Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism...Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism remains unclear. Cerebral scans with functional magnetic resonance imaging （fMRI） have been used in the study of acupuncture and acupoint specifically. In this study, fMRI was used to detect the activation of the brain areas under different acupoints, matched along different meridians, to elucidate the acupoint combination via a modern medical approach. Forty healthy volunteers were randomly divided into the following groups： Waiguan point （SJ 5）, Waiguan （SJ 5） ＋ Zhigou （SJ 6） （2 acupoints come from the same meridian）, Waiguan （SJ 5） ＋ Neiguan （PC 6） （2 acupoints come from 2 meridians with the relationship of interior-exterior）, Waiguan （SJ 5） ＋ Yanglingquan （GB 34） （2 acupoints come from 2 meridians with the same name-Shaoyang Meridian）, and sham point groups （needling in different points on the right hand）. A real-time cerebral fMRI scan was simultaneously performed. The cerebral activation rate, and the number and strength of different regions of interest were compared among the groups. The fMRI cerebral imaging confirmed that there were some differences in the activation of cerebral areas by the needlings in SJ 5, and in combination with other acupoints. Needling at SJ 5 alone greatly activated the right cerebellum, while needling at both SJ 5 and different co-needling points activated different cerebral functional areas.展开更多
In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The th...In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ② acupoint combination and curative methods need to be researched further.展开更多
Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlyin...Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlying mechanisms remain unclear. Therefore, a randomized controlled parallel clinical trial is currently underway at Chengdu University of Traditional Chinese Medicine, China. This trial is designed to explore the efficacy of and central responses to the He-Mu point combination in patients with functional dyspepsia using functional magnetic resonance imaging. A total of 105 patients with functional dyspepsia will be allocated into 3 groups： the low-He point group（puncturing at Zusanli（ST36））, Mu point group（puncturing at Zhongwan（CV12））, and He-Mu point combination group（puncturing at ST36 and CV12）. Every participant will receive 20 sessions of manual acupuncture for 4 weeks. The needles will be inserted perpendicularly to a depth of 1 to 2 cun. The angle of rotation and twisting will range from 90 to 180 degrees, while lifting and thrusting will range from 0.3 to 0.5 cm. The various manipulations will be performed 60 to 90 times per minute. The needles will remain in place for 30 minutes, during which manipulation will be applied every 10 minutes. Magnetic resonance imaging will be performed before and after 20 sessions of acupuncture. The primary outcome is symptom improvement according to the Chinese version of the Nepean Dyspepsia Index. Secondary outcomes include the Leeds dyspepsia questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Beck Anxiety Inventory, Beck Depression Inventory, and visual analogue scale scores before and after 10 and 20 sessions of acupuncture. Needle sensation and adverse events will be used to assess the therapeutic effects. This study will promote more widespread awareness of the benefits of acupoint combination in the clinical setting and provide a further explanation of the neuromechanism by which acupuncture at the He-Mu point combination for functional dyspepsia. Registration： Chinese Clinical Trial Registry, Chi CTR-IOR-15006402.展开更多
Insomnia, a common sleep disorder, affects general well-being, hastens the onset of other diseases, and impairs work performance. Hypnotic medications are efficacious in the short term but have obvious side effects. A...Insomnia, a common sleep disorder, affects general well-being, hastens the onset of other diseases, and impairs work performance. Hypnotic medications are efficacious in the short term but have obvious side effects. Acupuncture, often used to treat insomnia in traditional Chinese medicine (TCM), is considered to be beneficial in restoring the normal sleep-wake cycle by regulating and restoring the natural flow of qi (energy power). The three main TCM theories for treating insomnia by acupuncture are the tranquilization disturbance, zangfu disturbance (disequilibrium of internal organs), and imbalance of yin and yang theories. Moxibustion, another treatment for insomnia, is usually combined with acupuncture. Acupuncture and moxibustion with tuina (exercise massage), acupuncture with Chinese herbal injection, electroacupuncture, and acupuncture with medication or psychotherapy are other interventions. Some acupuncture-based methods such as needle-rolling acupuncture, auricular acupoint plaster therapy, phlebotomy, and acupoint catgut-embedding therapy are used as well. Although most clinical trials have shown that acupuncture and its combination therapies are significantly effective in insomnia, the beneficial effects may have been overvalued, because of small sample size, nonstrict inclusion and exclusion criteria, flawed methodology, short follow-up, or nonstandardized evaluation. Therefore, clinical studies of high methodological quality are needed to verify the efficacy of acupuncture, moxibustion, and other combination therapies in insomnia.展开更多
Objective:To investigate the influencing mechanism of Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy on hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis, ...Objective:To investigate the influencing mechanism of Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy on hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis, thus to offer relevant help for clinical therapies on patients with chronic bronchitis. Methods:120 cases of patients with chronic bronchitis treated in our hospital were selected and randomly divided to be the therapeutic group and the control group, 60 cases each. Patients in control group were provided some basic treatments, such as spasmolysis, anti-inflammation, asthma relieving, oxygen inhalation and dissolve phlegm. For therapeutic group on this basis, Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy was provided. Hemorheology, inflammatory factors and pulmonary functions in the two groups of patients were detected before and after treatment. Results:Differences of hemorheology indexes, inflammatory factors and pulmonary function relevant indexes between the two groups of patients with chronic bronchitis before treatment showed no statistical significance (P>0.05). Compared with prior treatment, hemorheology relevant indexes [whole blood high shear viscosity (WHV), whole blood low shear viscosity (WLV), packed cell volume (PCV), plasma viscosity (PV) and red cell assembling index (RCAI)], inflammatory factors [IL-8 (interleukin-8) and TNF-α(tumor necrosis factor-α)] were significantly decreased and pulmonary function relevant indexes [forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), peak expiratory flow (PEF), maximal voluntary ventilation (MVV) and expiratory flow rate when exhale vital capacity was 0.50], inflammatory factors (IL-4, IL-2) were significantly increased in the two groups of patients with chronic bronchitis after relevant treatments;The differences between the groups showed statistical significance (P<0.05). After combined therapy provided, pulmonary function relevant indexes (FVC, FEV1.0, PEF, MVV and V0.50) and inflammatory factors (IL-4, IL-2) in therapeutic group were significantly higher than control group after basic therapy. Hemorheology relevant indexes (WHV, WLV, PV, PCV and RCAI) and inflammatory factors (IL-8 and TNF-α) in therapeutic group were significantly lower than control group;Differences between the two groups showed statistical significance (P<0.05). Conclusions: Combination of Jin-Shui-Liu-Jun-Jian and Acupoint Application significantly improved the levels of hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis. It has a great important clinical significance on therapies for patients with chronic bronchitis.展开更多
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...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。展开更多
OBJECTIVE:To investiage the effect of electroacupuncture(EA)at a single acupoint of Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6)and at combined acupoints of Shenmen(HT7)and Baihui(GV20)and Sanyinjiao(SP6)on the PKA/CREB ...OBJECTIVE:To investiage the effect of electroacupuncture(EA)at a single acupoint of Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6)and at combined acupoints of Shenmen(HT7)and Baihui(GV20)and Sanyinjiao(SP6)on the PKA/CREB and BDNF/TrkB signaling,as well as neuroapoptosis and neurogenesis in hippocampus and elucidate the underlying mechanism of single and combined acupoints on ameliorating spatial learning and memory deficits in a rat model of primary insomnia.METHODS:Primary insomnia was modeled by intraperitoneal injection of para-chlorophenylalanine(PCPA)once daily for 2 d.EA was applied at Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6),or Shenmen(HT7)+Baihui(GV20)+Sanyinjiao(SP6)(combined)for 30 min daily for 4 d.Spatial learning and memory function was evaluated by the Morris water maze(MWM)test.Protein expressions of hippocampal cAMP-dependent protein kinase(PKA)-Cβ,phosphorylated cAMP-responsive element-binding protein(p-CREB),brainderived neurotrophic factor(BDNF),and tyrosine kinase receptor B(TrkB)were evaluated by Western blotting.Neuronal apoptosis in the hippocampus was detected with the transferase-mediated dUTP-X nick end labeling assay.Endogenous neurogenesis was examined with bromodeoxyuridine staining.The MWM test and hippocampal p-CREB,BDNF,and TrkB protein levels in the combined acupoints group were evaluated after the administration of a PKA-selective inhibitor(H89).RESULTS:Spatial learning and memory were significantly impaired in rats with insomnia.The spatial learning deficits were ameliorated in the Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6),and combined groups;this improvement was significantly greater in the combined group than the single acupoint groups.The spatial memory impairment was improved in the combined,Baihui(GV20),and Shenmen(HT7)groups,but not the Sanyinjiao(SP6)group.The expressions of PKA-Cβ,p-CREB,BDNF,and TrkB were decreased in rats with insomnia.All these proteins were significantly upregulated in the combined group.PKA/p-CREB protein levels were elevated in the Baihui(GV20)and Shenmen(HT7)groups,whereas BDNF/TrkB expression was upregulated in the Sanyinjiao(SP6)group.The staining results showed significant attenuation of hippocampal cell apoptosis and increased numbers of proliferating cells in the combined group,whereas the single acupoint groups only showed decreased numbers of apoptotic cells.In the combined group,the PKA inhibitor reversed the improvement of spatial memory and upregulation of pCREB expression caused by EA,but did not affect its activation of BDNF/TrkB signaling.CONCLUSIONS:EA at the single acupoints Baihui(GV20),Shenmen(HT7),or Sanyinjiao(SP6)had an ameliorating effect on the spatial learning and memory deficits induced by insomnia.EA at combined acupoints exerted a synergistic effect on the improvements in spatial learning and memory impairment in rats with insomnia by upregulating the hippocampal PKA/CREB and BDNF/TrkB signaling,facilitating neurogenesis,and inhibiting neuronal apoptosis.These findings indicate that EA at combined acupoints[(Baihui(GV20),Shenmen(HT7),and Sanyinjiao(SP6)]achieves a more pronounced regulation of hippocampal neuroplasticity than EA at single acupoints,which may partly explain the underlying mechanisms by which EA at combined acupoints exerts a better ameliorative effect on the cognitive dysfunction caused by insomnia.展开更多
基金the National 973 Program of China, No. 2006CB504505the National Nature Science Foundation of China, No. 90709027
文摘Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism remains unclear. Cerebral scans with functional magnetic resonance imaging （fMRI） have been used in the study of acupuncture and acupoint specifically. In this study, fMRI was used to detect the activation of the brain areas under different acupoints, matched along different meridians, to elucidate the acupoint combination via a modern medical approach. Forty healthy volunteers were randomly divided into the following groups： Waiguan point （SJ 5）, Waiguan （SJ 5） ＋ Zhigou （SJ 6） （2 acupoints come from the same meridian）, Waiguan （SJ 5） ＋ Neiguan （PC 6） （2 acupoints come from 2 meridians with the relationship of interior-exterior）, Waiguan （SJ 5） ＋ Yanglingquan （GB 34） （2 acupoints come from 2 meridians with the same name-Shaoyang Meridian）, and sham point groups （needling in different points on the right hand）. A real-time cerebral fMRI scan was simultaneously performed. The cerebral activation rate, and the number and strength of different regions of interest were compared among the groups. The fMRI cerebral imaging confirmed that there were some differences in the activation of cerebral areas by the needlings in SJ 5, and in combination with other acupoints. Needling at SJ 5 alone greatly activated the right cerebellum, while needling at both SJ 5 and different co-needling points activated different cerebral functional areas.
文摘In the present paper, the author reviews the progresses in the study on acumoxi (acupuncture-moxi-bustion) treatment of diabetes mellitus (DM) from Chinese ancient classical works, Chinese and foreign journals. The therapeutic results reveal that acupuncture treatment of DM is effective in improving DM patients' symptoms via vagal-nerve reflex, regulation of neuroendocrine and immune functions. The author holds that ① correct selection of acupoints in accordance with syndrome differentiation and the related meridians and combined application of acupuncture and Chinese herbal medicines (for oral administration) are the key points for raising the therapeutic effect; and ② acupoint combination and curative methods need to be researched further.
基金supported by the National Scientific Foundation Committee in China,No.81473602the Education Ministry’s New Century Excellent Talents Supporting Plan in China+3 种基金the Foundation for the Author of National Excellent Doctoral Dissertation of China,No.201486the Youth Foundation of Science and Technology Department of Sichuan Province in China,No.15QNJJ0008the National Natural Science Foundation-Excellent Youth Foundation in China,No.81622052the 2011 Co-Innovation Center of Sichuan Province named Acupoint Effects of Acupuncture Co-Innovation Center
文摘Acupuncture is widely used to treat functional dyspepsia with satisfactory outcomes. Combination of the He and Mu acupoints is commonly used and has a synergistic effect on functional dyspepsia; however, its underlying mechanisms remain unclear. Therefore, a randomized controlled parallel clinical trial is currently underway at Chengdu University of Traditional Chinese Medicine, China. This trial is designed to explore the efficacy of and central responses to the He-Mu point combination in patients with functional dyspepsia using functional magnetic resonance imaging. A total of 105 patients with functional dyspepsia will be allocated into 3 groups： the low-He point group（puncturing at Zusanli（ST36））, Mu point group（puncturing at Zhongwan（CV12））, and He-Mu point combination group（puncturing at ST36 and CV12）. Every participant will receive 20 sessions of manual acupuncture for 4 weeks. The needles will be inserted perpendicularly to a depth of 1 to 2 cun. The angle of rotation and twisting will range from 90 to 180 degrees, while lifting and thrusting will range from 0.3 to 0.5 cm. The various manipulations will be performed 60 to 90 times per minute. The needles will remain in place for 30 minutes, during which manipulation will be applied every 10 minutes. Magnetic resonance imaging will be performed before and after 20 sessions of acupuncture. The primary outcome is symptom improvement according to the Chinese version of the Nepean Dyspepsia Index. Secondary outcomes include the Leeds dyspepsia questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Beck Anxiety Inventory, Beck Depression Inventory, and visual analogue scale scores before and after 10 and 20 sessions of acupuncture. Needle sensation and adverse events will be used to assess the therapeutic effects. This study will promote more widespread awareness of the benefits of acupoint combination in the clinical setting and provide a further explanation of the neuromechanism by which acupuncture at the He-Mu point combination for functional dyspepsia. Registration： Chinese Clinical Trial Registry, Chi CTR-IOR-15006402.
文摘Insomnia, a common sleep disorder, affects general well-being, hastens the onset of other diseases, and impairs work performance. Hypnotic medications are efficacious in the short term but have obvious side effects. Acupuncture, often used to treat insomnia in traditional Chinese medicine (TCM), is considered to be beneficial in restoring the normal sleep-wake cycle by regulating and restoring the natural flow of qi (energy power). The three main TCM theories for treating insomnia by acupuncture are the tranquilization disturbance, zangfu disturbance (disequilibrium of internal organs), and imbalance of yin and yang theories. Moxibustion, another treatment for insomnia, is usually combined with acupuncture. Acupuncture and moxibustion with tuina (exercise massage), acupuncture with Chinese herbal injection, electroacupuncture, and acupuncture with medication or psychotherapy are other interventions. Some acupuncture-based methods such as needle-rolling acupuncture, auricular acupoint plaster therapy, phlebotomy, and acupoint catgut-embedding therapy are used as well. Although most clinical trials have shown that acupuncture and its combination therapies are significantly effective in insomnia, the beneficial effects may have been overvalued, because of small sample size, nonstrict inclusion and exclusion criteria, flawed methodology, short follow-up, or nonstandardized evaluation. Therefore, clinical studies of high methodological quality are needed to verify the efficacy of acupuncture, moxibustion, and other combination therapies in insomnia.
文摘Objective:To investigate the influencing mechanism of Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy on hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis, thus to offer relevant help for clinical therapies on patients with chronic bronchitis. Methods:120 cases of patients with chronic bronchitis treated in our hospital were selected and randomly divided to be the therapeutic group and the control group, 60 cases each. Patients in control group were provided some basic treatments, such as spasmolysis, anti-inflammation, asthma relieving, oxygen inhalation and dissolve phlegm. For therapeutic group on this basis, Jin-Shui-Liu-Jun-Jian and Acupoint Application combined therapy was provided. Hemorheology, inflammatory factors and pulmonary functions in the two groups of patients were detected before and after treatment. Results:Differences of hemorheology indexes, inflammatory factors and pulmonary function relevant indexes between the two groups of patients with chronic bronchitis before treatment showed no statistical significance (P>0.05). Compared with prior treatment, hemorheology relevant indexes [whole blood high shear viscosity (WHV), whole blood low shear viscosity (WLV), packed cell volume (PCV), plasma viscosity (PV) and red cell assembling index (RCAI)], inflammatory factors [IL-8 (interleukin-8) and TNF-α(tumor necrosis factor-α)] were significantly decreased and pulmonary function relevant indexes [forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), peak expiratory flow (PEF), maximal voluntary ventilation (MVV) and expiratory flow rate when exhale vital capacity was 0.50], inflammatory factors (IL-4, IL-2) were significantly increased in the two groups of patients with chronic bronchitis after relevant treatments;The differences between the groups showed statistical significance (P<0.05). After combined therapy provided, pulmonary function relevant indexes (FVC, FEV1.0, PEF, MVV and V0.50) and inflammatory factors (IL-4, IL-2) in therapeutic group were significantly higher than control group after basic therapy. Hemorheology relevant indexes (WHV, WLV, PV, PCV and RCAI) and inflammatory factors (IL-8 and TNF-α) in therapeutic group were significantly lower than control group;Differences between the two groups showed statistical significance (P<0.05). Conclusions: Combination of Jin-Shui-Liu-Jun-Jian and Acupoint Application significantly improved the levels of hemorheology, inflammatory factors and pulmonary functions in patients with chronic bronchitis. It has a great important clinical significance on therapies for patients with chronic bronchitis.
文摘目的观察耳穴揿针联合栀黄散穴位贴敷对胆石症患者的应用效果。方法将120例患者随机分为A组:耳穴揿针组(40例),B组:穴位贴敷组(40例),C组:联合治疗组(40例)。A组患者在常规西医治疗的基础上加用耳穴揿针治疗,按压4~6次/d,1~3 min/次,5 d 1个疗程,双耳交替操作。B组患者在常规西医治疗的基础上加用栀黄散穴位贴敷,贴敷于双侧胆俞穴、双侧肝俞穴、右侧期门穴、双侧阳陵泉穴,贴敷时间为4~6 h,2次/d,5 d 1个疗程。C组患者在常规西医治疗的基础上联合使用耳穴揿针和栀黄散穴位贴敷治疗。通过疼痛数值评分量表(NRS)比较3组患者治疗后0.5、1、2、24、48 h疼痛评分;治疗前后3组患者C反应蛋白(C-reactive protein,CRP)、胆红素、肝功能(ALT)变化情况;通过B超检查治疗前后胆囊收缩功能、胆囊壁厚度。结果干预后3组患者疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于干预前,胆囊收缩功能较干预前增加,差异具有统计学意义(P<0.05),A组、B组两组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度、胆囊收缩功能比较,差异无统计学意义(P>0.05)。C组患者干预后疼痛评分时间效应值、CRP、胆红素、ALT数值、胆囊壁厚度均低于A、B两组,胆囊收缩功能高于A、B两组,差异具有统计学意义(P<0.05)。结论耳穴揿针和栀黄散穴位贴敷应用于胆石症患者,均可减轻患者的疼痛反应,降低炎症作用,促进肝功能恢复,增强胆囊收缩功能。将两者联合应用,临床疗效更加显著,能够加速患者康复,值得临床推广。
文摘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。
基金“973”Program of the Ministry of Science and Technology of China:Research on Acupoint Optimization,Combination and Evaluation Methods(No.2014CB543103)the SelfSelected Research Program from of China Academy of Chinese Medical Sciences:Study on the Mechanism of Central Amygdala Nucleus Mediated Electroacupuncture on Relieving Chronic Pain and Related Aversive Mood(No.ZZ13-YQ-063)。
文摘OBJECTIVE:To investiage the effect of electroacupuncture(EA)at a single acupoint of Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6)and at combined acupoints of Shenmen(HT7)and Baihui(GV20)and Sanyinjiao(SP6)on the PKA/CREB and BDNF/TrkB signaling,as well as neuroapoptosis and neurogenesis in hippocampus and elucidate the underlying mechanism of single and combined acupoints on ameliorating spatial learning and memory deficits in a rat model of primary insomnia.METHODS:Primary insomnia was modeled by intraperitoneal injection of para-chlorophenylalanine(PCPA)once daily for 2 d.EA was applied at Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6),or Shenmen(HT7)+Baihui(GV20)+Sanyinjiao(SP6)(combined)for 30 min daily for 4 d.Spatial learning and memory function was evaluated by the Morris water maze(MWM)test.Protein expressions of hippocampal cAMP-dependent protein kinase(PKA)-Cβ,phosphorylated cAMP-responsive element-binding protein(p-CREB),brainderived neurotrophic factor(BDNF),and tyrosine kinase receptor B(TrkB)were evaluated by Western blotting.Neuronal apoptosis in the hippocampus was detected with the transferase-mediated dUTP-X nick end labeling assay.Endogenous neurogenesis was examined with bromodeoxyuridine staining.The MWM test and hippocampal p-CREB,BDNF,and TrkB protein levels in the combined acupoints group were evaluated after the administration of a PKA-selective inhibitor(H89).RESULTS:Spatial learning and memory were significantly impaired in rats with insomnia.The spatial learning deficits were ameliorated in the Shenmen(HT7),Baihui(GV20),Sanyinjiao(SP6),and combined groups;this improvement was significantly greater in the combined group than the single acupoint groups.The spatial memory impairment was improved in the combined,Baihui(GV20),and Shenmen(HT7)groups,but not the Sanyinjiao(SP6)group.The expressions of PKA-Cβ,p-CREB,BDNF,and TrkB were decreased in rats with insomnia.All these proteins were significantly upregulated in the combined group.PKA/p-CREB protein levels were elevated in the Baihui(GV20)and Shenmen(HT7)groups,whereas BDNF/TrkB expression was upregulated in the Sanyinjiao(SP6)group.The staining results showed significant attenuation of hippocampal cell apoptosis and increased numbers of proliferating cells in the combined group,whereas the single acupoint groups only showed decreased numbers of apoptotic cells.In the combined group,the PKA inhibitor reversed the improvement of spatial memory and upregulation of pCREB expression caused by EA,but did not affect its activation of BDNF/TrkB signaling.CONCLUSIONS:EA at the single acupoints Baihui(GV20),Shenmen(HT7),or Sanyinjiao(SP6)had an ameliorating effect on the spatial learning and memory deficits induced by insomnia.EA at combined acupoints exerted a synergistic effect on the improvements in spatial learning and memory impairment in rats with insomnia by upregulating the hippocampal PKA/CREB and BDNF/TrkB signaling,facilitating neurogenesis,and inhibiting neuronal apoptosis.These findings indicate that EA at combined acupoints[(Baihui(GV20),Shenmen(HT7),and Sanyinjiao(SP6)]achieves a more pronounced regulation of hippocampal neuroplasticity than EA at single acupoints,which may partly explain the underlying mechanisms by which EA at combined acupoints exerts a better ameliorative effect on the cognitive dysfunction caused by insomnia.
