Regulative Effects of Auricular Acupuncture,Moxibustion and Chinese Herbs on Immunologic Function in the D-Galactose-induced Aging Mouse

Objective:To observe the regulative effect of auricular acupuncture, moxibustion and Chinese herbs on immunologic function in the D-galactose-induced aging mouse and to probe the feasibility and possible mechanisms for delaying aging, so as to provide experimental basis for acupuncture, moxibustion and Chinese herbs for delaying aging. Methods: Aging mouse model was established by subcutaneous injection of D-galactose, and treated by auricular acupuncture, auricular acupuncture plus moxibustion, and auricular acupuncture plus Chinese herbs respectively for 6 weeks and then serum interleukin-2 (IL-2) and IL-6 contents and splenic lymphocyte transformation rate were compared among the groups. Results: Compared with the young group, the serum IL-2 level and the splenic lymphocyte transformation rate significantly decreased and the IL-6 level significantly increased in the aging mouse. After treatment by auricular acupuncture, auricular acupuncture plus Chinese herbs, especially auricular acupuncture plus moxibustion, the serum IL-2 level and the splenic lymphocyte transformation rate significantly increased, and the IL-6 level significantly decreased as compared with the model group. Conclusions: Combined application of auricular acupuncture, moxibustion and Chinese herbs can improve the decline or dysfunction of immunological function in the aging organism to a certain extent.

Clinical Research on Treatment of Migraine with Combination of Characteristic and Superior Techniques of Zhuang Medicine

Objective:To study the application effect of the combination of special advantages of Zhuang medical technology for migraine patients.Methods:80 patients with migraine were selected and all were admitted to Mingxiu Branch of International Zhuang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from February 2019 to February 2020.Random number table method was used to divide patients into two groups,with 40 patients in each group.Among them,the patients in the study group were treated with the therapy combining characteristics of Zhuang medicine and superior technology,that is,Zhuang medicine meridian tendon therapy+Zhuang medicine lotus needle cupping blood stasis removal therapy+Zhuang medicine thread moxibustion therapy+Zhuang medicine acupuncture therapy;the patients in the control group were treated with conventional Western medicine.The efficacy of the two treatments were compared.Results:After treatment,the total effective rate of clinical treatment in the study group was higher than that in the control group(P<0.05),and the visual analogue scale(VAS)score and integral improvement rate were higher than those in the control group(P<0.05).The onset time of action was statistically shorter than that of the control group(P<0.05).There was a statistically significant difference in the adverse reaction rate between the two groups(P<0.05).Conclusion:The combination of Zhuang medicine’s characteristic and superior techniques for patients with migraine has a significant curative effect.

柳国斌教授从“寒凝血瘀”论治血栓闭塞性脉管炎的经验

本文对柳国斌教授治疗血栓闭塞性脉管炎的学术思想进行总结。柳教授提出阳虚寒凝是血栓闭塞性脉管炎的始动病机,而后形成瘀血、脉络闭阻等病理环节,故将本病的病机概括为“寒凝经脉,瘀血阻络”,其提出以“温经散寒,活血通络”为治疗法则,遣方用药注重扶阳,认为机体的阳气充足后,气血得以运行顺畅,瘀血等病理因素随之消散。柳教授强调只有抓住病机才能抓住治疗的关键,在复杂的疾病中找出矛盾所在,才能取得良效。现将柳教授临证经验总结如下,并附验案1则,为治疗血栓闭塞性脉管炎提供思路。

王济华治疗风湿病经验

王济华教授认为,风湿病的基本病机为人体阴阳失调,正气亏虚,外感风寒湿邪,表邪入里郁而化热,导致痹阻关节、肌肉、筋骨,病情日久多见肝肾不足、气血亏虚、脾虚湿胜、痰瘀交阻等。王教授治疗风湿病常个体化分辨患者风寒湿之偏重、阴阳气血之盛衰,遵循轻微解表发汗,兼顾温经止痛,重视健脾化湿、热痹当清、调补气血、虫类药化瘀剔络、滋补肝肾等治痹要点,组方精妙、配伍严谨、疗效肯定,可有效缓解关节炎症,减轻症状,改善患者生活质量。王济华教授强调,对于沉寒痼冷痹阻络脉,一般温药不能奏效,必用附子、乌头之品,用药时需要注重辨证准确、炮制方法得当、用量适度,且需在正确配伍的前提下间断运用,密切观察,以防蓄积中毒,而达到增效减毒的目的。

管氏针灸学术流派伤科用药规律分析

目的:系统梳理管氏针灸学术流派伤科用药规律,为流派传承及临床用药提供依据。方法:将《管氏常用中医处方与遣药圭臬》所载管氏第二代名医管庆鑫的伤科经验方分别归类并建立数据库,通过Excel进行频数统计,JAVA及Gephi软件进行可视化分析,挖掘管氏针灸学术流派伤科用药规律。结果:管氏伤科经验方共71首,其中内服方66首(含4首小方)、外用方5首。使用药物共139味,使用频次802次,使用频次10的常用药共有26味,使用关联频次≥10的药对组合54对,前5位的依次是乳香与没药、当归与红花、当归与没药、当归与乳香、当归与桃仁。在药物属性中,温、平、寒及辛、苦、甘药常用,归经前三位依次为肝经、心经、脾经。结论:管氏针灸学术流派伤科用药以活血化瘀药为主,佐以补虚药、理气药、清热药或温里药。

艾灸对原发性痛经寒凝血瘀证患者小肠经热学特性的影响

目的:基于红外热成像技术探究原发性痛经寒凝血瘀证患者小肠经相关经穴的热学特性,以及艾灸关元穴对其热学特性的影响。方法:选取原发性痛经寒凝血瘀证患者21例(痛经组)及正常女性21名(正常组)。在月经来潮的第1~3天,采用红外热成像仪检测两组受试者小肠经相关经穴(腕骨、养老、小海、肩贞、臑俞、关元)的红外辐射温度,比较两组的红外温度变化;痛经组在关元穴进行单次30 min的艾灸治疗,比较艾灸前后痛经组患者小肠经相关经穴的温度变化及腹痛视觉模拟评分法(VAS)评分。结果:与正常组比较,痛经组患者关元、双侧养老、左侧小海、左侧肩贞、双侧臑俞红外温度均降低(P<0.05);与艾灸前比较,痛经组患者艾灸后腹痛VAS分值降低(P<0.05),痛经组患者关元、双侧腕骨、养老、小海、肩贞、臑俞红外温度增高(P<0.05)。结论:原发性痛经寒凝血瘀证患者小肠经穴位的红外温度低于正常女性,验证了小肠经与胞宫的特异性联系。原发性痛经寒凝血瘀证患者艾灸后肠经穴位温度显著升高,提示小肠经温度升高可能是艾灸关元穴疗效的经络效应机制之一。

针灸治疗血管性痴呆及对患者血液流变学与血清炎性因子的影响

目的:观察针灸治疗对血管性痴呆(VD)患者的临床疗效及对血液流变学、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)水平的影响。方法:收集确诊VD的患者90例,随机分为针刺组(辨经刺井针治疗)、艾灸组(化瘀通络灸治疗)及针灸组(辨经刺井结合化瘀通络灸治疗),每组各30例。3组患者均予以基础药物及康复训练、普通针刺治疗,每周6次,疗程8周。分别在治疗前、治疗8周后当天观察各组简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)及血液流变学、血清IL-1β、IL-10水平的变化。结果:与治疗前比较,3组患者MMSE、MoCA及ADL量表的评分均升高(P<0.05);全血高切黏度、全血低切黏度、血浆黏度水平及血清IL-1β水平均降低(P<0.05),而IL-10水平差异无统计学意义(P>0.05);与针刺组比较,艾灸组治疗后各指标无明显差异,针灸组治疗后各指标均有明显差异(P<0.05);与艾灸组相比,针灸组治疗后MMSE及ADL评分明显升高(P<0.05),全血高切黏度、全血低切黏度、血浆黏度水平及IL-1β水平明显下降(P<0.05)。结论:针灸结合治疗VD疗效肯定,能有效改善VD患者智能缺损、认知障碍及日常生活能力,其作用机制可能与调节血液流变学,减轻神经细胞炎性损伤有关。

温经通络推拿法联合温针灸治疗瘀血阻滞型腰椎间盘突出症临床研究

目的:观察温经通络推拿法联合温针灸治疗瘀血阻滞型腰椎间盘突出症(LDH)的疗效。方法:选取112例瘀血阻滞型LDH患者,按随机数字表法分为观察组及对照组各56例,经过剔除,最终2组各纳入54例。对照组给予温针灸治疗,观察组给予温经通络推拿法联合温针灸治疗。比较2组临床疗效,比较2组治疗前后腰椎功能[Oswestry功能障碍指数(ODI)、腰椎功能评估(JOA)]、疼痛程度[疼痛视觉模拟评分法(VAS)]、腰椎活动度及血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平的变化。结果:观察组、对照组临床疗效总有效率分别为96.30%、85.19%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组JOA评分均较治疗前上升(P<0.05),ODI评分、VAS评分均较治疗前下降(P<0.05);观察组JOA评分高于对照组(P<0.05),ODI、VAS评分均低于对照组(P<0.05)。治疗后,2组腰椎屈伸、侧屈及旋转活动度均较治疗前增大(P<0.05),观察组上述3项活动度均大于对照组(P<0.05)。治疗后,2组IL-6、TNF-α水平均较治疗前下降(P<0.05),观察组上述2项水平均低于对照组(P<0.05)。结论:温经通络推拿法联合温针灸治疗瘀血阻滞型LDH疗效确切,可有效缓解疼痛程度,改善腰椎功能及腰椎活动度,减轻炎症反应。

基于“治痿独取阳明”运用外治法治疗桡神经损伤的临证体会

[目的]阐发基于“治痿独取阳明”运用外治法治疗桡神经损伤的体会。[方法]立足桡神经损伤的症状表现,探析其病因病机,并深入分析“治痿独取阳明”的内涵,以经典条文为指导,阐发运用外治法治疗桡神经损伤的策略,并举典型医案进行论证。[结果]桡神经损伤的成因不外乎虚实,虚证包括脾胃虚衰、肝肾亏虚,实证包括湿热、瘀血、痰浊阻滞,易发为虚实夹杂证。“治痿独取阳明”非独专注脾胃,同时也并非一味补益脾胃之虚,而是重视以调理脾胃为核心,辨别虚实,兼顾五脏,以疏通和补益气血为根本。在“治痿独取阳明”指导下的外治策略可总结为“针灸治病,重取阳明”“穴位按摩,推行气血”“中药外用,活血通络”“康复锻炼,辅以理疗”“中西并举,效捷为要”,临床上诸多手段灵活配合,能够收获显著效果。所举医案中,患者因车祸损伤桡神经而发病,辨为瘀血阻滞之痿证,治以活血化瘀、通络止痛,综合运用针刺、推拿以及中药熏洗等手段,治疗1月患者手腕活动自如,收效显著。[结论]“治痿独取阳明”非独补益脾胃之虚,而是重在畅达阳明气血,使得气机和调,生化正常。该理论开创了从活血化瘀角度论治桡神经损伤的思路,重视发挥针刺、推拿及中药熏洗等外治法的优势。

督脉铺灸治疗寒凝血瘀型产后身痛的临床疗效

目的探讨督脉铺灸治疗寒凝血瘀型产后身痛的临床疗效。方法选取2019年6月至2021年6月海安市中医院收治的92例寒凝血瘀型产后身痛患者作为研究对象,随机分为对照组与观察组,各46例。对照组给予常规针刺治疗,观察组给予督脉铺灸药物治疗。比较两组临床疗效及治疗前后疼痛程度、症状量化积分。结果观察组治疗总有效率为97.83%,高于对照组82.61%,差异有统计学意义(P<0.05);治疗21d后,观察组疼痛程度轻于对照组,差异有统计学意义(P<0.05);治疗21d后,观察组麻木、不利、头晕评分及总分均低于对照组,差异有统计学意义(P<0.05),两组肢酸、乏力、心悸、面萎评分比较差异无统计学意义。结论督脉铺灸治疗寒凝血瘀型产后身痛疗效显著,可有效缓解患者疼痛,减轻临床症状。

足三阴经循经灸法治疗踝部骨折术后血瘀气滞型患者夜间肿痛临床观察

目的探讨足三阴经循经灸法治疗踝部骨折术后血瘀气滞型患者夜间肿痛的疗效和机制。方法选取2020年12月—2022年5月在深圳平乐骨伤科医院康复科住院收治的踝部骨折术后血瘀气滞型患者80例,采用随机数字表法分为对照组和观察组,每组40例。对照组给予骨折术后常规康复治疗,观察组在对照组基础上给予足三阴经循经灸法治疗。2组患者均治疗1周。比较2组患者治疗前后VAS、关节肿胀评价量表、PSQI、SAS、SDS评分。结果2组患者治疗前VAS、关节肿胀评价量表、PSQI、SAS、SDS评分比较,差异无统计学意义(P>0.05);治疗后,观察组VAS、关节肿胀评价量表、PSQI、SAS、SDS低于对照组,差异有统计学意义(P<0.05)。结论足三阴经循经灸法可缓解踝部骨折术后血瘀气滞型患者肿痛,尤其是缓解了夜间疼痛不适的症状,改善了睡眠,提高了康复效率和质量。

近10年中医辨治胃癌前病变的研究进展

对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治PLGC具有一定的优势。PLGC主要可分为脾胃虚弱证、脾胃湿热证、肝胃气滞证、胃络瘀阻证、胃阴不足证5种证型。胃镜技术的普及促进了胃病微观辨证的发展,微观辨证与宏观辨证的结合为PLGC的中医辨证论治提供了更加丰富的理论支持。PLGC根本病机为脾胃虚弱,脾胃气机不畅,兼有湿热、瘀毒、痰湿等病理因素蕴结,日久胃阴亏耗。中药治疗PLGC的临床研究开展较多,治疗主要采用以益气健脾为主,兼以疏肝活血、化湿消瘀、化瘀解毒、养阴益胃,从而防止PLGC向胃癌进一步发展。针灸治疗胃癌前病变的研究开展较少。今后需开展更多严格且规范的多中心、大样本的临床随机对照试验,深入研究针灸治疗胃癌前病变机制,以期为中医辨治PLGC提供更多高级别的循证依据。

固元灸在慢性肾脏病中应用的临床研究进展

以固元灸为中心,从其调补气血、温补肾阳、清热利湿、活血化瘀等方面阐述了固元灸在慢性肾脏病病人中的应用,以期为改善慢性肾脏病病人精神状态、提升生活品质提供新的治疗思路,为扩大固元灸在临床中的应用提供参考。

Effects of different directions of moxibustion therapy on hemorheology in rats with blood stasis due to cold retention

Objective： To investigate the effects of different directions of moxibustion therapy on hemorheology in rat models with blood stasis due to cold retention. Methods： A total of 32 Wistar rats were randomly divided into 4 groups, based on the random digits table, including a normal group, a model group, a moxibustion along the meridian group, and a moxibustion against the meridian group, with 8 rats in each group. Except the normal group, the other 3 groups were used to make the rat models with blood stasis due to cold retention. Rats in the moxibustion along and against the meridian groups accepted moxibustion therapy in different directions on the trunk segment of the Bladder Meridian after successful modeling. Moxibustion for 10 min every day, and 7 d as a course of treatment. Two courses of treatment（a total of 14 d） were carried out. Quantitative score of signs and symptoms change was observed once a week, with a total of 7 times. Hemorheological indexes of rats were detected when the treatment finished. Results： The quantitative scores of signs and symptoms in the model, moxibustion along the meridian and against the meridian groups were significantly higher than those in the normal group after modeling（P〈0.05）. When the treatment finished, the quantitative score of signs and symptoms in the model group was significantly higher than that in the normal group（P〈0.05）; the quantitative scores of signs and symptoms of rats in the moxibustion along and against the meridian groups were significantly lower than that in the model group（P〈0.05）; the quantitative score of signs and symptoms in the moxibustion along the meridian group was significantly lower than that in the moxibustion against the meridian group（P〈0.05）; the whole blood viscosity and erythrocyte aggregation index in the model group were significantly higher than those in the normal group（P〈0.05）, however the increases of erythrocyte hematocrit and erythrocyte sedimentation rate were not obvious（P〈0.05）; whole blood viscosity and erythrocyte aggregation index in the moxibustion along and against the meridian groups were significantly lower than those in the model group（P〈0.05）, while there were no statistically significant differences between the moxibustion along the meridian group and moxibustion against the meridian group（P〈0.05）. Conclusion： Moxibustion along and against the meridian both showed different degrees of improvement for hemorrheology and symptoms of blood stasis due to cold retention. Improvement for symptoms of blood stasis due to cold retention was better in the moxibustion along the meridian group than that in the moxibustion against the meridian group. The influence on rat hemorrheology showed no significant difference between moxibustion along the meridian and moxibustion against the meridian.

黄健玲治疗输卵管阻塞性不孕用药规律的数据挖掘分析

【目的】运用数据挖掘方法分析广东省名中医黄健玲教授治疗输卵管阻塞性不孕的组方用药规律。【方法】收集整理黄健玲教授在广东省中医院诊治的输卵管阻塞性不孕患者的有效病例的处方资料,基于中医传承辅助平台(V2.5版)系统,采用频次分析、关联规则分析、聚类分析等数据挖掘方法分析黄健玲教授治疗输卵管阻塞性不孕的组方用药规律。【结果】纳入的110例患者的231首处方中,涉及中药66味;用药频次居前10位的药物为桑寄生、白术、菟丝子、茯苓、丹参、赤芍、毛冬青、路路通、太子参、牡丹皮;药物功效分类以补虚药、清热药、活血祛瘀药为主;药性以平、寒为主,药味以苦、甘为主,多归肝、肾、脾经。关联规则分析结果得到核心药物组合为8个;聚类分析结果得到新方组合5个。【结论】黄健玲教授认为输卵管性不孕症病机特点为虚实夹杂,瘀阻胞络;治疗原则当活血化瘀通络,同时重视补肾健脾。

卢敏教授从“虚、瘀、毒”论治股骨头缺血性坏死的经验

股骨头缺血性坏死属于中医学“骨蚀”“骨痿”“骨痹”“髋骨痹”范畴。卢敏教授认为股骨头缺血性坏死病机为本虚标实,其特点为“虚、瘀、毒”并存,故在临证时多注重扶正固本,卫外解毒,活血化瘀,通络止痛。卢敏教授针对股骨头缺血性坏死的不同伴随症状,采取不同的康复策略,予以个体化治疗,改善肢体的活动功能,缓解疾病症状,延缓疾病进展,对于提高患者的生活质量起到积极作用。

筋骨止痛膏联合化瘀通络灸治疗气滞血瘀型膝原发性骨关节炎的临床观察

目的探讨自拟筋骨止痛膏联合化瘀通络灸治疗膝原发性骨关节炎(气滞血瘀型)的临床疗效。方法将68例符合纳入标准的膝原发性骨关节患者按照随机数字法分为观察组和西药组,各34例。西药组给予药物消炎止痛联合玻璃酸钠注射液关节腔注射,观察组采用自拟筋骨止痛膏联合化瘀通络灸疗法,每周治疗6次,连续2周。分别在治疗前、治疗后当天以及疗程结束后1个月随访观察两组患者的WOMAC骨关节量表、步行测试以及炎性指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和不良反应发生率。结果观察组总有效率96.7%,优于西药组总有效率的86.7%(P<0.05);与治疗前比较,两组患者在治疗后及随访时的膝关节疼痛评分、TNF-α及IL-6炎性指标较前均有所改善(P<0.05,P<0.01);与西药组比较:观察组治疗后及治疗后1个月随访时的WOMAC骨关节量表评分、相关炎性指标均较前显著改善(P<0.01);观察组的不良反应发生率(5.88%)与西药组不良反应发生率(14.70%)相比,差异无统计学意义(P>0.05)。结论筋骨止痛膏联合化瘀通络灸能有效减少气滞血瘀型膝原发性骨关节炎患者关节腔积液及炎性指标含量,改善膝关节活动度、减轻疼痛,治疗安全有效,疗效优于单纯使用西药治疗。

国家专利数据库中骨关节炎外用方的用药规律探讨

【目的】基于国家知识产权局的专利检索及分析系统(http://pss-system.cnipa.gov.cn),分析专利中药外用方治疗骨关节炎(osteoarthritis,OA)的用药规律。【方法】以“骨关节炎”“中药”为关键词,检索专利数据库从建库至2022年12月公布的治疗OA的专利复方,并筛选出外用复方,运用古今医案云平台对外用复方进行药物的频次统计、性味归经分析、聚类分析及复杂网络分析。【结果】共纳入治疗OA的中药外用复方专利72项,涉及药物284味,用药频次居前的药物有牛膝、威灵仙、红花、当归等。药性以温为主,药味以辛、苦、甘味为主,药物多归肝、脾、肾经,药物具有祛风除湿、强筋骨、补肝肾、温经通络止痛等功效。药物配伍以牛膝-川芎、威灵仙-牛膝、当归-红花、羌活-独活的出现频次较高;聚类分析结果得到祛风除湿止痛类、补肝肾强筋骨类、活血温经通络类3个聚类;复杂网络分析得到的核心药物组合为威灵仙、牛膝、川芎、独活、羌活、红花、当归、乳香、没药。【结论】专利外用复方治疗OA以辛温药为主,从肝、脾、肾三脏同治,以祛风除湿止痛、活血温经通络等药物治其标,以补肝肾强筋骨类药物治其本,核心药物与祛风越痹酒(白术、当归、杜仲、牛膝、防风、苍术、川芎、羌活、红花、桂枝、威灵仙)的药物组成的相似度较高。

廖慧慧运用加味脱花煎治疗现代妇科疾病的经验

脱花煎来源于《景岳全书》,由当归、川芎、红花、肉桂、牛膝、车前子组成,具有温通化瘀、祛瘀下胎之效。加味脱花煎为古方脱花煎去红花,加益母草、生蒲黄、黄芪、卷柏、枳壳、三棱、莪术而成。廖慧慧教授认为,瘀血停滞胞宫是现代妇科疾病中多种月经病、妊娠病的某一阶段病机之根本,故基于该病机,结合“急则治其标”的治疗原则,提出运用加味脱花煎治疗异常子宫出血、不全流产、子宫内膜息肉等现代妇科疾病,以温通活血、行气逐瘀,临床常获良效,可为现代妇科疾病的临床治疗提供参考。

中医活血化瘀配合针灸治疗广泛性焦虑的临床心得

广泛性焦虑症(GAD),也称慢性焦虑症,是最常见的焦虑症表现形式。随着社会的发展和工作节奏的加快,人们越来越感到人际关系紧张、经济压力加大,导致精神疾病的发病率逐年上升。焦虑症又称焦虑性神经症,是一种由频繁且逐步加强的压力或意外发作引起的精神障碍,根据临床表现分为GAD和恐慌症(PD)。GAD患者反复就诊,重复不必要甚至不准确的诊断和治疗,用药后产生的不良反应不断加重患者的痛苦,影响患者的生活质量和人类社会的进步。在中医中,焦虑症常被归为“郁症”。病因复杂,以肝气不舒为主,病位涉及心、脾、肾等脏腑,对GAD患者的治疗要以理气开郁、调畅肝气、平和情志为基本原则。该文作者认为治疗GAD最重要的是活血化瘀配合行气解郁,方选血府逐瘀汤加减,同时配合针灸可调畅气血运行。