病灶点的解剖位置、解剖层次等超声病变特征,证实弓弦平衡针刀法的安全性和有效性,为针刀医学的标准化、规范化研究提供重要参考依据。

甘肃产不同品种松针的抗氧化活性研究

以甘肃产白皮松、雪松、油松、落叶松、樟子松和华山松6个树种的松针为研究对象,采用DPPH法、ABTS法和铜离子还原能力测定其不同浓度乙醇提取物的体外抗氧化活性,并采用熵值法综合评价遴选出抗氧化活性强的松针资源,为松针的进一步开发利用提供参考。研究表明:采用不同浓度乙醇提取时,40%乙醇提取物的抗氧化活性最好;不同品种松针中,雪松松针的抗氧化活性最好,其中天水产雪松松针40%乙醇提取物的评分最高达99.52%,表明其可以作为进一步研究松针抗衰老研究的资源。

温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎5例

目的分析头部脓肿性穿掘性毛囊炎的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对5例头部脓肿性穿掘性毛囊炎的临床表现、中医证候、中医治则、方药、预后进行回顾性分析。结果5例患者均为青年男性,年龄为19~26岁,平均年龄22.62岁,5例患者皮损以头皮大量结节、囊肿、融合性脓肿为主,伴有明显脓性分泌物、压痛、脱发明显等临床特点。5例患者中2例肥胖(BMI≥30.0 kg/m 2)。5例患者皮疹辨证均符合痰瘀互结证。中医内治均采用温通化瘀散结之法,局部红肿者仙方活命饮加减。外治采用箍围-火针法,箍围使用自制消炎膏配合冲和散,火针针刺后按压排脓。中医药治疗时间为56~180 d,平均时间为101.20 d,5例中3例结节、囊肿完全消退,脓性分泌物消失,遗留色减斑及瘢痕(病例1~3);1例结节消失,囊肿变平,硬化性囊肿缩小(病例4);1例硬化性囊肿略缩小(病例5)。随访6个月后,2例肥胖患者均有复发,继续治疗后复发皮损消失。结论温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎临床疗效较好,值得进一步研究和推广。

毫针速刺法松解肌筋膜改善神经根型颈椎病患者上肢功能障碍的疗效观察

目的观察毫针速刺法松解肌筋膜改善神经根型颈椎病患者上肢功能障碍的治疗效果。方法本研究为随机对照试验,纳入2021年1月至2022年12月南京中医药大学连云港附属医院收治的72例神经根型颈椎病患者,以区组随机方法进行分组。试验组36例中男20例,女16例,年龄(47.94±6.16)岁,病程(27.25±9.49)个月;对照组36例中男18例,女18例,年龄(46.73±5.14)岁,病程(26.02±7.58)个月。试验组采用毫针速刺法治疗,针对颈项部软组织损伤部位予以穿透性松解刺激,隔日1次,并与推拿治疗交替进行,各治疗6次;对照组予传统针刺治疗,每日1次,6次为1个疗程,每隔1个疗程休息1 d,共治疗2个疗程。分别于治疗前1 d、治疗结束后第1天比较两组患者的田中靖久颈椎症状评分、颈椎功能障碍指数(NDI),并评定两组临床疗效。采用t检验、χ^(2)检验。结果与治疗前1 d比较,治疗结束后第1天两组患者的田中靖久颈椎症状评分均升高[试验组(14.93±2.74)分比(9.70±2.45)分,对照组(12.70±2.93)分比(9.40±2.01)分],NDI评分均降低[试验组(15.92±4.21)分比(38.19±5.86)分,对照组(25.46±3.84)分比(36.76±7.25)分],差异均有统计学意义(均P<0.05);且试验组各评分改善程度均优于对照组[田中靖久颈椎症状评分(5.23±1.89)分比(3.30±1.25)分,NDI评分(22.27±4.67)分比(11.30±3.97)分,均P<0.05]。试验组患者的治疗总有效率高于对照组[91.7%(33/36)比72.2%(26/36)],差异有统计学意义(χ^(2)=4.560,P=0.032)。结论毫针速刺法松解肌筋膜治疗能够缓解神经根型颈椎病患者的临床症状,减轻患者痛苦,并实现对上肢功能的良性调节,降低疾病对生活能力的影响,相对传统针刺治疗方案具有一定优势,值得在临床上进一步推广应用。

针刀“解结法”对膝骨关节炎兔股骨髁软骨组织PI3K/AKT/mTOR相关因子的影响

目的:通过针刀“解结法”治疗兔膝骨关节炎,探讨其对股骨髁软骨组织PI3K/AKT/mTOR相关因子的影响。方法:将SPF级雄性新西兰大白兔24只,采用随机数字表法分为空白组、模型组和针刀组,每组8只。模型组和针刀组采用Videman改良法制备KOA兔模型,造模成功后针刀组采用针刀“解结法”松解治疗患侧膝周结筋病灶点,空白组和模型组同等抓取并固定5 min,未行任何干预,每周1次,连续4次。末次干预1周后,采用HE染色及Mankin's评分观察三组患侧膝关节股骨髁软骨组织病理形态变化,qPCR检测三组患侧膝关节股骨髁软骨组织PI3K、AKT、mTOR mRNA转录水平,Western-blot检测三组患侧膝关节股骨髁软骨组织PI3K、AKT、mTOR的蛋白表达水平。结果:与空白组比较,模型组患侧膝关节股骨髁软骨组织表层缺失且不平整、移行细胞簇集、排列欠规整,Mankin's评分升高(P<0.05),PI3K、AKT mRNA转录水平及蛋白表达均上调(P<0.05),而mTOR转录水平下调及蛋白表达水平上调(P<0.05);与模型组比较,针刀组患侧膝关节股骨髁软骨组织细胞形态和排列完整性趋于空白组、偶见软骨细胞簇集、潮线较模型组完整,Mankin's评分显著降低(P<0.05),PI3K、AKT mRNA转录水平及蛋白表达均下调(P<0.05),mTOR mRNA转录水平及蛋白表达均上调(P<0.05)。结论:针刀“解结法”能改善膝骨关节炎兔患侧膝关节股骨髁软骨退变,有效保护患膝关节功能,其机制可能与调控PI3K/AKT/mTOR通路相关因子转录水平相关。

火针联合清肺健脾方预防中重度痤疮患者瘢痕形成的作用机制研究

目的:探究火针联合清肺健脾法预防中重度痤疮患者瘢痕形成的作用机制。方法:选取2021年4月至2022年3月河南省中医院、河南中医药大学第一附属医院、郑州市第六人民医院皮肤科诊治的肺热脾虚型中重度痤疮患者248例,随机分为对照组1、对照组2、对照组3、治疗组,每组各62例。对照组1给予西医基础治疗,对照组2在对照组1治疗的基础上给予火针治疗,对照组3在对照组1治疗的基础上给予自拟清肺健脾方治疗,治疗组在对照组1治疗的基础上给予火针加自拟清肺健脾方治疗。观察4组患者的临床疗效、皮损积分、中医证候积分、痤疮继发瘢痕权重评分(echelle d′evaluation clinique des cicatrices d′acne,ECCA)、生活质量指数(dermatology life quality index,DLQI)、血清指标[胰岛素样生长因子-1(insulin like growth factor1,IGF-1)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、血小板衍生生长因子(platelet-derived growth factor,PDGF)、脑源性神经营养因子(brain derived neurotrophic factor,BDNF)]、不良反应发生情况及复发情况。结果:治疗组愈显率为91.38%,对照组3愈显率为75.00%,对照组2愈显率为72.88%,对照组1愈显率为52.46%,治疗组愈显率高于对照组3、对照组2、对照组1,且对照组3、对照组2愈显率高于对照组1,差异有统计学意义(P<0.05)。治疗组治疗后皮损积分、中医证候积分、ECCA评分及DLQI评分均低于对照组3、对照组2、对照组1,且对照组3、对照组2低于对照组1,差异有统计学意义(P<0.05)。治疗组治疗后IGF-1、TGF-β1、PDGF、BDNF均低于对照组3、对照组2、对照组1,且对照组3、对照组2低于对照组1,差异有统计学意义(P<0.05)。对照组1不良反应发生率为4.92%,对照组2不良反应发生率为8.47%,对照组3不良反应发生率为6.67%,治疗组不良反应发生率为12.07%,4组不良反应发生率比较,差异无统计学意义(P>0.05)。对照组1复发率为40.62%,对照组2复发率为13.95%,对照组3复发率为15.56%,治疗组复发率为1.89%,治疗组复发率低于对照组3、对照组2、对照组1,且对照组3、对照组2低于对照组1,差异有统计学意义(P<0.05)。结论:火针联合清肺健脾法治疗中重度痤疮,可通过降低TGF-β1、PDGF水平预防和减少继发瘢痕的形成,提高患者生活质量。

俞募配穴温针灸法联合健脾止泻汤治疗慢性小儿腹泻临床观察

目的研究俞募配穴温针灸法联合健脾止泻汤治疗慢性小儿腹泻的临床效果。方法选择2020年6月—2022年3月江西省兴国县人民医院儿科收治的50例慢性腹泻患儿,以随机抽签法分为观察组与参照组,各25例。观察组施予俞募配穴温针灸法联合健脾止泻汤治疗,参照组给予常规西药治疗。观察两组各项症状缓解时间;检验免疫蛋白及肠道微生物数量。结果观察组各项症状缓解时间均较参照组短(P<0.05)。治疗2周后,两组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)水平均升高,且观察组高于参照组(P<0.05);两组双歧杆菌属、乳杆菌属肠道微生物数量均升高,且观察组高于参照组(P<0.05);两组大肠杆菌属、肠球菌属肠道微生物数量均降低,且观察组低于参照组(P<0.05)。结论慢性腹泻患儿接受俞募配穴温针灸法联合健脾止泻汤治疗,症状改善明显,有利于患儿优势菌群数量恢复,提高免疫功能。

肾俞穴穴性及用法新探

肾俞穴作为肾脏之气输注于背腰部的腧穴,其属于足太阳膀胱经范畴,在临床上广泛运用于生殖泌尿系统等疾病的治疗。该穴位于人体背部足太阳膀胱经直行支脉循行处,且为足少阴经脉之标部所在,故具有特殊的穴性。但当前对于肾俞穴穴性及运用缺乏深入研究。该文基于经脉、标本、四海等理论探究了其穴性,并通过古籍溯源及临床实践探究其疗效发挥与刺灸方法、穴位配伍、针刺深度等关系。结果表明,不同的刺灸方法、穴位配伍、针刺深度能激发肾俞穴不同的穴位疗效,因此,只有明辨肾俞穴穴性并辅予合适的刺灸方法、穴位配伍及针刺深度,才可更好地发挥肾俞穴的治疗效果。