Herbs-partitioned moxibustion alleviates aberrant intestinal epithelial cell apoptosis by upregulating A20 expression in a mouse model of Crohn's disease

BACKGROUND A20 inhibits intestinal epithelial cell apoptosis in Crohn's disease, and herbspartitioned moxibustion(HPM) has been demonstrated to be an effective treatment for Crohn's disease. However, the mechanism by which HPM reduces intestinal epithelial cell apoptosis in Crohn's disease has not been thoroughly elucidated to date.AIM To elucidate whether HPM exerts its effects by upregulating A20 to affect intestinal epithelial cell apoptosis in a Crohn's disease mouse model.METHODS In this study, mice with A20 deletion in intestinal epithelial cells(A20 IEC-KO) were utilized to establish a Crohn's disease mouse model with 2,4,6-trinitrobenzenesulfonic acid(TNBS) administration, as well as wild-type mice. Mice were randomly divided into normal control(NC), model control(MC), mesalazine(MESA), and HPM groups. The morphology of the colonic mucosa was observed by hematoxylin-eosin staining, and serum endotoxin and apoptosis of epithelial cells were evaluated by enzyme-linked immunosorbent assay and terminal dUTP nick-end labeling assay accordingly. The protein expression levels of A20 and tumor necrosis factor receptor 1(TNFR1)-related signaling molecules were evaluated by Western blot, and co-expression of A20 and TNFR1-associated death domain(TRADD) and co-expression of A20 and receptor-interacting protein 1(RIP1) were observed by double immunofluorescence staining.RESULTS The intestinal epithelial barrier was noted to have an improvement in the HPM group of wild-type(WT) mice compared with that in A20 IEC-KO mice. Compared with A20 IEC-KO HPM mice, serum endotoxin levels and apoptosis percentages were decreased(P < 0.01), A20 expression levels were increased(P < 0.01), and expression of TNFR1, TRADDD, and RIP1 was decreased in the HPM group of WT mice(PTNFR1 < 0.05, PTRADD < 0.01, PRIP1 < 0.01). Both of the co-expression of A20/TRADD and A20/RIP1 showed a predominantly yellow fluorescence in the HPM group of WT mice, while a predominantly red fluorescence was noted in the HPM group of A20 IEC-KO mice.CONCLUSION Our findings suggest that HPM in treating Crohn's disease functions possibly via upregulation of the A20 expression level, resulting in downregulation of TNFR1,TRADD, and RIP1 to alleviate increased cell apoptosis in the intestinal epithelial barrier in Crohn's disease.

Extracellular signal-regulated kinase, substance P and neurokinin-1 are involved in the analgesic mechanism of herb-partitioned moxibustion

Herb-partitioned moxibustion can effectively mitigate visceral pain, a major symptom in inflammatory bowel disease, but the analgesic lnechanism is still unclear. Moreover, extracellular signal-regulated kinase, substance P, and neurokinin-1 are involved in formation of central hyperalgesia. Thus, we postulated that the analgesic effect of herb-partitioned moxibustion may be associated with these factors. Accordingly, in this study, we established an inflammatory bowel disease visceral pain model in rat by enema with a mixed solution of 5% trinitrobenzenesulfonic acid and 50% ethanol. Bilateral Tianshu （ST25） and Qihai （CV6） points were selected for herb-partitioned moxi- bustion. Our results showed that herb-partitioned moxibustion improved visceral pain and down-regulated extracellular signal-regulated kinase, substance P, and neurokinin-1 protein and mRNA expression in dorsal root ganglia. These results indicate that down-regulation of extracellular signal-regulated kinase, substance E and neurokinin-1 protein and mRNA may be a central mechanism for the analgesic effect of herb-partitioned moxibustion.

Herb-partitioned moxibustion alleviates colon injuries in ulcerative colitis rats

AIM To observe the effect of herb-partitioned moxibustion(HPM) on expression of colonic cytokines in ulcerative colitis(UC) rats.METHODS A UC rat model was established by protein immunization in combination with topical chemical stimulation.Rats in the HPM group(n = 8) received HPM at bilateral Tianshu(ST25) points.The gross injury and pathological scores of the colon were recorded.The expression profile of colonic cytokines was assayed using the protein microarray technique.Specific differential cytokines were selected and verified by ELISA.The corresponding Uni Prot Accessions of the differentially expressed cytokines were retrieved in the Uni Prot database.The pathways involved were analyzed with the help of the KEGG PATHWAY database.The DAVID database was used for functional cluster and pathway analysis.RESULTS HPM improved colon injuries in UC rats,manifested by accelerated repair of ulcers and alleviation of inflammation,and the gross injury and pathological scores both significantly decreased(P < 0.01).Fold change > 1.3 or < 0.77 was taken as the screening standard.There were 77 down-regulated and 9 up-regulated differentially expressed colonic cytokines in the HPM group compared with the model group,and expression of 20 differed significantly(P < 0.05).Twelve of the 20 significantly differentially expressed cytokines [β-catenin,interleukin-1 receptor 6(IL-1 R6),IL-1β,B7-1,nerve growth factor receptor,AMP-activated protein kinase-α1,neuropilin-2,orexin A,adipocyte differentiation-related protein,IL-2,Fas and Fas L] were up-regulated in the model group(n = 3,compared with the normal group) but downregulated in the HPM group(n = 3,compared with the model group).Functional cluster analysis showed that the differentially expressed colonic cytokines in the HPM group regulated apoptosis and protein phosphorylation.KEGG pathway analysis showed that 52 down-regulated and 7 up-regulated differentially expressed colonic cytokines in the HPM group had pathways.The pathways that interacted between the cytokines and their receptors accounted for the largest proportion(28 of the downregulated and 5 of the up-regulated cytokines).CONCLUSION HPM promotes the repair of colon injuries in UC rats,which is related to the regulation of several abnormally expressed cytokines.

Moxibustion combined with acupuncture increases tight junction protein expression in Crohn's disease patients

AIM:To investigate the effect of herb-partitioned moxibustion combined with acupuncture on the expression of intestinal epithelial tight junction(TJ) proteins.METHODS:Sixty patients diagnosed with mild to moderate Crohn’s disease(CD)were allocated into the herb-partitioned moxibustion combined with acupuncture(HMA)group(n=30)or the mesalazine(MESA)group(n=30)using a parallel control method.There were 2 sets of acupoints used alternately for HMA treatment.The following points were included in Set A:ST25(Tianshu),RN6(Qihai),and RN9(Shuifen)for herb-partitioned moxibustion and ST36(Zusanli),ST37(Shangjuxu),LI11(Quchi),and LI4(Hegu)for acupuncture.The points for Set B included BL23(Shenshu)and BL25(Dachangshu)for herb-partitioned moxibustion and EX-B2 of T6-T1(Jiajixue)fo r acupuncture.The patients received the same treatment6 times a week for 12 consecutive weeks.The MESA group received 1 g of mesalazine enteric coated tablets4 times daily for 12 consecutive weeks.Intestinaltissues were stained and examined to compare the morphological and ultrastructural changes before and after the treatment session.Immunohistochemistry and in situ hybridization assays were used to detect the expression of intestinal epithelial TJ proteins zonula occludens-1(ZO-1),occludin,and claudin-1.The m RNA levels were also evaluated.RESULTS:After the treatment,both herb-partitioned moxibustion combined with acupuncture and mesalazine improved intestinal morphology and ultrastructure of CD patients;the patients treated with HMA showed better improvement.HMA significantly increased the expression of ZO-1(P=0.000),occludin(P=0.021),and claudin-1(P=0.016).MESA significantly increased the expression of ZO-1(P=0.016)and occludin(P=0.026).However,there was no significant increase in the expression of claudin-1(P=0.935).There was no statistically significant difference between the two groups for the expression of occludin and claudin-1(P>0.05).The HMA group showed a significant improvement in ZO-1 expression compared to the MESA group(2333.34±352.51 vs 2160.38±307.08,P=0.047).HMA significantly increased the expression of ZO-1 m RNA(P=0.000),occludin m RNA(P=0.017),and claudin-1 m RNA(P=0.017).MESA significantly increased the expression of ZO-1 m RNA(P=0.000),occludin m RNA(P=0.042),and claudin-1 m RNA(P=0.041).There was no statistically significant difference between the two groups in the expression of occludin and claudin-1 m RNA(P>0.05).However,the HMA group showed a significant improvement in ZO-1 m RNA expression compared with the MESA group(2378.17±308.77 vs 2200.56±281.88,P=0.023).CONCLUSION:HMA can repair intestinal epithelial barrier lesions and relieve inflammation by upregulating the expression of TJ proteins and their m RNAs.

Effect of herb-partitioned moxibustion on dopamine levels and dopamine receptor 1 expression in the colon and central nervous system in rats with Crohn’s disease

OBJECTIVE:To observe the effect of herb-partitioned moxibustion at the Tianshu (ST 25) and Qihai (CV 6) acupoints in rats with Crohn's disease,and explore the underlying mechanism from dopamine (DA) and dopamine receptor 1 (D1 R) in the colon,spinal dorsal horn and hypothalamus.METHODS:The rats were randomly divided into the normal,model (CD),herb-partitioned moxibustion (Mox) and mesalazine (Mesa) groups.Damage in the colons was scored and observed by hematoxylin and eosin staining.DA and D1R protein expression in the colonic mucosa were detected by immunohistochemistry.The concentrations of DA and D1R in the spinal dorsal horn and hypothalamus were measured by enzyme-linked immunosorbent assay,and D1R mRNA expression was evaluated by quantitative real-time polymerase chain reaction.RESULTS:In the colon,compared with the normal group,DA,D1 R protein expressions and D1 R mRNA expression were significantly higher in the model group,while decreased in the Mox group and the Mesa group.In the spinal dorsal horn and hypothalamus,compared with the normal group,the concentrations of DA and D1 R,and the D1R mRNA expressions were significantly higher in the model group,and decreased in the Mox group and the Mesa group.CONCLUSION:Herb-partitioned moxibustion at the Tianshu (ST 25) and Qihai (CV 6) acupoints relieved ulceration in CD rats,the underlying mechanism maybe relative with the regulation of DA and D1R in the colon,spinal dorsal horn and hypothalamus by moxibustion.

背俞穴隔药灸配合天灸治疗变应性鼻炎的疗效观察

目的 观察背俞穴隔药灸配合天灸治疗变应性鼻炎的临床疗效。方法 将60例变应性鼻炎患者随机分成对照组和观察组,每组30例。对照组口服氯雷他定片,观察组采用背俞穴隔药灸配合天灸。观察两组治疗前后鼻部症状总评分(total nasal symptom score, TNSS)、鼻伴随症状总分(total non-nasal symptom score,TNNSS)、症状体征总分及鼻结膜炎生活质量调查问卷(rhino-conjunctivitis quality of life questionnaire,RQLQ)评分,并比较两组临床疗效。结果 两组治疗后TNSS、TNNSS、症状体征总分和RQLQ评分较治疗前降低(P<0.05);观察组治疗后TNSS、TNNSS、症状体征总分和RQLQ评分均低于对照组(P<0.05)。对照组总有效率为83.3%,观察组总有效率为93.3%,观察组高于对照组(P<0.05)。结论 背俞穴隔药灸配合天灸可以有效改善变应鼻炎的相关临床症状,提高变应性鼻炎患者生活质量,其疗效优于口服氯雷他定。

不同灸量隔药灸治疗原发性痛经寒凝血瘀证临床观察

目的探讨不同灸量隔药灸治疗原发性痛经寒凝血瘀证的临床效果。方法选择上饶市妇幼保健院妇科于2020年1月—2021年12月收治的原发性痛经寒凝血瘀证患者68例,根据采用的方法不同将其分为观察组(34例)与对照组(34例),观察组患者每次每穴隔药灸治4壮,对照组患者每次每穴隔药灸治8壮,确保对两组患者每个月经周期施灸7次,持续3个月,比较两组治疗前后中医证候评分、视觉模拟量表(VAS)评分、持续痛经时间。结果观察组患者临床治疗有效率为91.2%(31/34),高于对照组的73.5%(25/34),但差异无统计学意义(P>0.05)。两组患者治疗前后的VAS评分及疼痛持续时间均得到显著改善(P<0.05)。结论隔药灸可改善原发性痛经寒凝血瘀证患者的疼痛症状,缩短疼痛持续时间,有很好的疗效,而不同灸量对疗效的影响不大,文章建议应用4壮治疗。

隔药饼灸调节大鼠免疫抑制机制的转录组测序分析

背景:免疫抑制会导致机体免疫功能受损,加重病情。隔药饼灸能有效调节机体免疫功能,提高机体免疫力,但其调节机制目前仍不清楚。目的:基于转录组学的生物信息学技术对隔药饼灸干预的免疫抑制模型大鼠进行测序,探究隔药饼灸调控免疫的机制。方法:将24只SD大鼠随机分为空白组、模型组和隔药饼灸组,每组8只,模型组与隔药饼灸组采用腹腔注射环磷酰胺制备免疫抑制模型,35 mg/kg,连续3 d,造模结束后空白组与模型组不做干预,隔药饼灸组在大鼠中脘、神阙、关元及足三里穴位进行艾炷与药饼结合的隔药饼灸干预,连续10 d,1次/d,干预结束后次日取材。取各组大鼠外周血进行白细胞数量检测;采用Illumina测序平台进行RNA-seq,筛选差异基因,结合GO与KEGG数据库,对差异基因进行生物信息学相关分析。结果与结论:①与空白组比较,模型组白细胞数量显著减少(P<0.001)。②RNA-seq共筛选出模型组与空白组间差异基因3026个,其中1565个上调、1461个下调,隔药饼灸组与模型组间差异基因535个,其中280个上调、255个下调。③韦恩图分析获得模型组与空白组159个下调基因经隔药饼灸干预后上调,蛋白互作网络分析获得Oasl,Oas2,Isg15,Herc6,Mx2,Helz2,Mx1,Syk,Hspa1a及Ret等10个核心靶点;④GO与KEGG分析隔药饼灸调节机体的机制有免疫应答途径、病毒相关、血管新生和自身免疫系统等通路。⑤上述结果证实,实验筛选出隔药饼灸干预免疫抑制与Oasl,Oas2,Isg15,Herc6,Mx2,Helz2及Mx1靶点有明显关联,并且在免疫应答、病毒相关及血管新生等通路中发挥调控作用。

基于春夏养阳理论评价隔姜灸脐疗在慢性心力衰竭护理中的应用

[目的]观察隔姜灸脐疗对慢性心力衰竭患者临床症状及生活质量改善的效果。[方法]于2021年3月—2021年7月选择在中国中医科学院西苑医院心血管科住院治疗的心力衰竭患者80例,采用简单随机数字表法,分为观察组和对照组,每组各40例。对照组采用心力衰竭标准药物治疗及护理,观察组在常规治疗及护理的基础上辅以隔姜灸脐疗,每日3柱,14 d为1个疗程。比较两组心力衰竭患者心功能、血清N末端B型脑钠肽前体(NT-proBNP)水平、中医症状积分及明尼苏达心衰生活质量量表(MLHFQ)评分的改善情况。[结果]两组患者均完成研究,观察组心功能等级改善优于对照组,差异有统计学意义(P<0.05);两组患者中医证候积分均有所下降,且观察组优于对照组(P<0.05);两组患者干预后NT-proBNP水平均显著降低(P<0.05),与对照组比较,观察组治疗后血浆NT-proBNP水平明显降低(P<0.05);两组MLHFQ评分比较,与对照组比较,观察组治疗MLHFQ评分降低显著(P<0.05)。[结论]隔姜灸脐疗可有助于慢性心力衰竭患者的心功能及中医症状的改善,提高生活质量,操作简便易行,值得临床推广。

隔药灸配合中药口服治疗寒凝血瘀型原发性痛经临床观察

目的探讨隔药灸配合中药口服治疗寒凝血瘀型原发性痛经的临床效果。方法选取2020年1月—2020年12月在南昌市洪都中医院就诊的寒凝血瘀型原发性痛经患者75例,按随机数字表法将其分为西药组及中药组,西药组37例,中药组38例。西药组患者采用布洛芬治疗,中药组在西药组的基础上,使用隔姜灸的同时口服温经汤治疗。3个疗程后,观察2组患者的临床治疗效果;评估2组患者的经期疼痛程度及疼痛持续时间;检测2组患者的β-内啡肽(β-EP)及前列腺素E2(PGE2)的水平。结果3个疗程后,中药组总有效率为92.11%(35/38),高于对照组的72.97%(27/37);中药组疼痛程度低于西药组,疼痛持续时间短于西药组;中药组患者的PGE2水平低于西药组,β-EP水平高于西药组,差异均有统计学意义(P<0.05)。结论隔药灸配合中药口服治疗寒凝血瘀型原发性痛经,可在减轻患者疼痛程度的基础上,缩短患者疼痛时间,有效抑制机体疼痛介质因子的释放,临床效果显著。

“温脾涩肠方”隔药饼灸对克罗恩病的作用机制

目的:探讨隔药饼灸对克罗恩病(CD)模型大鼠的作用机制,为隔药饼灸的临床应用提供科学依据。方法:将18只雄性SD大鼠随机分为正常对照组、模型对照组和隔药饼灸组,每组6只。模型采用2,4,6-三硝基苯磺酸(TNBS)灌肠法建立,隔药饼灸组用天枢(双)和气海穴隔药饼灸治疗14 d。采用结直肠扩张刺激(CRD)检测内脏敏感性。采用逆转录PCR和蛋白质印迹法分别检测磷脂酰肌醇3激酶(PI3K)、蛋白激酶B(AKT)和哺乳动物雷帕霉素靶蛋白(mTOR)以及下游自噬相关16样蛋白1(Atg16L1)、免疫相关鸟苷三磷酸酶M蛋白(IRGM)的mRNA和蛋白表达水平。结果:与正常对照组比较,模型对照组和隔药饼灸组的内脏疼痛阈值均显著下降(P<0.001)。干预后,与模型对照组比较,隔药饼灸组内脏疼痛阈值均显著上升(P<0.01),与正常对照组比较,隔药饼灸组内脏疼痛阈值差异无统计学意义(P>0.05)。与正常对照组比较,模型对照组的PI3K、AKT、mTOR、Atg16L1、IRGM蛋白表达量及mRNA表达量均明显升高,差异有统计学意义(均P<0.01);与模型对照组比较,隔药饼灸组的PI3K、AKT、mTOR、Atg16L1、IRGM蛋白表达及mRNA表达均明显降低,差异有统计学意义(均P<0.001)。结论:隔药饼灸可通过P13K/AKT/mTOR信号通路调节CD模型大鼠结肠组织自噬,提高内脏疼痛阈值,促进大鼠结肠溃疡组织恢复正常。

浅述脾虚湿盛型泄泻中医辨治思路

脾虚湿盛型是泄泻中最常见的症型之一,就近年来相关的临床研究文献进行梳理,总结并提出新的中医辨治思路。脾虚湿盛型泄泻传统的中医内治法以健脾、渗湿为主,外治法以脐灸、穴位贴敷、灌肠等为主,而内外联合治疗是当今中医药治疗的研究热点与趋势。在临床实践中另辟蹊径,予以升阳止泻法治疗脾虚湿盛型泄泻疗效同样显著,并且发现联合应用升阳除湿法内涵组方的隔药灸脐法疗效更佳,通过使阳气升、浊气降,升降恢复有序达到止泻的效果。故提出升阳止泻法可以用于治疗脾虚湿盛型泄泻,升阳止泻法不但是内服中药组方用药的法则,而且还是隔药灸脐法的核心,临床疗效显著。基于此,阐述升阳止泻法的内涵及病机,并结合临床经验来论证其有效性,为脾虚湿盛型泄泻的中医治疗提供了一个新思路。

隔药灸配合药物防治宫颈癌患者化疗后骨髓抑制的临床研究

目的观察隔药灸配合固髓生血汤对脾肾阳虚型宫颈癌患者紫杉醇联合顺铂(paclitaxel-cisplatin,TP)化疗后骨髓抑制的防治效果及其对Notch信号通路蛋白的影响。方法将74例脾肾阳虚型宫颈癌患者随机分为观察组和对照组,每组37例。两组均接受TP化疗,对照组采用常规骨髓抑制防治方案,观察组采用隔药灸配合固髓生血汤防治骨髓抑制。观察两组治疗前后各项中医证候积分、骨髓抑制发生率、血常规各项指标[血红蛋白(hemoglobins,Hb)、白细胞(white blood cell,WBC)、血小板(platelet,PLT)、中性粒细胞比例(neutrophil percentage,NEUT%)水平]及Notch信号通路相关蛋白(Jagl、Notch2、Numb1、Nubm2)水平的变化情况,比较两组治疗后不良反应发生率。结果与同组治疗前比较,两组治疗1个周期后各项中医证候积分均显著增加(P<0.05),各项血常规指标及Numb1、Numb2水平均显著降低(P<0.05),Notch2、Jag1水平均显著升高(P<0.05)。治疗2个周期后,两组各项中医证候积分均较同组治疗1个周期后显著降低(P<0.05);各项血常规指标均较同组治疗1个周期后显著增加(P<0.05),但仍低于同组治疗前(P<0.05);Notch2、Jag1水平均较同组治疗1个周期后显著降低(P<0.05),但仍高于同组治疗前(P<0.05);Numb1、Numb2水平均较同组治疗1个周期后显著升高(P<0.05),但仍低于同组治疗前(P<0.05)。观察组治疗1、2个周期后各项中医证候积分、骨髓抑制发生率、消化道反应发生率及Notch2、Jag1水平均明显低于对照组,各项血常规指标及Numb1、Numb2水平均明显高于对照组,差异均具有统计学意义(P<0.05)。两组肝、肾功能损害发生率比较,差异均无统计学意义(P>0.05)。结论隔药灸配合固髓生血汤能减轻脾肾阳虚型宫颈癌患者TP化疗后骨髓抑制症状,改善血常规,且有助于降低消化道反应发生率,其作用机制可能与调节Notch信号通路有关。

艾灸对高血压患者血压控制效果的网状Meta分析

目的 通过文献分析,探究艾灸在改善高血压患者症状及血压控制中的应用效果。方法 检索PubMed、Cochrane Library、Embase、FMRS、中国知网、万方数据库中关于艾灸在高血压患者中应用的随机对照研究,检索时间为2000年1月1日至2022年3月31日。经文献筛选、资料提取及质量评价后,应用ADDIS 1.16.8软件进行贝叶斯网状Meta分析。结果 纳入文献20篇,共1 650例患者,其中观察组样本量845例,对照组805例,涉及6种艾灸方法。网状Meta分析结果显示,在西药治疗的基础上,各种艾灸的症状疗效从高到低依次为:热敏灸>隔药灸>温灸(均OR<1,P<0.05),降压效果从高到低依次为:温灸联合子午流注>热敏灸>隔药灸(均OR<1,P<0.05)。结论 在西医药物干预的基础上实施艾灸,特别是温灸联合子午流注、热敏灸及隔药灸,在高血压患者中具有更佳疗效。

通元针法联合隔药脐灸治疗绝经后女性遗忘型轻度认知功能障碍

【目的】观察通元针法联合隔药脐灸治疗绝经后女性遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,aMCI)患者的临床疗效。【方法】将60例绝经后女性肾虚髓减型aMCI患者随机分为观察组和对照组,每组各30例。观察组给予通元针法联合隔药脐灸治疗,对照组给予普通针刺治疗,隔日治疗1次,连续治疗8周。观察2组患者治疗前后中医证候积分、简易精神状态检查量表(MMSE)及其瞬时记忆部分评分、蒙特利尔认知评估量表(MoCA)及其延迟回忆部分评分、华山版听觉语言学习测验(AVLT-H)及其长延迟回忆评分的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗8周后,观察组的总有效率为86.67%(26/30),对照组为63.33%(19/30),组间比较(秩和检验),观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的MMSE及其瞬时记忆部分评分、MoCA及其延迟回忆部分评分、AVLT-H及其长延迟回忆评分均较治疗前明显提高(P<0.01),中医证候积分均较治疗前明显降低(P<0.01);组间比较,观察组对MMSE及其瞬时记忆部分评分、MoCA及其延迟回忆部分评分、AVLT-H及其长延迟回忆评分的提高幅度以及对中医证候积分的降低幅度均明显优于对照组(P<0.05或P<0.01)。【结论】通元针法联合隔药脐灸可有效治疗绝经后女性肾虚髓减型aMCI患者,其疗效优于普通针刺治疗。

隔药灸联合调胃承气汤对脾虚湿困型糖尿病胃轻瘫疗效观察

目的观察隔药灸联合调胃承气汤治疗脾虚湿困型糖尿病胃轻瘫的临床疗效。方法将94例脾虚湿困型糖尿病胃轻瘫患者随机分为治疗组和对照组,每组47例。治疗组采用隔药灸联合调胃承气汤治疗,对照组采用单纯调胃承气汤治疗。检测两组治疗前后胃泌素-17(gastrin-17,G-17)、生长素释放肽(ghrelin)、血管活性肠肽(vasoactive intestinal peptide,VIP)、胃动素(motilin,MTL)、胆囊收缩素(cholecystokinin,CCK)、胃蛋白酶原(pepsinogen,PG)Ⅰ、PGⅡ、空腹血糖(fasting plasma glucose,FPG)、丙二醛(malondialdehyde,MDA)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、超氧化物歧化酶(superoxide dismutase,SOD)和活性氧(reactive oxygen species,ROS)水平,测量患者胃窦收缩幅度、胃窦收缩频率和胃排空率,给予患者胃轻瘫主要症状指数(gastroparesis cardinal symptom index,GCSI)、尼平消化不良生活质量指数(Nepean dyspepsia life quality index,NDLQI)及症状指数(Nepean dyspepsia symptom index,NDSI)评价,观察两组患者临床疗效。结果两组治疗后VIP、CCK、ROS、MDA、FPG水平及GCSI、NDSI评分均较同组治疗前显著下降,G-17、ghrelin、MTL、PGⅠ、PGⅡ、SOD、GSH-Px水平及NDLQI评分均显著上升,胃窦收缩幅度、胃窦收缩频率、胃排空率均较同组治疗前显著升高,差异均具有统计学意义(P<0.05)。治疗组治疗后VIP、CCK、ROS、MDA、FPG水平及GCSI、NDSI评分明显低于对照组,G-17、ghrelin、MTL、PGⅠ、PGⅡ、SOD和GSH-Px水平及胃窦收缩幅度、胃窦收缩频率、胃排空率和NDLQI评分均明显高于对照组,差异均具有统计学意义(P<0.05)。治疗组总有效率为95.7%,明显高于对照组的83.0%(P<0.05)。结论隔药灸联合调胃承气汤对脾虚湿困型糖尿病胃轻瘫疗效确切,可提升患者胃动力,改善胃黏膜功能,降低氧化应激及血糖水平,促进胃肠收缩,改善其临床症状和生活质量。

酸枣仁汤加味联合隔药灸对阴虚火旺证失眠的疗效及睡眠质量、生活质量的影响

目的探讨酸枣仁汤加味联合隔药灸对阴虚火旺证失眠的疗效及睡眠质量、生活质量的影响。方法随机选取2020年5月—2022年3月福建省泉州市正骨医院收治的阴虚火旺证失眠患者80例为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组接受常规西药治疗,观察组接受酸枣仁汤加味联合隔药灸治疗。比较两组患者疗效、β-内啡肽(β-EP)、5-羟吲哚乙酸(5-HIAA)、5-羟色胺(5-HT)、睡眠质量、生活质量、不良反应情况。结果观察组总有效率高于对照组(95.00%vs 75.00%),差异有统计学意义(χ^(2)=6.274,P<0.05)。治疗前,两组β-EP、5-HIAA、5-HT指标比较,差异无统计学意义(P>0.05);治疗后,与对照组相比,观察组β-EP、5-HT水平更高,5-HIAA水平更低,差异有统计学意义(P<0.05)。治疗前,两组PSQI评分、SRSS评分、SF-36评分比较,差异无统计学意义(P>0.05);治疗后,与对照组相比,观察组PSQI评分、SRSS评分更低,SF-36评分更高,差异有统计学意义(P<0.05)。两组不良反应发生率比较(5.00%vs 7.50%),差异无统计学意义(P>0.05)。结论临床治疗阴虚火旺证失眠患者可应用酸枣仁汤加味联合隔药灸治疗,以更好地改善机体β-EP、5-HIAA、5-HT指标,提升睡眠和生活质量,安全高效。

当归四逆汤化裁联合隔药饼灸对子宫内膜异位症患者炎症因子的影响

目的 研究当归四逆汤化裁联合隔药饼灸对子宫内膜异位症患者炎症因子的影响。方法 方便选取2021年5月—2022年6月于泉州市中医院收治的子宫内膜异位症患者146例为研究对象,根据随机数表法将其分为对照组和研究组,各73例。其中对照组给予当归四逆汤化裁治疗,研究组在对照组的基础上采用隔药饼灸的方法治疗。比较两组临床疗效、中医证候积分、炎症因子水平、血清糖类抗原125(carbohydrate antigen 125,CA125)以及临床有效率。结果 治疗后研究组炎症因子水平、CA125水平均低于对照组,差异有统计学意义(P<0.05);治疗后研究组中医证候积分低于对照组,差异有统计学意义(P<0.05)。研究组临床疗效总有效率为93.15%,高于对照组的79.45%,差异有统计学意义(χ^(2)=5.794,P<0.05)。结论 当归四逆汤化裁联合隔药饼灸治疗子宫内膜异位症能够有效减轻患者的临床症状,降低其炎症反应,具有较高的临床效果。

隔药灸对慢性炎性内脏痛大鼠mTOR-4E-BP1/S6RP信号通路的调控作用

目的:从mTOR-4E-BP1/S6RP信号通路角度,探讨隔药灸治疗慢性炎性内脏痛的中枢机制。方法:将雄性SD(Sprague Dawley)大鼠随机分为正常组、模型组、隔药灸组、mTOR抑制剂组。采用TNBS合50%乙醇灌肠的方法制备CIVP大鼠模型。隔药灸组采用隔附子饼灸“天枢”(双侧)“气海”;mTOR抑制剂组在L5~L6间鞘内注射雷帕霉素。采用腹壁撤回反射评分(Abdominal Withdrawal Reflex,AWR评分)观察各组大鼠痛行为变化;采用Western Blotting及RT-qPCR技术检测各组大鼠脊髓mTOR、4E-BP1、S6RP磷酸化蛋白及mRNA表达。结果:与正常组比较,模型组大鼠AWR评分在各个压力梯度下均明显升高(均P<0.01);脊髓mTOR、4EBP1、S6RP磷酸化蛋白及mRNA表达均明显增高(P<0.01或P<0.05)。与模型组比较,隔药灸组及mTOR抑制剂组大鼠经干预治疗后,AWR评分均显著下降(P<0.01,P<0.05);脊髓mTOR、4EBP1、S6RP磷酸化蛋白及mRNA表达均明显降低(P<0.01,P<0.05)。隔药灸组AWR评分、脊髓mTOR、4EBP1、S6RP磷酸化蛋白及mRNA表达与mTOR抑制剂组比较差异均无统计学意义(P>0.05)。结论:隔药灸能显著下调慢性炎性内脏痛大鼠脊髓mTOR、4E-BP1、S6RP的磷酸化蛋白和mRNA表达水平,抑制mTOR-4E-BP1/S6RP信号通路的过度激活,这可能是隔药灸发挥镇痛作用的重要中枢机制之一。

基于AMPK-ERK/mTOR信号通路探讨隔药灸对慢性炎性内脏痛大鼠的镇痛机制

目的:从腺苷酸活化蛋白激酶(AMP-activated Protein Kinase,AMPK)-细胞外信号调节激酶(Extracellular Signalregulated Kinase,ERK)/雷帕霉素靶蛋白(Mechanistic Target of Rapamycin,mTOR)信号通路角度,探讨隔药灸治疗慢性炎性内脏痛(Chronic Inflammatory Visceral Pain,CIVP)的中枢机制。方法:将雄性SD大鼠随机分为正常组、模型组、隔药灸组、AMPK激活剂组。采用三硝基苯磺酸(Trinitrobenzene Sulfonic Acid,TNBS)合50%乙醇溶液灌肠的方法制备CIVP大鼠模型。隔药灸组采用隔附子饼灸天枢穴(双侧)、气海穴进行治疗;AMPK激活剂组在L5~L6间鞘内注AMPK激活剂ATCAR。采用腹壁撤回反射(Abdominal Withdrawal Reflex,AWR)评分观察各组大鼠痛行为变化;采用蛋白质印迹法(Western Blotting,WB)及实时荧光定量(Real Time Quantitative,RT-q PCR)技术检测各组大鼠脊髓磷酸化AMPK(p-AMPK)、磷酸化ERK(p-ERK)、磷酸化mTOR(p-mTOR)蛋白及m RNA表达。结果:与正常组比较,模型组大鼠AWR评分在各个压力梯度下均明显升高(均P <0.01);脊髓p-AMPK蛋白及m RNA表达均明显降低(均P <0.01);脊髓p-ERK、p-mTOR蛋白及m RNA表达均明显增高(均P <0.01)。与模型组比较,隔药灸组及AMPK激活剂组大鼠经干预治疗后,AWR评分均显著下降(P <0.01,P <0.05);脊髓p-AMPK蛋白及m RNA表达均明显升高(均P <0.01);脊髓p-ERK、p-mTOR蛋白及m RNA表达均明显降低(P <0.01)。与AMPK激活剂组比较,隔药灸组AWR评分和脊髓p-AMPK、p-ERK、p-mTOR蛋白及m RNA表达差异均无统计学意义(P> 0.05)。结论:隔药灸能显著提高CIVP大鼠脊髓p-AMPK蛋白和m RNA表达水平,抑制AMPK下游p-ERK、p-mTOR蛋白及m RNA表达,进而抑制ERK及mTOR的过度激活,这可能是隔药灸发挥镇痛作用的重要中枢机制之一。