目的观察电针上肢穴位对健康受试者初级运动皮层(primary motor cortex,M1)躯干脑区皮质脊髓兴奋性的影响。方法纳入15名健康受试者,采用交叉设计。试验一观察电针上肢穴位对竖脊肌(erector spinae,ES)皮质脊髓兴奋性的影响,受试者随机...目的观察电针上肢穴位对健康受试者初级运动皮层(primary motor cortex,M1)躯干脑区皮质脊髓兴奋性的影响。方法纳入15名健康受试者,采用交叉设计。试验一观察电针上肢穴位对竖脊肌(erector spinae,ES)皮质脊髓兴奋性的影响,受试者随机先后进入3组试验,A组电针合谷穴,B组电针孔最穴,C组假针合谷穴。运用经颅磁刺激,检测干预前后对侧M1第一骨间背侧肌、桡侧腕屈肌及ES的运动诱发电位(motor evoked potentials,MEPs)的波幅和潜伏期,ES的MEPs波幅升高者进入试验二。试验二为抑制背侧前运动皮层(premotor cortex,PMd)后电针上肢穴位对ES的皮质脊髓兴奋性的作用研究,受试者随机先后进入两组试验,D组采用抑制PMd配合电针合谷穴干预,E组采用抑制PMd配合电针孔最穴干预。观察并比较两组对侧M1上肢脑区和躯干脑区MEPs的波幅和潜伏期。结果A组和B组干预后上肢脑区及躯干脑区MEPs总波幅均较同组干预前显著增加(P<0.001,P<0.01)。A组干预后上肢脑区及躯干脑区MEPs总波幅均明显高于C组,B组干预后仅躯干脑区MEPs总波幅明显高于C组,差异均具有统计学意义(P<0.001)。D组干预后上肢脑区最佳刺激点MEPs平均波幅及总波幅较同组干预前均显著增加(P<0.05)。D组和E组干预前后躯干脑区最佳刺激点的MEPs平均波幅及总波幅比较,差异也均无统计学意义(P>0.05)。结论生理状况下,电针合谷、孔最穴均可增强ES的皮质脊髓兴奋性,二者之间无明显差异,PMd可能参与其过程。展开更多
目的观察针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎的临床疗效及对患者关节疼痛和关节功能的影响。方法选取100例膝骨关节炎患者,随机分为对照组(50例)和观察组(50例)。对照组予口服蠲痹汤治疗,观察组在对照组治疗基础上联合针刺四关...目的观察针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎的临床疗效及对患者关节疼痛和关节功能的影响。方法选取100例膝骨关节炎患者,随机分为对照组(50例)和观察组(50例)。对照组予口服蠲痹汤治疗,观察组在对照组治疗基础上联合针刺四关穴和郄穴治疗。比较两组临床疗效,比较两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、西安大略与麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分和美国特种外科医院关节功能(Hospital for Special Surgery,HSS)评分,观察两组治疗前后骨代谢指标[血清骨钙素(osteocalcin,OC)和破骨细胞抑制因子(osteoclastogenesis inhibitory factor,OPG)]和炎症因子指标[血清白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-1(interleukin-1,IL-1)]的变化。结果观察组总有效率为94.0%,高于对照组的72.0%(P<0.05)。治疗后,两组VAS评分和WOMAC总分以及血清IL-6、TNF-α和IL-1水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组HSS评分以及血清OC和OPG水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎可有效减轻患者膝关节疼痛,改善膝关节功能及骨代谢水平,降低炎症因子水平,疗效优于单一中药治疗。展开更多
Objective： To study, through blood oxygen level dependent functional magnetic resonance imaging （BOLD fMRI）, the cerebral activated areas evoked by electro-acupuncturing （EA） the right Hegu point （LI4） or non-a...Objective： To study, through blood oxygen level dependent functional magnetic resonance imaging （BOLD fMRI）, the cerebral activated areas evoked by electro-acupuncturing （EA） the right Hegu point （LI4） or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods： EA was applied at volunteers＇ right LI4 （of 9 subjects in the LI4 group） and facial non-acupoint points （of 5 subjects in the control group）, and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm^3 used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results： Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients＇ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group （P〈0.01）. In the LI4 group, the areas which showed signal activation were： midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were： bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were： bilateral frontal lobe, postcentral gyrus, Reil＇s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion： The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect＇s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research.展开更多
Hegu （LI 4） and Taichong （LR 3） are the Yuan- Primary acupoints of the Large Intestine and Liver Meridian, and are collectively named as Si Guan （four gates） point. Combined use of these two acupoints can harmon...Hegu （LI 4） and Taichong （LR 3） are the Yuan- Primary acupoints of the Large Intestine and Liver Meridian, and are collectively named as Si Guan （four gates） point. Combined use of these two acupoints can harmonize yin and yang, regulate qi and blood, and balance ascending or descending. This paper attempts to study the effects of Si Guan point on the vascular dilation and constriction in migraine patients from the perspective of its feature.展开更多
OBJECTIVE: To observe the analgesic effect of acupuncture at Hegu (LI 4) in vitro fertilization-embryo transfer (IVF-ET) transvaginal oocyte retrieval using ultrasonography and explore its mechanism. METHODS: Ninety p...OBJECTIVE: To observe the analgesic effect of acupuncture at Hegu (LI 4) in vitro fertilization-embryo transfer (IVF-ET) transvaginal oocyte retrieval using ultrasonography and explore its mechanism. METHODS: Ninety patients undergoing IVF-EF oocyte retrieval were randomly divided into three groups: an acupuncture group with needles inserted into bilateral Hegu (LI 4) points, a placebo group given placebo needles, and a control group with routine oocyte retrieval. Each group had an indometacin enema 30 min before the operation. We compared the pain-rated index (PRI), visual analogy scale (VAS), and present pain intensity (PPI) immediately after operation and 1 h after operation. We also determined the neuropeptide Y (NPY) level of the follicular fluid. RESULTS: PRI, VAS, and PPI after operation and 1 hafter operation in the acupuncture group were significantly lower than those in the control group (P< 0.01). No obvious difference (P>0.05) was observed in PRI,VAS, and PPI after operation and 1 h after operation between the placebo group and the control group.The NPY level of the follicular fluid in the acupuncture group was significantly higher than that in the control group (P<0.01). No obvious difference (P>0.05) was observed in the NPY level of the follicular fluid between the placebo group and the control group. CONCLUSION: The analgesic effect of acupuncture at Hegu in transvaginal oocyte retrieval using ultrasonography may be related to the increase in the NPY level of the follicular fluid.展开更多
Epigastric pain, also known as stomach pain, is presented with fi＇equently recurrent pain in the upper abdomen or stomach area, which is mainly caused by exogenous pathogen, improper diet or internal injuries due to ...Epigastric pain, also known as stomach pain, is presented with fi＇equently recurrent pain in the upper abdomen or stomach area, which is mainly caused by exogenous pathogen, improper diet or internal injuries due to seven emotions. All 45 cases with epigastric pain caused by various fitctors were treated with mainly needling Hegu （LI 4） between November 2010 and November 2012, and the report is given as follows.展开更多
文摘目的观察针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎的临床疗效及对患者关节疼痛和关节功能的影响。方法选取100例膝骨关节炎患者,随机分为对照组(50例)和观察组(50例)。对照组予口服蠲痹汤治疗,观察组在对照组治疗基础上联合针刺四关穴和郄穴治疗。比较两组临床疗效,比较两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、西安大略与麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分和美国特种外科医院关节功能(Hospital for Special Surgery,HSS)评分,观察两组治疗前后骨代谢指标[血清骨钙素(osteocalcin,OC)和破骨细胞抑制因子(osteoclastogenesis inhibitory factor,OPG)]和炎症因子指标[血清白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-1(interleukin-1,IL-1)]的变化。结果观察组总有效率为94.0%,高于对照组的72.0%(P<0.05)。治疗后,两组VAS评分和WOMAC总分以及血清IL-6、TNF-α和IL-1水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组HSS评分以及血清OC和OPG水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎可有效减轻患者膝关节疼痛,改善膝关节功能及骨代谢水平,降低炎症因子水平,疗效优于单一中药治疗。
基金Supported by the National Natural Science Foundation (No. 90209031)
文摘Objective： To study, through blood oxygen level dependent functional magnetic resonance imaging （BOLD fMRI）, the cerebral activated areas evoked by electro-acupuncturing （EA） the right Hegu point （LI4） or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods： EA was applied at volunteers＇ right LI4 （of 9 subjects in the LI4 group） and facial non-acupoint points （of 5 subjects in the control group）, and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm^3 used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results： Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients＇ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group （P〈0.01）. In the LI4 group, the areas which showed signal activation were： midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were： bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were： bilateral frontal lobe, postcentral gyrus, Reil＇s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion： The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect＇s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research.
基金Scientific Research Foundation of Zhejiang Education Department (Y200805946)Open Foundation of Top Priority Projects of Zhejiang Universities (Acupuncturemoxibustion and Tuina) (ZJZZ-0902)
文摘Hegu （LI 4） and Taichong （LR 3） are the Yuan- Primary acupoints of the Large Intestine and Liver Meridian, and are collectively named as Si Guan （four gates） point. Combined use of these two acupoints can harmonize yin and yang, regulate qi and blood, and balance ascending or descending. This paper attempts to study the effects of Si Guan point on the vascular dilation and constriction in migraine patients from the perspective of its feature.
文摘OBJECTIVE: To observe the analgesic effect of acupuncture at Hegu (LI 4) in vitro fertilization-embryo transfer (IVF-ET) transvaginal oocyte retrieval using ultrasonography and explore its mechanism. METHODS: Ninety patients undergoing IVF-EF oocyte retrieval were randomly divided into three groups: an acupuncture group with needles inserted into bilateral Hegu (LI 4) points, a placebo group given placebo needles, and a control group with routine oocyte retrieval. Each group had an indometacin enema 30 min before the operation. We compared the pain-rated index (PRI), visual analogy scale (VAS), and present pain intensity (PPI) immediately after operation and 1 h after operation. We also determined the neuropeptide Y (NPY) level of the follicular fluid. RESULTS: PRI, VAS, and PPI after operation and 1 hafter operation in the acupuncture group were significantly lower than those in the control group (P< 0.01). No obvious difference (P>0.05) was observed in PRI,VAS, and PPI after operation and 1 h after operation between the placebo group and the control group.The NPY level of the follicular fluid in the acupuncture group was significantly higher than that in the control group (P<0.01). No obvious difference (P>0.05) was observed in the NPY level of the follicular fluid between the placebo group and the control group. CONCLUSION: The analgesic effect of acupuncture at Hegu in transvaginal oocyte retrieval using ultrasonography may be related to the increase in the NPY level of the follicular fluid.
文摘Epigastric pain, also known as stomach pain, is presented with fi＇equently recurrent pain in the upper abdomen or stomach area, which is mainly caused by exogenous pathogen, improper diet or internal injuries due to seven emotions. All 45 cases with epigastric pain caused by various fitctors were treated with mainly needling Hegu （LI 4） between November 2010 and November 2012, and the report is given as follows.
