Moxibustion at ST36 activates peritoneal macrophages in CTX-induced immunosuppression in mouse model via IFN-γ

Background:To explored whether moxa cone moxibustion can reduce peritoneal inflammation by increasing the content of peritoneal macrophages and B cells via interferon-gamma.Methods:The mice were randomly divided into three groups with six mice in each group:the control group,model group,and moxibustion group,and the model was established in mice using cyclophosphamide.In the moxibustion group,the mice received moxa cone moxibustion at Zusanli(ST36)for 7 days.Analysis of Peritoneal cell were detected by flow cytometry and immunofluorescence,the protein expression level in the peritoneal fluid were measured with mouse cytokine antibody arrays and verified by enzyme linked immuno sorbent assay test,and RNA-Sequencing was used for peritoneal cell RNA analysis.Results:Our results showed that moxa cone moxibustion could reduce the loss of large peritoneal macrophages and B1 cells(P<0.05).With the cytokine array analysis and enzyme linked immuno sorbent assay test of peritoneal fluid,we found that IFN‐γwas up-regulated in moxibustion group(P<0.05).There were 169 genes were down-regulated in the model group and up-regulated in the moxibustion group while 19 genes that were up-regulated in the model group and down-regulated in the moxibustion group via RNA-sequencing.Kyoto Encyclopedia of Genes and Genomes pathway analysis of 188 intersect differentially expressed genes were found that the top 3 pathways with the highest enrichment of up-regulated genes included Hematopoietic cell lineage,Inflammatory bowel disease and Malaria.The differentially expressed genes visualization protein-protein interaction network shows the top 10 genes including Ifng,Grb2,CCR7,CTLA4,CXCR5,Foxp3,kit,PRF1,CD5 and klrg1.Conclusion:These findings showed that moxa cone moxibustion can alleviate chemotherapy-induced diarrhea by reducing the loss of large peritoneal macrophages and B1 cells in the peritoneal cavity,possibly through up-regulating inflammatory bowel disease signaling pathway via interferon-gamma to regulate the survival and function of large peritoneal macrophages and B1 cells.

Effects of electroacupuncture at Zusanli(ST36) on inflammatory cytokines in a rat model of smokeinduced chronic obstructive pulmonary disease

OBJECTIVE： Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease （COPD）, but little is known about the underlying mechanisms. Because an immune response imbalance could be seen in COPD, we hypothesize that electroacupuncture （EA） may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD. METHODS： A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established. The rats were randomly divided into four groups （control, sham, COPD, and COPD plus EA）, and COPD model was evaluated by measuring pulmonary pathological changes and lung function. EA was applied to the acupuncture point Zusanli （ST36） for 30 min/d for 14 d in sham and COPD rats. Bronchoalveolar lavage fluid （BALF） was used to measure levels of tumor necrosis factor-a （TNF-a）, interleukin-113 （IL-113）, and malonaldehyde （MDA）. RESULTS： Compared with the control rats, COPD rats had significant changes in lung resistance （R,） and lung compliance （C,） （both P〈0.01）, bronchi and bronchiole airway obstruction （P〈0.01）, and levels of MDA, TNF-α, and IL-1β（P〈0.01）. There were no significant differences between the control and the sham groups. Compared with the COPD rats, the COPD plus EA rats had decreased R, and increased CL （both P〈0.05）, and reduced bronchi and bronchiole airway obstruction （P〈0.05, P〈0.01, respectively）, while levels of TNF-α, IL-1β, and MDA in BALF were lowered （P〈0.05 and P〈0.01, respectively）. However, TNF-α and IL-1β levels of the EA group rats remained higher than those of the control group （P〈0.05）. CONCLUSION： EA at ST36 can reduce lung injury in a COPD rat model, and beneficial effects may be related to down-regulation of inflammatory cytokines. The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.

Effects of pre-moxibustion at Zusanli (ST36) on heat shock protein 70 expression in rats with gastric mucosal lesions after neurotomy

Studies have shown that pre-moxibustion protects the gastric mucosa by up-regulating the expression of heat shock protein 70. However, the signaling pathway underlying this effect remains unclear. Rats were intragastrically administered absolute alcohol, causing obvious lesion of the gastric mucosa. Following pre-moxibustion at Zusanfi （ST36） for 8 days, the ulcer index decreased to different degrees. The results of an enzyme linked immunosorbent assay and western blotting showed significant upregulation of heat shock protein 70 expression in the gastric mucosa and serum. None out of transection of the spinal cord, damage to the nucleus of the solitary tract, neurotomy of the vagal nerve and neurotomy of the common peroneal nerve affected the decrease in ulcer index or the increase in heat shock protein 70 expression in serum after pre-moxibustion at Zusanfi, and heat shock protein 70 expression was obviously decreased in the gastric mucosa. These findings suggest that pre-moxibustion at Zusanfi can protect the gastric mucosa against lesioning, and that the mechanism underlying this effect involves its induction of heat shock protein 70 expression. Neural pathways participate in the regulatory effects of moxibustion on heat shock protein 70 expression in the gastric mucosa.

Comparison of protective effects of electroacupuncture and moxibustion at Zusanli(ST 36)on perinatal nicotine exposure-induced lung phenotype in rat offspring

Objective:To compare the effects of electroacupuncture(EA)and moxibustion at Zusanli(ST 36)on the lung phenotype of rat offspring exposed to nicotine during the perinatal period.Methods:Pregnant Sprague-Dawley rats were randomly divided into 4 groups:the control group(saline only),the model group(nicotine only),the EA group(nicotine+EA at ST 36 acupoints bilaterally),and the moxibustion group(nicotine+moxibustion at ST 36 acupoints bilaterally).n=6 rats per group.On postnatal day 21,the body weight,lung weight,and pulmonary function were determined and lung morphometry was performed.Peroxisome proliferator-activated receptor gamma andβ-catenin levels in the lung tissue of offspring were also determined.Results:Perinatal nicotine exposure(PNE)results in decreased body and lung weights of offspring rats,abnormal lung tissue morphology,and significantly altered pulmonary function,showing an increase in total airway resistance and a decrease in tidal volume,minute ventilation,total airway compliance,and peak expiratory flow.Bilateral EA at ST 36 acupoints could block all of these perinatal nicotine-induced effects.Although moxibustion also had protective effects in nicotine-induced offspring lungs,some of these effects did not reach statistical significance,e.g.,protection against the upregulation ofβ-catenin,the downregulation of PPARγsignaling,and the increase in peak expiratory flow.Conclusion:Maternal EA at ST 36 blocked the PNE-induced changes in key developmental signaling pathways,prevented the PNE-induced changes in lung morphology,and protected pulmonary function.Moxibustion at ST 36 showed similar but weaker protective effects against the PNE-induced changes in the exposed offspring.It is important to note that the mechanism underlying the protective effects of moxibustion at ST 36 may be different from those of EA at ST 36,and further research is needed to understand these differences.

坐骨神经胞外核苷酸酶在针刺缓解大鼠踝关节炎性痛中的作用

目的 探讨坐骨神经胞外核苷酸酶[CD39(NTPDase1)]在针刺缓解大鼠踝关节炎性痛中的作用。方法 将54只雄性大鼠随机分为9组,即空白组、踝关节炎性痛模型组、针刺组、坐骨神经腺苷三磷酸(ATP)水解酶抑制(ARL67156注射)+针刺组、坐骨神经CD39上调(三磷酸腺苷双磷酸酶注射)组、坐骨神经CD39特异性抑制(噻氯匹啶注射)+针刺组、坐骨神经CD73特异性抑制(α,β-亚甲基腺苷5′-二磷酸钠盐注射)+针刺组、穴区CD39上调(三磷酸腺苷双磷酸酶注射)组、穴区CD39特异性抑制(噻氯匹啶注射)+针刺组,每组6只。除空白组外,其余各组大鼠均采用注射完全弗氏佐剂建立佐剂性关节炎疼痛模型;造模48 h后,需针刺组大鼠针刺患侧“足三里”穴20 min,需注射药物组于针刺前20 min进行局部相关试剂注射。以大鼠患侧足底机械痛阈值和热痛阈值作为疼痛评价指标;采用实时荧光定量逆转录聚合酶链式反应(RT-qPCR)法和Western blot法检测坐骨神经以及“足三里”穴胞外核苷酸酶的表达。结果 (1)调节坐骨神经ATP水解酶活性:与空白组比较,踝关节炎性痛模型组和坐骨神经ATP水解酶抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组热痛阈值和机械痛阈值明显上升(P<0.05)。(2)调节坐骨神经CD39活性:与空白组比较,坐骨神经CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组和坐骨神经CD39上调组热痛阈值和机械痛阈值明显上升(P<0.05);与针刺组比较,坐骨神经CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05)。(3)调节穴区CD39活性:与空白组比较,穴区CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组和穴区CD39上调组热痛阈值和机械痛阈值明显上升(P<0.05);与针刺组比较,穴区CD39特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05)。(4)调节坐骨神经CD73活性:与空白组比较,坐骨神经CD73特异性抑制+针刺组热痛阈值和机械痛阈值明显下降(P<0.05);与踝关节炎性痛模型组比较,针刺组热痛阈值和机械痛阈值明显上升(P<0.05)。(5)针刺对坐骨神经以及穴区CD39表达的影响:Western blot法检测结果显示,与空白组比较,踝关节炎性痛模型组坐骨神经CD39的表达显著增加(P<0.05);与踝关节炎性痛模型组比较,针刺组CD39表达显著下调(P<0.05)。RT-qPCR法检测结果显示,与踝关节炎性痛模型组比较,针刺组CD39 mRNA表达水平明显上调(P<0.05)。结论 坐骨神经局部CD39参与了针刺缓解大鼠踝关节炎性痛的机制,这可能与CD73联合促进胞外ATP向腺苷转化有关。

针刺足三里、内关穴对老年髋关节置换术后镇痛疗效及对血清炎症因子的影响

目的探讨针刺足三里、内关穴对老年髋关节置换术后镇痛疗效及对血清炎症因子的影响。方法选择196例行全髋关节置换术的老年患者作为研究对象,采用随机数字法平均分为观察组与对照组:对照组术后给予常规对症止痛及冰袋冷敷治疗,观察组术后6 h在对照组基础上给予足三里、内关穴针刺治疗。于术后6 h、24 h、48 h、72 h及第5天采用疼痛视觉模拟评分(Visual analogue scale,VAS)评价患者疼痛状态,于术后6 h、48 h及72 h评价术后胀气情况;于术后6 h、24 h、48 h及72 h检测血清炎症因子:前列腺素E2(Prostaglandin E2,PGE2)、白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α);于髋关节置换术前、术后72 h、出院时采用Harris髋关节评分标准评价髋关节功能。结果两组患者术后24 h VAS评分最高,随后逐渐降低(P<0.05);术后48 h观察组VAS评分降至术后6 h水平,而对照组仍高于术后6 h水平(P<0.05);术后24 h、48 h、72 h及第5天观察组VAS评分均低于对照组(P<0.05)。术后两组患者腹胀评分均逐渐降低(P<0.05);术后48 h、72 h观察组腹胀评分低于对照组(P<0.05)。观察组术后肠鸣音出现及恢复正常时间、首次排气及排便时间均较对照组短(P<0.05)。两组患者术后24 h PGE2、IL-1β、TNF-α水平最高,术后72 h逐渐降低(P<0.05);术后5 d观察组PGE2、IL-1β、TNF-α水平降至术后6 h水平,而对照组仍高于术后6 h水平(P<0.05);术后24 h、72 h及第5天观察组PGE2、IL-1β、TNF-α水平均低于对照组(P<0.05)。两组术后Harris髋关节评分均逐渐升高(P<0.05);术后72 h及出院时观察组Harris髋关节评分高于对照组(P<0.05)。结论针刺足三里、内关穴可以更好地降低老年髋关节置换术后疼痛程度,缩短疼痛时间,同时更好地促进胃肠道功能恢复,其机制可能与降低PGE2、IL-1β、TNF-α等炎症因子相关。

基于miRNA-29c/白血病抑制因子轴探讨针刺调节脾虚大鼠肠道炎症机制研究

目的观察针刺调节miRNA-29c/白血病抑制因子(leukemia inhibitory factor,LIF)轴改善脾虚大鼠结肠炎症机制,探讨“健脾益气”针刺疗法改善脾虚便溏症状现代作用机理。方法将60只SD雄性大鼠以随机数字表法分为正常组、模型组、非经非穴组、针刺组,每组15只。除正常组外,其余3组采用劳倦过度和不规律饮食复合方法建立脾虚证大鼠模型。造模成功后,针刺组电针“足三里”穴及“脾俞”穴干预治疗,非经非穴组给予电针尾尖作为对照干预,每日1次/20 min,共治疗14 d。治疗结束后,取大鼠结肠组织及全血。qPCR检测大鼠结肠组织miRNA-29/LIF轴相关基因的表达;Western blot检测大鼠白介素-6(interleukin6,IL-6)、肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)的表达;ELISA检测结肠组织中白介素-1β(interleukin1β,IL-1β)、白介素-18(interleukin18,IL-18)的含量;HE染色法观察大鼠结肠组织病理形态变化;TUNEL染色观察各组结肠组织凋亡情况;流式细胞术观察外周血单个核细胞(PBMC)凋亡状况。结果与正常组相比,模型组大鼠结肠组织LIF的表达水平明显下降(P<0.05),miRNA-29、IL-1β、IL-6、白介素-8(interleukin18,IL-8)、TNF-αmRNA表达以及IL-6、TNF-α蛋白表达水平有所升高(P<0.05);与模型组相比,针刺组大鼠结肠组织LIF表达水平明显升高(P<0.05),miRNA-29c、IL-1β、IL-6、IL-8、TNF-αmRNA表达以及IL-6、TNF-α蛋白表达水平有所降低(P<0.05),非经非穴组差异无统计学意义(P>0.05);与正常组相比,模型组大鼠结肠组织中促炎因子IL-1β、IL-18表达水平明显升高(P<0.05),与模型组相比,针刺组大鼠结肠组织中促炎因子IL-1β、IL-18的表达水平有所降低(P<0.05)。另外HE染色结果显示,针刺治疗可有效减轻结肠黏膜组织中炎症细胞浸润和杯状细胞的损失;TUNEL染色结果显示,针刺可以抑制miRNA-29c/LIF轴,改善脾虚大鼠结肠炎症,抑制结肠黏膜细胞凋亡;流式细胞术结果显示与正常组相比,模型组、非经非穴组大鼠PBMC凋亡率明显升高(P<0.05),与模型组相比,针刺组大鼠PBMC细胞凋亡率有所降低(P<0.05)。结论电针“足三里”“脾俞”穴可以调节miRNA-29c/LIF轴,抑制肠道炎症和促炎症介质的表达,进而抑制血液、结肠黏膜细胞凋亡,提高机体免疫力,从而改善脾虚便溏症状。

益气养阴降糖方联合穴位注射治疗初发2型糖尿病临床观察

【目的】观察益气养阴降糖方(由黄芪、生地黄、白茅根、麦冬、葛根等中药组成)联合穴位注射治疗初发2型糖尿病的临床疗效。【方法】将100例气阴两虚兼血瘀证的初发2型糖尿病患者随机分为治疗组和对照组,每组各50例。对照组给予盐酸二甲双胍片口服治疗,治疗组在对照组的基础上给予益气养阴降糖方中药颗粒剂联合穴位注射(每次取足三里、肾俞、气海单侧穴位)治疗,疗程为4周。观察2组患者治疗前后中医证候积分、空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)和血清炎症因子白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平以及血液流变学指标(全血低切黏度和全血高切黏度)的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)脱落情况方面:研究过程中,治疗组脱落5例,对照组脱落4例,最终共有91例患者纳入疗效统计,其中,治疗组45例,对照组46例。(2)疗效方面:治疗4周后,治疗组的总有效率为93.33%(42/45),对照组为71.74%(33/46),组间比较(χ2检验),治疗组的疗效明显优于对照组(P<0.01)。(3)中医证候评分方面:治疗后,2组患者的口干咽燥、夜尿频多、气短乏力、潮热盗汗等各项中医证候评分及总评分均较治疗前明显降低(P<0.05),且治疗组的降低幅度均明显优于对照组(P<0.01)。(4)血糖、血脂方面:治疗后,2组患者的FPG、2hPG、HbA1c、TC、TG水平均较治疗前降低(P<0.05),且治疗组的降低幅度均明显优于对照组(P<0.05或P<0.01)。(5)炎症因子方面:治疗后,2组患者的血清IL-6、CRP、TNF-α水平均较治疗前降低(P<0.01),且治疗组的降低幅度均明显优于对照组(P<0.01)。(6)血液流变学方面:治疗后,2组患者的全血低切黏度、全血高切黏度等血液流变学指标均较治疗前降低(P<0.05),且治疗组的降低幅度均明显优于对照组(P<0.05)。(7)安全性评价方面:治疗组的不良反应发生率为8.89%(4/45),明显低于对照组的21.74%(10/46),差异有统计学意义(P<0.01)。【结论】对于气阴两虚兼血瘀证的初发2型糖尿病患者,益气养阴降糖方联合穴位注射治疗疗效显著,能有效减轻患者早期临床表现,降低患者血糖、血脂、炎症因子水平,改善患者的血液流变学指标,提高患者的生活质量。

内关穴和足三里穴位刺激对腹腔镜结直肠癌根治术麻醉及术后胃肠功能的影响

目的 观察内关穴和足三里穴位刺激对腹腔镜结直肠癌根治术麻醉及术后胃肠功能的影响。方法 以2021年1月—2022年6月医院进行腹腔镜结直肠癌根治术的患者126例作为研究对象,通过随机数表法分为两组,每组63例,对照组术后常规镇痛干预,观察组在对照组基础上进行内关穴和足三里穴位刺激,比较两组的麻醉术后恢复、胃肠功能及免疫功能情况和不良反应发生率,观察指标包括疼痛视觉模拟评分法(Visual Analogue Scale, VAS)、拉姆齐(Ramsay)镇静评分,胃肠反应分级,肠鸣音恢复时间、肛门排气时间、进食流质饮食时间、排便时间,外周血T淋巴细胞亚群(CD^(+)3、CD^(+)4、CD^(+)8)及自然杀伤细胞(natural killer cell, NK),不良反应。结果 术后24、48 h观察组VAS评分显著低于对照组,差异均有统计学意义(P<0.05),Ramsay评分差异无统计学意义(P>0.05)。术后48 h观察组胃肠反应分级显著优于对照组,差异有统计学意义(P<0.05)。两组肠鸣音恢复时间、肛门排气时间、进食流质饮食时间比较差异有统计学意义(P<0.05),观察组均短于对照组。术后5 d两组CD^(+)3、CD^(+)4、NK水平均显著升高,且观察组高于对照组,差异有统计学意义(P<0.05),但两组CD^(+)8变化不明显,差异无统计学意义(P>0.05)。观察组不良反应发生率为9.53%,对照组不良反应发生率为14.29%,组间差异无统计学意义(P>0.05)。结论 内关穴和足三里穴位刺激有利于腹腔镜结直肠癌根治术患者麻醉及术后恢复,镇痛、镇静效果良好,胃肠功能恢复更快,提高患者免疫功能,利于术后康复。

穴位注射联合贴敷治疗腹腔镜术后胃肠功能紊乱的疗效观察及对胃肠黏膜损伤的影响

目的观察穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱的临床疗效及对患者胃肠黏膜损伤修复作用和创伤应激、胃泌素调节及血清生长素释放肽(Ghrelin)和胃动素(motilin,MTL)的影响。方法将128例腹腔镜术后胃肠功能紊乱患者按随机数字表法分为联合组和西医组,每组64例。西医组予西医常规治疗,联合组在西医常规治疗基础上予穴位注射足三里穴联合腹部穴位贴敷治疗。比较两组肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间和临床疗效,观察两组治疗前后中医证候积分、血清MTL、Ghrelin、胃泌素(gastrin,GAS)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-LA)、瓜氨酸、胃蛋白酶原Ⅱ、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、醛固酮和皮质醇水平的变化。结果联合组总有效率为96.9%,高于西医组的84.4%(P<0.05)。联合组治疗后肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间均较西医组短(P<0.05);联合组治疗后中医证候积分中疲乏无力、食欲不振、脘腹痞满、食物后痞满加重、大便溏稀和恶心呕吐的评分较西医组降低(P<0.05);联合组治疗后血清TNF-α、醛固酮、皮质醇、DAO、胃蛋白酶原Ⅱ和D-LA水平低于西医组(P<0.05);联合组治疗后血清MTL、Ghrelin、GAS和瓜氨酸水平高于西医组(P<0.05)。结论在西医常规治疗基础上,穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱可减少患者创伤应激反应,改善胃动力,促进胃肠黏膜损伤修复,缓解患者临床症状,提高临床疗效。

联合针刺梁丘穴和足三里穴与足三里穴和上巨虚穴的fMRI-BOLD对比研究

目的:探讨同一经络内2个相邻穴位针刺的联合效应,为针刺的中枢机制和经络学说提供一定证据。方法:50例健康志愿者随机分为2组,分别行右侧梁丘穴+足三里穴和足三里穴+上巨虚穴脉冲电针治疗仪针刺。采用区块设计模式行fMRI,分析针刺过程中的脑活动模式,并比较2组的差异。记录2组针刺感觉类型和强度,评估针刺感觉与脑活动的关系。结果:梁丘穴+足三里组和足三里穴+上巨虚穴组共同激活区集中在右侧额上回眶缘、左侧额下回盖部、左侧前扣带回和左侧眶前回,2组共同负激活区则集中在右侧缘上回、右侧尾状核、右侧壳核和左侧岛叶。梁丘穴+足三里穴组在左侧额下回盖部、左侧前扣带回等区域更活跃,而足三里穴+上巨虚穴组在右侧缘上回、左侧岛叶和左侧壳核等区域更活跃。结论:同一经络内2个相邻穴位的针刺刺激可产生协同效应,不同穴位组合对大脑活动的影响也有差异。这些结果可为针刺的中枢机制和经络学说提供一定证据,为针刺方案的设计提供参考。

剪切波弹性成像技术对低强度脉冲超声刺激足三里穴引起肌张力变化的评估

目的:应用剪切波弹性成像技术(SWE)评估低强度脉冲超声(LIPUS)刺激足三里穴位时肌张力的变化特点,初步探讨LIPUS刺激穴位的可行性,以期为LIPUS在外周神经调控研究中提供定量评估信息。方法:实验动物为16只雄性SD大鼠,随机分为胫骨前肌组和腓肠肌组各8只,应用LIPUS刺激大鼠足三里穴20 min,通过SWE连续监测胫骨前肌和腓肠肌的肌张力变化。酶联免疫吸附试验(ELISA)测定刺激前后血清5-羟色胺(5-HT)水平变化。结果:胫骨前肌在LIPUS刺激足三里穴后3 min的剪切波速度和杨氏模量值均较刺激前显著升高(均P<0.05);腓肠肌在刺激足三里穴后13、14 min的剪切波速度和杨氏模量值均较刺激前显著升高(均P<0.001)。血清5-HT水平较刺激前显著升高(P<0.05)。结论:SWE可为评估LIPUS刺激足三里穴位引起的肌张力变化提供客观依据,为LIPUS的经穴效应的研究提供更多信息。

Electro-acupuncture at Zusanli(ST 36) to improve lower extremity motor function in sensory disturbance patients with cerebral stroke A randomized controlled study of 240 cases

BACKGROUND： Studies have shown that sensory transduction is a way to introduce needle sensation. OBJECTIVE： To observe the influence of electro-acupuncture at the ＂Zusanll＂ （ST 36） point on lower extremity motor function in various sensory disturbance patients with cerebral stroke. DESIGN, TIME AND SETTING： A randomized, controlled, clinical study was performed at the Department of Neurological Rehabilitation, China Rehabilitation Research Centre from September 2006 to June 2008. PARTICIPANTS： Patients with first-time cerebral infarction or hemorrhage, or with a stroke history, but no neurodysfunction （single damage）, were selected for this study. The subjects were right-handed and disease state was stable. A total of 240 inpatients were randomly assigned to the following groups： electro-acupuncture （n = 124） and control （n = 116）. The two groups were further assigned into sub-groups： no sensory disturbance, superficial sensory disturbance, deep sensory disturbance, and deep and superficial sensory disturbance. METHODS： On the basis of routine limb function training, the acupoint Zusanliwas utilized in all patients from the electro-acupuncture group. Perpendicular acupuncture was 3.0-4.0 cm deep. An electric acupuncture instrument was connected when patients developed the needle sensation, deqi. A stimulation pattern consisting of distant and dense waves of 50 Hz was used to elicit slight dorsal foot extension. Acupuncture was administered 5 times per week, 30 minutes per session, for 6 weeks in total. MAIN OUTCOME MEASURES： FugI-Meyer assessment （FMA） was used to evaluate lower extremity motor function; Ver.1.0 gait analysis to estimate gait （step frequency, step speed, and step scope）; lower extremity Composite Spasticity Scale （CSS） to estimate muscle spastic degree. RESULTS： Following treatment, motor function improved in both groups. Compared with the control group, FMA score, step speed, step frequency, and step scope were increased in the electro-acupuncture group, but there was no difference in lower extremity CSS scores between the electro-acupuncture and the control groups （P 〉 0.05）. Compared with the control group, Zusanli （ST 36） electro-acupuncture improved motor function indices as follows： FMA score, step frequency, step speed, and step scope of patients with no sensory disturbance （P 〈 0.05-0.01）, step frequency of patients with superficial sensory disturbance （P 〈 0.05）, and step frequency and step speed of patients with deep sensory disturbance （P 〈 0.05）. CONCLUSION： Zusanfi （ST 36） electro-acupuncture effects on lower extremity motor function in stroke patients were improved with no muscle tone rise. Therefore, this form of treatment can be used in convalescent treatment, Moreover, effects were different according to various sensory disturbance types, which suggested that sensory input influenced acupuncture effects.

Downregulation of electroacupuncture at ST36 on TNF-α in rats with ulcerative colitis

AIM: To investigate the regulatory effect of electroacupuncture (EA) at Zusanli (ST36) on tumor necrosis factor-alpha (TNFα) in rats with ulcerative colitis (UC), and further elucidate the therapeutic mechanism of EA on UC.METHODS: Thirty-two male Sprague-Dawley (SD) rats were randomly divided into four groups (n=-8): normal control group, UC control group, UC+ST36 group and UC+nonacupoint group. A solution containing ethanol and 2,4,6-trinitrobenzenesulfonic acid (TNBS) was instilled into the distal colon in the rat (at a dose of 100 mg/kg) to set up UC rat model. Rats in wakefulness state of UC+ST36 group were stimulated at ST36 by EA once a day, while those of UC+nonacupoint group were done at 0.5 cm beside ST36. After 10d treatment, all rats were sacrificed simultaneously. Colon musocal inflammation and damage were assessed by measuring colon mass, morphologic damage score, colonic myeloperoxidase enzyme (MPO) activity, serum TNF-α and colonic TNF-α mRNA level. Morphologic damage score was examined under stereomicroscope. Colonic MPO activity was measured by spectrophotometer method. Serum TNF-αconcentration was determined by radioimmunoassay (RIA).Colonic TNF-α mRNA expression level was analyzed by semiquantitative reverse transcription polymerase chain reaction (RT-PCR).RESULTS: Ratio of colonic mass/body mass (mC/mB) and activity of colonic MPO (μkat/g tissue) markedly increased (8.5±2.6 vs 2.5±0.4; 145±25 vs 24±8, P＜0.01 vs normal control group). Compared with normal control rats, serum TNF-α and colonic TNF-α mRNA level in UC control group were increased 2.5 fold (2 278±170 vs 894±248, P＜0.01)and 4.3 fold (0.98±0.11 vs 0.23±0.11, P＜0.01)respectively. After EA at ST36, mc/mB and MPO activity were reduced significantly (5.3±2.0 vs 8.5±2.6; 104±36 vs145±25, P＜0.01, 0.05) compared with those of UC control group. Serum TNF-α and colonic TNF-α mRNA level were inhibited by EA stimulation at ST36 (P＜0.01). The inhibitory rate was 16 % and 44 % respectively.Morphologic damage score was also increased markedly in rat with UC (P＜0.01), whereas it was decreased by EA at ST36 (P＜0.05). There was no significant difference between UC control group and UC+EA at non-acupoint (P＞0.05). Furthermore, these parameters were highly correlated with each other (P＜0.01).CONCLUSION: Serum TNF-α concentration and colonic TNF-α mRNA expression level are increased significantly in UC rats in correlation with the severity of disease. It indicates that TNF-α is closely involved in the immune abnormalities and inflammatory responses in UC. EA at ST36 has therapeutic effect on UC by downregulating serum TNF-r and colonic TNF-r mRNA expression. High levels of TNF-αand its corresponding mRNA expression seem to be implicated in the pathogenesis of UC.

EXPERIMENTAL STUDY ON MOXIBUSTION AT ZUSANLI(ST 36) AND LIANGMEN (ST 21) INDUCING HEAT SHOCK PROTEIN 70 (HSP70) EXPRESSION TO RESIST OXIDATIVE INJURY OF GASTRIC MUCOSA

Objective: To observe effect of moxibustion at Zusanli (足三里 ST 36) and Liangmen (梁门 ST 21) on expression of heat shock protein 70 (HSP70) in gastric mucosa of the rat of stress ulcer (SU) to explore the mechanism of moxibustion in resisting oxidative injury of the gastric mucosa. Methods: Sixty SD rats were evenly randomized into 4 groups, a blank group, a model group, an acupoint moxibustion group and a non-acupoint moxibustion group. Water restraint stress (WRS) method was used to make stress gastric ulcer rat model. The ulcerative index (UI) of gastric mucosa was evaluated by using GUTH method, the gastric mucosa blood flux (GMBF) was detected by a laser Doppler bloodflow monitor, and HSP70 expression and malondialdehyde (MDA) content in the gastric mucosa were determined respectively with immunohistochemical and thiobarbiturate methods. Results: Moxibustion at Zusanli (ST 36) and Liangmen (ST 21) significantly decreased UI, up-regulated HSP70 expression, increased GMBF, and decreased MDA content in the gastric mucosa in the rat of stress gastric ulcer, with significant differences as compared with the model group and the non-acupoint moxibustion group (P<0.05 or P<0.01). Conclusion: Moxibustion at Zusanli (ST 36) and Liangmen (ST 21) can induce high expression of HSP70 and decrease MDA content in the gastric mucosa, so as to resist oxidative injury, with relative acupoint specificity.

TREATMENT WITH ACUPUNCTURE AT ZUSANLI (St 36) FOR EPIGASTRIC PAIN IN THE ELDERLY

Acupuncture at a single point is a spe-cial feature in the treatment of acute symp-toms for its simplicity and effectiveness.Theauthor experienced many cases of acuteepigastric pain treated with acupuncture at asingle acupoint with satisfactory results.Pain in the elderly is most often of

电针缓解癌痛患者阿片耐受的临床观察

目的观察电针缓解癌痛患者阿片耐受的临床疗效。方法将60例癌痛患者随机分为电针组和对照组,每组30例。两组均使用阿片类药物进行镇痛治疗,电针组取双侧内关和足三里穴进行电针治疗,对照组取双侧内关和足三里穴旁开15 mm处非穴位点进行电针治疗。观察两组阿片耐受指数、爆发痛的次数和疼痛缓解持续时间,比较两组治疗前后数字等级评定量表(numeric rating scale,NRS)和欧洲癌症研究与治疗组织生命质量核心量表(European Organization for Research and Treatment of Cancer quality of life questionnaire-C30,EORTC QLQ-C30)评分变化,并比较两组不良反应发生率。结果电针组阿片耐受指数低于对照组(P<0.05),爆发痛次数低于对照组(P<0.05),疼痛缓解持续时间长于对照组(P<0.05)。电针组治疗后情绪、躯体、认知和社会功能及总体健康评分高于治疗前和对照组(P<0.05);电针组治疗后疲倦、恶心呕吐、疼痛、气促、失眠、食欲丧失和便秘评分低于治疗前和对照组(P<0.05)。电针组恶心呕吐和便秘的发生率低于对照组(P<0.05)。结论电针可减少癌痛患者镇痛治疗期间阿片耐受的发生,减轻疼痛,提高生活质量。

电针足三里对失血性休克合并海水浸泡损伤大鼠的作用研究

目的研究电针足三里对失血性休克(hemorrhagic shock,HS)合并海水浸泡损伤后延迟静脉补液大鼠的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、乳酸(lactate,LAC)及腹腔脏器血流量的影响。方法选取84只SPF级雄性SD大鼠,随机分为HS+海水浸泡+延迟静脉补液组(对照组)和HS+海水浸泡+电针足三里+延迟静脉补液组(电针组)。大鼠经右侧颈总动脉快速放血,失血量为全身血容量的45%。失血后立即将剑突以下0.5 cm的身体浸泡在(23±1)℃人工海水中30 min。海水浸泡后2 h,回输全部失血及2倍失血量的乳酸林格氏液。电针组于浸泡后0.5 h电针双侧足三里,对照组仅进行固定。监测失血前(基线)、浸泡后即刻、浸泡后2 h、浸泡后5 h和浸泡后24 h的MAP、HR、LAC和腹腔脏器血流量的变化。结果浸泡后即刻,两组大鼠MAP及HR均显著低于失血前(P<0.01);浸泡后2 h,电针组的MAP及HR显著高于对照组(P<0.05)。浸泡后即刻两组大鼠的LAC水平较失血前显著升高(P<0.01);浸泡后5 h,电针组LAC显著低于对照组(P<0.05)。两组大鼠海水浸泡后肾、肝及小肠黏膜血流量比失血前均显著降低(P<0.01)。浸泡后2 h,电针组肾、肝及小肠黏膜血流量较对照组明显改善(P<0.01);浸泡后5 h,电针组肝脏及小肠黏膜血流量仍然显著高于对照组(P<0.05)。结论电针足三里能显著提高失血性休克海水浸泡损伤动物的MAP和HR,降低血LAC水平,改善腹腔脏器血流量,具有一定的抗海战伤休克作用。

电针预处理对脓毒症小鼠肠黏膜屏障功能保护作用及MLCK/MLC信号通路的调节作用

目的观察电针足三里穴预处理对脂多糖(lipopolysaccharide,LPS)诱导的脓毒症小鼠肠黏膜功能损伤的保护作用及其机制研究。方法将40只美国癌症研究所(Institute of Cancer Research,ICR)小鼠随机分为正常组、模型组、电针组和非经非穴组,电针组小鼠选取足三里穴予以电针预处理,每日1次,每次30 min,持续5 d;第5天时采用腹腔注射LPS构建脓毒症肠黏膜损伤小鼠模型。通过苏木精-伊红(hematoxylin-eosin,HE)染色法观察小鼠回肠组织病理学改变并评分;采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测小鼠血清中C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)和结肠组织中白细胞介素-1(interleukin-1,IL-1)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达水平;蛋白印迹(Western blot,WB)法测定结肠组织中IL-1、IL-6、TNF-α和闭合蛋白(occludin)表达的水平;免疫荧光法检测胞质紧密粘连蛋白-1(zonula occludens-1,ZO-1)和连接蛋白-5(claudin-5)在回肠组织的表达水平;逆转录聚合酶链式反应(reverse transcription polymerase chain reaction,RT-PCR)检测肌球蛋白轻链激酶(myosin light chain kinase,MLCK)、肌球蛋白轻链(myosin light chain,MLC)、ZO-1、claudin-5、occludin在结肠组织中的含量。结果电针组中因LPS引起细胞排列紊乱与缺失、结构破坏、腺体变形等病理损伤均有改善,电针组小鼠回肠组织病理评分明显低于模型组(P<0.05),电针组小鼠结肠组织中IL-1、IL-6和TNF-α的含量低于模型组(P<0.05)。与模型组比较,电针组小鼠血清中CRP和PCT含量较低(P<0.05),小鼠结肠组织中occludin蛋白、occludin mRNA、claudin-5 mRNA、ZO-1 mRNA的相对表达量较高(P<0.05),小鼠结肠组织中MLCK和MLC mRNA相对表达量较低(P<0.05)。结论电针足三里预处理可通过抑制炎症反应和MLCK/MLC信号通路上调紧密连接蛋白的表达,发挥对LPS诱导的脓毒症肠黏膜屏障功能损伤的保护作用。

针灸“足三里”对高尿酸血症小鼠肠道菌群的影响

目的:观察针刺及艾灸“足三里”对高尿酸血症模型小鼠尿酸及肠道菌群的影响。方法:选取56只雄性昆明小鼠,随机分为空白组和造模组,采用氧嗪酸钾联合次黄嘌呤灌胃构建高尿酸血症模型,造模成功后随机分为模型组、针刺组、艾灸组,每组14只。选择“足三里”穴进行针刺或艾灸治疗,治疗2周后检测小鼠血清尿酸,16SrDNA测序分析肠道菌群变化。结果:与空白组相比,模型组SUA水平显著升高(P<0.01),肠道菌群多样性下降,厚壁菌门/拟杆菌门比值升高,Lachnoclostridium菌属丰度升高,颤杆菌克属、罗斯氏菌属丰度下降(P<0.05)。与模型组相比,针刺组、艾灸组SUA水平均显著下降(P<0.05),厚壁菌门/拟杆菌门比值下调,针刺组另枝菌属丰度升高,Lachnoclostridium丰度下降(P<0.05),艾灸组副拟杆菌属丰度升高,Lachnoclostridium、肠杆菌属丰度下降(P<0.05),其中Lachnoclostridium菌属与SUA含量呈正相关(r=0.388,P=0.037),另枝菌属与SUA含量呈负相关(r=-0.387,P=0.038)。一般功能预测提示针刺和艾灸均提高了嘌呤代谢率。结论:针刺和艾灸可有效调控高尿酸血症小鼠肠道菌群的结构和功能,可能是针灸改善高尿酸血症的潜在机制。