Brain activation and inhibition after acupuncture at Taichong and Taixi: resting-state functional magnetic resonance imaging

Acupuncture can induce changes in the brain. However, the majority of studies to date have focused on a single acupoint at a time. In the present study, we observed activity changes in the brains of healthy volunteers before and after acupuncture atTaichong （LR3） andTaixi （KI3） using resting-state functional magnetic resonance imaging. Fifteen healthy volunteers underwent resting-state functional magnetic resonance imaging of the brain 15 minutes before acupuncture, then received acupuncture atTaichong andTaixi using the nail-pressing needle insertion method, after which the needle was retained in place for 30 minutes. Fifteen minutes after withdrawal of the needle, the volunteers underwent a further session of resting-state functional magnetic res-onance imaging, which revealed that the amplitude of low-frequency lfuctuation, a measure of spontaneous neuronal activity, increased mainly in the cerebral occipital lobe and middle occipital gyrus （Brodmann area 18/19）, inferior occipital gyrus （Brodmann area 18） and cuneus （Brodmann area 18）, but decreased mainly in the gyrus rectus of the frontal lobe （Brodmann area 11）, inferi-or frontal gyrus （Brodmann area 44） and the center of the posterior lobe of the cerebellum. The present ifndings indicate that acupuncture atTaichong andTaixi speciifcally promote blood lfow and activation in the brain areas related to vision, emotion and cognition, and inhibit brain areas related to emotion, attention, phonological and semantic processing, and memory.

Dynamic functional connectivity analysis of Taichong (LR3) acupuncture effects in various brain regions

The present study conducted a multi-scale dynamic functional connectivity analysis to evaluate dynamic behavior of acupuncture at Taichong （LR3） and sham acupoints surrounding Taichong Results showed differences in wavelet transform coherence characteristic curves in the declive, precuneus, postcentral gyrus, supramarginal gyrus, and occipital lobe between acupuncture at Taichong and acupuncture at sham acupoints. The differences in characteristic curves revealed that the specific effect of acupuncture existed during the post-acupuncture rest state and lasted for 5 minutes.

TREATING 100 CASES OF HEADACHE BY MAINLY NEEDLING FENGCHI AND TAICHONG

This article introduces the writers’ experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and there is a saying of "no wind, no headache". The combinationof the two points can expel both endogenous and exogenous wind. So we treat headache mainly withneedling Fengchi and Taichong. The result is good, especially for cluster headache and psychicheadache.’

Clinical Application of the Point Taichong

Taichong (LR 3) is a yuan (source) point of the Liver Channel of Foot Taiyin. Having the effects of relieving the depressed liver, and regulating the circulation of qi to relieve pain, this point is widely used in clinic with quite satisfactory therapeutic effects. The following is a report of example cases.

Effect of Repetitive Transcranial Magnetic Stimulation(rTMS)Combined with Repetitive Magnetic Stimulation at Taichong Acupoint(LR3)on Depression:A Protocol for a Randomized Controlled Study

[Objectives]To explore the clinical treatment effect of repetitive transcranial magnetic stimulation(rTMS)combined with repetitive magnetic stimulation at Taichong acupoint(LR3)therapy in the treatment of depression.[Methods]60 patients who met the inclusion standard were chosen as the research subjects.They were split into two sets using a randomized parallel control method,with 30 cases each in the experimental and control groups.The experimental group adopted the treatment with rTMS+repetitive magnetic stimulation at Taichong acupoint(LR3),and the control group adopted the treatment with rTMS alone.The course of treatment was 8 weeks.Then the clinical efficacy,Hamilton Depression Scale 17 item score(HAMD-17),Symptom Check List-90(SCL-90),Patient Health Questionnaire-15(PHQ-15)and Pittsburgh Sleep Quality Index(PSQI)were compared.[Results]After treatment,the scores of HAMD-17,SCL-90,PHQ-15 and PSQI in the two groups were lower than those before and 4 weeks after treatment(P<0.05 or P<0.01),and the scores in the experimental group were inferior to those in the control group(P<0.01),The effective rate was 96.66%in the experimental group and 76.47%in the control group(P<0.05).In the course of treatment,no serious adverse reactions happened in either group.[Conclusions]The rTMS combined with repetitive magnetic stimulation at Taichong acupoint(LR3)can enhance the control of depression in the right frontal lobe,significantly improve the symptoms of depression and somatic discomfort,and improve the sleep quality of patients.It has a wide range of application,and is safe and noninvasive,so it is worthy of clinical promotion.

针刺四关穴缓解无痛胃镜诊疗术中并发呃逆疗效观察

目的 基于“气逆动膈”理论,观察针刺四关穴缓解无痛胃镜诊疗术中并发呃逆的有效性和安全性。方法 将100例无痛胃镜诊疗术中并发呃逆的患者随机分为治疗组和对照组,每组50例。治疗组采用针刺双侧合谷、太冲穴治疗,对照组不做任何治疗。观察并记录两组呃逆持续时间、胃镜治疗时间、麻醉苏醒时间及不同时间点各项血流动力学指标[平均动脉压(mean arterial pressure, MAP)、心率(heart rate, HR)、血氧饱和度(oxygen saturation, SPO_(2))],比较两组临床疗效。结果 治疗组治疗后治愈率和总有效率分别为50.0%和82.0%,明显高于对照组的14.0%和48.0%,两组比较差异均具有统计学意义(P<0.05)。治疗组呃逆持续时间、胃镜治疗时间均明显少于对照组(P<0.05)。两组呃逆开始时SPO_(2)水平均较基础值显著下降(P<0.05)。治疗组施针后5 min和10 min SPO_(2)水平均明显高于对照组,两组比较差异均具有统计学意义(P<0.05)。结论 针刺四关穴治疗无痛胃镜诊疗术中并发呃逆疗效确切,能有效减少患者呃逆持续时间和胃镜治疗时间。

针药并用治疗膝骨关节炎的疗效观察及对疼痛和关节功能的影响

目的观察针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎的临床疗效及对患者关节疼痛和关节功能的影响。方法选取100例膝骨关节炎患者,随机分为对照组(50例)和观察组(50例)。对照组予口服蠲痹汤治疗,观察组在对照组治疗基础上联合针刺四关穴和郄穴治疗。比较两组临床疗效,比较两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、西安大略与麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分和美国特种外科医院关节功能(Hospital for Special Surgery,HSS)评分,观察两组治疗前后骨代谢指标[血清骨钙素(osteocalcin,OC)和破骨细胞抑制因子(osteoclastogenesis inhibitory factor,OPG)]和炎症因子指标[血清白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-1(interleukin-1,IL-1)]的变化。结果观察组总有效率为94.0%,高于对照组的72.0%(P<0.05)。治疗后,两组VAS评分和WOMAC总分以及血清IL-6、TNF-α和IL-1水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组HSS评分以及血清OC和OPG水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论针刺四关穴和郄穴联合蠲痹汤治疗膝骨关节炎可有效减轻患者膝关节疼痛,改善膝关节功能及骨代谢水平,降低炎症因子水平,疗效优于单一中药治疗。

《针灸大成》中太冲穴的临床应用探析

本研究通过整理《针灸大成》中太冲穴的相关条文,并结合近年来的临床研究,探讨分析太冲穴的命名、定位、刺法灸法及针灸临床应用,以期为临床及实验研究提供理论依据和支撑。足厥阴肝经从足走胸腹,属肝络胆,与肺、胃、肾、脑、喉、目、唇及阴器相联系。太冲穴定位在足背区,操作方法多用针法和灸法,临床操作多为泻法。太冲穴作为足厥阴肝经的原穴和输穴,在五行中属土为木经之土穴,其功效主要与其定位、归经及穴性有关,具有疏肝理气、活血调血、通络止痛等作用,配合他穴使用可以治疗内科相关疾病(肝胆疾病、脾胃疾病、肾系疾病、肢体经络疾病)、又可兼治妇科疾病及外科疾病等。太冲穴为临床常用穴位,现代临床多用于妇科疾病、肢体经络疾病及情志类疾病。

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- Primary acupoints of the Large Intestine and Liver Meridian, and are collectively named as Si Guan （four gates） point. Combined use of these two acupoints can harmonize yin and yang, regulate qi and blood, and balance ascending or descending. This paper attempts to study the effects of Si Guan point on the vascular dilation and constriction in migraine patients from the perspective of its feature.

Effect of Taichong(LR 3) acupuncture in spontaneously hypertensive rats

OBJECTIVE: To evaluate the effects of Taichong(LR3) acupuncture points(acupoints) on the expression of glucose transporter protein 1(GLUT1) in the hypothalamus of spontaneously hypertensive rats(SHRs) as measured by combined positron emission tomography and computed tomography(PETCT).METHODS: Spontaneously hypertensive rats(SHR)were divided into model, Taichong(LR 3) acupuncture, and sham groups. Additionally, Tokyo Wistar rats were used as the control group. Changes in blood pressure were recorded in different groups of rats before and after the corresponding treatment. Hematoxylin and eosin(HE) staining was used to study basic morphological changes, and immunohistochemistry was used to determine GLUT1 expression in the hypothalamus. Further,PET-CT was utilized to elucidate the antihypertensive mechanism after acupuncture at the Taichong(LR 3) acupoints.RESULTS: PET-CT indicated activation of the hypothalamus. Measurement of blood pressure showed that acupuncture at the Taichong(LR 3) acupoints lowered blood pressure. HE staining did not show any significant pathological changes, although differences in cell number were observed. Immunohistochemical analysis indicated a GLUT1 downregulation in the SHRs of the Taichong(LR 3) acupuncture group after the treatment.CONCLUSION: Acupuncture at Taichong(LR 3) acupoints lowered blood pressure in SHRs, with possible mechanisms being changes in cell number and GLUT1 expression in the hypothalamus.

“开四关”探析

开四关临床应用甚广,但都局限于狭义的“合谷太冲”。本文从《标幽赋》《灵枢·九针十二原》《针灸大成》等古典医籍中探究开四关的病机理论,结合四象、阴阳探讨开四关的科学内涵,供同仁参考。

Treatment of Toothache by Needling Taichong (LR 3): A Report of 20 Cases

Purpose To explore the feasibility of treating toothache with the acupoints in Liver Meridian. Method According to syndrome differentiation, toothache was divided into pathogenic wind-fire type and deficiency-fire type. Twenty patients were treated by needling Tai-chong (LR 3) o! the affected side. Reducing manipulation was performed for toothache due to pathogenic windfire while early-reducing-late-tonifying was performed for toothache due to deficiency-fire type. Results The pain disappearance occurred in 14 cases, improved in 5 cases and no effect in one case. Conclusion Needling Tai-chong( LR 3) was effective for toothache.

内关、太冲穴位埋线对自发性高血压前期大鼠心肌损伤和能量代谢的影响

目的:探讨内关、太冲穴位埋线对自发性高血压(SHR)前期大鼠心肌损伤和能量代谢的影响。方法:选择16只4周龄自发性高血压大鼠,随机分为埋线组与模型组(n=8),另取8只同龄的京都种Wistar(WKY)大鼠为对照组。埋线组大鼠定位内关、太冲并进行穴位埋线干预,模型组及对照组仅予以抓取固定干预,实验周期为2周。在干预前1 h及干预2、7、14 d后,测定各组大鼠收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及心率(HR);并取心肌组织,采用HE染色比较各组大鼠左心室前壁心肌组织病理改变,电镜观察左心室前壁心肌组织线粒体的结构差异,酶联免疫吸附试验(ELISA)试剂盒测定心肌组织血管紧张素Ⅱ(AngⅡ)水平,三磷酸腺苷(ATP)检测试剂盒测定心肌组织中ATP水平。结果:干预2、7和14 d后,与模型组比较,埋线组大鼠DBP和MBP显著降低(P<0.01);干预7 d和14 d后,与模型组比较,埋线组大鼠SBP明显降低(P<0.01)。3组大鼠HR比较,差异无统计学意义(P>0.05)。模型组心肌细胞排列紊乱,心肌细胞横径和细胞间隙明显增大;与模型组比较,埋线组心肌细胞排列规则,心肌细胞横径明显减小(P<0.05),细胞间隙基本正常。在高倍透射电镜下,模型组线粒体排列紊乱,形状不规则,线粒体密度减小,埋线组较模型组有所改善。与模型组比较,埋线组左心室心肌组织中ATP水平升高,AngⅡ水平降低(P<0.05)。结论:内关、太冲穴位埋线可调节自发性高血压前期大鼠心肌能量代谢,对改善心肌损伤和降低血压水平有积极作用。

Influence of Electroacupuncture at Taichong(LR 3) and Ququan(LR 8) on Hepatic Hemodynamics

Objective： To observe the influence Taichong （LR 3） and Ququan （LR 8） on patients with chronic hepatic diseases. of electroacupuncture hepatic hemodynamics （EA） at in the Methods： Sixty cases with chronic hepatic diseases were randomly divided into a Taichong （LR 3） group and a Ququan （LR 8） group, 30 cases in each group, and were respectively treated with electroacupuncture at Taichong （LR 3） and Ququan （LR 8）. The blood flow results of the hepatic artery and portal vein by color ultrasonic test were used as the objective indexes, to compare and observe the hemodynamics changes of the hepatic artery and portal vein in the patients before and after EA. Results： After EA, in Taichong （LR 3） group, the average velocity, the lowest velocity, resistance indexes and the highest velocity of blood flow of the hepatic artery, and the highest velocity, average velocity of blood flow of the portal vein, blood flow volume of the portal vein （PVBF）, total blood flow volume of the liver （TLBF）, and Doppler blood perfusion indexes of the hepatic artery （DPI） were all statistically different from those before intervention （all P^O,O5）, In Ququan （LR 81 group, the highest velocity, average velocity, lowest velocity and resistance indexes of blood flow of the hepatic artery, and the highest velocity and average velocity of blood flow of the portal vein, and PVBF were significantly different from those before intervention （P〈0.05）. The TLBF and DPI were significantly different from those before intervention （P〈0.01）. All various indexes were not statistically different between the two groups. Conclusion： EA at Taichong （LR 3） and Ququan （LR 8） can speed up blood flow velocity of the portal vein, increase PVBF, increase the TLBF, increase the resistance indexes of the hepatic artery, decrease the blood flow velocity of the hepatic artery, and decrease DPI in the liver.

持续太冲穴电刺激治疗昏迷患者的临床观察

目的观察持续太冲穴电刺激对昏迷患者的治疗效果。方法选择格拉斯哥昏迷评分法(GCS)8分以下的昏迷患者24例,随机分成治疗A组和治疗B组,2组均予常规综合康复治疗,A组在此基础上加用右侧正中神经电刺激治疗,B组加用太冲穴持续电刺激治疗。结果所有患者入组前进行康复评定,2组患者治疗1个月后、3个月后苏醒率及苏醒时间、GCS分比较差异无统计学意义。结论对昏迷患者持续太冲穴电刺激是一种有效的康复方法。

A hippocampal anti-hypertensive mechanism induced by twirling reinforcing-reducing manipulation in rats

Objective:To investigate a hippocampal anti-hypertensive mechanism induced by twirling reinforcingreducing manipulation(TRRM)using proteomics in rats.Methods:Forty-two male spontaneously hypertensive rats were randomly divided into 3 groups,and 14 Wistar-Kyoto rats were served as control group.In the twirling reinforcing(TRF)group,needles were directly inserted into the Taichong(LR 3)point,then thumbs were moved heavily forward and lightly backward for 3 min,while needles remained inserted for 17 min.In the twirling reduction(TRD)group,the same treatment was applied as in the TRF group except that the thumb moved lightly forward and heavily backward.In the model and control groups,only the corresponding grasping and fixation were applied.All interventions were conducted for 14 days.The blood pressure(BP)of all rats was measured one day before intervention and every other day after.Then hematoxylin-eosin(H&E)staining,label-free and parallel reaction monitoring proteomic techniques were used to assess hippocampal samples from each group.Results:Systolic BPs showed a significant decrease in the TRF and TRD groups compared with the model group(P<.01).In the model group,H&E staining showed obvious pathological changes in the hippocampus,while in the TRF and TRD groups,the hippocampal morphology was only slightly altered.Labelfree proteomic analysis revealed 1163 differential protein expressions between groups.Gene Ontology enrichment analysis confirmed that the differentially expressed proteins were enriched in different biological processes,cellular components,and molecular functions.Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that TRRM proteins were expressed in the serotonergic synapse pathway,renin-angiotensin system,the mitogen-activated protein kinase signaling pathway,and the peroxisome pathway,which were all also related to BP regulation.Conclusion:TRRM can significantly lower the BP of SHRs.The mode of action may be through the activation of various protein pathways in the hippocampus that are related to BP regulation.

针刺治疗原发性抑郁症取穴及配伍规律研究

目的:挖掘针刺治疗原发性抑郁症的选穴配伍规律,为临床取穴及科学研究提供参考。方法:检索Pubmed、中国知网、万方数据知识服务平台、维普期刊资源整合服务平台发表的针刺治疗原发性抑郁症的临床研究文献,应用Excel软件整理文献中的腧穴处方数据(使用频次、分布部位、归经、特定穴等),并对使用频次大于10的高频腧穴进行关联规则分析。结果:最终纳入文献79篇,其中中文文献61篇,英文文献18篇。(1)针刺处方中单穴累计为69个,取穴总计546频次,腧穴使用频率较高的为百会、印堂、太冲等。(2)特定穴在原发性抑郁症的针刺治疗中应用广泛,以五输穴、交会穴的使用频次最高。(3)取穴涵盖了手太阳小肠经外的13条正经,较常用的经脉包括督脉、足厥阴肝经等,其中以督脉的使用频率最高,经外奇穴的使用频率也较高,且均位于头部。(4)关联规则分析发现,本病腧穴使用相对集中,以百会-印堂、百会-太冲,百会-内关,百会-三阴交为主。结论:原发性抑郁症的针刺取穴以百会、印堂、太冲、内关、三阴交为主,多督脉、足厥阴肝经穴位,特定穴及头部经外奇穴应用较多。

基于功能性磁共振成像技术探讨针刺太冲穴脑激活区的性别差异

目的 采用功能性磁共振成像(functional magnetic resonance image, fMRI)技术观察针刺太冲穴所激活脑区的性别差异,以阐明针刺效应性别差异的机制。方法 女性组选取25例青年女性志愿者,男性组选取30例青年男性志愿者,针刺志愿者左侧太冲穴并收集fMRI数据。结果 女性组针刺太冲穴激活的脑区有左侧小脑下部、右侧缘上回、左侧中央后回。男性组针刺太冲穴激活的脑区有右侧缘上回、左侧中央盖沟、右侧中央旁小叶。与女性组比较,男性组更广泛地激活了右侧缘上回、右侧中央沟盖。结论 针刺受试者太冲穴激活脑区并不完全对称,针刺效应在大脑具有偏侧性,针刺太冲穴时大脑活动反应存在性别差异。

“心胀咽痛,刺太冲必除之”理论探讨

探讨“心胀咽痛,刺太冲必除之”理论依据,扩展太冲穴临床应用。从心与肝生理病理、气血调节联系、经络循行理论以及标本根结理论四方面分析,得出肝疏泄失常致心主血脉、心主神志功能异常,故治心脏疾患需先调肝清其源;肝与心,气与血的调节相互影响,调气为主,调血为辅,不可忽视肝调节气机对维持其他脏腑生理功能的重要性;太冲穴为肝经的原穴,针刺其可治疗胸腹部疾病;针刺太冲可调理气机不畅,血行不利所致心神疾患,故“心胀咽痛,刺太冲必除之”理论可指导临床应用太冲穴治疗胸闷心烦、短气、咽痛、卧不安等。

探意太冲

“气穴所发,各有处名”,腧穴的名称是天文、地理、建筑等多学科的综合体现,腧穴释名有利于体会其丰富的中华传统文化内涵。太冲穴为足厥阴肝经的输穴、肝之原穴,是临床常用穴之一。以本穴为例,从穴名角度出发,通过对经典文献和现代研究的梳理,总结了太冲理气调血、通络止痛、开窍息风、转输津液的功用,为挖掘其穴名内涵和扩展其应用范围提供借鉴,以期引起对腧穴名称涵义的重视。