EFFECT OF ACUPUNCTURE STIMULATION AT SANYINJIAO (SP 6) ON CEREBRAL GLUCOSE METABOLISM IN DYSMENORRHEA PATIENTS

To study the central mechanism of acupuncture stimulation of Sanyinjiao （三阴交 SP 6） in relieving dysmenorrhea. Methods： A total of 6 dysmenorrhea volunteer patients were subjected into this study. On the first positron emission tomography （PET） scan examination, they were assigned to pseudoacupuncture group by using the acupuncture needle just to prick the skin of Sanyinjiao （SP 6） ; while on the second PET scans, they were assigned to acupuncture group by inserting the needle into the same acupoint. 18F fluorodeoxyglucose （;SF-FDG） PET of the whole brain was performed during pseudo-acupuncture and real acupuncture of Sanyinjiao （SP 6）. The acquired PET data were analyzed by using statistical parametric mapping （SPM） software to determine changes of glucose metabolism in different cerebral regions. The patient＇s pain intensity was rated by using 0-10 numerical pain intensity scale. Results： After pseudo-acupuncture stimulation of Sanyinjiao （SP 6）, no significant changes were found in the pain intensity （ P 〉0.05）, while after real-acupuncture stimulation, the pain intensity declined significantly （ P〈0.01 ）. Following acupuncture of the right Sanyinjiao （SP 6）, multiple cerebral regions involving pain were activated （increase of glucose metabolism）, including ipsilateral lenticular nucleus （globus palliclus, putamen）, ipsilateral cerebellum and insular lobe, bilateral dorsal thalamus, ipsilateral paracentral Iobule, bilateral amygdaloid bodies, contralateral substantia nigra of the midbrain, bilateral second somatosensory （S Ⅱ ） areas, ispsilateral hippocampal gyms, frontal part of the ipsilateral cingulated gyrus, and bilateral mammary bodies of the hypothalamus. In addition, fewer regions of the cerebral cortex responded with decrease of the glucose metabolism after real acupuncture.

AN ANALYSIS ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE AT SANYINJIAO POINT FOR TREATMENT OF 120 CASES OF PRIMARY DYSMENORRHEA

In the present paper, the authors make an analysis on the therapeutic effect of acupunc-ture at Sanyinjiao(SP 6) alone for treatment of 120 cases of primary dysmenorrhea. Results show atotal effective rate of 96.7%.

Analgesic effects and hemodynamic mechanisms of perpendicular and transverse needling at Sanyinjiao(SP 6) in patients with primary dysmenorrhea: A randomized controlled trial

Objective: To explore the analgesic effects and uterine hemodynamics of perpendicular needling(PN)and transverse needling(TN) at SP 6 in patients with primary dysmenorrhea(PD).Methods: In this randomized controlled trial, patients with PD diagnosed with cold-dampness congealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min.Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain(VAS-P). The primary outcome was average menstrual pain(VAS-P). Secondary outcomes included the pulsatility index(PI), resistance index(RI), and systolic-diastolic peaks ratio(S/D) in uterine arteries as measured using color Doppler ultrasonography;anxiety as assessed using the Hamilton Anxiety Rating Scale(HAMA), blood pressure(BP),and heart rate(HR).Results: Forty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores(-5.71 mm, 95% confidence interval(CI): -8.78, -2.63, P =.001), RI values(-0.05, 95% CI:-0.09, -0.01, P=.015), and HAMA values(-2.50, 95% CI: -4.78, -0.22, P=.032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups(P >.05).Conclusion: TN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD.This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.

三阴交电温针对早发性卵巢功能不全模型大鼠卵巢储备功能调节的实验研究

目的:观察三阴交电温针对早发性卵巢功能不全(POI)模型大鼠卵巢储备功能的调节作用,为三阴交临床应用提供科学依据。方法:将动情周期规律的32只SPF级雌性SD大鼠,随机分为空白组、模型组、三阴交组、非经非穴组,每组8只。空白组以0.9%生理盐水进行灌胃,模型组以雷公藤多苷片混悬液灌胃造模。造模成功次日进行干预,三阴交组取三阴交穴,非经非穴组取非经非穴,2组均连接温针电针综合治疗仪,选连续波,频率为2 Hz,每次留针20 min,每日干预1次,连续干预14 d。空白组和模型组分别在与电温针组相同时辰给予相同时间的抓取、固定,不进行任何治疗。干预结束后各组大鼠在动情间期取材,采用ELISA检测血清促卵泡生成素(FSH)、雌二醇(E2)、抑制素B(INHB)、抗苗勒管激素(AMH)水平;HE染色观察各组卵巢组织形态变化。结果:与空白组比较,模型组卵巢脏器指数,血清E2、AMH、INHB水平均明显降低,血清FSH含量明显升高(P<0.01)。与模型组比较,三阴交组卵巢脏器指数,血清AMH、E2、INHB水平均明显升高,血清FSH水平明显降低,差异均具有统计学意义(P<0.05,P<0.01);非经非穴组AMH水平升高(P<0.01)。与非经非穴组比较,三阴交组卵巢脏器指数,血清AMH、E2、INHB、FSH水平变化明显,差异均具有统计学意义(P<0.05,P<0.01)。结论:(1)三阴交电温针可调节POI模型大鼠性激素水平,改善生殖内分泌环境;(2)三阴交电温针可能是通过调节POI大鼠血清激素、AMH水平,从而发挥改善卵巢储备功能的作用。

患者针感与医生手下感之间相关性:一项随机对照试验的二次分析

目的分析同为针刺得气指征的患者针感与医生手下感的相关性。方法将一项随机对照试验原始数据进行二次分析,62例原发性痛经寒湿凝滞证患者随机分为A组32例和B组30例。两组均针刺双侧三阴交穴,A组采用促使得气方法(深刺、粗针、行手法)干预,B组采用避免得气方法(浅刺、细针、不行手法)干预。二次分析聚焦A组数据,采用《受试者针感临床评价量表》评估患者主观感受(针感强度、时间和成分),采用自制量表评估医生手下感强度,分析两者之间相关性。结果患者主观感受的3个指标之间呈两两正向直线相关(P<0.05)。12种常见得气感成分中有7种与针感持续总时间明显正向直线相关(P<0.05)。不属于得气感之刺痛与患者针感强度具有正向直线相关(P<0.05)。单次行针后患者针感持续时间同该次行针时医生手下感强度具有正向直线相关(P<0.05)。医生手下感总强度与患者针感强度、得气感成分总强度未见明显线性相关(P>0.05),却与患者麻感强度正向直线相关(P<0.05)。结论三阴交单穴针刺时,患者针感强度易受非得气之刺痛感的干扰,其与医生手下感强度表现为不会线性同步增加,但该穴处患者针感持续时间和单一得气感成分麻感不受刺痛感干扰,与医生手下感强度表现出同步增加。故科研中应重视得气感时间指标和医生手下感的记载。

电针治疗糖尿病周围神经病变选穴规律及刺激参数的数据挖掘

【目的】通过数据挖掘探索电针治疗糖尿病周围神经病变(DPN)的常用腧穴及刺激参数。【方法】检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学数据库(CBM)、美国生物医学信息检索系统(PubMed)自建库至2023年5月收录的电针治疗DPN的临床研究文献,建立电针治疗DPN的选穴处方及电针刺激参数数据库,对数据进行描述性统计、聚类分析与关联规则分析。【结果】对纳入的36篇文献中的36首处方进行分析,使用频次较高的前3位腧穴为:三阴交、足三里、合谷;腧穴归经以足太阳膀胱经、足阳明胃经、足太阴脾经为主;聚类分析得出8个聚类集群;关联规则分析得到“合谷、足三里、三阴交”的核心处方,其中支持度最高的穴位组合是“足三里-三阴交”。最常使用的刺激参数为:连续波、疏密波,5 Hz,强度耐受,30 min/次,1次/d,总治疗时间4周。【结论】电针治疗DPN的核心穴组为合谷、足三里、三阴交;电针参数推荐5 Hz,连续波,30 min/次,1次/d,治疗4周。可为电针治疗DPN的临床取穴及参数选择提供一定的参考依据。

针灸治疗女性更年期肥胖的选穴规律分析

【目的】运用数据挖掘技术探讨针灸治疗女性更年期肥胖的选穴规律,为临床针灸治疗女性更年期肥胖提供参考。【方法】通过计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)以及PubMed数据库中针灸治疗女性更年期肥胖的临床文献,检索时限为数据库建库至2023年8月1日,根据纳入和排除标准筛选文献并提取腧穴处方,采用IBM SPSS Moderler 18.0软件进行关联规则分析,运用IBM SPSS Statistics 27.0软件进行聚类分析。【结果】共筛选出符合要求的文献50篇,提取出83组腧穴处方。描述性分析提示,针灸治疗女性更年期肥胖干预措施主要为穴位埋线、电针和针刺耳穴结合运用;使用频次前7位的腧穴是三阴交、足三里、肾俞、天枢、关元、中脘、气海;足阳明胃经、任脉、足太阳膀胱经、足太阴脾经是最常选取的经脉;特定穴方面,主要选取交会穴、募穴、背俞穴,腧穴分布以胸腹、下肢、腰背为主。运用数据挖掘技术得到针灸治疗更年期肥胖的核心穴对为“足三里-三阴交”,核心腧穴处方为“足三里、三阴交、中脘、天枢、肾俞、关元、气海”;聚类分析发现7类临床取穴聚类。【结论】针灸治疗女性更年期肥胖注重补益肾中精气,恢复脾胃气机的选穴规律及特色。

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 Acupoint Sanyinjiao(SP6) Moxibustion on the First Stage of Labor and Uterine Contractive Pain in Primiparae

Objective：To observe the effect of acupoint Sanyinjiao（SP6） moxibustion（S-Mox） on the duration of the first labor stage and uterine contractive pain in primiparae.Methods：Sixty primipara women in labor were equally assigned according to their choice to three groups：women in the S-Mox group received bilateral S-Mox for 30 min,women in the non-acupoint group received moxibustion（Mox） applied on non-acupoints for 30 min,and those in the control group did not receive Mox intervention.The duration of the first labor stage was recorded and the degree of labor pain was estimated by a visual analogue scale（VAS） before and after Mox. Results：The duration of the first stage active phase in the S-Mox group was significantly shorter than that in the other two groups（P0.05,P0.01）;the VAS score after Mox was lower in the S-Mox group,showing a statistical difference in comparison with the control group（P0.05）.Conclusions：Applying S-Mox could markedly shorten the active phase of the first stage of labor and lower the VAS score of uterine contractive pain,which means alleviating the pain caused by vaginal delivery.Its mechanism is worthy of further study.

Effect of Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)on uterine inertia during painless parturition

Objective:To observe the effect of Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)on uterine inertia during painless parturition.Methods:A total of 100 cases of patients with uterine inertia during painless parturition were randomized into an acupoint group and a medicine group by the SPSS programming,with 50 cases in each group.Patients in the acupoint group received the treatment of Anrou-pressing and kneading bilateral Hegu(LI 4)and Sanyinjiao(SP 6),while patients in the medicine group received intravenous oxytocin.The labor time and maternal-child safety were evaluated,and the labor stage was compared.Results:The latent and active phases in the 1st labor stage and the 2nd labor stage in the acupoint group were substantially shorter than those in the medicine group,and the between-group comparisons showed statistical significance(all P<0.05).The between-group comparison of the 3rd labor stage showed no statistical significance(P>0.05).The postpartum hemorrhage amount in both groups was within the safe range,and the between-group comparison showed no statistical significance(P>0.05).The newborn 1 min Apgar score was ranged 8-10 points,and the between-group comparison showed no statistical significance(P>0.05).The between-group comparison of the labor stage efficacy showed statistical significance(P<0.01),with a better progression in the acupoint group.Conclusion:Anrou-pressing and kneading Hegu(LI 4)and Sanyinjiao(SP 6)is both effective and safe for uterine inertia during painless parturition.

择时艾灸三阴交在考前紧张综合征医学生中的应用效果

目的探讨择时艾灸三阴交在考前紧张综合征医学生中的应用效果。方法选取2022年1月和6月江西医学高等专科学校在期末考试前两周诊断为考前紧张综合征的来自临床医学院、药学院、医学影像院、医学技术学院和护理学院5个不同专业的100名大专生作为研究对象,采用随机数字表法分为对照组(50名)和观察组(50名)。对照组采用常规护理,观察组加用择时艾灸三阴交护理,7 d为1个疗程,两组均连续干预2个疗程。比较两组的考试焦虑水平、睡眠质量、脉率、症状评分及护理满意度。结果两组干预前Sarason考试焦虑量表(TAS)评分、匹兹堡睡眠质量指数问卷(PSQI)评分、脉率及症状评分比较,差异无统计学意义(P>0.05);两组干预后TAS评分、PSQI评分、脉率及症状评分低于本组干预前,差异有统计学意义(P<0.05);观察组干预后TAS评分、PSQI评分、脉率及症状评分低于对照组,差异有统计学意义(P<0.05);观察组护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论考前紧张综合征医学生应用择时艾灸三阴交护理可改善考试焦虑水平、睡眠质量,控制脉率,缓解临床症状,提高护理满意度,值得推广。

三阴交温针灸联合运动疗法对脑卒中后抑郁患者的疗效

目的探讨三阴交温针灸联合运动疗法对脑卒中后抑郁(PSD)患者的疗效。方法采用前瞻性研究方法,选取2020年1月至2023年10月榆林市星元医院收治的80例PSD患者作为研究对象,采用摸球法进行随机分组,奇数为对照组(40例),偶数为试验组(40例)。试验组男20例,女20例;年龄48~72(61.87±8.74)岁;抑郁程度:轻度20例,中度20例;脑卒中类型:脑梗死30例,脑出血10例。对照组男21例,女19例;年龄47~71(60.13±8.49)岁;抑郁程度:轻度19例,中度21例;脑卒中类型:脑梗死31例,脑出血9例。对照组采用运动疗法治疗,试验组在此基础上接受三阴交温针灸治疗,两组疗程均为6周。比较两组患者中医症候评分、蒙哥马利阿斯伯格抑郁量表(MADRS)评分、单胺神经递质水平[多巴胺(DA)、5-羟色胺(5-HT)和去甲肾上腺素(NE)]、Carroll上肢功能测试量表(UEFT)评分、Burke倾斜量表(BLS)评分、躯干控制试验(TCT)评分、自觉疲劳程度分级量表(Borg)评分、阿森斯失眠量表(AIS)评分和汉密尔顿抑郁量表(HAMD)失眠子部分评分。采用独立样本t检验、配对样本t检验和χ^(2)检验。结果治疗6周后,试验组中医症候评分[(7.39±2.13)分]、MADRS评分[(11.58±1.53)分]均低于对照组[(9.65±3.34)分、(13.34±1.60)分](均P<0.05);试验组DA[(74.08±7.60)ng/L]、5-HT[(280.96±34.85)μg/L]、NE水平[(45.44±6.51)μg/L]均高于对照组[(65.19±7.01)ng/L、(248.09±30.21)μg/L、(37.21±5.48)μg/L](均P<0.05);试验组UEFT评分[(35.81±6.17)分]、TCT评分[(75.34±16.55)分]均高于对照组[(23.42±3.63)分、(36.32±13.06)分](均P<0.05);试验组BLS评分[(4.85±1.86)分]、AIS评分[(4.64±1.36)分]和HAMD失眠子部分评分[(1.77±0.85)分]均低于对照组[(9.18±1.74)分、(6.52±1.63)分、(2.62±0.83)分](均P<0.05);试验组步行后Borg量表评分[(3.77±0.90)分]低于对照组[(5.34±1.27)分](P<0.05)。结论三阴交温针灸联合运动疗法在PSD患者的中医症候、情绪状态、神经递质水平、上肢功能、躯干控制能力、疲劳程度及睡眠质量方面均表现出显著的改善效果,具有推广价值。

三阴交温针灸对脑卒中失眠患者脑血流、血管内皮功能及疗效的影响

目的:探究三阴交温针灸对脑卒中后失眠患者的应用效果。方法:选取2022年1月至2022年12月华中科技大学同济医学院附属同济医院收治的脑卒中失眠患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组60例。对照组采用耳穴压豆,观察组采用耳穴压豆+三阴交温针灸,观察和比较2组患者临床疗效、脑血流指标、血管内皮功能指标、睡眠状况和睡眠质量。结果:观察组总有效率96.67%(58/60),高于对照组的85.00%(51/60),差异有统计学意义(P<0.05);治疗前,2组患者的各项脑血流指标、血管内皮功能指标、睡眠状况及睡眠质量评分比较,差异无统计学意义(P>0.05);治疗后,观察组患者的各项脑血流指标和血管内皮功能指标均优于对照组,相比于对照组,观察组睡眠质量更优,差异有统计学意义(P<0.05)。结论:对脑卒中后失眠患者采用三阴交温针灸的方式,能够有效提高患者的临床效果,改善患者的脑血流指标及血管内皮功能指标,让患者的睡眠质量及睡眠状况得到明显改善,疗效确切,值得在临床推广。

经三阴交注射甲硫酸新斯的明注射液治疗子宫全切术后尿潴留的效果

目的:分析经三阴交注射甲硫酸新斯的明注射液治疗子宫全切术后尿潴留的效果。方法:选取2020年6月—2023年6月于菏泽市单县妇幼保健院行子宫全切术治疗且术后并发尿潴留的患者90例为研究对象,采用数字盲选法分为对照组与观察组,每组45例。对照组经臀部肌内注射甲硫酸新斯的明注射液,观察组经三阴交注射甲硫酸新斯的明注射液。比较两组临床疗效、排尿情况及不良反应发生率。结果:观察组治疗总有效率高于对照组(P=0.014)。观察组恢复自主排尿时间短于对照组(P<0.05)。治疗前,两组残余尿量对比,差异无统计学意义(P>0.05);治疗后,两组残余尿量减少,且观察组少于对照组(P<0.001)。观察组不良反应发生率低于对照组(P=0.007)。结论:与肌内注射新斯的明相比,经三阴交穴位注射治疗尿潴留的临床疗效较好,能够促进患者自主排尿,且具有较高的安全性。

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).

三阴交穴位按摩联合低频脉冲反馈电刺激对产后压力性尿失禁患者盆底功能、尿失禁次数的影响

目的探究三阴交穴位按摩联合低频脉冲反馈电刺激对产后压力性尿失禁患者盆底功能、尿失禁次数的影响。方法选取2018年6月—2020年6月期间在南京中医药大学太仓附属医院进行产后压力性尿失禁治疗的患者110例,根据随机数字表法分为按摩组和联合组,每组各55例。两组患者均进行常规治疗,适当减少水分摄入,及时排尿,进行膀胱功能训练,按摩组在常规治疗的基础上进行三阴交穴位按摩治疗,联合组在按摩组的基础上,进行低频脉冲反馈电刺激治疗。治疗6周后,观察比较两组患者临床疗效,治疗前后尿流动力学指标[腹压漏尿点压力(Abdominal leak point pressure,ALPP)、最大尿流率(The maximum flow rate,Qmax)、最大尿道闭合压(Maximum urethral closure pressure,MUCP)];膀胱颈活动度、尿道旋转角水平;盆底功能水平(阴道收缩压、阴道静息压、阴道收缩持续时间);ICI-Q-SF评分(总排尿量、总排尿次数、总漏尿次数、总分)。结果治疗后两组患者尿流动力学指标ALPP、Qmax、MUCP水平较治疗前升高,差异有统计学意义(P<0.05),且联合组高于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者膀胱颈活动度、尿道旋转角水平较治疗前降低,差异有统计学意义(P<0.05);且联合组低于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者阴道收缩压、阴道静息压、阴道收缩持续时间水平较治疗前升高,差异有统计学意义(P<0.05);且联合组高于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者ICI-Q-SF评分总分及总排尿次数、总漏尿次数较治疗前降低,总排尿量较治疗前升高,差异有统计学意义(P>0.05);且联合组ICI-Q-SF评分总分及总排尿次数、总漏尿次数低于按摩组,总排尿量高于按摩组,差异有统计学意义(P<0.05)。治疗后联合组临床疗效总有效率92.73%(51/55)明显高于按摩组70.91%(39/55),差异有统计学意义(P<0.05)。结论经三阴交穴位按摩联合低频脉冲反馈电刺激联合治疗后,产后压力性尿失禁患者尿流动力学指标水平提高,盆底功能改善,ICI-Q-SF评分降低,尿失禁症状明显减轻,联合治疗效果显著。

针刺单穴与配伍腧穴对原发性失眠患者多导睡眠图睡眠参数的影响差异研究

目的评估针刺配伍腧穴和单穴在对改善原发性失眠患者多导睡眠参数影响的差异。方法使用中央随机系统将2015年5月-2018年5月3个临床中心门诊和住院的144名原发性失眠患者按1:1:1比例随机分为配伍组、单穴组、非经非穴组,接受不同针刺治疗。3组所有参与者接受5周共25次针刺治疗。所有原发性失眠患者在治疗前和治疗后的第1天22:00至第2天6:00进行多导睡眠检测,并完成匹兹堡睡眠指数(PSQI)和阿森斯失眠量表(AIS)评分。结果共纳入128名参与者,3组的基线期特征具有可比性。配伍组与单穴组PSQI和AIS评分、多导睡眠参数与治疗前相比均有改善(P<0.05)。与单穴组、非经非穴组比较,配伍组PSQI评分显著改善(P<0.01),睡眠总时间、睡眠效率、睡眠潜伏期显著增加(P<0.01,P<0.05),但AIS评分、觉醒时间、觉醒次数、快速眼动睡眠期差异无统计学意义(P>0.05)。结论针刺配伍腧穴可有效改善原发性失眠患者睡眠质量,调整睡眠结构,总体疗效优于针刺单穴治疗。

电针对骶上脊髓损伤大鼠尿流动力学和近端尿道组织结构的影响

目的 观察电针治疗后骶上脊髓损伤(suprasacral cord injury, SSCI)大鼠的膀胱最大容量(maximum cystometric capacity, MCC)、逼尿肌漏尿点压力(leakage point pressure, DLPP)和近端尿道组织形态学的变化,通过分析近端尿道组织结构形态和细胞成分变化具体引起的功能改变,探讨电针治疗在改善SSCI大鼠下尿路功能的过程中对近端尿道结构和功能的影响。方法 将36只SD雌性大鼠按随机数字表法抽取12只成为空白组;剩余大鼠采用改良的Hassan Shaker法在T10脊髓节段全横断制作SSCI大鼠模型,脊髓休克期后将成模大鼠随机分为模型组和电针组,12只/组。电针组取“次髎”“中极”“三阴交”穴予持续电针刺激40 min,空白组与模型组捆绑固定40 min,1次/d,连续7 d。治疗结束后麻醉大鼠,行尿流动力学检测(MCC和DLPP);随后处死,剪取大鼠近端尿道组织,HE染色观察组织形态结构。结果 与空白组比,模型组大鼠MCC和DLPP均显著升高(P<0.01);电针组大鼠MCC和DLPP显著低于模型组(P<0.01),DLPP较空白组差异无统计学意义(P>0.05),MCC仍显著高于空白组(P<0.01);与模型组相比,电针组大鼠尿路上皮细胞结构损伤减轻,固有层胶原纤维弯曲折叠,平滑肌层胶原纤维浸润减少。结论 电针刺激T10脊髓节段全横断大鼠“中极”“次髎”“三阴交”穴,可能通过减小MCC和DLPP,降低膀胱尿道由于过度充盈所承受的张力,从而保护近端尿道组织结构,提高其顺应性。

温和灸对原发性痛经模型大鼠子宫微循环及血液流变学的影响

目的:探讨温和灸对原发性痛经大鼠子宫微循环的影响。方法:将40只雌性SD大鼠随机分为空白组、空白加艾灸组、模型组、艾灸组,采用苯甲酸雌二醇联合缩宫素造模法制备大鼠子宫痛经模型,选择关元和三阴交对痛经大鼠进行温和灸治疗,分别观察测定大鼠扭体反应、子宫组织形态学、子宫微血管管径和血液流变学的变化情况。结果:除空白组和空白加艾灸组外,模型组与艾灸组均出现扭体反应,提示痛经大鼠模型制造成功;与空白组及空白加艾灸组比较,模型组子宫横径明显增加(P<0.05),微血管管径明显收缩(P<0.05)。与模型组比较,艾灸组子宫横径减少明显(P<0.05),微血管管径显著扩张(P<0.05);与空白组比较,模型组与艾灸组全血黏度各切变度、红细胞刚性指数、红细胞变形指数、红细胞沉降率方程K值及红细胞压积降低(P<0.05)。与模型组比较,艾灸组全血黏度各切变度、红细胞刚性指数、红细胞变形指数、红细胞沉降率方程K值及红细胞压积有升高的趋势(P>0.05);空白组与空白加艾灸组各项指标差异均无统计学意义(均P>0.05)。结论:温和灸对缩宫素所致大鼠实验性痛经有一定抑制作用,其抗痛经作用可能与改善子宫水肿及血液流变学,缓解子宫微循环障碍有关。

基于CiteSpace的三阴交穴相关文献可视化分析

目的围绕三阴交穴进行文献可视化分析,探索近20年来三阴交穴的研究现状、研究热点及未来发展趋势。方法以中国知网(CNKI)为数据来源,利用CiteSpace6.1.R6软件对2003年1月至2023年3月发表的与三阴交穴相关的文献进行可视化分析,绘制作者、机构、关键词相关图谱。结果最终纳入文献2251篇,发文量最多的作者是朱江(42篇),发文量最大的机构是天津中医药大学(49篇),共得到11个关键词聚类,针刺治疗中心度最高(强度值为0.876)。结论目前三阴交穴的临床应用主要集中在“针灸治疗”“电针”等方面,主要治疗“痛经”“失眠”等疾病,应继续探索关于三阴交穴的治疗机制研究及临床病种的拓展,建议加强各研究团队间的学术交流。