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.

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.

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.

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.

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

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 （Ul） of gastric mucosa was evaluated by using GUTH method, the gastric mu- cosa 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 de- creased Ul, 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

世界知识产权组织ST.36与ST.96标准的比较研究

本文通过对WIPO的XML专利旧数据标准ST.36和ST.96多方面的比较和研究,增进对WIPO新标准的理解,探索未来WIPO标准的发展动向,以期为我国知识产权行业的数据业务发展提供一定的借鉴。

Adenosine triphosphate mediates the pain tolerance effect of manual acupuncture at Zusanli(ST36) in mice

OBJECTIVE:To investigate the mechanisms behind the effects of acupuncture in Traditional Chinese Medicine,we delved into the adenosine triphosphate/peripheral purinergic P2X receptor 3(ATP/P2X3)receptor signaling system as an indicator of the body's energy state,commonly referred to as"Qi".METHODS:The tail-flick test was utilized to explore the impact of acupuncture on pain tolerance threshold(PTT)in mice,while also assessing adenosine(ADO)levels and adenylate energy charge(EC)at Zusanli(ST36).The study further investigated the dose-dependent effects of acupuncture on PTT and ADO levels at Zusanli(ST36).To shed light on the underlying mechanisms of acupuncture's effects,the study examined the impact of ATP,a P2X3 receptor antagonist,and adenosine disodium on PTT following acupuncture administration.RESULTS:Acupuncture at Zusanli(ST36)led to significant improvements in PTT in mice,with the most effective interventions being twirling for 2 min and needle retention for 28 min.These interventions also resulted in significant increases in ATP levels.The effects of acupuncture were further augmented by administration of different doses of ATP at Zusanli(ST36),and pretreatment with a P2X3 receptor antagonist decreased PTT.Adenylate EC peaked at 30 min after intraperitoneal injection of ATP,and pretreatment with various doses of i.p.ATP 30 min prior to acupuncture increased PTT in a dose-dependent manner.Additionally,pretreatment with an i.p.or intramuscular injection of adenosine disodium enhanced the effects of acupuncture.CONCLUSION:This research provides compelling evidence that ATP is involved in the regulation of PTT through acupuncture,revealing new avenues for achieving enhanced clinical outcomes.

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.

新型抗缺血药物治疗急性冠状动脉综合征的评价:雷诺嗪用于减少非ST段抬高型急性冠状动脉综合征局部缺血的代谢效能(MERLIN)-TIMI36试验的试验设计与原理

Background: Despite advances in antithrombotic therapies and invasive technology, the risk of recurrent ischemic complications in patients with non-ST-elevation acute coronary syndromes(NSTE-ACSs) remains substantial. Ranolazine is a novel agent that inhibits the late sodium current thereby reducing cellular sodium and calcium overload and has been shown to reduce ischemia in patients with chronic stable angina. Study Design: MERLIN-TIMI 36 is a phase III, randomized, double-blind, parallel-group, placebo-controlled, multinational clinical trial to evaluate the efficacy and safety of ranolazine during long-term treatment of patients with NSTE-ACS receiving standard therapy(N=6500). Eligible patients are randomized 1 ∶1 to ranolazine or matched placebo, initiated as 200 mg intravenously over 1 hour, followed by an 80-mg/h infusion(40 mg/h for patients with severe renal insufficiency) for up to 96 hours and oral ranolazine ER 1000 mg BID or matched placebo until the end of study. The primary end point is the time to first occurrence of any element of the composite of cardiovascular death, myocardial infarction, or recurrent ischemia. Secondary end points include ischemia on Holter monitoring, hospitalization for new or worsening heart failure, quality of life measures, and exercise performance. The evaluation of longterm safety will include death from any cause and symptomatic documented arrhythmia. Recruitment began in October 2004. The trial will continue until 730 major cardiovascular events and 310 deaths are recorded with expected completion in 24 to 28 months. Conclusions: MERLIN-TIMI 36 will evaluate the role of ranolazine in the acute and chronic management of patients presenting with NSTE-ACS.

针灸足三里穴位周围肌肉微循环的超声造影评估

目的探讨超声造影评价正常人足三里穴位针灸前后局部肌肉微循环情况的价值。资料与方法前瞻性收集2018年9月—2020年5月于福建医科大学附属第二医院超声科就诊的72例健康志愿者,分别于针灸前、针灸得气最强时、针灸后2h进行超声造影,观察胫前肌内微血管血流灌注情况,分析感兴趣区中的小动脉、肌肉组织和小静脉,获得时间-强度曲线和造影剂渡越时间(CTTs)。采用针灸者结合受灸者的客观评分标准评价针感。于针灸前、针灸得气最强时、针灸后2 h检测胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平。结果①针灸得气最强时,胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs明显缩短,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2hCTTs差异无统计学意义(P>0.05);②针灸得气最强时,志愿者血清内胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平升高,与针灸前及针灸后2h比较,差异均有统计学意义(P均<0.001),针灸前及针灸后2h差异无统计学意义(P>0.05);③针灸得气最强时,胃泌素、血浆促胃动力素、胆囊收缩素、胰泌素水平与胫前肌动脉-肌肉间、肌肉-静脉间、动脉-静脉间CTTs均呈正相关(r=0.360~0.702,P<0.001)。结论针刺足三里得气最强时,可造成骨骼肌周围微循环改变,导致CTTs明显缩短,同时也能促进胃肠道的分泌功能。

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。

针灸气海、关元、足三里治疗结直肠癌化疗患者癌因性疲乏:一项随机对照试验

目的:观察针灸气海、关元、双侧足三里治疗结直肠癌患者化疗后所致癌因性疲乏(CRF)的疗效及其对肿瘤坏死因子α(TNF-α)的影响。方法:共51例接受化疗后出现CRF的结直肠癌患者纳入分析,随机分成两组,其中针灸组25例,对照组26例。两组患者均接受常规化疗,其中针灸组化疗期间配合针灸治疗,分别于化疗前1天、化疗第1~3天接受针灸治疗,每天1次,每次30分钟,两个疗程(对应两个化疗周期),共8次针灸治疗。主要疗效指标为Piper疲乏量表,次要疗效指标为中医证候评分、TNF-α含量。分别于随机化入组后的第一程化疗前,第二程化疗结束后及第二程化疗后2周进行评估。结果:Piper疲乏量表评分方面,随着针灸干预次数的增加,针灸组内患者Piper疲乏评分逐渐下降(F=67.425,P<0.001),说明随时间的推移,针灸组癌因性疲乏程度改善。与对照组比较,针灸组Piper疲乏评分明显下降(F=6.706,P=0.013),说明针灸组患者的疲乏程度改善显著优于对照组。中医证候总疗效方面,针灸组和对照组的有效率分别为68%、34.6%,针灸组有效率显著提高(χ^(2)=5.68,P=0.017)。其中,针灸组单项症状中的“体倦乏力”(χ^(2)=14.41,P <0.001)、“神疲”(χ^(2)=7.06,P=0.008)等单项疗效对比对照组亦显著性改善。针灸组治疗后TNF-α含量较治疗前下降(t=1.14,P=0.26),对照组治疗后TNF-α含量较治疗前上升(t=-1.02,P=0.31),呈现出针灸抑制CRF患者TNF-α含量的趋势。结论:针灸气海、关元、双侧足三里4穴减轻结直肠癌患者化疗致CRF的疲乏程度,改善“体倦乏力”“神疲”症状,且存在下调TNF-α水平的趋势,初步提示下调TNF-α促炎细胞因子水平可能是针灸治疗CRF的作用机制之一。

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。

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。

麦粒灸足三里穴调控氧化应激对自然衰老小鼠睾酮水平影响

目的观察艾灸是否通过影响氧化应激,维护生殖系统中睾酮之水平,以期为深入研究艾灸延缓生殖衰老机制问题奠定基础。方法以自然衰老小鼠(18月龄)为衰老模型,随机分为衰老组、艾灸组;另设青年组(3月龄)。艾灸组进行麦粒灸双侧足三里穴,艾绒制成麦粒大小的艾炷,置于涂抹凡士林的穴位上,线香引燃,每穴5壮,衰老组只在相同部位做抓取固定动作,不做艾灸,麦粒灸每干预5次间隔2 d。采用HE染色、衰老相关β半乳糖苷酶(senescence-associatedβ-galactosidase,SA-β-gal)染色观察麦粒灸足三里穴干预自然衰老小鼠的效应,并应用ELISA法测量血清睾酮(testosterone,T)含量,WB法测量p53、p21、丙二醛(malondialdehyde,MDA)、锰超氧化物歧化酶(manganese superoxide dismutase,MnSOD)、谷胱甘肽过氧化物酶4(glutathione peroxidase 4,GPX4)表达量。结果HE染色结果显示麦粒灸足三里穴可改善自然衰老小鼠睾丸组织形态学,SA-β-gal染色结果显示麦粒灸足三里穴可改善自然衰老小鼠睾丸衰老程度。与青年组比较,衰老组p53、p21表达均显著升高,表明造模成功,而经过麦粒灸足三里穴干预后,均显著降低;衰老组血清T显著降低,而艾灸组显著上升;在氧化与抗氧化指标方面,衰老组MDA明显上升,而艾灸组MDA水平下降,衰老组MnSOD、GPX4都下降,而艾灸组显著升高。结论麦粒灸足三里穴可以提高自然衰老模型小鼠的血清睾酮水平,而这种作用的发挥与氧化应激密切相关,艾灸通过抑制活性氧(reactive oxygen species,ROS)的产生与增强抗氧化能力,进而阻碍氧化应激,维护了睾丸间质细胞的结构与功能,提高了睾酮水平,从而延缓了睾丸间质细胞的衰老。

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。

曲安奈德足三里穴位注射治疗非过敏性鼻炎的临床观察

目的观察曲安奈德注射液足三里穴位注射治疗非过敏性鼻炎的临床疗效并探讨其作用机制。方法随机选取非过敏性鼻炎(non-allergic rhinitis,NAR)与过敏性鼻炎(allergic rhinitis,AR)门诊患者各50例,均予以双侧足三里穴位注射曲安奈德注射液治疗,每周1次,连续注射4周。治疗前后检测患者Th1、Th2相关因子水平;观察两组治疗4周时、3月后以及1年后随访期间的鼻部症状总评分(TNSS)变化,比较分析两组近期疗效和远期疗效。结果NAR组与AR组在治疗4周结束时、疗后3月及1年随访期间的TNSS均比治疗前明显下降(P<0.05)。NAR组与AR组患者治疗4周后的血清白介素-2(IL-2)、干扰素-γ(INF-γ)、肿瘤坏死因子(TNF)水平均比治疗前上升(P<0.05),白介素-4(IL-4)则较治疗前显著下降(P<0.05)。治疗4周后NAR组有效率84.0%,AR组有效率92.0%。随访期间,疗后3月NAR组有效率72.0%,AR组有效率64.0%,两组疗效差异无统计学意义(P>0.05);1年后,NAR组总有效率54.0%,AR组总有效率30.0%,NAR组总有效率显著高于AR组(P<0.05)。结论足三里穴位注射治疗NAR远期疗效更佳,对脾气虚弱和肺气虚寒型的治疗有效率更高。其机制可能与提升Th1细胞因子的分泌并抑制IL-4的产生,从而调节Th1/Th2的稳定状态相关。

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。