Study on the Regulatory Effect of Electro-acupuncture on Hegu Point (LI4) in Cerebral Response with Functional Magnetic Resonance Imaging

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.

Influence of Needling Point Hegu(LI4)on Colonoscopy

目的:研究结肠镜检前针刺双合谷对镜检患者及对插镜时间的影响。方法:依接受镜检单、双序号将全部结肠镜检患者185例分为针刺组(93例)、对照组(92倒)。针刺组在镜检前30min 针刺双合谷,对照组不予任何防治措施。分别观察两组过乙状结肠和横结肠时的疼痛级别并记录插镜时间。结果:共有165例患者完成插镜确定为有效病例,其中针刺组84例,对照组81例。统计表明,针刺组患者在过横结肠及乙状结肠时疼痛级别较对照组显著低(P<0.01),针刺组的插镜时间较对照组短(P<0.05)。结论:结肠镜检前针刺双合谷可有效降低结肠镜检时患者的不适并缩短镜检时间。

Differences in thermal effects of moxibustion at Zusanli(ST 36) and Hegu(LI 4) on various facial areas in healthy people

OBJECTIVE:To study the effects of temperature on different facial areas by suspended moxibustion at two points,Zusanli(ST 36) and Hegu(LI 4),and probe the phenomena underlying self-regulation in the human body after thermal stimulation.METHODS:Thirty healthy volunteers accepted moxibustion over Zusanli(ST 36) and Hegu(LI 4),and the order of moxibustion points was randomly determined.Moxibustion method:suspension of moxibustion over Zusanli(ST 36) and Hegu(LI 4) on both sides was performed using an ignited moxa stick stuck in a support for 20 min.Observation method:An infrared thermal image of the face was taken before and after suspended moxibustion using a CK350 medical infrared thermal imaging instrument.Data analysis:A thermal microscopic section view system(TMTSys) was used to analyze the change in temperature in special facial areas.Statistical analysis was carried out using SPSS 14.0 software.RESULTS:Before moxibustion was suspended,the facial thermal image showed a T-shaped thermal area related to the vascular distribution with even temperature and good symmetry on both sides.Suspended moxibustion over Zusanli(ST 36) have a very significant increase in temperature at the forehead,around the nose,at the corners of the mouth,and at the cheeks and lips(P<0.01).Suspended moxibustion over Hegu(LI 4) also have a significant(P<0.05) increase in temperature around the nose,the corners of the mouth,the cheeks,and lips,where has a new high temperature area was formed(P<0.01).Suspended moxibustion over Hegu(LI 4) raised the temperature at the middle point of the lips more obviously than did Zusanli(ST 36) in the same person,(P<0.05).After 10 min of moxibustion over Zusanli(ST 36) and Hegu(LI 4),the change in temperature in the facial area reached its peak value.CONCLUSIONS:Facial infrared thermography of healthy people revealed a T-shaped thermal area reflecting a physiological thermal area.Moxibustion over Zusanli(ST 36) or Hegu(LI 4) raised the temperature in this facial T-shaped thermal area.Hegu(LI 4) led to the formation of a new thermal area in the lips.The time required for moxibustion to regulate human body temperature was 10 min.

Effect of electroacupuncture at Ximen(PC 4) and Hegu(LI 4) on expression of Akt in rats with myocardial ischemia-reperfusion injury

OBJECTIVE: To investigate the effect of electroacupuncture(EA) at acupoints on the pericardium meridian on the expression of phosphorylated Akt(p-Akt) protein in rat myocardium after ischemia and reperfusion.METHODS: Seventy Wistar rats were evenly randomized into seven groups: the sham operation group(group A), ischemia-reperfusion model Ⅰgroup(group B), ischemia-reperfusion model Ⅱgroup(group C), EA at Neiguan(PC 6) group(group D), EA at Ximen(PC 4) group(group E), EA at Hegu(LI 4) group(group F), and LY294002 + EA at Neiguan(PC 6) group(group G). All processes were monitored by electrocardiography. In group A, the left anterior descending coronary artery was only threaded without ligation for 100 min. In group B,the left anterior descending coronary artery was ligated for 40 min and reperfused for 60 min. The left anterior descending coronary artery in group C was ligated for 40 min and reperfused for 100 min.Groups D, E, and F received EA for 20 min before undergoing ischemia for 40 min, and then received EA for 20 min before undergoing reperfusion for 60 min. Before modeling, group G was injected with LY294002(0.3 mg/kg) into the tail vein, and then underwent the same intervention as the other EA groups. After reperfusion, myocardial tissue from the left cardiac ventricle was collected to enable Western blot analysis of the p-Akt level, and analysis of electrocardiographic changes.RESULTS: In groups B and C, electrocardiography showed obvious elevation of the ST-segment Ⅱlead(ECG-STⅡ), while the ECG-STⅡvalues were significantly lower in groups D, E, and G(P < 0.01). The p-Akt levels in groups D and E were significantly greater than those in groups B and C(P < 0.01).Compared with all other groups, group G showed a significantly different expression of p-Akt(P < 0.01).CONCLUSION: The expression of p-Akt protein in cardiomyocytes was significantly greater in rats that were injected with LY294002 and received EA at Ximen(PC 4) compared with all other groups.This suggests that EA at Ximen(PC 4) resulted in activation of the phosphoinositide 3-kinase/Akt signaling pathway and phosphorylation of Akt.

Effects of Hegu (LI 4) and Taichong (LR 3) on Vascular Dilation and Constriction in Migraine Patients

Hegu(LI 4)and Taichong(LR 3)are the Yuan-Primaryacupoints of the Large Intestine and LiverMeridian,and are collectively named as Si Guan(four gates)point.Combined use of these twoacupoints can harmonize yin and yang,regulate

Analgesic effect of acupuncture at Hegu (LI 4) on transvaginal oocyte retrieval with ultrasonography

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.

Forty-five Cases with Epigastric Pain Treated with Puncturing Hegu(LI 4)

Epigastric pain,also known as stomach pain,is presented with frequently 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 factors were treated with mainly needling Hegu(LI 4)between November 2010 and November 2012,and the report is given as follows.

Treatment of Toothache by Puncturing Hegu （LI 4）

目的：观察针刺合谷穴治疗牙痛的临床疗效。方法：将278例病例随机分为治疗组（139例）和对照组（139例），治疗组采用电针针刺合谷穴治疗，对照组采用电针针刺承山穴治疗，疗程为3d，分别对疼痛分级及镇痛情况进行观察。结果：治疗ld拔针前显效率比较，实验组与对照纽无统计学意义（P〉0．05），其余各时间点显效率实验组均明显高于对照组（P〈0．05）。结论：针刺合谷穴治疗牙痛有效。

“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病临床观察

目的:观察“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病的临床疗效。方法:选取2020年1月至2022年7月上海市静安区中医医院收治的颈椎病患者112例,按照随机数字表法分为对照组与研究组各56例。对照组给予常规针刺治疗,研究组在对照组治疗的基础上行“气伤痛”理论指导下针刺合谷穴、太冲穴治疗。观察两组患者治疗前后症状评分、疼痛视觉模拟评分(visual analogue scale, VAS)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein, CRP)、P物质(substance p, SP)、血管阻力指数(resistant index, RI)、搏动指数(pulsitility index, PI)、收缩期峰值血流速度(peak systolic velocity, PSV)及临床疗效。结果:研究组有效率为94.64%,对照组有效率为82.14%,研究组有效率高于对照组,差异有统计学意义(P<0.05);研究组治疗后症状评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);研究组治疗后TNF-α、CRP、SP低于对照组,差异有统计学意义(P<0.05);研究组治疗后RI、PI低于对照组,PSV高于对照组,差异有统计学意义(P<0.05)。结论:“气伤痛”理论指导下针刺合谷穴、太冲穴治疗颈椎病,能有效减轻患者疼痛,改善患者症状。

The Safety of Electroacupuncture at Hegu(LI 4) plus Oxytocin for Hastening Uterine Contraction of Puerperants—A Randomized Controlled Clinical Observation

Objective:To investigate the safety of electroacupuncture plus oxytocin for uterine contraction of puerperants.Methods:276 puerperants with difficult labor were randomly divided into a medication group,treated with intravenous dripping of oxytocin,and an acupuncture plus medication group,in the medication group,intravenous dripping of oxytocin was given,and in the other group,acupuncture at bilateral Hegu(LI 4) was added.Heart rate,respiratory frequency,blood pressure of puerperants,fetal heart rate and birth process were observed.Results:During laboring,the indices observed,including heart rate,respiratory frequency,blood pressure,fetal heart rate and birth process,were all in normal range in all of the 276 cases,with better effects in acupuncture plus medication Group M.Conclusions:Electroacupuncture at bilateral Hegu(LI 4) plus intravenous dripping of oxytocin can intensify the uterine contraction,shorten the birth process to avoid probable systemic exhaustion due to excessive consumption,and with no side effects on life signs of the puerperants and newborns.

针刺合谷与太冲fMRI脑功能成像的比较研究

目的 :探讨针刺不同穴位对脑组织fMRI功能成像的影响。方法 :将健康受试者随机分为针刺合谷组、太冲组、合谷配伍太冲组各 7人 ,分别观察fMRI脑功能成像。结果 :针刺合谷穴诱导额叶和枕叶脑组织血流量和血流容积的增加 ;针刺太冲穴仅诱导颞叶脑组织血流量和血流容积的增加 ;针刺合谷配太冲穴诱导额叶和颞叶脑组织血流量和血流容积的增加。 结论 :针刺不同穴位激发不同脑区的脑组织变化 ,而两个穴位配伍并不是两个穴位引起脑组织fMRI功能改变作用的叠加 ,而是引起脑组织fMRI功能重新分布。

电针“合谷”“三阴交”穴促分娩作用机理的实验研究

目的 :通过动物实验探讨电针“合谷”“三阴交”穴促分娩的作用机理。方法 :选健康成年Wistar大鼠 55只 ,分正常对照组、模型对照组、“合谷”组、“三阴交”组、“合谷”加“三阴交”组。以子宫颈及子宫体组织前列腺素E2 (PGE2 )、血清及羊水雌二醇 (E2 )和孕酮 (P)为指标。结果 :电针“合谷”穴使晚孕大鼠宫体及宫颈组织PGE2 、血清E2 、羊水中P含量显著升高 ;电针“三阴交”穴仅使晚孕大鼠羊水中P含量显著升高 ;同时电针“合谷”“三阴交”穴对本实验所测各项内分泌指标影响不显著。

“面口合谷收”的形态学基础

目的:探讨合谷穴与口面部联系的形态学基础。方法:采用荧光素单标记和双标记法,将荧光素碘化丙啶(PI)和双苯甲亚胺(Bb)分别注入“合谷”穴区和“四白”穴区,取同侧脊神经节颈1～颈8,胸1～胸2,颈上、中、下交感节及三叉神经半月节,荧光显微镜下观察计数。结果:在脊神经节颈5～颈8观察到大量PI单标记细胞,主要分布于颈6～颈7,在三叉神经半月节也可见大量Bb单标记细胞,另外在三叉神经半月节可见少量PI～Bb双标记细胞,占标记细胞的4.5％。结论:三叉神经半月节有向“合谷”穴和“四白”穴的分支投射,这可能是“面口合谷收”的形态学基础。

针刺治疗抑郁性神经症：多中心随机对照研究

目的:观察针刺对于抑郁性神经症的临床疗效。方法:采用多中心随机对照研究,将440例患者分为针刺组、百忧解组、非穴位针刺组。针刺组采用四关穴(合谷、太冲)为主的穴位,百忧解组服用药物百忧解20 mg/d,非穴位针刺组患者接受针刺治疗,但取穴偏离真正的穴位。在治疗前、后进行汉密尔顿抑郁量表(HAMD)计分,按HAMD减分率进行疗效评价,以Asberg氏抗抑郁药副反应量表(SERS)结合严重不良反应记录进行安全性评估,对数据进行意向性分析(ITT分析)。结果:针刺组的总有效率为86.4%,优于非穴位针刺组的59.1%及百忧解组的72.7%;针刺组的HAMD计分与百忧解组相当,而且2组均优于非穴位针刺组;针刺组及非穴位针刺组的SERS计分均明显低于百忧解组,未见晕针等严重针刺不良反应记录。结论:针刺对于抑郁性神经症是一种有效、安全的疗法;针刺治疗抑郁性神经症的疗效可能优于百忧解或与百忧解相当,但副作用远低于百忧解。

论四关穴在慢性疲劳综合征治疗中的作用

目的探讨四关穴在慢性疲劳综合征针刺治疗中的作用。方法以慢性疲劳综合征在中医学中的诊断归属以及病因病机分析作为切入点,通过对近10年来四关穴的相关文献分析,从3个方面对四关穴在慢性疲劳综合征针刺治疗中的作用进行了归纳。结论对于涉及身心两方面众多纷繁复杂症状的慢性疲劳综合征,以四关穴为主进行针刺治疗可以收到较好的疗效。

溃疡性结肠炎患者大肠经原穴与下合穴红外光谱的比较研究

目的:探讨穴位红外光谱对溃疡性结肠炎的诊断价值。方法:使用PHE 201型高灵敏度红外光谱分析仪检测34名溃疡性结肠炎患者大肠经原穴合谷与大肠经下合穴上巨虚的红外光谱。结果:在59个检查波长中,溃疡性结肠炎患者右侧合谷穴共有28个波长的红外辐射强度与正常人有显著差异(P<0.05或P<0.01),左侧有13个波长的红外辐射强度与正常人有显著差异(P<0.05)。右侧上巨虚穴共有16个波长的红外辐射强度与正常人有显著差异(P<0.05或P<0.01),左侧有17个波长的红外辐射强度与正常人有显著差异(P<0.05或P<0.01)。患者左右合谷有18个波长的辐射强度有显著差异(P<0.05或P<0.01),正常人左右合谷7个波长上有显著差异(P<0.05)。患者左右上巨虚共有4个波长的辐射强度有显著差异(P<0.05或P<0.01),而正常人左右上巨虚有1个波长的辐射强度有显著差异(P<0.01)。结论:上巨虚与合谷穴均能在红外辐射光谱上反映出肠道病变,而合谷穴似乎更明显一些。

电针合谷、三阴交对药物流产近期副反应的影响

目的：探讨减轻药物流产近期副反应的治疗方法。方法：将90例早孕患者随机分为3组：对照组只服用药物；电针1组在服用米索前列醇后30～60分钟内同时电针合谷、三阴交；电针2组在服用米索前列醇后30～60分钟内依次电针合谷、三阴交。结果：电针组电针后近期副反应减轻程度较对照组明显（P〈0．05），且先电针合谷后电针三阴交减轻腹痛的程度有更为显著的趋势。结论：电针合谷、三阴交可以减轻药物流产近期副反应，其中先电针合谷后电针三阴交减轻腹痛的程度更为显著。

电针合谷对子宫收缩乏力产妇宫缩时间的影响

目的:评价合谷穴对子宫收缩乏力的治疗作用与应用价值。方法:3个中心共276例产妇入组,所有病例随机分为针药组和药物组。药物组采用静脉滴注催产素治疗,针药组在药物组治疗基础上加电针合谷。观察电针合谷对子宫收缩乏力的影响,以及对宫缩持续时间和间歇时间的影响。结果:针药组对子宫收缩乏力的总有效率为97·1%,而药物组为70·3%,两组比较,差异有非常显著性意义(P<0·01);与药物组相比,针药组在治疗后0·5、1、1·5、2小时,对宫缩持续时间和间歇时间的影响差异有显著或非常显著性意义(P<0·05,P<0·01)。结论:由于产力异常而导致的难产可采用电针合谷的方法。

针四关穴为主治疗原发性痛经临床观察

目的:观察青龙摆尾法针刺四关穴为主治疗原发性痛经(PD)的临床疗效,并探讨其作用机制。方法:将180例PD患者随机分为针四关穴组( A组)60例、常规取穴组(B组)60例、月月舒组(C组)60例。A组以青龙摆尾法针刺四关穴(合谷、太冲);B组常规取穴,穴取三阴交、次醪为主;C组口服月月舒冲剂。治疗3个月后统计疗效,并观察治疗前后患者血液流变学及前列腺素等指标的改变。结果:A组治愈率为75.0%,总有效率为100.0%;B组分别为60.0%、95.O%;C组分别为25.0%、90.0%。A、B组疗效优于C组(P<0.01);而治疗30分钟内止痛疗效比较,A、B两组优于C组(P<0.01),A组优于B组(P<0.01)。结论:青龙摆尾法针刺四关穴为主治疗原发性痛经疗效显著,其作用机制可能是通过改善患者的血液循环状态、抑制前列腺素而达到缓解疼痛的目的。

针刺合谷穴对合谷及迎香穴区温度变化的影响

目的研究不同刺激量针刺合谷穴对合谷穴区及对侧迎香穴区红外热像温度的影响。方法将30名缺血性脑卒中致中枢性面瘫患者依据不同刺激量随机分为合谷1-4组和对照组。观察针刺过程中合谷穴区、对侧迎香穴区红外温度变化。结果针刺合谷穴前后,合谷穴及对侧迎香穴区红外温度发生先降低再升高的变化(P<0.05)。结论针刺合谷穴后合谷穴局部与对侧面部迎香穴区体表红外热像温度变化具有相关性,提示经脉体表循行路线具有特异性,不同合谷组的两穴区温度变化虽有不同,但尚未发现明确规律。