Catgut implantation at acupoints increases the expression of glutamate aspartate transporter and glial glutamate transporter-1 in the brain of rats with spasticity after stroke

Catgut implantation at acupoints has been shown to alleviate spasticity after stroke in rats.However,the underlying mechanisms are poorly understood.In this study,we used the rat middle cerebral artery occlusion model of stroke.Three days after surgery,absorbable surgical catgut sutures were implanted at Dazhui（GV14）,Jizhong（GV6）,Houhui,Guanyuan（CV4）and Zhongwan（CV12）.The Zea Longa score was used to assess neurological function.The Modified Ashworth Scale was used to evaluate muscle tension.The 2,3,5-triphenyl-tetrazolium chloride assay was used to measure infarct volume.Immunohistochemical staining was performed for glutamate aspartate transporter（GLAST）and glial glutamate transporter-1（GLT-1）expression.Western blot assay was used to analyze the expression of GLAST and GLT-1.Reverse transcription and polymerase chain reaction were carried out to assess the expression of GLAST and GLT-1m RNAs.After catgut implantation at the acupoints,neurological function was substantially improved,muscle tension was decreased,and infarct volume was reduced in rats with spasticity after stroke.Furthermore,the expression of GLAST and GLT-1 m RNAs was increased on the injured（left）side.Our findings demonstrate that catgut implantation at acupoints alleviates spasticity after stroke,likely by increasing the expression of GLAST and GLT-1.

Effect of stimulating acupoint Guanyuan(CV 4) on lower back pain by burning moxa heat for different time lengths: a randomized controlled clinical trial

OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.

压灸百会、关元对轻中度阿尔茨海默病患者认知障碍及血清Aβ_(1-42)、tau、P-tau水平的影响

目的:比较压灸百会、关元联合盐酸多奈哌齐片与单纯盐酸多奈哌齐片治疗轻中度阿尔茨海默病(AD)患者认知障碍的临床疗效,从血清β淀粉样蛋白1-42(Aβ_(1-42))、微管相关蛋白tau、磷酸化tau(P-tau)水平探讨压灸治疗轻中度AD的机制。方法:将76例轻中度AD患者随机分为观察组(38例,脱落4例)和对照组(38例,脱落2例)。对照组予口服盐酸多奈哌齐片(每次5 mg,每天1次);观察组在对照组基础上予压灸百会、关元治疗,每次每穴施灸5壮,隔日1次,每周3次。两组均连续治疗8周。比较两组患者治疗前后及治疗结束后4、12周简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分,治疗前后血清Aβ_(1-42)、tau、P-tau水平,并进行安全性评价。结果:治疗后各时间点,两组患者MMSE、MoCA评分均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患者血清Aβ_(1-42)、tau、P-tau水平较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者安全等级比较差异无统计学意义(P>0.05)。结论:压灸百会、关元联合盐酸多奈哌齐片改善轻中度AD认知障碍的近远期疗效优于单纯盐酸多奈哌齐片,且可降低血清Aβ_(1-42)、tau、P-tau水平,这可能是压灸改善认知障碍的机制之一。

Assessment of Heat-sensitization at Guanyuan （CV4） in Patients with Primary Dysmenorrhea： A Comparative Study between Moxibustion Sensation and Infrared Thermography

目的：采用灸感与红外法对原发性痛经患者关元穴热敏态进行检测对比研究，探讨腧穴热敏态红外客观显示的可能性。方法：共纳入原发性痛经患者71例，比较灸感法与红外法对原发性痛经患者关元穴热敏态的检测差异。结果：原发性痛经患者关元穴区发生热敏化时，其红外辐射强度多数显示低温特征，与灸感法比较，其敏感性（真阳性率）为76．6％，特异性（真阴性率）为70．1％，准确性为74．6％；艾灸热敏态关元穴区后，产生明显纵向或横向扩散的红外辐射增强区域，与灸感法比较，其敏感性（真阳性率）为78．7％，特异性（真阴性率）为83．3％，准确性为80.3％。结论：原发性痛经患者关元穴区热敏态在一定程度上可被红外成像客观显示；艾灸热敏腧穴产生的腧穴热敏现象（如扩热、传热），除了被受试者主观感觉之外，在一定程度上也能被红外成像客观显示。

Effects of electroacupuncture at Guanyuan(CV 4)or Sanyinjiao(SP 6)on hypothalamus-pituitary-ovary axis and spatial learning and memory in female SAMP8 mice

OBJECTIVE: To investigate the effects of electroacupuncture(EA) at the Guanyuan(CV 4) or Sanyinjiao(SP 6) acupoints on the hypothalamus-pituitary-ovary(HPO) axis and spatial learning and memory in female mice.METHODS: Nine-month-old female mice with senescence-accelerated mouse prone 8(SAMP8)were divided into three groups: the disease model,EA-Guanyuan and EA-Sanyinjiao groups. Concurrently, 9-month old female mice with senescence-accelerated mouse resistance 1(SAMR1)were set as the control model group. The two treatment groups were given the same pattern of EA stimulation. Gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone(FSH) and Serum estradiol levels in the Hypothalamus-pituitary-ovary axis were assessed by enzyme-linked immunosorbent assay to determinethe HPO axis function level. Spatial learning and memory were assessed by the Morris Water Maze(MWM) test.RESULTS:(a) HPO axis: compared with the control model group, the disease model group displayed a decrease in E2 levels(P < 0.01), and an increase in Gn RH, LH and FSH levels(P < 0.01). E2 levels were increased in EA treatment groups compared with the disease model group(P < 0.05). In contrast,Gn RH and LH and FSH levels were reduced(P <0.05). EA-Sanyinjiao group was superior than EA-Guanyuan group on increasing E2 and declining Gn RH levels(P < 0.01).(b) The MWM test demonstrated that the response latency in the EA-Sanyinjiao treatment group declined from day 2 to day5 compared with the disease model group(P <0.05), whereas the EA-Guanyuan treatment group showed no significant difference.CONCLUSION: EA can regulate hormone(E2, FSH,LH, Gn RH) levels in the HPO axis and the spatial learning and memory ability in female SAMP8 mice. Moreover, this effect may have been more pronounced in the EA-Sanyinjiao group than the EA-Guanyuan group. The underlying mechanism of the EA-induced changes may be related to gonadal hormone shifts in the HPO axis, followed by an improvement in spatial learning and memory.

Effect of a comprehensive therapy plus Gushenyutai plaster administered at Guanyuan(CV 4) on male infertility associated with semen non-liquefaction

OBJECTIVE: To observe the clinical effect of Gushenyutai plaster administered at the Guanyuan(CV4) acupoint on male infertility associated with semen non-liquefaction.METHODS: Sixty-two male patients with infertility caused by semen non-liquefaction were random-ized into a treatment and control group. The control group received comprehensive therapy, which included oral administration of clarithromycin sustained release tablets, hip bath with Zhongyaoxiaoyan granules, prostate massage, and transurethral microwave treatment. The treatment group was administered Gushenyutai plaster in addition to the comprehensive therapy. Both groups were treated for 8 weeks. After treatment, the clinical effect and pregnancy rate were assessed and compared between the two groups.RESULTS: The effective rate of the treatment group was significantly higher than that of the control group(96.77% vs 70.97%, P<0.05) and the pregnancy rates of the treatment group and control groups were 38.71% and 16.13%, respectively(P<0.05).CONCLUSION: The effect of Gushenyutai plaster plus comprehensive therapy was better than that of the comprehensive therapy alone on male infertility induced by semen non-liquefaction.

Clinical Application of Moxibustion on Guanyuan(CV 4)

Guanyuan(CV 4)is located 3 cun below theumbilicus,on the midline of abdomen.It is theFront-Mu Point of the Small Intestine,a crossingpoint of Three Yin Meridians of Foot and ConceptionVessel.It can warm the kidney to invigorate yang,

Effect of moxibustion at “Guanyuan”( CV4) and “Sanyinjiao”( SP 6) on bone morphology,metabolism and ERα of bone marrow mesenchymal stem cells in the ovariectomized rats

Objective To observe the effects of moxibustion at'Guanyuan'(CV 4) and'Sanyinjiao'(SP 6) on bone morphology,metabolism and ERαof bone marrow mesenchymal stem cells (MSCs) in the ovariectomized rats and explore the underlying mechanism of moxibustion at Guanyuan (CV 4) and Sanyinjiao (SP 6) on the regulationof bone metabolism. Methods A total of 60 SD ratswere randomized into a normal group (20 rats) and anovariectomy group (40 rats).

针刺老年大鼠“足三里”“关元”穴对NO、SOD、MDA以及免疫影响的实验研究

目的 :探讨针刺抗衰老的作用机理。方法 :针刺老年大鼠的“足三里”“关元”穴 ,观察对脑、心、肝、肾组织中一氧化氮 (NO)、超氧化物歧化酶 (SOD)、丙二醛 (MDA)变化以及对单核巨噬系统吞噬功能的影响。结果 :针刺能调节脑心肝肾组织中NO的含量 ;能提高脑心肝肾组织中抗氧化能力 ,使SOD的含量增高 ,MDA的含量降低 ;能提高单核巨噬系统的吞噬指数。结论 :针刺“足三里”“关元”

大椎、关元对腰椎间盘突出症临床疗效的影响

目的:探讨大椎、关元对腰椎间盘突出症临床疗效的影响,以及任督脉在腰椎间盘突出症临床治疗上的指导意义。方法:将427例腰椎间盘突出症患者随机单盲分为常规(循经取穴)组、常规加大椎组和常规加关元组进行治疗观察,采用u检验评定比较各组间疗效。结果:加大椎组和加关元组的治愈率与常规组比较,差异有显著或非常显著性意义(P<0.05,P<0.01),而有效率组间比较差异无显著性意义(P>0.05)。结论:大椎、关元可以提高腰椎间盘突出症的治愈率,调节任督、温补阳气可能是治疗腰椎间盘突出症的重要手段和方法之一。

经前隔姜灸治疗寒凝血瘀型原发性痛经疗效观察

目的观察经前隔姜灸神阙、关元穴治疗寒凝血瘀型原发性痛经的临床疗效。方法 65例寒凝血瘀型原发性痛经患者均在经前5 d采用隔姜灸神阙、关元穴治疗,共治疗3个月经周期。结果 65例患者经治疗后痊愈34例,显效23例,有效5例,总有效率为95.4%。65例患者治疗前痛经症状积分为(11.02±3.76)分,治疗后为(3.45±4.13)分,两者比较差异具有统计学意义(P<0.01)。结论经前隔姜灸是一种治疗寒凝血瘀型原发性痛经的有效方法。

正常和病理状态下“关元”穴的中枢神经束路示踪研究及电针的影响

目的:应用伪狂犬病毒(PRV)作为神经示踪剂研究正常和病理状态下"关元"穴针刺信号从穴位传递到神经中枢的通路,并观察电针对其影响。方法:将SD雌性大鼠随机分为正常组(NC)、正常加电针组(NC+EA)、去卵巢组(OVX)和去卵巢加电针组(OVX+EA)。OVX和OVX+EA组行双侧卵巢切除术,术后4周与NC和NC+EA组同时在"关元"穴注射10μl滴度为108plaque-formingunits(PFU)/ml的PRV。NC+EA和OVX+EA组在注射病毒后30min在"关元"穴给予电针处理(2Hz,2～3mA),每天1次,每次30min,连续3d。用免疫组化法观察PRV免疫阳性细胞在中枢神经系统的分布及数量。结果:1)4组大鼠的脊髓、脑干、下丘脑以及大脑皮层均可观察到PRV免疫阳性细胞,其主要分布为:脊髓腰、胸、颈段的腹侧和背侧角,脑干孤束核、巨细胞网状核、三叉神经脊束核、下橄榄核等,下丘脑室旁核、弓状核、腹内侧核、斜角带核、视前大细胞亚核等,以及皮层的纹状区等。2)在OVX组,与神经内分泌密切相关的核团中PRV免疫阳性细胞数量明显减少,如:隔内侧核、室旁核、弓状核、斜角带核(P<0.05);部分核团甚至无阳性表达,如:下丘脑视前大细胞亚核、腹内侧核(P<0.01)。OVX+EA组在相同核团内的阳性细胞数量与OVX组相比明显增加(P<0.05)。NC和NC+EA组相比差异无显著性意义(P>0.05)。结论:去卵巢后,机体功能发生异常,正常状态下的神经通路受到影响;针刺"关元"可促进原有神经结构的恢复。

乳腺增生病不同证型关元穴红外辐射光谱探讨

目的:比较乳腺增生病患者不同证型任脉经穴关元穴体表红外辐射光谱特性。方法:采用高灵敏度PHE201体表红外光谱仪,观察了60例乳腺增生病患者不同证型关元穴1.5～16μm波段体表红外辐射光谱的差异。结果:乳腺增生病肝郁痰凝型患者与冲任失调型患者比较,两组关元穴体表红外辐射强度存在显著性差异。具有统计学意义差异的波段为:1.5～2.25μm,2.75μm,3μm,3.5μm,3.75～5μm,6～6.5μm,7μm,7.75μm,10.5～14μm,(P<0.05)。结论:关元穴红外辐射强度的差异可能与乳腺增生病不同证型有关。

电针对“关元”穴区初级感觉传入神经元节段分布的影响

目的：用CB—HRP示踪法对大鼠“关元”穴传入的神经节段分布进行研究。方法：SD大鼠随机分成对照组和电针组，分别在“关元”穴注入0．03％CB-HRP 20μL。注射后，电针组动物每天给予“关元”穴电针30min，共3d。84h后，观察两组动物的双侧相应节段的背根神经节（DRG）中阳性标记细胞的形态学变化和数量的变化。结果：在两组动物的T11～L3双侧DRG中，都存在有与“关元”穴相关的CB—HRP标记细胞；电针组的标记细胞总数显著高于对照组；标记细胞总数分布最多的节段，对照组在L3，电针组比对照组高一节段，在L2；两组标记细胞的形态学观察，均可分为大、中、小三型细胞，其中以小型细胞占多数。结论：针刺大鼠“关元”穴，可使穴位区局部感觉神经初级传入功能活动加强，L2可能是针刺“关元”穴信号传入脊髓的主要途径。

论厥阴病

厥阴为人体阴阳之气交替转换的阶段,可以将其概括为:两阴交尽,谓之厥阴;阴极阳生,极而复返,这是厥阴的生理。厥阴病是伤寒最后的厥证阶段。外感病的发生是从太阳开始的,因为太阳主表,外邪不经太阳则无由进入人体;外感病的死亡则在厥阴,因为厥阴是人体阴阳之气交替转换的阶段,厥阴病乃人体阴阳之气不能正常交替,即所谓"阴阳气不相顺接",阴阳气不相顺接的临床特征就是"厥","阴阳气不相顺接"的再发展就是"阴阳离决",即死亡。厥阴病篇讨论了很多种厥,但厥阴病主要是热厥和寒厥,厥阴病是从热厥开始的,其他的厥是为了和厥阴病鉴别。另外,要强调一点的是,如果厥阴病讨论的是厥,则326条不能作为厥阴病的提纲,因为这条原文并没有揭示厥阴病的本质特征,与之相关联的是,乌梅丸不是厥阴病的主方。

针刺三阴交单穴及多穴对原发性痛经即刻镇痛效应临床观察

目的通过选用两组不同穴位对原发性痛经患者进行治疗,观察其对原发性痛经患者即刻镇痛效应的差异,为针刺治疗原发性痛经的优化治疗方案提供客观依据。方法将符合纳入标准的60例原发性痛经患者随机分为3组,其中A组(针刺三阴交)、B组(针刺三阴交、关元)、C组(空白组)各20例。观察本次月经周期针刺治疗前、针刺后及起针后3组的疼痛视觉模拟评分(Visual Analogue Scale,VAS)的变化情况。结果治疗后,A组及B组VAS评分与治疗前比较差异均有统计学意义(P<0.05);A组与B组VAS评分比较差异无统计学意义(P>0.05)。结论对于原发性痛经患者疼痛发作时,针刺三阴交及针刺三阴交、关元均有镇痛效应,但从优化方案角度考虑,单针三阴交穴即可。

“双固一通”温针灸治疗膝骨性关节炎疗效观察及对血清炎性因子表达的影响

目的:探讨"双固一通"温针灸治疗膝骨性关节炎(KOA)的临床疗效及作用机制。方法:选取KOA患者90例,随机分为观察组和对照组各45例,对照组口服双氯芬酸钠缓释片治疗,观察组给予"双固一通"温针灸法治疗,观察并比较两组患者治疗前后膝关节功能、血清炎性因子水平,评定临床疗效。结果:治疗后观察组疼痛评分、关节僵硬评分、日常生活评分及总分均低于对照组(P<0.01);血清转化生长因子β(TGF-β)、胰岛素样生长因子-1(IGF-1)、成纤维细胞生长因子-2(FGF-2)水平均高于对照组(P<0.01),治疗愈显率高于对照组(P<0.05)。结论:"双固一通"温针灸法可有效改善KOA患者膝关节功能,抑制炎症反应,疗效显著。

穴位埋线关元穴、肾俞穴对慢性前列腺炎大鼠IgG和血清Zn的影响

目的:探讨简易埋线关元穴和肾俞穴对琼脂所致慢性非细菌性前列腺炎大鼠的前列腺匀浆IgG和血清Zn的影响。方法:将40只雄性SD大鼠定时定量喂养1周后,随机分为假手术组、模型对照组、肾俞组、关元组,共4组,每组10只,除假手术组外,其余各组大鼠均予以注射琼脂溶液建立模型;假手术组于同样部位、以同样方法注入氯化钠溶液。造模24 h后每7天埋线1次,连续4周。28 d后取材,采用单项免疫扩散法检测各组大鼠前列腺匀浆中IgG水平;原子吸收分光光度法检测各组大鼠前列腺血清Zn含量。结果:与假手术组相比,模型对照组的大鼠小便浑浊、活动度低、精神状态差,前列腺组织有水肿充血、粘连和硬结,前列腺匀浆中IgG含量增高,血清Zn含量降低,差异有统计学意义(P<0.05);与模型对照组对比,肾俞组和关元组的大鼠活动度、饮水量增高,小便浑浊度降低,前列腺组织仅见软性结节、粘连减少,前列腺匀浆中的IgG含量均降低,Zn含量均升高,差异有统计学意义(P<0.05)。结论:简易埋线肾俞穴和关元穴可以改善大鼠小便浑浊度和前列腺组织粘连程度,可能与降低慢性前列腺炎大鼠匀浆IgG的含量、升高血清Zn的含量有关。

A Systematic Review and Meta-Analysis of Herb-Partitioned Moxibustion in the Treatment of Primary Dysmenorrhea

OBJECTIVE: To systematically evaluate the clinical effects of herb-partitioned moxibustion on patients with primary dysmenorrhea. METHODS: Randomized controlled trials of herb-partitioned moxibustion for primary dysmenorrhea published from the year the database was established to November, 2017 were searched from CNKI,Wanfang Database, VIP database, CBM, PubMed, Embase, and Cochrane Library. Data extraction and quality evaluation were performed in papers meeting inclusion criteria. The outcomes measurements included clinical effect rate, visual analogue score(VAS), plasma PGF2α, adverse events, recurrence rate, and quality of life. The Rev Man 5.3 software was applied for meta-analysis. RESULTS:(1) A total of 16 studies were eligible and included in the meta-analysis involved1126 patients.(2) A statistically significant increasing in clinical effective rate was found in HMP group compared with control group [OR=3.49, 95%CI(2.25, 5.39), P<0.00001].(3) There was significant difference between two groups in visual analogue score [MD=–7.48, 95%CI(–9.93, –5.02), P<0.00001], which suggested the patients who received HPM had lower VAS scales than those who received no HPM.(4) There was significantly difference in serum PGF2α between the groups receiving HPM and the control group [MD=–4.61, 95%CI(–9.19, –0.03), P=0.05].(5) 2 trials reported followup duration, and all included studies did not mention the recurrence of PD during the follow-up stage, and all included studies did not mention the improvement of quality of life of PD during period of management and follow-up stage.CONCLUSIONS: Herb-partitioned moxibustion is beneficial for primary dysmenorrhea. However, the conclusion is not completely accurate with limitations of the current RCTs. The safety of herb-partitioned moxibustion remains to be defined by future studies. Attention should be paid to long-term effects of herb-partitioned moxibustion in clinical research. High-quality RCTs are required to confirm the effectiveness of herb-partitioned moxibustion for primary dysmenorrhea.

Effect of catgut implantation at acupoints on GABA_B and mGluR1 expressions in brain stem of rats with spasticity after stroke

OBJECTIVE: To investigate the effect of catgut implantation at acupoints on the expressions of γ-amino butyric acid B receptor(GABAB ) and metabotropic glutamate receptor 1(mGluR1) in the brain stem of rats with spasticity after stroke.METHODS: In total, 60 male Sprague-Dawley rats were randomly divided into three groups: a sham group(n=10), a model group(n=25) and a treatment group(n=25). The rats in both the model group and the treatment group were subjected to middle cerebral artery occlusion to establish a model of focal cerebral ischemia. Rats with limb-spasm met the inclusion criteria. Only the left carotid artery was isolated in sham group rats. Three days after modeling, the treatment group was subjected to catgut implantation at Dazhui(GV 14), Guanyuan(CV 4), and Zhongwan(CV 12). Neurological deficit symptoms were assessed with the Zea-Longa neurological deficit score. The Modified Ashworth Scale(MAS), and isolated muscle tone were used to evaluate spasticity before and after treatment. Immunohistochemistry was applied to determine the expression of GABAB and mGluR1 in the rat brain stem after treatment.RESULTS: After treatment, neural impairment symptoms had significantly improved in the treatment group when compared to the model group(P<0.05). Both MAS and isolated muscle tone in the treatment group were significantly decreased when compared with the model group(P<0.05),and were also lower than before treatment. GABAB expression was significantly higher and mGluR1 was lower in the treatment group when compared with the model group(P<0.01 and P<0.05, respectively).CONCLUSION: Catgut implantation at Dazhui(GV 14), Guanyuan(CV 4), and Zhongwan(CV 12), can relieve limb spasticity by increasing the expression of GABAB and reducing the expression of mGluR1 in the brain stem of rats after stroke.